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2024-10-16 Final PacketI N0110E OF MEE FING—10/16/2024 October 16, 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 Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: 1. Call 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. Kim Moore with Senator Louis Kolkhorst thanked Calhoun County for the hospitality during the Warriors Weekend activities. Page 1 of 5 NOTICE OF MEETING — 10/16/2024 5. Approve September 18, 2024 and October 9, 2024 Commissioners' Court Meeting Minutes. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES:' Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese ` 6. Consider and take necessary action to approve the contract with Fun Abounds, Inc. for Bid No. 2024.08 - Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 for Calhoun County, Texas - Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. E-1 and authorize the County Judge to sign. (DEH) Scott Mason with G&W explained the bid. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 7. Consider and take necessary action to approve the Resolution Endorsing the Passage of Legislation to Amend Section 382.018 of the Texas Local Government Code. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1= SECONDER: Gary Reese, Commissioner Pct'4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 8. Consider and take necessary action to approve the Professional Services Agreements for the County and District Clerk's for "IDocket.com Ruby Red Services" and allow the County and District Clerk to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 5 N0110E OE MEETING — 10/16/2024 9. Consider and take necessary action to enter into negotiations with the lowest and best responsive bidder (Weaver and Jacobs Constructors) for the 2024.06 Memorial Medical Center HVAC & Roof Improvements for Calhoun County, Texas. (RHM) Scott Mason with G&W Engineers explained the negotiation process:, RESULT: APPROVED[UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct'4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 10. Consider and take necessary action to accept G&W's recommendations for the second payment of $143,476.921 to Con -Metal Contractors, Inc. for the Recycle Waste Transfer Station Project. (VLL) Scott Mason with G&W Engineers explained the project should be completed by the first of the New Year. RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese; Commissioner Pct 4 SECONDER: ; Joel Behrens, Commissioner Pct 3 AYES:Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 11. Consider and take necessary action to update/revise the Calhoun County Job Description for "Assistant Director of EMS/Training Coordinator". (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 12. Consider and take necessary action to approve the preliminary plat of the Desilos Subdivision situated in the William Arnold Survey, Abstract No. 2, Calhoun County, TX (re - plat of farm tracts 9-16 in Lot 6 of Section 10 of the J.D. Mitchell Wolf Point Ranch Subdivision as recorded in Volume 5. Page 417 of the Calhoun County Deed Records). (JMB) Henry,Danysh explained preliminary' plat. RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 5 NOTICF GF MEETING—10/16/2024 13. Consider and take necessary action to authorize Commissioner Reese to utilize $31,158.20 in COMESA funds to repair pavilion at King Fisher Beach Park in Port O'Connor, Texas. (GDR) RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct'1 SECONDER: Joel' Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 14. Accept Monthly Reports from the following County Offices: a) Justice of the Peace Pct 3 — September, 2024 b) County Clerk — September, 2024 c) District Clerk — September, 2024 RESULT: APPROVED [UNANIMOUS]' MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct 4 AYES: s Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese 15. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary, Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 5 NOTICE OF MEETING - 10/16/2024 16. Approval of bills and pavroll. (RHM) Indigent Healthcare: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese MMC Bills: RESULT: APPROVED [UNANIMOUS] MOVER: David Hail, Commissioner Pct`I SECONDER: Vern Lyssy, Commissioner Pct2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County Bills: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct I SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 10:25am Page 5 of 5 � 110 i I !l I\ I 1 ((f,AI \I I: �,I�-\I.I"�' "MIMI (ayy I I I(A�\ �I11 All Agenda items properly Numbered Contracts Completed and Signed All IZW-lagged-for-Acceptance- (number-of-1295's ) All Documents for Clerk Signature Flagged (All documents needing to be attested to need to be signed day of Commissioner's Court.) On this day of r�14 &C 22024, the packet _ VC" �o for the day of Ige,K_ 2024 Commissioners' Court Regular Session was submitted from the Calhoun County Judge's office to the Calhoun County Clerk's office. Vi C Calhoun County judge/Ass Sant I_�l7�I�f% INl; 1U/, (V—)U 4 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern l yssy, Commissioner, Precinct 2 )Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4- NOTICE OF MEETING ING October e 2024 is io er a.m. in the "P Tlde.�On1n1i8@floner9 C'.ourt of Calhoun County, Texas will meet on Wednesday, : Commissioners'Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: FlLEP9 p AT O'CLOCK r fR I. Call meeting to order. OCT 11 2924 2. Invocation. k1aNnM.6E0UM1�N CpUNttCLEIaCCHLH0UN000NlY,TEY,H3 3. Pledges of Allegiance. Lr l lr��An�� 4. General Discussion of Public Matters and Public Participation. 5. Approve September 18, 2024 and October 9, 2024 Commissioners' Court Meeting Minutes. (RHM) 6. Consider and take necessary action to approve the contract with Fun Abounds, Inc. for Bid No. 2024.08 - Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 for Calhoun County, Texas - Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG=DR Contract Work Order No. E-1 and authorize the County Judge to sign.'(DEH) 7. Consider and take necessary action to approve the Resolution Endorsing the Passage of Legislation to Amend Section 382.018 of the Texas Local Government Code. (RHM) 8. Consider and take necessary action to approve the Professional Services Agreements for the County and District Clerk's for "IDocket.com Ruby Red Services" and allow the County and District Clerk to sign. (RHM) 9. Consider and take necessary action to enter into negotiations with the lowest and best responsive bidder (Weaver and Jacobs Constructors) for the 2024.06 Memorial Medical Center HVAC & Roof Improvements for Calhoun County, Texas. (RHM) Page 1 of 10. Consider and take necessary action to accept G&W's recommendations for the second payment of $143,476,921 to Con -Metal Contractors, Inc. for the Recycle Waste Transfer Station Project. (VLL) 11. Consider and take necessary action to update/revise the Calhoun County Job Description for "Assistant Director of EMS/Training Coordinator". (RHM) 12. Consider and take necessary action to approve the preliminary plat of the Desilos Subdivision situated in the William Arnold. Survey, Abstract No. 2, Calhoun County, TX (re - plat of farm tracts 9-16 in Lot 6 of Section 10 of the J.D. Mitchell Wolf Point Ranch Subdivision as recorded in Volume S. Page 417 of the Calhoun County Deed Records). (JMB) 13. Consider and take necessary action to authorize Commissioner Reese to utilize $31,158.20 in COMESA funds to repair pavilion at King fisher Beach Park in Port O'Connor, Texas. (GDR) 14. Accept Monthly Reports from the following County Offices: a) Justice of the Peace Pct3 —September, 2024 b) County Clerk— September, 2024 c) District Clerk— September, 2024 15. Consider and take necessary action on any necessary budget adjustments. (RHM) 16. Approval of bills and payroll, (RHM) Richard H. Meyer, County Judge Calhoun County, Texas A copy of this Notice has been placed on the inside bulletin board of the Calhoun County Courthouse, 211 South Ann Street Port Lavaca, Texas, which is readilyaccessible to the general public during regular business hours. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time_ For your convenience, you may visit the counws website at www,calhouncotx ora under "Commissioners' Court Agenda" for any official court postings. Page 2 of 2 # 04 NOTICE OF MEETING— 10/16/2024 October 16, 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 Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: 1. Call 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 loam 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. Kim Moore with Senator Louis Kolkhorst thanked Calhoun County for the hospitality during the Warriors Weekend activities. Page 1 of 13 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: I` I Yin J "i 00y e , ADDRESS: l 1 'QL AhdQVe-r Strl.e:fi V ICb-i d,) I x TELEPHONE: ?-(Pl. 0144- 30L-(.p (R OF EMPLOYMENT: Genelfor W-1 5 10I k hor -st EMPLOYMENT TELEPHONE: `r rr r]I®O Do you represent any particular group or organization? YES NO (Circle one) If you do represent a group or organization, please provide the name, address and telephone number of the group or organization: Which agenda item (or items) do you wish to address? In general, are you for or against the agenda item (or items)? I hereby swear that any statement 1 make well be the truth and nothing but the truth to the best of my knowledge and ability. Signature: V� # 05 NOTICE OF MEETING — 10/16/2024 5. Approve September 18, 2024 and October 9, 2024 Commissioners' Court Meeting Minutes. (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 2 of 13 NOTICEOFMEETING-9/14/2024 Richard H. Meyer Country judge David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Clyde Synm, Commissioner, Precinct 3 (wary Reese, Commissioner, Precinct 4 The Commissioners'Court of Calhoun County, "Texas met on Wednesday, September 18, 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. Attached are the true and correct minutes of the above referenced meeting. Richard Meyer, County Judge Calhoun County, Texas Anna Goodman, County Clerk i Page 1 of 1 NOTICE OF MEETING — 9/18/2024 September 18, 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 Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: 1. Call 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. Jonas Titas with VEDC Regional Partnership spoke briefly on tax abatement opportunity. Page 1 of 5 NO1ICE OF MEETING — 9/18/2024 S. Discuss and take necessary action on an order authorizing the Issuance, sale, and delivery of up to $30,000,000 in aggregate principal amount of "COMBINATION TAX AND SURPLUS HOSPITAL REVENUE CERTIFICATES OF OBLIGATION, SERIES 2024", securing the payment thereof by authorizing the levy of an annual ad valorem tax and a pledge of certain surplus revenues of the County's Hospital System; execution of instruments and Procedures related thereto; the form of an official statement; and declaring an effective date. (RHM) 6. Consider and take necessary action to approve Motorola proposal on purchase of two additional radio consoles, service contract, and the relocation of the two old radio consoles for Combined Dispatch and authorize all appropriate signatures with the understanding the project will be complete prior to December 31st, 2024. (DEH) RESULT APPROVED [UNANIMOUS] MOVER GaryReese; Commissioner Pct_4 SECONDER:: David HaIG Commissioner Pct 1. AYES Judge Meyer, Omjmissicirier Hall, Lysby;:;Behrens-Reese. 7. Consider and take necessary action regarding Texas Department of Transportation Grant for Routine Airport Maintenance Program (TXDOT Project No. M2513PTLA) and authorize all appropriate signatures. (VLL) CfES.ULT APPROVED'{UNANIMOUS] . MOVER Vern Lyssy, commissioner Pct 2 - SECONDER:.:: David Hall, Commissioner Pct I AYES: Judge Meyer; -Commissioner Hall, Lyssy-'BehPens, Reese 8. Consider and take necessary action on Grant Agreement for the Texas Department of Transportation Aviation Grant 24AWPTLAV of $150,000 for the AWOS System and authorize appropriate signatures. (VLL) RESULT.. APPROVED [UNANIMOUS].- MOVERC Vern Lyssy, Commissioner Ptt:1 SECONDER: David:.Hall, Commissioner Pal AYES: Judge Meyer, Commissioner Hail, Lyssy, Behrens,: Reese '= Page 2 of 5 NOTICE OF MEETING — 9/1.8/2024 9. Consider and take necessary action to accept anonymous donation to the Sheriffs Office to be deposited into the Motivation account (2697-001-49082-679) in the amount of $75.00. (RHM) RESULT, = APPROVED [UNANIMOUS] MOVER David Hall, Commissioner Pct SECONDER: Joel Behrens, Commissioner i?ct 3 . AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens; Reese 10. Consider and take necessary action on declaring a Dell Laptop, Serial Number 2XHM2ND, Inventory #406-0145 purchased in February 2008 as waste and removed from Management Inventory. (RHM) RESULT: APPROVED [UNANIMOUS] . MOVER. Joel Behrens, Commissione1, 3 SECONDER: >' David Halh Commissioner Pet 3 AYES Judge Meyer, Commissioner Hall, Lyssy, SehPans, Reese 11. Consider and take necessary action to authorize Kathy Smartt with Smartt Grants to prepare three Matagorda Bay Mitigation Trust grant applications for infrastructure improvements at King Fisher Beach Park and Bill Sanders Memorial Park at a cost of $500 per application for a total cost of $1,500. (GDR) RESULT. APPROVED [UNANIMOUS] MOVER. GaryReese; Commissioner Oct 4 SECONDER::: Joel. Behrens, Commissioner Pct 3 AYES,. Judge Meyer, Commissioner Hall, Lyssy, Behrens Reese 12. Consider and take necessary action to approve the Certificate of Substantial Completion for the Calhoun County Combined Dispatch Facility Project for Calhoun County, Texas and authorize Commissioner Hall to sign. (DEH) Table for next week pending County Attorney Approval. 13. Consider and take necessary action to use Secure Tech Systems Inc. bid proposal for replacement of the Calhoun County Panic Button System and allow County Judge Richard Meyer to sign all pertinent documentation. Secure Tech Is on the Buy Board. (RHM) Page 3 of 5 NOTICE OF MEETING — 9/18/2024 14. Consider and take necessary action to approve a proclamation declaring October 6-12, 2024 as National 4-H Week in Calhoun County. (RHM) Pass 15. Consider and take Necessary action to approve the contract with United Specialty Advertising, LLC to produce t-shirts free of charge for the Calhoun County Emergency Communication Division Employees. The shirts will include the Calhoun County Emergency Communication Division logo on the front and acquired Sponsor's Advertisements on back. Authorize the Calhoun County Emergency Communication Director to sign all required documents. (RHM) RESUiLt. APPROVED_[UNANMDUS] MOVER: ' Vern Lyssy, Commissioner Oct 2 SECONDER: WvidHall;: Commissioner Pct,1 AYESE Judge Meyer, Commiwioner Hall, Lyssy, beh.rens, Reese 16. Consider and take necessary action to approve a proposal from the Calhoun County Extension Office to the Matagorda Bay Mitigation Trust for funding to purchase a new 4WD pickup truck to be used by the Extension Office to deliver public education regarding the waterbodies and surrounding ecosystems and authorize the County Judge to sign the proposal. (RHM) RESULT: APPROVEb' [UNANIMOUS].._ MOVER. Joel. Behrens; Commissioner Pct 3 SECONDER.:, David Hall, Commissioner MI. AYES: Judge Meyer, Commissioner Hail, Lyssy;Behrens; Reese 17. Accept Monthly Reports from the following County Offices: 1. Tax Assessor- Collector — August 2024 RESULt AP. PROVED.[UNANIMOUSr. MO1/ER Vern Lyssy, Gommissloner`Pct 2 SECONDER: Gary Reese, Commissioner Pct4 AYES. Judge Meyer, CommissloneP'Hali, Lyssy, Behrens, Reese 18. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT:, APPROVED [UNANIMOUS]. MOVER: Gary Reese, Commissioner Oct 4 SECONDER: Joel Behrens;. Commissioner Pet 3 AYES:: 7iadge Meyer; Commissioner Hall, Lyssy Behrens;' Reese - Page 4 of 5 NOTICE OF MEETING— 9/18/2024 19. Approval of bills and payroll. (RHM) MMC Bills RESULT APPROYA [UNANIMOUS] MOVER David Hall; Commissigner,Pct 1 SECONDER: 'Vern Lyssy, Commisslorier-Pct 2.11 AYES Judge Meyer, Commssioner:Hall, Lyssy, Behrens, Reese County Bills RESULT. APPROVED [UNANIMOUS] . MOVER: David Hall, Commissioner Pct l' SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 10:47am Page 5 of 5 NOTICE OF MEETING— 10/9/2024 Richard ]H . Meyer County judge ][David Hall, Commissioner, Precinct 1 Vern Lyssy, Commissioner, Precinct 2 Clyde Syma, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 The Commissioners' Court of Calhoun County, Texas met on Wednesday, October 9, 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. Attached are the true and correct minutes of the above referenced meeting. Richard Meyer, Cou& Judge Calhoun County, Texas Anna Goodman, County Clerk Page 1 of 1 I NOTICE OF MEETING---10/9/2024 October 9, 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 Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: I. Call meeting to order. County Judge Commissioner Pct 1 Commissioner Pct 2 Commissioner Pct 3 Commissioner Pct 4 County Clerk Deputy Clerk Meeting was called to order at loam 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. Commissioner Lyssy reminds public to keep Florida in their prayers as they are in direct hit for the Category 5 Hurricane Milton. Page 1 of 4 I NOTICE OF MEETING— 10/9/2024 5. Approve October 2, 2024 Commissioners' Court Meeting Minutes. (RHM) RESULT.=pPR01iE4;[UNANIMOUS� MOVER Vern Lyssy, Commissioner Pct Z SEG�ONDER� r Joel Behrens Commissioner Pci 3 AYES:Judge Meyer; Commissipner Hall, Lyssy,-6ehrens,`Reese 6. Consider and take necessary action to approve the Memorandum of Understanding (MOU) between The Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) and the Calhoun County Sheriff's Office and allow the Sheriff to sign all necessary documents. 7. Consider and take necessary action to declare the items listed on the attached waste declaration form (12 Box Springs; 12 bed Frames; 3 mattresses) from EMS as waste and approve their disposal. (RHM) RESULt-ARpROVED [UNAN3MOUS7:. MOVER David Hdk Commissioner Pct i SEG NDER ]oektehr®ns, Com. missioner PCE 3 AYE5: Judge Meyer; Commissioner Hall, Lyssy,`Behrens; Raestr. B. Hear progress report from Calhoun County EMS Director regarding CCEMS & Girard & Associates QA/QI program. (RHM) Dustinjonkins epla'ined and read a'letter from the program-' director , 9. Consider and take necessary action to authorize Commissioner Reese to accept and sign proposal with Pest Solutions for Fire Ant Control at Bill Sanders Memorial Park for the playground equipment, sign, and all picnic tables in the amount of $1,000. (RHM) RESULT APPROVED [UNANIMOUS] ;y MOVER Joel •Behrens Commissipn,er"Pct 3 SIECONDEIt. ' David Hall, Cuffim ssiorter pct; AYES Judge Meyer; Commissioner Hall, Lyssy`Behrens Reese . Page 2 of 4 NOTICE OF MEE PING—10/9/202.4 10. Consider and take necessary action to apply for the Matagorda Bay Mitigation Trust Grant for Feral Hog Control for the prevention of water pollution. (RHM) 11. Consider and take any action deemed necessary to authorize Judge Meyer to sign Texas Enterprise Zone Reports for the reporting years of 2018, 2019 and 2020. (RHM) RESULT: ' AhROVED rUNANINIU$] M( MeR: Vern Lyssy, Commissioner Pct 2 _ 9EGONDER::' David Hall, Colnmis5iosionernePrrt 1 AYES' JUdge Meyer`Commisl Hall, Lyssy,-Behrens;=Reese . 12. Accept Monthly Reports from the following County Offices: a) Justice of the Peace Pct 1— September, 2024 b) Justice of the Peace Pct 2 — September, 2024 c) Justice of the Peace Pct 4 — September, 2024 d) Justice of the Peace Pct 5 — September, 2024 e) Floodplain Administration — September, 2024 —RESULT — APPROVE, [UNAN LNbIJS] _ MS�VER Vern Lyssy; Commissioner Pct,2 SlEC6NDER ' Gary Reese; -0mmissianerftl:4 AYES: Judge Meyer; Comirlssli Hall, Lyssy, Behrens; Reese . 13. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT APPROVEQ [UNANhMOUS] MOVER' Gary Reese; Commissiioner. Pct+ $EGONDER: , Joel Behrens, Comrnissiener Pcll AYES:, _Judge'Meyer; Commissioner Hall, Lyssy,`EehriKrs; Reese Page 3 of 4 NOTICE OF MEETING--10/9/2024 1d Ann.. —1 -f L01- --A Adjourned 10:23am Page 4 of 4 # 06 NOTICF OF MFEFING—10/16/2024 6. Consider and take necessary action to approve the contract with Fun Abounds, Inc. for Bid No. 2024.08 - Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 for Calhoun County, Texas - Texas General Land Office Contract No. 20-065-064-C182 and Calhoun County 2020 CDBG-DR Contract Work Order No. E-1 and authorize the County Judge to sign. (DEH) Scott Mason with G&W explained the bid. RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: ' Joel'Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese; Page 3 of 13 ATTORNEY'S REVIEW CERTIFICATION Bid No. 2024.08 — Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 Project — GLO Contract No. 20-065-064-C182 for Calhoun County, Texas I, the undersigned, k,.", W h, �, , the duly authorized and acting legal representative of the Calhoun County, do hereby certify as follows: 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 respective 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: 0--es Date; l (s 2-4( Print Attorney's Name: P V o Texas State Bar Number: 2. qU �, �;—J `) o Standard Form of Agreement for Construction Contracts THIS AGREEMENT made this the 28th day of August, 2024, by and between fun abounds, Inc. a corporation organized and existing under the laws of the State of Texas hereinafter called the "Contractor", and CALHOUN COUNTY, TEXAS 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 No. 2024.08 — Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 Project — GLO Contract No. 20-066-064-C182 for Calhoun County, Texas for the Community Development Block Grant — Mitigation (CDBG- DR) project, all in strict accordancewith the contract documents including all addenda thereto, Addendum No. 1, dated June 13, 2024 and Addendum No. 2, dated June 25, 2024, all as prepared by G&W Engineers, Inc. acting and in these contract documents preparation, referred to as the "Engineer'. 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 Seven Hundred Thousand Dollars and No Cents ($700,000.00). 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 Conditions h. Special Conditions g. i. Performance Bond j. Payment Bond k. Technical Specifications I. Drawings m. Other ARTICLE 4. Performance. Work, in accordance with the Contract dated August 28, 2024, 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 150 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. fun abounds Inc. (The Colqlrator) By Name/Title: Leigh Walden, President CALHOUN COUNTY (Count By l Name/Title: Richard H. Meyer, County Judq Corporate Certifications I, Ewe, M� certify that I am the OrGro-'IOhs M kof the corporation named as Contractor herein; that _LP@I W ft who signed this Agreement n behalf of the Contractor, was then _ 'C �� 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 6.Q, AIPI KAO cal (Corporate Secretary) Please indicate above with N/A to all blanks above if LLC and authorized person signature at Corporate Secretary. BID SCHEDULE Playground Option #1 ORIGINAL SUBMITTED BID SCHEDULE PROJECT NAME: BID NO. 2024.08 — Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 Project - GILD Contract No. 20-065-064-C182 DUE DATE: JULY 2 2024 BEFORE 2:00:00 P.M. BIDDER NAME: fun abounds, Inc. - Payton Palmer -Newton BASE WORK SCOPE: The project shall consist of demolition of existing EWF surface, reconstructing a new playground base material to receive geo-fabric and rubber surfacing, installation of three new shade structures, and a new playground equipment as more described in the contract documents and bid package. BASE BID Item It ITEM DESCRIPTION ITE BID UNIT PRICE TOTAL BID PRICE UNIT QUANTITY 1 MOBILIZATION, INSURANCE AND BONDS LS 1 $7,306.00 $7,306.00 PER PLANS AND SPECIFICATIONS 2 TEMPORARY PROJECT SIGNAGE PER LS 1 $550.00 $550.00 PLANS AND SPECIFICATIONS DEMOLITION OF ENGINEERED WOOD 3 FIBER (EWF)(APPDX.12"THICK) AND SF 7,575 $1.35 $10,226.25 TRANSFER TO AREAS WITHIN PARK PER PLANS AND SPECIFICATIONS. TYPE D, CRUSHED LIMESTONE, 8.5" 4 THICK AFTER COMPACTED IN PLACE TO SF 7,575 $5.75 $43,556.25 95°%COMPLETE IN PLACE PER PLANS AND SPECIFICATIONS GEO-GRID OR GEO-FABRIC INSTALLED 5 ON TOP OF BASE MATERIAL COMPLETE SF 7,575 $0,55 $4,166.25 IN PLACE PER PLANS AND SPECIFICATIONS RUBBER SURFACING 3.5" THICK 6 COMPLETE IN PLACE PER PLANS AND SF 7,575 $20.00 $151,500.00 SPECIFICATIONS NEW PLAYGROUND STRUCTURES) MEETING THE MINIMUM REQUIREMENTS AS SET FORTH IN THE PLANS AND SPECIFICATIONS AND WITHIN THE AREAS LISTED. THIS 7 INCLUDES A SUPER STRUCTURE, SWING LS 1 SET, MERRY-GO-ROUND, STEM PLAY, $479,421.00. $479,421.00 ELECTRONIC GAME AND MUSIC PLAY. CORRISION RESISTANT PACKAGE REQUIRED AND WIND RESISTANT PACKAGE REQUIRED. TWO -POST HIP SHADE STRUCTURE (15' X 22' X 10') CORRISION RESISTANT PACKAGE REQUIRED AND WIND $13,150.00 $26,300.00 8 RESISTANT PACKAGE REQUIRED. EA 2 INCLUDES CUTTING EXISTING CONCRETE AS REQUIRED FOR FOUNDATION INSTALLATION. SINGLE -POST SQ SHADE STRUCTURE (16') CORRISION RESISTANT PACKAGE REQUIRED AND WIND RESISTANT 9 PACKAGE REQUIRED. INCLUDES EA 1 $10,950.00 $10,950.00 CUTTING EXISTING CONCRETE AS REQUIRED FOR FOUNDATION INSTALLATION. TOTAL BASE BID $733,975.75 -Submission of a bid tab with "Clarifications" or "Exclusions" and/or any other stipulations will not be accepted. It shall be the bidder's responsibility to provide a complete bid and ask any questions necessary to clarify any bid items or relevant concerns within the questions period. "The award will be based on the BASE BID and the Owner reserves the right to determine the most advantageous and best bid for the project. ---The Calhoun County Commissioners Court shall be the sole judge in determining which bid will be the most advantageous to Calhoun County. BID SCHEDULE Playground Option #1 NEGOTIATED FINAL BID SCHEDULE PROJECT NAME: BID NO. 2024.08 — Infrastructure at Little Chocolate Bayou County Park Playground Im rp ovements Phase 2 Project - GLO Contract No, 20-065-064-C182 DUE DATE: JULY 2, 2024 BEFORE 2:00:00 P.M. BIDDER NAME: fun abounds Inc, - Payton Palmer -Newton BASE WORK SCOPE: The project shall consist of demolition of existing EWF surface, reconstructing a new playground base material to receive geo-fabric and rubber surfacing, installation of three new shade structures, and a new playground equipment as more described in the contract documents and bid package. nncv nun Item if ITEM DESCRIPTION ITEM O UNIT PRICE TOTAL BID PRICE UNIT QUANTITY 1 MOBILIZATION, INSURANCE AND BONDS L5 1 $7,306.00 $7,306.00 PER PLANS AND SPECIFICATIONS 2 TEMPORARY PROJECT SIGNAGE PER LS 1 $550.00 $550.00 PLANS AND SPECIFICATIONS DEMOLITION OF ENGINEERED WOOD 3 FIBER (EWF) (APPDX. 12" THICK) AND SF 7,575 $1.35 $10,226.25 TRANSFER TO AREAS WITHIN PARK PER PLANS AND SPECIFICATIONS. TYPE D, CRUSHED LIMESTONE, 8.5" 4 THICK AFTER COMPACTED IN PLACE TO SF 7,575 $5.75 $43,556,25 95%COMPLETE IN PLACE PER PLANS AND SPECIFICATIONS GEO-GRID OR GEO-FABRIC INSTALLED 5 ON TOP OF BASE MATERIAL COMPLETE SF 7,575 $0.55 $4,166.25 IN PLACE PER PLANS AND SPECIFICATIONS RUBBER SURFACING 3.5" THICK 6 COMPLETE IN PLACE PER PLANS AND SF 7,575 $20.00 $151,500.00 SPECIFICATIONS NEW PLAYGROUND STRUCTURE(S) MEETING THE MINIMUM REQUIREMENTS AS SET FORTH IN THE PLANS AND SPECIFICATIONS AND WITHIN THE AREAS LISTED, THIS 7 INCLUDES A SUPER STRUCTURE, SWING LS 1 SET, MERRY-GO-ROUND, STEM PLAY, $445,445.25 $445,445.25 ELECTRONIC GAME AND MUSIC PLAY. CORRISION RESISTANT PACKAGE REQUIRED AND WIND RESISTANT PACKAGE REQUIRED. TWO -POST HIP SHADE STRUCTURE (15' X 22' X 10') CORRISION RESISTANT PACKAGE REQUIRED AND WIND $13,150.00 $26,300.00 8 RESISTANT PACKAGE REQUIRED. EA 2 INCLUDES CUTTING EXISTING CONCRETE AS REQUIRED FOR FOUNDATION INSTALLATION. SINGLE -POST SQ SHADE STRUCTURE (16') CORRISION RESISTANT PACKAGE REQUIRED AND WIND RESISTANT 9 PACKAGE REQUIRED. INCLUDES EA 1 $10,950.00 $10,950.00 CUTTING EXISTING CONCRETE AS REQUIRED FOR FOUNDATION INSTALLATION, TOTAL BASE BID $700,000.00 -Submission of a bid tab with "Clarifications" or "Exclusions" and/or any other stipulations will not be accepted. It shall be the bidder's responsibility to provide a complete bid and ask any questions necessary to clarify any bid items or relevant concerns within the questions period. "The award will be based on the BASE BID and the Owner reserves the right to determine the most advantageous and best bid for the project. ... The Calhoun County Commissioners Court shall be the sole judge In determining which bid will be the most advantageous to Calhoun County. SPECIFICATION NOTES The project shall consist of demolition of existing EWF surface, reconstructing a new playground base material to receive geo-fabric and rubber surfacing, installation of three new shade structures, and a new playground equipment as more described in the contract documents and bid package. The BIDDER, in compliance with the invitation for bids for Bid No. 2024.08 — Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 Project— GLO Contract No. 20-065-064-C182 for Calhoun County, Texas, 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 bid is a part. These price(s) are firm and shall not be subject to adjustment provided this bid is accepted within sixty (60) days after the time set for receipt of bids. 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 150 consecutive calendar days as stipulated in the specifications. BIDDER further agrees to pay as liquidated damages, the sum of $600.00 for each consecutive calendar day. I hereby acknowledge the receipt of the following addenda: 1, 2024.08 LCB Playground Phase 2 - Addendum No. 1 - Recieved 6/13/2024 2. 2024.08 LCB Playground Phase 2 - Addendum No. 2 - Recieved 6/25/2024 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. Type of Work Subcontracted Name of Subcontractor Installation Premier Outdoor Installations Rubber Surfacing Spectraturf The undersigned hereby declares that he has visited the site and has carefully examined the contract documents relative to the work covered by the above bid. Bidder Name: fun abounds, Inc. - Payton Palmer -Newton Address: 114 Venice Street, Sugar Land, TX 77478 Phone: 361-230-3006 EIN orTax ID No.: 36-4766562 Signature: C & ��I�zl Name and Title: Office Manager Email: ellie@fabpiaygrounds.com PAYMENT BOND Bond No. 101267570 KNOW ALL MEN BY THESE PRESENTS that: fun abounds, Inc. (Name of Contractor or Company) 114 Venice Street, Sugar Land, TX 77478 (Address) a Corporation hereinafter called Principal, (Corporation / Partnership) and Merchants National Bonding Inc. (Name of Surety Company) PO Box 14498, Des Moines, IA 50306 (Address) hereinafter called Surety, are held and firmly bound unto Calhoun County, Texas (Name of Recipient) 211 South Ann Street, Third Floor, Ste. 301, Port Lavaca. Texas (Recipient's Address) hereinafter called OWNER, in the penal sum of $ Seven Hundred Thousand and zero cents Dollars, $ 700,000.00 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 28thday of August, 2024 a copy of which is hereto attached and made a part hereof for the construction of: Bid No. 2024.08 — Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 Project— GLO Contract No. 20-066-064-Cl82 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 12th day of September, 2024 ATTEST: in nigIpal aecrerary) (SEAL) fun abounds, Inc. A44Y)fX,& 114 Venice Street, Sugar Land; TX 77478 as to Principal) (Address) (Address) ATTEST: Merchants National Bonding Inc. // (Surety) r�--� 01 Jr- By r y�� (Witness as to Surety Michael Hotchkiss (, ome i Fact) Maryana Zhuk 13430 NW Freeway, Ste 600, Houston, TX 77040 PO Box 14498, Des Moines, IA 50306 (Address) (Address) (a) 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: fun abounds, Inc. 1.14 Venice Street, Sugar Land, TX 77478 Bond No.101267570 (Name of Contractor or Company) (Address) a Corporation hereinafter called Principal, and Merchants National Bonding Inc. (Name of Surety Company) PO Box 14498, Des Moines, IA 50306 (Address) hereinafter called Surety, are held and firmly bound unto Calhoun County, Texas (Name of County) 211 South Ann Street. Third Floor, Ste 301 Port Lavaca Texas (County's Address) hereinafter called OWNER, in the penal sum of $ Seven Hundred Thousand and zero cents Dollars (g0o,000s9n 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 28th da of August, 2024 y a copy of which is hereto attached and made a part hereof for the construction of: Bid No, 2024.08 — Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 Project— GLO Contract No. 20-065-064-C182 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 terns 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 2024 ATTEST: k""JuNai Qvuluiajyl (SEAL) tvwutass as to Principal) fun abounds, Inc. 114 Venice Street, Sugar Land, TX 77478 (Address) (Address) ATTEST: Merchants National Bonding Inc. counterparts, day of September, (Surety) BY _. ! (Witness as to Surety) Michael Hotchkiss tto y in Fact) Maryana Zhuk 13430 NW Freeway, Ste 600, Houston, TX 77040 PO Box 14498, Des Moines, IA 50306 . -.. (Address) (Address) NOTE: Date of BOND must not be prior to date of Contract. If PRINCIPAL/CONTRACTOR is Partnership, all partners should execute BOND. MERCHANTS BONDING COMPANY, POWER OF ATTORNEY Know All Persons By These Presents, that MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., both being corporations of the State of Iowa, diala Merchants National Indemnity Company (in California only) (herein collectively called the "Companies') do hereby make, constitute and appoint, individually,. Maryana Zhuk their true and lawful Attomey(s)-in-Fact, to sign as name as surety(ies) and to execute, seat and acknowledge any and all bonds, undertakings, contracts and other written instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or I uardnteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law. This Power -of -Attorney is granted and is signed and sealed by facsimil under and by authority of the following By -Laws adopted by the Board of Directors of Merchants Bonding Company (Mutual) on April 23, 2011 an amended August 14, 2015 and April 27, 2024 and adopted by the Board of Directors of Merchants National Bonding, Inc., on October 16, 2015 and a nencled on April 27, 2024. "The President, Secretary, Treasurer, or any Assistant. Treasurer or any Assistant Secretary or any Vice President shall have power and authority to appoint Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of Indemnity and other writings obligatory In the nature thereof." "The signature or any authorized officer and the seal of the Company may be affixed by facsimile or electronic transmission to any Power of Attorney or Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of the Company, and such signature and seal when so used shall have the same force and effect as though manually fixed." In connection with obligations in favor of the Florida Department of Transortation only, it Is agreed that the powerand suit homy hereby given to the Attorney -in -Fact Includes any and all consents for the release of rote fined percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contra or and/or Its assignee, shall not relieve this surety company of any of its obligations under Its bond. In connection with obligations in favor of the Kentucky Department of HighWays only, it is agreed that the power and authority hereby given to the Attomey-in-Fact cannotbe modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at least tarty (30) days prior to the modification or revocation. In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 121b day of September 2024 - '�".'•[ -'•. �O"`�•`u!S),e .� MERCHANTS BONDING COMPANY (MUTUAL) NPO/y� �Z% ' ylOGrpltPO9NATIONAL A.;gyc: BONDING, INC. MERCHANTS dri la -0- o:o R MERCHANTS NATIONAL INDEMNITY COMPANY -o_ 2003 ;: Ip; : y: 1933 BY STATE OF IOWA , ... rest e COUNTY OF DALLAS ss. On this 12th day of Seepptember 2024 before me appeared Larry Taylor, to me personally known, who being by me duty swom did say that he is President of.MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC.; and that the seals affixed to the foregoing instrument am the Corporate Seals of the. Companies; and that the said instrument was signed and sealed in behalf of the Companies by authority of their respective Boards of Directors. (I , Vg4lA4 s Perini Miller I) z Commission Number 787952 • • My Commission Expires rMVN Januarv20.2027 Notao, Public does not Invalidate this Instrument) I, Elisabeth Sandersfeid, Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and MERCHANTS NATIONAL BONDING, INC., do hereby certify that the above and foregoing is a true and correct copy of the POWER -OF -ATTORNEY executed by said Companies,which is still In full force and effect and has not been amended or revoked. In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 12th day of September 2024 . �g,�attPOgq?Spy •C,GOPp09yy�<: a�b &&-4 L yt. 2003 ��'' a: 1933 e' secretary :y•. POA 0018 (6l24) " ' MERCHANTS BONDING COMPANY. MERCHANTS BONDING COMPANY (MUTUAL) • MERCHANTS NATIONAL BONDING. INC. P.O. Box 14498 • DES MOINES. IOWA 50306-3498 - (800) 678-8171 (515) 243-3854 FAX Please send all notices of claim on this bond to: Merchants Bonding Company (Mutual) / Merchants National Bonding, Inc. P.O. Box 14498 Des Moines, Iowa 50306-3498 (515) 243-8171 (800)678-8171 Physical Address: 6700 Westown Parkway, West Des Moines, Iowa 50266 SUP 0073 TX (2/15) ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 1 11,.� 7/1/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Hotchkiss Insurance Agency, LLC 13430 Northwest Freeway CONTACT' PHONE , 800-899-9810 (MC No.713-956-0331 Suite 600 Houston TX77040 nooliEss: certs hiallc.com INSURERS AFFORDING COVERAGE NAICIt INSURER A: Central Mutual Insurance Company 20230 INSURED FUNABOU-01 fun abounds, inc INSURERS: Texas Mutual Insurance Company 22945 INSURER C: 114 Venice Street Sugar Land TX 77478 INSURER°: NSURERE: INSURER F: COVERAut:6 CFRTIFICATF NIIMRFR• 1AR071007A oo.nelnM wuseee. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOLSUBR INSD WVD POUCYNUMBER POLICY EFF MM/DD/YYYY) POLICY UP IMMIDDfYYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY CIAIMS-MADE I OCCUR CLP8997805 4/19/2024 4/19/2025 EACH OCCURRENCE $1,000,000 DAMAGETO RE EO PREMISES Ee accunance $300,000 MED UP (Any one person) $ 5,000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEST E LOC GENERALAGGREGATE $2,000,000 PRODUCTS-COMP/OPAGG $2.000,000 $ OTHER: A AUTOMOBILE LIABILITY ANY AUTO BAPS998130 4/19/2024 4/19/2025 OMVU INEDSINGLE LIMIT $1,000,000 X INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS RY(Per accident) $ HIRED X NON -OWNED ONLY AUTOS ONLY X DAMAGEAUTOS t $ A X UMBRELLALIAB X OCCUR CXS8998131 4/19/2024 4/19/2025 EACH OCCURRENCE $2,000.000 AGGREGATE $2.000,000 EXCESS LIAB CLAIMS -MADE DEO I X I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICEWMEMBEREXCLUDED? NIA 0001321422 3/9/2024 3/9/2025 X PER ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 ( en n NH) if describe be under a, descri E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS be. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe .t .h.J it more spec. i. regelred) The general liability policy includes additional insured endorsements, (8-1932 07/14) that provides additional insured status for ongoing and completed operations to the certificate holder only when required by written contract. The auto policy includes a blanket additional insured endorsement when required by written contract per (3-2546 11/20). The auto policy includes a special endorsement with Primary and Noncontributory wording, per (CA0449 11116). The general liability, auto and workers compensation policies includes a blanket waiver of subrogation endorsement when required byy written contract. The general liability policy includes a special endorsement with Primary and Noncontributory wording as required by written contract (B-1834 12104). The workers compensation policy excludes coverage for Leigh Walden per endorsement WC420308. Calhoun County West Austin Street Port Lavaca TX 77979 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE T ©1988-2015 ACORn ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD Texasmut @ WORKERS' COMPENSATION INSURANCE WORKERS' COMPENSATION AND WC 42 03 04 B EMPLOYERS LIABILITY POLICY Agent copy TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in item 3.A, of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1. ( ) Specific Waiver Name of person or organization (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas operations 3. Premium: The premium charge for this endorsement shall be 2.00 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance'Premium: Included, see Information Page This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective on 3/9/24 at 12:01 a.m, standard time, forms a part of: Policy no. 0001321422 of Texas Mutual Insurance Company effective on 3/9/24 Issued to: FUN ABOUNDS INC This is not a bill NCCI Carrier Code: 29939 Authorized representative 2126124 PO Box 12058, Austin, TX 78711-2058 1 of 1 texasmutual.com 1 (800) 859-5995 1 Fax (800) 359-0650 WC 42 03 04 B CA0449 11 16 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. The following is added to the Other Insurance Condition in the Business Auto Coverage Form and the Other Insurance — Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary: This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that: 1. Such "insured" is a Named Insured under such other insurance; and 2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured". CA0449 11 16 Copyright, Insurance Services Office, Inc., 2016 3-2546 11 20 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BAP PLUS COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the: BUSINESS AUTO COVERAGE FORM These coverages are subject to the terms and conditions applicable to coverage in this policy except as provided below. A. Hired Auto Physical Damage Coverage 1. If hired "autos' are covered "autos" for Liability Coverage in this policy or another policy provided by us and if Comprehensive, Specified Causes of Loss or Collision coverages are provided under this coverage form for any "auto' you own, then the Physical Damage Coverages provided are extended to "autos" you hire, subject to the following limit. The most we will pay for "loss" to any hired "auto' is $75,000 or Actual Cash Value or Cost of Repair, whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage. No deductible applies to "loss" caused by fire or lightning. Subject to the above limit, and deductible, we will provide coverage equal to the broadest coverage applicable to any covered "auto" you own. 2. Changes In Liability Coverage: The following is added to the Who Is An Insured Provision: An "employee" of yours is an "insured" while operating an "auto" hired or rented under a contract or agreement in that "employee's" name, with your permission, while performing duties related to the conduct of your business. 3. Changes In General Conditions: Paragraph 5.b. of the Other Insurance Condition in the Business Auto and Business Auto Physical Damage Coverage Forms are replaced by the following: For Hired Auto Physical Damage Coverage, the following are deemed to be covered "autos' you own: 1. Any covered "auto' you lease, hire, rent or borrow; and 2. Any covered "auto' hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, while performing duties related to the conduct of your business. However, any "auto' that is leased, hired, rented or borrowed with a driver is not a covered "auto." B. Hired Auto Physical Damage - Additional Loss of Use Expenses Paragraph AA.b. of SECTION III -PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $85 per day and a maximum limit of $1,350. C. Physical Damage - Additional Transportation Expense Coverage Paragraph AA.a. of SECTION III - PHYSICAL DAMAGE COVERAGE is amended to provide a limit of $50 per day and a maximum limit of $1,000. D. Towing and Labor Costs Coverage We will pay up to $200 for towing and labor costs incurred each time an owned "auto' is disabled. However, the labor must be performed at the place of disablement. E. Parked Auto Collision Coverage (Waiver of Deductible) The deductible does not apply to "loss" caused by collision to such covered "auto" while it is: 1. In the charge of an "insured"; 2. Legally parked; and 3. Unoccupied. 3-2546 11 20 Page 1 of 4 The total amount of the damage to the covered "auto" must exceed the deductible shown in the Declarations or Change Endorsement. This provision does not apply to any "loss" if the covered "auto" is in the charge of any person or organization engaged in the automobile business. F. Rental Reimbursement Coverage When there is a "loss" to a covered "auto," we will pay for rental reimbursement expenses incurred by you for the rental of an "auto." Payment applies in addition to the otherwise applicable amount of each coverage you have on a covered "auto." No deductibles apply to this coverage. This coverage applies only: 1. For those expenses incurred during the policy period beginning 24 hours after the loss; 2. To necessary and actual expenses incurred; 3. To a "loss" for which we also pay a "loss" under Physical Damage Coverage - Comprehensive Coverage, Specified Causes of Loss Coverage or Collision Coverage; and 4. If there are no spare or reserve "autos' available to you for your operations. Our payment will be limited to that period of time reasonably required to repair or replace the covered "auto." We will pay up to $75 per day to a maximum of $1,500. If "loss" results from total theft of a covered "auto" we will pay under this coverage only that amount of rental reimbursement expenses which are not already provided under the Physical Damage Coverage Extension. G. Difference in Value Coverage - Loan/Lease Gap 1. PHYSICAL DAMAGE COVERAGE, is amended by the addition of the following: a. In the event of a total "loss" to a covered "auto', we will pay any unpaid amount due on the lease or loan for a covered "auto", less: 1) The amount paid under the Policy's Physical Damage Coverage; and 2) Any: i) Overdue or any deferred loan/lease payments at the time of "loss'; III) Financial penalties imposed under the lease for excessive use, abnormal wear and tear or high mileage; iii) Security deposits not returned by the lessor; iv) Costs for extended warranties, Credit Life Insurance, Health, Accident or Disability Insurance purchased with the loan or lease; and v) Carry-over balances from previous loans or leases. For the purposes of this endorsement, the following is added to the Other Insurance Condition in the Business Auto Coverage Form: The insurance provided by this Auto Loan/Lease GAP Coverage is excess over any other collectible insurance including but not limited to any coverage provided by or purchased from the lessor or any financial institution. H. Glass Repair - Waiver of Deductible Under Paragraph D. - Deductible of SECTION III - PHYSICAL DAMAGE COVERAGE, the following is added: No deductible applies to the cost of repairing or replacing damaged glass. I. Employees as Insureds Paragraph A.1 -Who is an Insured of SECTION II -COVERED AUTOS LIABILITY COVERAGE is amended to add: d. Any employee of yours while using a covered "auto' you don't own, hire or borrow in your business or your personal affairs. Coverage is excess over any other collectible insurance. 3-2546 11 20 Page 2 of 4 J. Fellow Employee Coverage The Fellow Employee Exclusion contained in SECTION II - COVERED AUTOS LIABILITY COVERAGE does not apply. K. Doubled Automobile Medical Payments Coverage If you have purchased Automobile Medical Payments Coverage, the limit of insurance for that coverage as shown in the Declarations or Change Endorsement will be doubled in the event an "insured" is injured in an .'accident' while within an "auto" and is: 1. Wearing a seat belt; or 2. The "auto" is equipped with passive restraints. L. Waiver Of Transfer Of Rights Of Recovery Against Others To Us The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US, SECTION IV CONDITION 5., is amended by the addition of the following: The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to any person(s) or organization(s) for whom you are required to waive subrogation with respect to the coverage provided under this Coverage Form, but only to the extent that subrogation is waived: 1. Under a written contract or agreement with such person(s) or organization(s); and 2. Prior to the "accident" or the "loss'. M. Additional Insured - Automatic Status 1. Any "leased auto' will be considered a covered "auto' you own and not a covered "auto' you hire or borrow. 2. Paragraph A.1 - Who is an Insured of SECTION II - COVERED AUTOS LIABILITY COVERAGE is amended to include as an insured any person or organization (called additional insured) whom you are required to add as an additional insured on this policy under: A written contract, permit or agreement, and a. Currently in effect or becoming effective during the term of this policy; and b. Executed prior to the "bodily injury," "property damage," "personal injury and advertising injury." 3. The insurance provided to the additional insured is limited as follows: a. The Limits of Insurance applicable to the additional insured are those specified in the written contract or agreement or in the Declarations for this policy, whichever is less. These Limits of Insurance are inclusive and not in addition to the Limits of Insurance shown in the Declarations. 4. Additional Definition As used in this endorsement: "Leased auto" means an "auto' leased or rented to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. N. Loss Payee - Lessor 1. We will pay, as interest may appear, you and the lessor for "loss" to a "leased auto." 2. The insurance covers the interest of the lessor unless the "loss" results from fraudulent acts or omission on your part. 3. If we make any payment to the lessor, we will obtain his or her rights against any other party. 4. Additional Definition As used in this endorsement: "Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. 3-2546 11 20 Page 3 of 4 O. Tapes, Records and Discs Coverage SECTION III -PHYSICAL DAMAGE COVERAGE is amended as follows: 1. The exclusion referring to tapes, records, discs or other similar audio, visual or data electronic devices designed for use with audio, visual or data electronic equipment does not apply. 2. The following is added to Paragraph A. Coverage: Under Comprehensive Coverage we will pay for "loss" to tapes, records, discs or other similar devices used with audio, visual or data electronic equipment. We will pay only if the tapes, records, discs or other similar audio, visual or data electronic devices: a. Are your property or that of a family member, and b. Are in a covered "auto" at the time of "loss" 3. The most we will pay for "loss" is $250. 4. No Physical Damage Coverage deductible applies to this coverage. P. Audio, Visual and Data Electronic Equipment Coverage SECTION III - PHYSICAL DAMAGE COVERAGE is amended as follows: 1. The sublimit in Paragraph C.1.b. of the Limit Of Insurance provision is increased to $2,500. 3-2546 11 20 Page 4 of 4 8-1834 12 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. AMENDMENT OF PRIMARY AND EXCESS PROVISIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless a contract specifically requires that this insurance be either primary or primary and noncontributing. Where required by contract, we will consider any other insurance maintained by the additional insured for injury or damage covered by this endorsement to be excess and noncontributing with this insurance. 8-1834 12 04 8-1932 07 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEXAS GENERAL LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART This endorsement amends the policy by adding the following; please read each section carefully. EMPLOYEE BENEFITS LIABILITY COVERAGE ADDITIONAL INSURED - OWNERS, LESSEES, OR CONTRACTORS -AUTOMATIC STATUS ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES - AUTOMATIC STATUS ADDITIONAL INSURED - LESSOR OF LEASED EQUIPMENT - AUTOMATIC STATUS ADDITIONAL INSURED - VENDORS - AUTOMATIC STATUS INCLUDE DIRECTORS OR TRUSTEES ON COMMITTEES AS EMPLOYEES WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHER TO US NEWLY FORMED OR ACQUIRED ORGANIZATIONS NOTICE OF OCCURRENCE, KNOWLEDGE OF OCCURRENCE, UNINTENTIONAL OMISSION VOLUNTARY PROPERTY DAMAGE NON -OWNED WATERCRAFT AND NON -OWNED AIRCRAFT LIABILITY FIRE, SPRINKLER LEAKAGE OR EXPLOSION POLLUTION COVERAGE FOR UPSET OF MOBILE EQUIPMENT AGGREGATE LIMITS OF INSURANCE AMENDMENT SUPPLEMENTARY PAYMENTS - HIGHER LIMITS REASONABLE FORCE EXPANSION - PROPERTY DAMAGE LOST KEY COVERAGE PERSONAL AND ADVERTISING INJURY DEFINITION AMENDED These modifications are subject to the terms and conditions applicable to coverage in the policy except as provided below. A. Employee Benefits Liability Coverage The following is added to Section I - Coverages: EMPLOYEE BENEFITS LIABILITY COVERAGE. 1. Insuring Agreement. a. We will pay those sums that the insured becomes legally obligated to pay as damages because of any act, error or omission of the insured, or of any other person for whose acts the insured is legally liable, to which this insurance applies. We will have the right and duty to defend the insured against any "suit' seeking those damages. However, we will have no duty to defend the insured against any "suit" seeking damages to which this insurance does not apply. We may, at our discretion, investigate any report of an act, error or omission and settle any "claim" or "suit" that may result. But: 1) The amount we will pay for damages is limited as described in SECTION III LIMITS OF INSURANCE for Employee Benefits Liability Coverage and 2) Our right and duty to defend end when we have used up the applicable limit of insurance in the payment of judgments or settlements. No other obligation or liability to pay sums or perform acts or services is covered unless explicitly provided for under Supplementary Payments. b. This insurance applies to damages only if: 1) The act, error or omission is negligently committed in the "administration" of your "employee benefit program"; 2) The act, error or omission is caused by an "occurrence' that takes place in the "coverage territory"; and 3) The act, error or omission occurs during the policy period. 2. Exclusions This insurance does not apply to: a. Dishonesty or Fraud 8-1932 07 14 Page 1 of 12 Damages arising out of any dishonest, fraudulent or malicious act or omission, committed by any insured, including the willful or reckless violation of any statute. b. Bodily Injury, Property Damage, or Personal and Advertising Injury "Bodily injury," "property damage' or "personal and advertising injury." c. Failure to Perform a Contract Damages arising out of failure of performance of contract by any insurer. d. Insufficiency of Funds Damages arising out of an insufficiency of funds to meet any obligations under any plan included in the "employee benefit program." e. Inadequacy of Performance of Investment/Advice Given to Participate Any "claim" or "suit' based upon: 1) Failure of any investment to perform; 2) Errors in providing information on past performance of investment vehicles; or 3) Advice given to any person to participate or not to participate in any plan included in the "employee benefit program." f. Workers Compensation and Similar Laws Damages arising out of any "claim" related to any workers compensation, unemployment compensation insurance, social security or disability benefits law or any similar law. g. ERISA Damages for which the insured is liable because of liability imposed on a fiduciary by the Employee Retirement Income Security Act of 1974, as now or hereafter amended, or any similar federal, state or local laws. h. Available Benefits Any "claim" for benefits to the extent that such benefits are available, with reasonable effort and cooperation of the insured, from the applicable funds accrued or other collectible insurance. I. Taxes, Fines or Penalties 1) Taxes, fines or penalties, including those imposed under the Internal Revenue Code or any similar state or local law; or 2) Loss or damages arising out of the imposition of such taxes, fines or penalties. j. Employment -Related Practices Damages arising out of wrongful termination of employment, discrimination, or other employment -related practices. 3. Supplementary Payments - Coverages A and B For the purposes of the coverage provided by Employee Benefits Liability Coverage, the Supplementary Payments - Coverages A and B apply except for Paragraphs 1.11b. and 2. SECTION II - WHO IS AN INSURED, Paragraphs 2, and 3. are replaced by the following for Employee Benefits Liability Coverage: 2. Each of the following is also an insured: a. Each of your "employees" who is or was authorized to administer your "employee benefit program." b. Any persons, organizations or "employees" having proper temporary authorization to administer your "employee benefit program' if you die, but only until your legal representative is appointed. c. Your legal representative if you die, but only with respect to duties as such. That representative will have all your rights and duties under this Endorsement. 3. Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: a. Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is earlier. b. Coverage under this provision does not apply to any act, error or omission that occurred before you acquired or formed the organization. 8-1932 07 14 Page 2 of 12 SECTION III - LIMITS OF INSURANCE is replaced by the following for the Employee Benefits Liability Coverage: 1) The Limits of Insurance shown below and the rules below fix the most we will pay regardless of the number of: a) Insureds; b) "Claims" made or "suits" brought; c) Persons or organizations making "claims" or bringing "suits'; d) Acts, error or omissions which result in loss; or e) Benefits included in your "employee benefit program." 2) $2,000,000 is the most we will pay for all damages because of acts, errors or omissions committed in the "administration" of your "employee benefit program." 3) Subject to the above Limit, $1,000,000 is the most we will pay for all damages sustained by any one "employee," including damages sustained by such "employee's" dependents and beneficiaries, as a result of: a) An act, error or omission; or b) A series of acts, errors or omissions negligently committed in the "administration" of your "employee benefit program." However, the amount paid under this endorsement shall not exceed, and will be subject to, the limits and restrictions that apply to the payment of benefits in any plan included in the "employee benefit program." The Limits of Insurance of this endorsement apply separately to each consecutive annual period and to any remaining period of less than 12 months, starting with the beginning of the policy period shown in the Declarations of the policy to which this endorsement is attached, unless the policy period is extended after issuance for an additional period of less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits Of Insurance. 4. Deductible a. Our obligation to pay damages on behalf of the insured applies only to the amount of damages in excess of $1,000. The limits of insurance shall not be reduced by the amount of this deductible. b. The deductible amount applies to all damages sustained by any one "employee," including such "employee's" dependents and beneficiaries, because of all acts, errors or omissions to which this insurance applies. c. The terms of this insurance, including those with respect to: 1) Our right and duty to defend any "suits" seeking those damages; and 2) Your duties, and the duties of any other involved insured, in the event of an act, error or omission, "claim' or "suit" apply irrespective of the application of the deductible amount. d. We may pay any part or all of the deductible amount to effect settlement of any "claim" or "suit' and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as we have paid. SECTION IV - CONDITIONS, Paragraphs 2. and 4. are replaced by the following for the Employee Benefits Liability Coverage: 2. Duties In The Event Of An Act, Error or Omission, "Claim" Or "Suit" a. You must see to it that we are notified as soon as practicable of an act, error or omission which may result in a "claim." To the extent possible, notice should include: 1) What the act, error or omission was and when it occurred; and 2) The names and addresses of anyone who may suffer damages as a result of the act, error or omission. b. If a "claim" is made or "suit" is brought against any insured, you must: 1) Immediately record the specifics of the "claims" or "suit' and the date received; and 2) Notify us as soon as practicable. You must see to it that we receive written notice of the "claim" or "suit" as soon as practicable. 5-1932 07 14 Page 3 of 12 c. You and any other involved insured must: 1) Immediately send us copies of any demands, notices, summonses or legal papers received in connection with the "claim" or "suit'; 2) Authorize us to obtain records and other information; 3) Cooperate with us in the investigation or settlement of the "claim" or defense against the ..suit'; and 4) Assist us, upon our request, in the enforcement of any right against any person or organization which may be liable to the insured because of an act, error or omission to which this insurance may also apply. d. No insured will, except at the insured's own cost, voluntarily make a payment, assume any obligation or incur any expense without our consent. 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under this endorsement, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in c. below. b. Excess Insurance Any other primary insurance available to you covering acts, errors or omissions for which you have been added as an additional insured. When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit." If no other insurer defends, we may undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: 1) The total amount that all such other insurance would pay for the loss in absence of this insurance; and 2) The total of all deductible and self -insured amounts under all that other insurance. We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown. C. Method of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limits of insurance of all insurers. SECTION V - DEFINITIONS is amended by adding the following definitions for Employee Benefits Liability Coverage: "Administration" means: a. Providing information to "employees," including their dependents and beneficiaries, with respect to eligibility for or scope of "employee benefit programs"; b. Handling records in connection with the "employee benefit program'; or C. Effecting, continuing or terminating any "employee's" participation in any benefit included in the "employee benefit program;" However, "administration' does not include handling payroll deductions. 2. "Cafeteria plans" means plans authorized by the applicable law to allow employees to elect to pay for certain benefits with pre-tax dollars. 8-1932 07 14 Page 4 of 12 3. "Claim' means any demand, or "suit," made by an "employee" or an "employee's" dependents and beneficiaries, for damages as the result of an act, error or omission. 4. "Employee benefit program' means a program providing some or all of the following benefits to "employees," whether provided through a "cafeteria plan" or otherwise. a. Group life insurance; group accident or health insurance; dental, vision and hearing plans; and flexible spending accounts; provided that no one other than an "employee" may subscribe to such benefits and such benefits are made generally available to those "employees" who satisfy the plan's eligibility requirements; b. Profit sharing plans, employee savings plans, employee stock ownership plans, pension plans and stock subscription plans, provided that no one other than an "employee' may subscribe to such benefits and such benefits are made generally available to all "employees" who are eligible for such benefits; c. Unemployment insurance, social security benefits, workers compensation and disability benefits; d. Vacation plans, including buy and sell programs; leave of absence programs, including military, maternity, family and civil leave; tuition assistance plans; transportation and health club subsidies. SECTION V - DEFINITIONS - the definition of "employee" and "suit" is replaced for Employee Benefits Liability Coverage by the following: "Employee" means a person actively employed, formerly employed, on leave of absence or disabled, or retired. "Employee" includes a "leased worker." "Employee" does not include a "temporary worker." "Suit" means a civil proceeding in which damages because of an act, error or omission to which this insurance applies are alleged. "Suit" includes: a. An arbitration proceeding in which such damages are claimed and to which the insured must submit or does submit with our consent; or b. Any other alternative dispute resolution proceeding in which such damages are claimed and to which the insured submits with our consent. B.;Addrtional,Insurec�,,;;pytff,,,LZssees oeCorttraEttrs,__/uYo%}atrc,SYaYuS(nat,�ppllcableta Empfojree B;eneftb°cCAiiii ,Jo Ggtrerage 1. Section II - Who Is An Insured is amended to include as an additional insured any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy and any other person or organization you are required to add as an additional insured under the contract or agreement. Such person or organization is an additional insured only with respect to liability for "bodily injury," "property damage' or "personal and advertising injury' caused, in whole or in part, by: a. Your acts or omissions; or b. The acts or omissions of those acting on your behalf; Except as provided for in the exception to 2.b. below, a person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. However, the insurance afforded to such additional insured described above: a. only applies to the extent permitted by law; and b. will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: a. "Bodily injury," "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: 1) The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, 8-1932 07 14 Page 5 of 12 reports, surveys, field orders, change orders or drawings and specifications; or 2) Supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence' which caused the "bodily injury" or "property damage', or the offense which caused the "personal and advertising injury', involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. b. 'Bodily injury" or "property damage" occurring after: 1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Howe (e€ exc[usrort b,, i s not, "apprywir -,in-cRfafl[c vy¢hffhd re auiref eFl s gf a,writte cdh ttiEf o€ agree)clent 3. The most we will pay on behalf of the additional insured is the amount of insurance required by the contract or agreement you have entered into with the additional insured or the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or Change Endorsement, whichever is less. These Limits of Insurance are inclusive and not in addition to the Limits of Insurance shown in the Declarations or Change Endorsement. C. Additional Insured -Managers or Lessors of Premises -Automatic Status (not applicable to Employee Benefits Liability Coverage) 1. Section II - Who Is An Insured is amended to include as an insured any person or organization when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and subject to the following additional exclusions: This insurance does not apply to: a. Any "occurrence" which takes place after you cease to be a tenant in that premises. b. Structural alterations, new construction or demolition operations performed by or on behalf of the additional insured. However, the insurance afforded to such additional insured described above: a. only applies to the extent permitted by law, and b. will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. The most we will pay on behalf of the additional insured is the amount of insurance required by the contract or agreement you have entered into with the additional insured or the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or Change Endorsement, whichever is less. These Limits of Insurance are inclusive and not in addition to the Limits of Insurance shown in the Declarations or Change Endorsement. D. Additional Insured -Lessor of Leased Equipment -Automatic Status (not applicable to Employee Benefits Liability Coverage) 1. Section II - Who Is An Insured is amended to include as an additional insured any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy. Such person or organization is an insured only with respect to liability for "bodily injury," 'property damage' or 'personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. However, the insurance afforded to such additional insured described above: a. only applies to the extent permitted by law; and b. will not be broader than that which you are required by the contract or agreement to provide for 8-1932 07 14 Page 6 of 12 such additional insured. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. 2. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires. 3. The most we will pay on behalf of the additional insured isthe amount of insurance required by the contract or agreement you have entered into with the additional insured or the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or Change Endorsement, whichever is less. These Limits of Insurance are inclusive and not in addition to the Limits of Insurance shown in the Declarations or Change Endorsement. E. Additional Insured Vendors - Automatic Status (not applicable to Employee Benefits Liability Coverage) Section II - Who Is An Insured is amended to include as an insured any person or organization (referred to below as vendor) when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy, but only with respect to "bodily injury" or "property damage" arising out of "your products' shown in the Schedule, Declarations or Change Endorsement which are distributed or sold in the regular course of the vendor's business. However, the insurance afforded to such additional insured described above: a. only applies to the extent permitted by law; and b. will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. With respect to the insurance afforded to these vendors, the following additional exclusions apply: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. An express warranty unauthorized by you; C. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; f. Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor; or h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: 1) The exceptions contained in Sub -paragraphs d. orf.; or 2) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. 3. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing such products. 4. The most we will pay on behalf of the vendor is the amount of insurance required by the contract or agreement you have entered into with the additional insured or the amount of insurance available under the applicable Limits of Insurance shown in the Declarations or Change Endorsement, whichever is less. These Limits of Insurance are inclusive and not in addition to the Limits of Insurance shown in the Declarations or Change Endorsement. F. Include Directors Or Trustees On Committees As Employees (not applicable to Employee Benefits Liability Coverage) 8-1932 07 14 Page 7 of 12 SECTION V - DEFINITIONS is amended by the addition of the following to definition 5.: "Employee" also includes any of your directors or trustees acting as a member of any of your elected or appointed committees to perform on your behalf specific, as distinguished from general, directorial acts. G. Waiver Of Transfer Of Rights Of Recovery Against Others To Us The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US, SECTION IV CONDITION 8., is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard." This waiver applies only to the person or organization which, before the loss, you have agreed in writing to waive your right of recovery. H. Newly Formed or Acquired Organizations (not applicable to Employee Benefits Liability Coverage) SECTION II - WHO IS AN INSURED is amended to include any organization you newly acquire or form, other than a partnership or joint venture, and over which you maintain ownership or majority interest, will qualify as a Named Insured if there is no other similar insurance available to that organization. However: 1. Coverage under this provision is afforded only until 180 days after you acquire or form theorganization or the end of the policy period, whichever is earlier. 2. Coverage A does not apply to "bodily injury" or "property damage" that occurred before you acquired or formed the organization; and 3. Coverage B does not apply to "personal injury and advertising injury" arising out of an offense committed before you acquired or formed the organization. Notice Of Occurrence, Knowledge of Occurrence, Unintentional Omission The following is added to SECTION IV.2. - DUTIES IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT: e. Notice of Accident/Occurrence When you report to your Workers Compensation carrier the occurrence of any accident which later develops into a liability claim covered under this policy, failure to report the accident to us at the time of occurrence is not in violation of the Conditions of this policy. However, as soon as you are definitely made aware of the fact that the particular accident is a liability claim rather than a Workers Compensation claim prompt notification must be given to us. Unintentional Errors and Omissions The insurance afforded by this policy is not invalidated by any unintentional errors, omissions or improper description of premises or your unintentional failure to disclose all hazards existing at inception date of the policy. g. Knowledge of Accident/Occurrence Knowledge of an accident/occurrence by your agent, servant or employee is not knowledge by you unless an executive officer of your Corporation received such notice from its agent, servant or employee. Voluntary Property Damage 1. We will pay, at your request, for loss due to "Property Damage" to property of others caused by you, or while in your possession, arising out of your business operations. 2. "Loss" means unintentional damage or destruction but does not include disappearance, theft, or loss of use. 3. Limits of Insurance - The most we will pay for "loss" under the Voluntary Property Damage is $2,500 for each "occurrence." The most we will pay for the sum of all damages because of "Property Damage" is an annual policy aggregate limit of $25,000. 4. Deductible - We will not pay for "loss" in any one "occurrence" until the amount of "loss" exceeds $250. We may pay any part or all of the deductible amount to effect settlement of any "claim" or "suit" and, upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as we have paid. 5. The insurance under the Voluntary Property Damage shall not apply: 8-1932 07 14 Page 8 of 12 a. To "loss' of property at premises owned, rented, leased, operated, or used by you; b. To "loss" of property while in transit; c. To "loss" of property owned by, rented to, leased to, borrowed by or used by you; d. To the cost of repairing or replacing (1) any work defectively or incorrectly done, (2) any product manufactured, sold or supplied by you, unless the "Property Damage' is caused directly by you after delivery of the product or completion of the work and resulting from a subsequent undertaking; e. To "loss" of property included within the "Products/Completed Operations Hazard"; f. To "loss" of property which is an "auto' or "mobile equipment." g. To "loss" of property caused by "pollutants." 6. In the event of "loss" covered by this endorsement, you shall, if requested by us, replace the property or furnish the labor and materials necessary for repairs thereto at your actual cost, excluding profit or overhead charges. K. Non -Owned Watercraft Liability and Non -Owned Aircraft Liability SECTION 1 - COVERAGE A, exclusion 2.g. is replaced by the following: g. 'Bodily injury" or 'property damage" arising out of the ownership, maintenance, use or entrustment to others of any aircraft, "auto' or watercraft owned or operated by or rented or loaned to any insured. Use includes operations and "loading or unloading." This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the "occurrence" which caused the 'bodily injury" or 'property damage' involved the ownership, maintenance, use or entrustment to others of any aircraft, "auto' or watercraft that is owned or operated by or rented or loaned to any insured. This exclusion does not apply to: 1) A watercraft while ashore on premises you own or rent; 2) A watercraft you do not own that is: a) Less than 60 feet long; and b) Not being used to carry persons or property for a charge; 3) Parking an "auto" on, or on the ways next to, premises you own or rent, provided that "auto" is not owned by or rented or loaned to you or the insured; 4) Liability assumed under any "insured contract' for the ownership, maintenance or use of aircraft or watercraft; or 5) "Bodily injury" or "property damage" arising out of: a) The operation of machinery or equipment that is attached to, or part of, a land vehicle that would qualify under the definition of "mobile equipment' if it were not subject to a compulsory or financial responsibility law or other motor vehicle insurance law where it is licensed or principally garaged; or b) The operation of any of the machinery or equipment listed in paragraph f.2) or 0) of the definition of "mobile equipment." L. Fire, Sprinkler Leakage Or Explosion 1. SECTION I -GENERAL LIABILITY COVERAGES is amended as follows: a. The last paragraph of 2. Exclusions under A. Bodily Injury and Property Damage Liability is replaced by the following: Exclusions c. through q. do not apply to damage by fire, sprinkler leakage or explosion to premises while rented to you or temporarily occupied by you with permission of the owner. - A separate limit of insurance applies to this coverage as described in Section III - Limits of Insurance. But the Limit for Damage to Premises Rented To You shown in the Declaration will apply to all damage proximately caused by the same event, whether such damage results from fire, sprinkler leakage or explosion or any combination of the three. b. Section III - Limits of Insurance is amended to replace paragraph 6. with the following: 6. Subject to Paragraph 5. above, the Damage To Premises Rented to You Limit is the most we will pay under Paragraph A. Bodily Injury And Property Damage Liability for damages 8-1932 07 14 Page 9 of 12 ' because of "property damage" to any one premises, while rented to you, or in the case of damage by fire, sprinkler leakage, or explosion, while rented to you or temporarily occupied by you with permission of the owner. But the Limit of Insurance shown in the Declaration will apply to all damage proximately caused by the same event whether such damage results from fire, sprinker leakage or explosion or any combination of the three. 2. The Damage to Premises Rented To You Limit is $300,000 unless a higher limit is shown on the declaration or change endorsement. 3. Paragraph 4.b. of the Other Insurance is amended as follows: The term "Fire" in Paragraph B. (1)(a)(i) is replaced by "Fire, Sprinkler Leakage, or Explosion" 4. Section 9.a. under SECTION V - DEFINITIONS is amended as follows: The term "fire" is replaced by "fire, sprinkler leakage, or explosion" M. Pollution Coverage For Upset of Mobile Equipment The Insuring Agreement for "property damage' liability with respect to your operations is extended as follows: 1. We will pay those sums which you become legally obligated to pay for "property damage" caused directly by immediate, abrupt and accidental upset, overturn or collision of your "mobile equipment' while transporting "pollutants" which are intended for and normally used in your operations. The operations must be in compliance with local, state, and federal ordinances and laws. 2. EXCLUSIONS a. With regard only to the coverage provided by this extension K., SECTION I -COVERAGES, COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. Exclusions, f. is deleted and replaced by the following for this extension only: f. Pollution Any loss, cost or expense arising out of any: 1) Request, demand, order or statutory or regulatory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of, "pollutants"; or 2) Claim or suit by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of "pollutants.' 3) Premises, site or location which is or was at any time owned, rented or loaned to any insured. Aggregate Limits Of Insurance (not applicable to Employee Benefits Liability Coverage) The General Aggregate Limit under SECTION III - LIMITS OF INSURANCE, Paragraph 2. applies separately to each of your "location(s)" owned by or rented to you or "project(s)" away from "location(s)" owned by or rented to you. "Location" and/or "project" means premises involving the same or connecting lots, or premises whose connection is interrupted only by a street, roadway, waterway or right-of-way of a railroad. O. Supplementary Payments - Higher Limits Under SECTION I - SUPPLEMENTARY PAYMENTS - COVERAGES A AND B: Paragraph 1.b. is replaced by the following: Up to $2000 for cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. Paragraph 1.d. is replaced by the following: All reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of the claim or "suit," including actual loss of earnings up to $400 a day because of time off from work. 8-1932 07 14 Page 10 of 12 P. Reasonable Force Expansion - Property Damage Exclusion 2.a. of Coverage A is replaced with the following: a. Expected Or Intended Injury "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. This exclusion does not apply to "bodily injury" or "property damage' resulting from the use of reasonable force to protect persons or property. Q. Lost Key Coverage 1. SECTION I - COVERAGES COVERAGE A. BODILY INJURY AND PROPERTY DAMAGE LIABILITY Exclusion 2.j.4) Personal property in the care, custody or control of the insured is amended to add: However, coverage for property of others in the care, custody or control of the insured is provided for the loss of keys which are in the possession of the insured or his "employees" subject to the following additional provisions: a. The insurance afforded with respect to Lost Key Coverage shall not apply to "property damage' caused by misappropriation, secretion, conversion, infidelity or any dishonest act on the part of any insured or his employees or agents; b. Our liability for all damages because of "property damage' to which this coverage applies shalbe limited to the actual cost of keys, adjustment of locks to accept new keys or, if required, new locks including cost of their installation. Subject to such limitation, our total liability for all damages as the result of any one occurrence shall not exceed $25,000. Each claim is subject to a $250 deductible. 2. SECTION II -WHO IS AN INSURED The following is added to item 2.a.2)b): However, coverage is provided for the loss of keys which are in the possession of the insured or his"employees," subject to the following additional provisions: a. The insurance afforded with respect to Lost Key Coverage shall not apply to "property damage' caused by misappropriation, secretion, conversion, infidelity or any dishonest act on the part of any insured or his "employees" or agents; b. Our liability for all damages because of "property damage" to which this coverage applies shall be limited to the actual cost of keys, adjustment of locks to accept new keys or, if required, new locks including cost of their installation. Subject to such limitation, our total liability for all damages as the result of any one occurrence shall not exceed $25,000. Each claim is subject to a $250 deductible. R. Personal and Advertising Injury Definition Under SECTION V — DEFINITIONS, 14.c. is replaced with the following: The wrongful eviction from, wrongful entry into, or invasion of the right of private occupancy of a room, dwelling or premises that a person or organization occupies, committed by or on behalf of its owner, landlord or lessor. S. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. OTHERINSURANCE: When this General Liability Plus endorsement provides coverage and such coverage is also provided by any other provision of this policy: a. There shall be no duplication of the Limits of Insurance. b. Any loss payment made under such other provisions shall reduce by such loss payments the Limits of Insurance available under the General Liability Plus endorsement. 8-1932 07 14 Page 11 of 12 SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended by adding: LIBERALIZATION If we adopt a change in our Comprehensive General Liability Coverage forms or rules that would broaden the coverage without extra charge, the broader coverage will apply to this Coverage Form. It will apply when the change becomes effective in your state. 8-1932 07 14 1 Page 12 of 12 U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM CONTRACTOR'S CERTIFICATION CONCERNING LABOR STANDARDS AND PREVAILING WAGE REQUIREMENTS TO (appropriate recipient) DATE 09/12/24 PROJECT NUMBER (if any) GLO C182 C/O PROJECT NAME LCB Playground Phase 2 1. The undersigned, having executed a contract with 2. for the construction of the above -identified project, acknowledges that: (a) The Labor Standards provisions are included in the aforesaid contract, (b) Correction of any infractions of the aforesaid conditions, including infractions by any subcontractors and any lower tier subcontractors, is Contractor's responsibility. (a) Neither Contractor nor any firm, partnership or association in which It has substantial interest is designated as an Ineligible contractor by the Comptroller General of the United States pursuant to Section 5.6(b) of the Regulations of the Secretary of Labor, Part 5 (29 CFR, Part 5) or pursuant to Section 3(a) of the Davis -Bacon Act, as amended. (b) No part of the aforementioned contract has been or will be subcontracted to any subcontractor if such subcontractor or any firm, corporation, partnership or association in which such subcontractor has a substantial interest is designated as an ineligible contractor pursuant to any of the aforementioned regulatory or statutory provisions. 3. Contractor agrees to obtain and forward to the aforementioned recipient within ten days after the execution of any subcontract, including those executed by subcontractors and any lower tier subcontractors, a Subcontractor's Certification Concerning Labor Standards and Prevailing Wage Requirements executed by the subcontractors. (a) The legal name and the business address of the undersigned are: fun abounds, Inc. 114 Venice Street Sugar Land, TX 77478 (1) A SINGLE PROPRIETORSHIP (3) A CORPORATION ORGANIZED IN THE STATE OF Texas (2) A PARTNERSHIP 1 (4) OTHER ORGANIZATION (Describe) (a) The names, addresses and trade classifications of all other building construction contractors in which the undersigned has a substantial Date 09/12/24 fun abounds, Inc. (Contractor) By CERTIFICATE OF INTERESTED PARTIES FORM 1295 1af1 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: 2024-1213477 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. fun abounds, Inc. Sugar Land, TX United States Date Filed: 09/12/2024 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. Calhoun County, Texas Date Ack owledged: �n v P©T►�2 a � 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, ana provide a description of the services, goods, or other property to be provided under the contract. 20-085-064-C182 Bid No. 2024.08 - Infrastructure at Little Chocolate Bayou County Park Playground Improvement Phase 2 Project 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Walden, Leigh Sugar Land, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is Ellie Mason and my date of birth is My address is MORROW TX USA (street) (city) (stale) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Fort Bend County, State of Texas on the 12 day of Septembe50 24 (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.48da51f7 SECTION 504 CERTIFICATION POLICY OF NONDISCRIMINATION ON THE BASIS OF DISABILITY The fun abounds, Inc. 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) fun abounds, Inc. (Address) 114 Venice Street Land, TX 77478 City State Zip Telephone Number ( 855) 226 - 8637 Voice ( ) _ TDD wawrl has been designated to coordinate compliance with the nondiscrimination requirements contained in the Department of Housing and Urban Development's (HUD) regulations implementing Section 504 (24 CFR Part 8. dated June 2, 1988). CHILD SUPPORT STATEMENT FOR NEGOTIATED CONTRACTS AND GRANTS Under Section 231.006, Family Code, the vendor or applicant certifies that the individual or business entity named in this contract, bid, or application is eligible to receive the specified grant, loan, or payment and acknowledges that this contract may be terminated and payment may be withheld if this certification is inaccurate. Section 231.006, Family Code, specifies that a child support obligor who is more than 30 days delinquent in paying child support and a business entity in which the obligor is a sole proprietor, partner, shareholder, or owner with an ownership interest of at least 25% is not eligible to receive payments from state funds under a contract to provide property, materials, or services; or receive a state -funded grant or loan. List below the name and ownership percentage of the individual or sole proprietor and each partner, shareholder, or owner with an ownership interest of at least 25% of the business entity submitting the bid or application. NAME OWNERSHIP BY Leigh Walden 100% A child support obligor or business entity ineligible to receive payments described above remains ineligible until all arrearage have been paid or the obligor is in compliance with a written repayment agreement or court order as to any existing delinquency. The undersigned proposer certifies that he or she, is the proposing individual, or the sole proprietor of the proposing business, and is eligible under Section 231.006 of the Texas Family Code, to receive the payments of State funds which may be disbursed in connection with a contract arising from this solicitation, The undersigned each further acknowledges that a contract resulting from this solicitation may be terminated and payment may be withheld if the certification provided herein is found to be inaccurate. Sig e — Company Official fun abounds, Inc. Printed/Type Firm Name Leigh Walden, President 09/12/24 Printed/Typed Name and Title Date DOCUMENT NO. 00417 TRENCH SAFETY SYSTEMS INDEMNITY AGREEMENT OWNER: Calhoun County CONTRACTOR: fun abounds. Inc. — Payton Palmer -Newton (company name) ENGINEER: G 8, W Engineers, Inc., Port Lavaca, Calhoun County, Texas PROJECT: Bid No. 2024.08 — Infrastructure at Little Chocolate Bayou County Park Playground Improvements Phase 2 Project — GLO Contract No. 20-066-064-C182 for Calhoun County, Texas CONTRACTOR has entered into a contract with OWNER for the construction of the Project. ENGINEER has designed the Project on behalf of OWNER, but has not designed any trench safety systems for the Project that may be required by applicable federal, state and/or local laws. CONTRACTOR, in its contract with OWNER, has agreed to prepare, and to conform all trenching work to plans for trench safety systems meeting the standards of applicable laws. CONTRACTOR, as part of its consideration to OWNER forthe contract forthe construction of the Project, agrees that it will be solely responsible for compliance with its trench safety plans and with all applicable standards of federal, state and/or local laws relating to trench safety. CONTRACTOR further agrees to hold harmless, indemnify, and defend OWNER and ENGINEER, and all officers, agents and employees of either OWNER or ENGINEER, from and against any and all claims, demands or causes of action of any nature, character or description in connection with the presence, or in any way arising out of, the use or construction of trenches or trench safety systems as part of the Project. EXECUTED, this day of fun aboun s, nc. — Payton Palmer -Newton B Officer's Name: Leigh Walden Title of Officer: President 20 Calhoun nty, Texas By: Officer's Name: Richard H. Meyer Title of Officer: Calhoun County Judge (Contractor's Seal) G&W Enginy rs, Inc. B j? e. E ' is Name: Scott P. Mason, P.E. itle of Engineer: Proiect Engineer NOTICE OE MEETING—10/16/2024 7. Consider and take necessary action to approve the Resolution Endorsing the Passage of Legislation to Amend Section 382.018 of the Texas Local Government Code. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct l SECONDER: - Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 13 Resolution Supporting a Bill to be Entitled AN ACT COMMISSIONER'S COURT OF CALHOUN COUNTY, TEXAS THE STATE OF TEXAS § COUNTY OF CALHOUN § Resolution Endorsing the Passage of Legislation to Amend Section 382.018 of the Texas Local Government Code WHEREAS, Section 382.018 of the Texas Local Government Code currently regulates outdoor burning in certain areas; and WHEREAS, during times of disaster, the ability to conduct controlled burns can be crucial for managing debris and preventing further hazards; and WHEREAS, the current requirement to obtain permission for a designated site during a disaster can delay necessary actions and exacerbate the situation; and WHEREAS, adding subsection "H" to Section 382.018 would allow for immediate and necessary burning activities during a disaster without the need for prior permission, thereby enhancing the safety and efficiency of disaster response efforts; NOW, THEREFORE, BE IT RESOLVED, that Calhoun County Commissioners' Court hereby endorses the passage of legislation to amend Section 382.018 of the Texas Local Government Code to include subsection "H", which would permit burning without requiring permission during a local state of disaster or a state of emergency that has been declared by the Governor or the President of the United States; BE IT FURTHER RESOLVED, that Calhoun County Commissioners' Court respectfully requests and appreciates that Representative J.M. Lozano introduce and support this legislation in the Texas Legislature. PASSED, ADOPTED AND APPROVED this 16th day of October, 2024. Richard H. Meyer, County Judge Attest: Anna Goodman, County Clerk By: Deputy Clerk 1 A BILL TO BE ENTITLED AN ACT 2 relating to the regulation by the Texas Commission on Environmental 3 Quality of certain outdoor burns conducted during a state of 4 disaster or state of emergency. 5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 6 SECTION 1. Section 382.018, Health and Safety Code, is 7 amended by adding Subsection (h) to read as follows: 8 (h) The commission may not require notification to or 9 authorization from a commission regional office as a prerequisite 10 for conducting a controlled outdoor burn of combustible plant 11 growth at designated site within each precinct in a county in which a 12 state of disaster or state of emergency has been declared by the 13 governor or the president of the United States' unless the 14 declaration expressly prohibits all outdoor burning 15 SECTION 2. This Act takes effect September 1, 2025. NOTICE OF MEETING -- 10/1.6%2024 8. Consider and take necessary action to approve the Professional Services Agreements for the County and District Clerk's for "IDocket.com Ruby Red Services" and allow the County and District Clerk to sign. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct2 SECONDER: Gary Reese,Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 13 County Clerk Anna M Goodman County of Calhoun October 9, 2024 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: AGENDA ITEM - "Professional Services Agreements" for County and District Clerks for "IDocket.com Ruby Red Services" Dear Judge Meyer: Please place the following item on the Commissioners' Court Agenda for October 16, 2024. • Allow the County Clerk and District Clerk to sign the "Professional Services Agreements for the IDocket.com Ruby Red Service" • Form 1295 is attached. Sincerely, 2� na M Anna Goodman County Clerk 211 South Ann Street, Suite 102, Port Lavaca, TX 77979 * Phone: 361-553-4416 * Email: anna.goodman@calhouncotx.org U:\AGoodman\AGENDA ITEMS\2024. I00924.PROFESSIONAL SERV AGREEMENT WITH IDOOKET.docx Professional Services Agreement Calhoun District Clerk— iDocket.com Ruby Red Service Parties - This agreement is between iDocket.com, hereinafter referred to as iDocket, a Texas S- Corp., whose offices are located at 447 Hickory, Hereford, Texas, 79045, and the County of Calhoun, Texas under the supervision of the Calhoun District Clerk, whose address is, 211 S. Ann St. Suite 203, Port Lavaca, Texas 77979 Services provided by iDocket A. Provide the software necessary to extract, filter, compress, and transfer, as designated by the County, information from the county's file and fee docket that is currently available for public inspection in the county's office, for placement on the Internet. B. Will provide and host the web site for the county's court information on the Internet. C. IDocket agrees that all information provided by the county for placement on the Internet is not subject to resell or distribution to any other party not used for any other purpose not stated within this agreement. D. Revenue Sharing - County shall receive 20% of subscription revenues from Users indicating Clerk's County as their primary county of interest. Payment shall be made monthly via ACH Deposit with notifications sent within sixty days of the month close date. A report listing quarterly subscription revenues for the County will be made available to the Clerk online. E. IDocket agrees to implement, support, and maintain the court information web site as stipulated in the agreement at no charge to the county. F. iDocket shall hold in trust for the county and shall not disclose to any nonparty to the agreement, any confidential information of the county. Confidential information is information that relates to the county's research, development, trade secrets or business affairs, but does not include information which is generally known or easily ascertainable by non-parties of ordinary skill in computer design and programming. G. Clerk has the discretion of using iDocket document image viewing capabilities whereby iDocket redacts documents selected for viewing after charging copy fees for the Clerk. Copy fees collected are paid to the Clerk on a regular basis. Quality of Services - IDocket will provide adequate Internet access to the information given by the county. Adequate Internet access is defined as providing public access to case information on the Internet for a minimum of five (5) days in any given week. Normal and acceptable access will allow for maintenance updates requiring periodic downtime. Termination of the Agreement - Either party may terminate this agreement without cause with ninety (90) days written notice to the address stated herein. Execution — IN WITNESS, thereof the CONTRACTOR (iDocket.com) and COUNTY (Calhoun) have hereunto affixed their hand and seal, by duly authorized representatives, and having caused these present to execute this contract agreement. Honorable Anna Kabela Calhoun District Clerk 10/16/2D zq- Date f Amelia Balderrama CEO, iDocket.com 10/08/2024 Date Professional Services Agreement Calhoun County Clerk- iDocket.com Ruby Red Service Parties - This agreement is between iDocket.com, hereinafter referred to as iDocket, a Texas S- Corp., whose offices are located at 447 Hickory, Hereford, Texas, 79045, and the County of Calhoun, Texas under the supervision of the Calhoun County Clerk, whose address is, 211 S. Ann St., Port Lavaca, Texas 77979. Services provided by iDocket A. Provide the software necessary to extract, filter, compress, and transfer, as designated by the County, information from the county's file and fee docket that is currently available for public inspection in the county's office, for placement on the Internet. B. Will provide and host the web site for the county's court information on the Internet. C. IDocket agrees that all information provided by the county for placement on the Internet is not subject to resell or distribution to any other party not used for any other purpose not stated within this agreement. D. Revenue Sharing - County shall receive 20% of subscription revenues from Users indicating Clerk's County as their primary county of interest. Payment shall be made monthly via ACH Deposit with notifications sent within sixty days of the month close date. A report listing quarterly subscription revenues for the County will be made available to the Clerk online. E. IDocket agrees to implement, support, and maintain the court information web site as stipulated in the agreement at no charge to the county. F. iDocket shall hold in trust for the county and shall not disclose to any nonparty to the agreement, any confidential information of the county. Confidential information is information that relates to the county's research, development, trade secrets or business affairs, but does not include information which is generally known or easily ascertainable by non-parties of ordinary skill in computer design and programming. G. Clerk has the discretion of using iDocket document image viewing capabilities whereby iDocket redacts documents selected for viewing after charging copy fees for the Clerk. Copy fees collected are paid to the Clerk on a regular basis. Quality of Services - IDocket will provide adequate Internet access to the information given by the county. Adequate Internet access is defined as providing public access to case information on the Internet for a minimum of five (5) days in any given week. Normal and acceptable access will allow for maintenance updates requiring periodic downtime. Termination of the Agreement - Either party may terminate this agreement without cause with ninety (90) days written notice to the address stated herein. Execution — IN WITNESS, thereof the CONTRACTOR (iDocket.com) and COUNTY (Calhoun) have hereunto affixed their hand and seal, by duly authorized representatives, and having caused these present to execute this contract agreement. Honorable Anne Goodman Amelia Balderrama Calhoun County Clerk CEO, iDocket.com 1p / �, 07 Date 10/08/2024 Date CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of l complete Nos. 1 -4 and 6 it there are interested parties. Complete Nos. 1, 2, 2, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2024-1207352 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Calhoun County Port Lavaca, TX United States Date Filed: 08/28/2024 2 Name of governmenta entity or state agency that is a panyto the contract for which the form is being filed. i0ockei Data Acknowledged: tin 3 Provide the Identification number used by the governmental entity or stale agency to track or identity the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2024 Ruby and Ruby Red Software 4 Name of Interested Party City, Slate, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Calhoun County Clerk Port Lavaca, TX United States X Calhoun District Clerk Port Lavaca, TX United States X 5 Check only If there is NO Interested Parry. ❑ 6 UNSWORN DECLARATION My name is Amelia Balderrama and my dale of birth is - My address is (shee) (city) (stole) (zip code, (country) I declare under penally of perjury that the foregoing is true and correct. Executed in United States Texas 6 Sept24 County, State or , on the _day of , 20 (month) (year) Signature of authori2ed agent of contracting business entity (Declarant) Forms provided by -Texas Ethics Commission evmv.elhics.state.tx.us Version V4.1.0.48da51f7 # 09 NOTICE OF MEETING - 10/1.6/2024 9. Consider and take necessary action to enter into negotiations with the lowest and best responsive bidder (Weaver and Jacobs Constructors) for the 2024.06 Memorial Medical Center HVAC & Roof Improvements for Calhoun County, Texas. (RHM) Scott Mason with G&W Engineers explained the negotiation, process. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER:: Gary Reese, Commissioner Pct 4 AYES:: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 6 of 13 NOTICE OF MEETING — 10/16/2024 10. Consider and take necessary action to accept G&W's recommendations for the second payment of $143,476.921 to Con -Metal Contractors, Inc. for the Recycle Waste Transfer Station Project. (VLL) Scott Mason with G&W Engineers explained the project should be completed by the first of the New Year. 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 13 Vern Lyssy Calhoun County Commissioner, Precinct #2 5812 FM 1090 Port Lavaca, TX 77979 October 10, 2024 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port -Lavaca, TX 77979 RE: AGENDA ITEM Dear Judge Meyer: SY nYC o/ r noGMrr or cn��oJj Please place the following item on the next Commissioners' Court Agenda (361) 552-9656 Fax (361) 553-6664 • Consider and take necessary action on to accept G&W's recommendations for the second payment of $143,476.921 to Con -Metal Contractors, Inc. for the Recycle Waste Transfer Station Project. Sincerely, V Lys VL/Ij �I11 uL� W 1�`2D, �i iAv 2 G&WENGINEERS, INC. 206 W. Live Oak • Port Lavaca, TX 77979 • p: (361 )552-4509 • f: (361 )552-4987 TBPE Firm Registration No. F04188 October 9, 2024 Commissioner Vern Lyssy Calhoun County Precinct No. 2 5812 FM 1090 Port Lavaca, Texas 77979 RE: RECOMMENDATION FOR PAYMENT NO.2 Recycle Waste Transfer Station Project Dear Honorable Judge & County Commissioners, We have reviewed Con -Metal Contractors, Inc.'s Invoice No. 26624-02 for the above referenced project and have enclosed Recommendation for Payment No. 2 for $143,476.92 for services between September 6, 2024 and October 3, 2024. The Contractor's Conditional Waiver and Release on Progress Payment is also enclosed. Please call if you have any questions. Sincerely, G & W Engineers, hic. Scott P. Mason, RE, cc: Con -Metal Contractors, Inc Demi Cabrera, Calhoun Couno, Assistant Auditor ,file 5310.023 Engineering Consulting Planning Surveying No. 2 RECOMMENDATION OF PAYMENT OWNER's Project No. ENGINEER'S Project No. 5310.023 Project BID NUMBER 2024.04 — RECYCLE WASTE TRANSFER STATION PROJECT CONTRACTOR CON -METAL CONTRACTORS, INC. Contact for Recycle Waste Transfer Station Project Contact Date March 27, 2024 Application Date October 3, 2024 Application Amount $143,476.92 Period Start Date September 6, 2024 Period Ending Date October 3, 2024 To COUNTY OF CALHOUN Owner Attached hereto is the CONTRACTOR's Application for Payment for Work accomplished under the Contact through the date indicated above. To the extent that we have been present on the project site as outlined in our Engineering Agreement, we believe that the Application meets the requirements of the Contact Documents and includes the CONTRACTOR's Certificate stating that all previous payments to him under the Contract have been applied by him, to discharge in full all of his obligations in connection with the Work covered by all prior Applications for Payments. In accordance with the Contact, the undersigned, subject to the limitation in the preceding paragraph, recommends payment to the CONTRACTOR of the amount due as shown below. G & W Engineers, Inc. Dated October 9 2024 BY Scott P. Mason, P.E.' Original Contract Price Net Change Orders ( ) Current Contract Price Work to be Done G & W ENGINEERS, INC. 205 W. Live Oak St. Port Lavaca, Texas 77979 (361) 552-4509 STATEMENT OF WORK $ 650,452.75 Work to Date $ 445,391.70 $ - Amount Retained $ (44,539.17) $ 650,452.75 Subtotal $ 400,852.53 $ 205,061.05 Previous Payments Recommended $ (257,375.61) Amount Due This Payment $ 143,476.92 RecPay No. 2 - Recycle Waste Tranarer Station INVOICE cmrtramnu Ina INVOICE #26624-02 BILL TO: Calhoun County DATE: 10/03/2024 211 South Ann Street, Third Floor, Ste 301 Port Lavaca, TX 77979 ATTN: Accounting Dept. Item Description of Work Quota unit Price Value Total QTY Total X10 From Previous Requestlng Total completed To Percent Balance to Retention This on,unit Date Thls Period Date Complete Finish Period Fumish all necessary equipment materiels, and 1 labor for mobillraHon, 1 LS $26,000.00 $26,000.00 95% 95% $ 20,800.00 $3,90D.00 $ 24,700.00 95% $1,300.00 $ 390.00 demobllications. barricades, and insurance. Finnish all necessary equipment materiels, and labor forthe Installation of the building foundation complete 2 In place. including select fill as designed and includes 1 LS $263,000.00 $263,000.00 70% 95% $ vo,100.00 $65,750.00 $ 249,850.00 95% $13,150.00 $ 6,575.00 incerpratial concrete push 118 and In eunn ance with the drawings and apac0lcatmns. Furnish all necessary equipment, materials, and Iahcr for the installation of the pre-engineered metal building, siding, gutter stall and mat 3 In accordance with the 1 LS $188,000.00 $188,000.00 40% 95% $ 75,200.00 $84,M.W $ 159,800.00 85% $28,200.00 $ 8,460.00 drawing and specifications. The Item Includes any englneedng wsVf.. to res.w. stamped Fil drawings from manufacturer INVOICE Famish all neeessary equipment, materiala, and Option labor for the installation of the $ 1) 8' Nick Wall concrete 3.470 SF $9.94 $34,491.80 1388 520 $5,168.80 $ 5,10.80 15% $29,323.00 $ 516.a8 pavement in accordance with - i,a drawings and specificati0n, Famish all necessary equipment. materials, and labor(., the Instillation of Me Option 2 8" thick limestone pavement (complete in piece and in final 17,160 SF $6.57 $112,741.20 0 0 $ $O.w $ 0% $112,741.20 $ poaiti0ed in ..roans. with the drawinga and specifications Furnish all necessary equipment, material, and labor Option 3 for Me inststores in he 24" HOFEance 77 LF $102.60 $7,900.20 38 38 $ 3,898.50 $0.00 $ 3,898.50 49% $4,001.70 $ with aorpeciewions tlrevngs the and specifications Famish all nemeses, equipment. materials, and O4 4 ofthe labmfar the lnsta pip. in 15'rdance HDPE mm pip ea 7] LF $51.95 $4.000.15 38 38 $ 1,974.10 $OAO $ 1,974.10 49% $2,026.05 _$ accordance with the drawings and specifications Famish all swans, equipment, materials, and Option labmforiha installaton ofthe $ $ $ 5 Veatm.ntm 2 EA $2,687.50 $5.375.00 0 0 $0.00 0% $5,375.00 ltssfofrmpend in accordance with the ,ings and apa.irk.fi n. Fumish ell necessary egalpmenl material., and Option labor for the Installation of the $ $ $ 6 pre -coat safety and treatments 2 EA $2,322.50 $4,645.00 0 0 $OAO 0% $4,645.00 for 24" at.. pipes In - cortlanct, aM the tlrewings and specifications Fumish all necessary equipment, materials, and Option labor for the installaton of the LF $11.62 $4,299.40 0 7 dednage.wale. in 370 0 _$ wrdence with the tlrewings and specikartions 2 1 P a Fumisb all necessary equipment, materlale, and laborrar the inslellation or fhe general fill material and site Option grading In accmdance with LS $ a the drawings and sgecglwtions. Useh.uae or revmm.led snsite materials foundation a Vafioo accepteble. IIW'c?lCE Less getainage Total I $143,476.92 3 1 P a ec THE STATE OF TEXAS COUNTY OF CALHOUN Project: BID NUMBER 2024.04 - RECYCLE WASTE TRANSFER STATION FOR CALHOUN COUNTY, TEXAS Job No. 5310.023 On receipt by the signer ofthis document o a check from CALHOUN COUNTY (makers f check) in the sum of $ �i3� t i r/(p� �a payable to CON -METAL CONTRACTORS, INC. (payee or payees (?f 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 ofCALHOUN COUNTY (owner) located at 900 Landfill Road, Port Lavaca, Texas to the following extent: BID NUMBER 2024.04 - RECYCLE WASTE TRANSFER STATION FOR CALHOUN COUNTY, TEXAS (job (Iescrir)tron). 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 CON -METAL CONTRACTORS, INC (CONTRACTOR'S NAME) SUBSCRIBED AND SWORN TO BEFORE ME by n O1l L C &p , , 202A-, to celti which witness my hand - i seal ofot3ice DDA NERNANDEZ Notary ID soon Expires '7, t My Commission o. July 77, zozb Notary Public, State of us 01025-3 NOTICE OF MEET ING — 10/16/2024 11. Consider and take necessary action to update/revise the Calhoun County Job Description for "Assistant Director of EMS/Training Coordinator". (RHM) RESULT: 'APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Joel Behrens, Commissioner Pct 4 AYES:: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 8 of 13 Calhoun County Job Description ASSISTANT DIRECTOR OF EMSITRAINING COORDINATOR CLASS NO. 13502 PAY GROUP: 27 SUMMARY OF POSITION EEOC CATEGORY: Officials and Managers FLSA STATUS: Exempt Supervises, evaluates and/or assigns duties to EMS Field Supervisors and other EMS personnel; oversees quality of EMS service and monitors all provider licensure functions; educates all EMS personnel in policies and procedures; assumes Director's duties in his or her absence. ORGANIZATIONAL RELATIONSHIPS 1. Reports to: Director of EMS. 2. Directs: Paramedic Field Supervisors and Crew Chiefs, Licensed Paramedics, Paramedics, EMT — Intermediates, EMTs, and Administrative Assistant. 3. Other: Has frequent contact with other emergency agencies, other department employees, county officials, and the general public. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Supervises, evaluates, and/or assigns duties to Paramedic Training Coordinator, Paramedic Supervisors and Crew Chiefs, Licensed Paramedics, Paramedics, EMT — hntermediates, EMTs, and Administrative Assistant; Directs daily activities of EMS employees and assists with various duties, including responding to calls when necessary; Performs various Human Resources functions; Oversees all provider licensure functions such as creating staffing plans, implementing quality improvement initiatives, and revising protocols and policy manuals; Drafts and educates EMS personnel in policies and procedures; Ensures that all personnel pass Texas Department of Health (TDH) inspections and comply with standards and regulations; Serves as EMS system representative to TDH, local healthcare providers, EMS departments, and other organizations; Reviews billing reports and audits; Coordinates monthly and annual emergency preparedness drills; Conducts reviews of EMS system databases for completeness and accuracy, validates and approves records; Calhoun County Job Description Page 1 CLASS NO. 13502 (Continued) Responds to written and oral inquires, including EMS Medical Record requests from various agencies and individuals; Acts as Public Information Officer for the department; Orders uniforms and other supplies; and Performs duties of Director of EMS in his or her absence. Coordinates and conducts continuing education classes for all EMS personnel; Maintains records of education classes and training; Ensures that all personnel are current with training and licenses; Maintains knowledge of new EMS technology and training; Provides community forum on EMS operations and education; Participates in community and school programs and functions; Provides medical coverage for special athletic and community events; Researches, purchases, and repairs EMS equipment as needed; Drafts correspondence and continuing education materials; Monitors inventory levels of narcotics, medicines, and supplies, and orders items as needed; and Oversees and/or Performs other administrative and clerical tasks. Protects the privacy of all patient information in accordance with the County's privacy policies, procedures, and practices and as required by HIPAA; Accesses protected health information and other patient information only to the extent necessary to complete the duties of this job, sharing information only with those persons who have a need to know to complete their job responsibilities relating to treatment, payment, or other related county operations; Reports any concerns regarding the county's policies and procedures on patient privacy, as well as any observed practices in violation of that policy, to the designated Privacy Officer; Actively participates in the county's privacy training and communicates privacy policy information to coworkers, students, patients, and others in accordance with the county's policies. Acts as Privacy Officer for the department, including: Prepares for, and conducts, employee training on Public Health Information (PHI) and confidentiality; Maintains password security and patient data integrity; Defines crew access to PHI and minimum necessary requirement for employees; Calhoun County Job Description Page 2 CLASS NO. 13502 (Continued) Serves as contact person for the dissemination of PHI to other health care providers; Addresses patient complaints and requests; Processes patient requests for access to, and amendment of, health information and consent forms; Processes all patient accounting requests; Ensures the capture and storage of patient PHI for six years; and Ensures ambulance service compliance with all applicable Privacy Rule requirements. OTHER DUTIES AND RESPONSIBILITIES. Performs such other related duties as may be assigned. REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES Knowledge of paramedic and first -responder protocols, policies, and procedures; incident command system and County Emergency Management Plan; Advanced Cardiac Life Support and Basic Trauma Life Support; standard office practices; and personnel policies and procedures. Skill/Ability to: supervise effectively; operate a computer, including word processing, spreadsheet, and database software; operate ambulance and other rescue vehicles; correctly use and read emergency medical instruments; communicate effectively, both orally and in writing; establish and maintain effective working relationships with co-workers and the general public; and remain calm and act decisively in highly stressful situations. ACCEPTABLE EXPERIENCE AND TRAINING At least four years of experience as an EMS Director or Assistant EMS Director; or a Licensed Paramedic with at least 4 years of experience as an EMS Field Supervisor. CERTIFICATES AND LICENSES REQUIRED Paramedic license from the Texas Department of Health and appropriate Texas driver's license. SIGNATURES Employee's Signature Date Supervisor's Signature Date Calhoun County, Texas is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, Calhoun County will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with employer. Calhoun County Job Description Page 3 CLASS NO. 13502 (Continued) ADA Information This attachment provides information on the job relating to the Americans with Disabilities Act. FREQUENCY DEFINITIONS The following frequency definitions are to be used in completing the Physical Environment and the Non -Physical Environment sections of this form: C = Constantly (2/3 or more of the time) F = Frequently (from 1/3 to 2/3 of the time) O = Occasionally (up to 1/3 of the time) R = Rarely (less than one hour per week) N = Not Applicable (does not apply in this job) PHYSICAL ENVIRONMENT Descriptive examples of physical job actions (please use the letter corresponding to the appropriate frequency): Requirement Frequency Example Lifting: 250-300 lbs. (with a partner) F Patients from ground, bed, cars Sitting: F Office work, driving Standing: F On scene, sometimes extended standby times Walking, on normal, flat surfaces: F Moving patients Walking, on uneven surfaces: O Moving patients from ditches, plowed fields, piers, etc. Walking, on slippery surfaces: F Muddy fields and wet roadways Driving: C Emergency and Non -emergency Bending (from waist): O Treating and rescuing patients Crouching/Squatting: F Treating and rescuing patients Kneeling: F Treating and rescuing patients Crawling: O Treating and rescuing patients Twisting: O Treating and rescuing patients Reaching: O Treating and rescuing patients Balancing: O Treating and rescuing patients Carrying: F I Treating and rescuing patients Pushing: O Treating and rescuing patients Pulling: O Treating and rescuing patients Throwing: O Treating and rescuing patients Repetitive Motion: F Treating and rescuing patients, office work Fingering (fine dexterity, picking, pinching): C Treating and rescuing patients, office work Handling (seizing, holding, grasping): C Treating and rescuing patients Wrist Motions (repetitive flexion/rotation): C Treating and rescuing patients, office work Feet (foot pedals): F Driving Calhoun County Job Description Page 4 CLASS NO. 13502 (Continued) SENSORY REQUIREMENTS Descriptive examples of sensory demands (please use the letter corresponding to the appropriate frequency): Sensory Demand Frequency Color (perceive/discriminate) C Sound (perceive/discriminate) C Taste (perceive/discriminate) R Odor (perceive/discriminate) F Depth (perceive/discriminate) C Texture (perceive/discriminate) C Visual (perceive/discriminate) C Oral Communications ability C NON-PHYSICAL ENVIRONMENT Descriptive examples of non-physical demands (please use the letter corresponding to the appropriate frequency): Non -Physical Demand Frequency Time Pressures (e.g., meeting deadlines) C Noisy/Distracting Environment F Performing Multiple Tasks Simultaneously C Danger/Physical Abuse F Deals With Difficult People C Periods of Idle time, Interspersed with Emergencies Requiring Intense Concentration C Emergency Situations C Tedious, Exacting Work C Works Closely with Others as Part of a Team C Works Alone F Irregular Schedule/Overtime C Frequent Change of Tasks C Other (describe) O WORK ENVIRONMENT 1. Please describe the degree of physical activity and effort required to perform your job, as well as any associated safety hazards and the level of risk of personal injury or illness (if any): Must be able to lift and carry patients of all sizes. Must be able to reach patients in various situations by any physical means necessary (walking, running, climbing, crawling, etc.). 2. Please list your job exposure to environmental factors (if any), including extreme temperatures, respiratory hazards, airborne diseases, vibrations, loud noises, or other sources of discomfort: May exposed to infectious diseases, hazardous chemicals, and other dangerous substances. May encounter environmental extremes, violent individuals, and numerous other hazards. Calhoun County Job Description Page 5 #12 NOTICE OF MEEFINC — 10/11/2024 12. Consider and take necessary action to approve the preliminary plat of the Desilos Subdivision situated in the William Arnold Survey, Abstract No. 2, Calhoun County, TX (re - plat of farm tracts 9-16 in Lot 6 of Section 10 of the J.D. Mitchell Wolf Point Ranch Subdivision as recorded in Volume 5. Page 417 of the Calhoun County Deed Records). (JMB) Henry Danysh explained preliminary plat. RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 SECONDER: Gary Reese, Commissioner Pct 4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese' Page 9 of 13 Joel Behrens Calhoun County Commissioner, Precinct 3 24627 State Hwy. 172—Olivia, Port Lavaca, Texas 77979 — Office (361) 893-5346 — Fax (361) 893-5309 Email:. ioel.behrensCncalhouncotx.o 0 Honorable Richard Meyer Calhoun County Judge 211 S. Ann Port Lavaca, TX 77979 RE: Agenda Item Dear Judge Meyer: Please place the following item on the Commissioner's Court Agenda for October 16, 2024 Consider and take necessary action to approve the preliminary plat of the Desilos Subdivision situated in the William Arnold Survey, Abstract No. 2, Calhoun County, TX (re -plat of farm tracts 9-16 in Lot 6 of Section 10 of the J.D. Mitchell Wolf Point Ranch Subdivision as recorded in Volume 5. Page 417 of the Calhoun County Deed Records). Sincerely, Joel Behrens Commissioner Pet. 3 DESILOS SUBDIVISION 40.00 ACRC SUBDIVISION REPIAT OF FARM TRACTS 0 THEORIES 10 IN LOT 0 OF SECTION 10 OF J. O. NITCORRL SEEM OF NOW POINT COUNTY 9OAO NO. 316 RANCH RECORDED IN YOI,VI18 O. PARR 411 OP CAUIOON COUNTY. TEXAS. "^ WILLIAM ARBOw SURVEY, AOSJ'RACT N0, 0, CAIJIOON COUNTY, TEEAS MN 1 J.EO Pn9 MT 0 P.00 AEw xnryrt♦ �] u C.CE ACan9 � rrvwtr yy 40t----9.VPAOPtl9-- r,vlun• i .1 QAE ACNEW ru wrr W IaT A P.00 AEA. --•-••••-•- IATT ••-- C.AE ACPnn RwCR Y r.a.Nf SwcN a .. r..r,.wr AEPna F I us pd:uvlxl ]nNl l:ol O MII:IfMMO rM Nfl rIXI�M[ N:C I:.tIP M xlMn Oa Pllull CM ,Q 9A0 AEatl .,ate r y .��. wm n A r,vnl Aunx. aonrvnn '_ e mr la � .EO Aenw °i , auusr. nArz Iar m ].0E new .,--�_ '"""'4 ��Clk'9�12IP` �.re.�•••••••• wrM e,00 noes. o..rw, 9 wr lA ,a. oaf e.w nave �� --COUNTY 'TICK NO. 305—' GRAPHIC SCALE G & W ENGINEERS, INC. _ q M u • —... 0�8� }� .uK aA Jma pt roar,A9AgRMe mae IN.n. emn -"- � (NII W1-IJE4:IIMr IPaV.� �(EJeI Ji>-IIW: EAV alY DESIGNATION OF AGENT G & W Engineers, Inc. 205 W. Live Oak Port Lavaca, Texas 77979 (361) 552-4509 PROJECT: REPLAT FARM TRACTS 9 THROUGH 16 IN LOT 6 OF SECTION 10 OF THE J. D. MITCHELL WOLF POINT RANCH SUBDIVISION RECORDED IN VOLUME 5, PAGE 417 OF THE CALHOUN COUNTY DEED RECORDS. PROPERTY ADDRESS: County Road No. 315, Port Lavaca, Texas LEGAL DESCRIPTION: Farm Tracts 9 through 16 in Lot 6 of Section 10 of the J. D. Mitchell Wolf Point Ranch Subdivision recorded in Volume 5, Page 417 of the Calhoun County Deed Records. This form designates G & W Engineers, Inc. as mylour duly designated agent, to act on mylour behalf in matters concerning Calhoun County's review process for platting and variance(s) for the property described above. OWNER: In Date lz� Before me, the undersigned authority, on this day personally appeared Cesar Ivan Luna known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to me that that such person executed the same for the purpose and considerations therein stated. Sworn to and Subscribed before me this � �'L day of 4 /// }Notary Public, State ofTexas ��`-- County, Texas m;,..Y l' Comm. Expim 01-25.2027 �': mNotary ID 1129420.8 I, the undersigned Agent, understand and accept by authority and responsibility to act as the legally authorized Agent on behalf of the Owner(s) of the property described above, in matters concerning this prop rty. Age s Signature Date #13 NOTICE OF MEETING - 10/1.6/2024 13. Consider and take necessary action to authorize Commissioner Reese to utilize $31,158.20 in COMESA funds to repair pavilion at King Fisher Beach Park in Port O'Connor, Texas. (GDR) RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Joel Behrens, Commissioner Pct 3 AYES:' Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 10 of 13 Gary D. Reese County Commissioner County of Calhoun Precinct 4 October 10, 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 October 16, 2024. • Consider and take necessary action to authorize Commissioner Reese to utilize $31,158.20 in GOMESA funds to repair pavilion at King Fisher Beach Park in Port O'Connor, Texas. SFin elyy, 1� Gary D. Reese GDR/at P.O. Box 177 — Seadrift. Texas 77983 —email: earv.reese(rlcalhouncotx.ore — (361) 785-3141 —Fax (361) 785.5602 Air JAG Metals LLC P.O. Box 969 Weatherford, TX 76086 United States Bill To Terms Due on receipt Ship To Po # Sales Rep POC Grant R Smalley Line # Pieces Description �ft)ngth (In hgth weight Price Each Quote QU023250 9/11/2024 Victoria Amount 1 JAG Metals LLC P.O. Box 969 Weatherford, TX 76086 United States Bill To Terms Due on receipt Ship To Po # Sales Rep POC Grant R Smalley Line # Pieces Description �ft)ngth (In hgth weight Price Each Quote QU023250 9/11/2024 Victoria Amount 1 72 Misc. Red Iron 27 0 0.00 $2.92 $5,676.48 8"x2-1/2" 14ga. DOMESTIC ZEE GALVANIZED (WITH HOLES) 2 8 Misc. Red Iron 25 0 0.00 $3.76 $752.00 8"x5" x 3-3/8" 14ga. DOMESTIC EAVE GALVANIZED 2112 LOWSIDE/DOUBLE SLOPE 3 8 Misc. Red Iron 17 0 0.00 $2.92 $397,12 S"x2-1/2" 14a. DOMESTIC CIE GALVANIZED 4 1 Misc. Retail 0 0 0.00 $570.00 $570.00 5/16" GALVANIZED CABLE 200' 5 8 Misc. Retail 0 0 0.00 $31.28 $250.24 1/2" EYEBOLTS W/ WASHER AND NUT 6 8 Misc. Retail 0 0 0.00 $2.80 $22.40 HILLSIDE WASHER 7 8 Misc. Retail 0 0 0.00 $34.00 $272.00 5/16" CABLE GRIPS 8 67 PER Panel Hawaiian 2 0 357.78 $2.50 $335.00 Blue 9 15 Head Trim Hawaiian 20 0 113.99 $1.08 $324.00 Blue 10 4 Outside Corner 2 0 7.09 $2.52 $20.16 Hawaiian Blue 11 67 PER Panel Galvalume 25 0 4472.25 $1.80 $3,015.00 12 67 PBR Peak Sheet 0 0 0.00 $15.00 $1,005.00 Hawaiian Blue 2:12 Pitch 13 40 Tacky Tape, 1 " x 3/32" 0 0 0.00 $7.47 $298.80 x 4 - 14 500 7/8" Lap ZXL Hawaiian 0 0 3.00 $0.20 $100.00 Blue II III IIIII IIIIIIIII III IIII II III 00023250 1 of 2 In M�111_1 JAG Metals LLC P.O. Box 969 Weatherford, TX 76086 United States Line # Pieces Description Length Le dt)th Weight Price Each Quote QU023250 9/11/2024 Victoria Amount 15 2,000 1-1/4"ZXL Steel 0 0 12.00 $0.21 $420.00 Galvalume 16 1,000 7/8" Lap ZXL 0 0 6.00 $0.20 $200.00 Galvalume Total Weight: 4972.11696 lbs Subtotal $13,658.20 PICKUP OF PANELS & TRIM IS TO OCCUR WITHIN 7 DAYS UPON COMPLETION, Tax Total (0%) $0.00 AFTER 7 DAYS, THERE WILL BE A $15 PER DAY STORAGE FEE AND WE WILL NO LONGER BE RESPONSIBLE FOR ANY DAMAGES TO YOUR PRODUCTS, RED IRON NEEDS TO BE PICKED UP WITHIN 5 DAYS. ANY MATERIALS AFTER THIS PERIOD WILL BE RETURNED TO INVENTORY. ANY DAMAGE, SHORTAGE OR OTHER DISCREPANCIES MUST BE REPORTED Total $13,658.20 WITHIN 7 DAYS OF PICKUP OR DELIVERY. THERE WILL BE A25% RESTOCKING FEE ON RETURNED RED IRON/INVENTORY STOCK ITEMS. NO RETURNS AFTER 30 DAYS. WE ACCEPT CARD PAYMENTS WITH A 4% FEE, CHECKS, AND CASH. Phone# E-mail Website 817-599-5241 arant@io(imetalslic.com www,jagmetaislic.com 11111111111111111111111111111111 2of2 00023250 ESTIMATE Maverick Metal Buildings 3005 F tvlocktn gbinl Ln Victoria, fX 77g04 Bill to Mike Chamber Of Commerce reynoltl64;naverirkmetalhuiklings.co �r4AV 1ER I C K In METAL BUILDINGS ,1 (361) 935-02'10 h ttp://vnvw. m avenrkm etalbu ildin gS. coin Estimate details Estimate no.: 1057 Estimate date: 09/03/2024 IT Date Product or service 1. 2. DEMO 3. Labor 4. Builders Fee 5. Thank You Ship to Mike Chamber Of Commerce Description Pavilion Refurbishing Remove all materials from existing structure and dispose of. Framing will be only thing remaining. Install new 8" galvanized purlins for roof panels and outside skirtings. Existing gutter Will be used unless needs replacingor leaving off. Long life screws will he used. CUSTOMER to supply materials oneded. Feel free to contact Reynold Canclwle at Maverick Metal Buildings - 361-935-0210 with any questions or concerns. We look forward to working with you on your amazing project and thank you again for considering US to build a relationship with. Qty Rate Amount 1 50.00 $0.00 1 $0.00 S0.00 1 $17,500.00 S17.500.00 1 S0.00 S0A0 Total $17,500.00 Accepted date Accepted by #14 NOTICE Of MEETING — I.O/1(>/2024 14. Accept Monthly Reports from the following County Offices: a) Justice of the Peace Pct 3 — September, 2024 b) County Clerk — September, 2024 c) District Clerk — September, 2024 RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: Gary Reese, Commissioner Pct4 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 11 of 13 CALHOUN COUNTY CLERK MONTHLY REPORT RECAPITUATION SEPTEMBER 2024 OFFICIAL PUBLIC. BBC GLCODE CIVIL/FAMILY CRIMINAL RECORDS PROBATE TOTAL DISTRICT ATTORNEY FEES 100044020 $ 116.02 $ 116.02 BEER LICENSE 1000-42010 $ 15.00 $ 15.00 COUNTY CLERK FEES 1000-44030 $ 126.00 $ 232.05 $ 10,410.10 $ 191.00 $ 10,959.15 APPEAL FROM IF COURTS 1000-44030 $ - $ - COUNTY COURT ATIAWNiJURY FEE 1000-44140 $ - JURY FEE 100044140 $ - $ - $ - ELECFRONIC FILING FEES FOR E-FILINGS 1000-44058 $ - $ - $ - $ - $ - JUDGE'S EDUCATION FEE 1000-44160 $ - $ - $ - $ 5.00 $ 5.00 JUDGE'S ORDER/SIGNATURE 1000-44180 $ 16.00 $ - $ - $ 32.00 $ 48.00 SHERIFF'S FEES 100DA4190 $ 75.00 $ 99.56 $ - $ 25.00 $ 199.56 VISUAL RECORDER FEE 1000-44250 $ 30.00 $ 30.00 TIME PAYMENT'FEE. COUNTY--NEW2020" 1000-44332 $ 60.00 $ 60.00 COURT REFPORTER FEE lODO-44270 $ 50.00 $ - $ - $ 25.00 $ 75.00 RESTITUTION DO E TO OTH ERS 1000-49020 $ - ATTORN EY FEES - COURT APPOINTED 1000-49030 $ - $ - APPELLATE FUND(TGC)FEE 2620-44030 $ 10.00 $ 5.00 $ 15.00 COURT FACILITYFEE FUND 2648-44030 $ 40.00 $ - $ - $ 20.00 $ 60.00 TECHNOLOGY FUND 2663-44030 $ 23.20 $ 23.20 COUNTYIURYFUND •-NEW2020-- 2669-44030 $ 20.00 $ 5.80 $ - $ 10.00 $ 35.80 COURTHOUSE SECURITY FEE 2670-44030 $ 40.00 $ 58.01 $ - $ 20.00 $ 118.01 COURT INITIATED GUARDIANSHIP FEE 2672-44030 $ 30.00 $ 30.00 COURT RECORD PRESERVATION FUND 2673-44030 $ - $ - $ - $ - COURTREPORTERSERVICEFUND--NEW2020-- 2674-44030 $ 17.40 $ 17.40 RECORDS ARCHIVE FEE 2675-44030 $ 3,340.00 $ 3,340.00 COUNTYSPECIALTYCOURT--NEW2020" 2676.44030 $ 116.02 $ 116.02 COUNTYDISPUTE RESOLUTION FUND 2677-44030 $ 30.00 $ - $ - $ 15.00 $ 45.00 DRUG& ALCOHOL COURT PROGRAM 2698-44030-005 $ - $ - JUVENILE CASE MANAGER FUND 2699-44033 $ - $ - FAMILY PROTECTION FUND 2706-44030 $ - $ - JUVENILE CRIME & DELINQUENCY FUND 2715-44030 $0.00 $ - LANGUAGEACCESSFUND 2725-44030 $ 6.00 $ - $ - $ 3.00 $ 9.00 PRE-TRIAL DIVERSON AGREEMENT 272944034 $ - $ - LAW LIBARY FEE 273144030 $ 70.00 $ 35.00 $ 105.00 RECORDS MANAGEMENT FEE -COUNTYCLERKK 2738-44380 $ - $ 3,410.00 $ 3,410.00 RECORDS MANGEMENT FEE - COUNTY 2739-44030 $ 60.00 $ 145.03 $ 15.00 $ 220.03 FINES -COUNTY COURT 2740-45040 $ 2,261.76 $ 2,261.76 BOND FORFEITURE 2740-45050 $ - $ - STATE POLICE OFFICER FEES - STATE (DPS)(20%) 7020-20740 $ 0.12 $ OA2 CONSOU DATED COO RT COSTS - COUNTY 7070-20610 $ - $ - CONSOUDATED COO RTCOSTS -STATE 7070-20740 $ - $ - CONSOLIDATED COURT COSTS -COUNTY "NEW20207072-20610 $ 79.44 $ 79.44 CONSOLIDATED COURTCOSTS -STATE --NEW2020--7072-20740 $ 714.98 $ 714.98 JUDICIAL AND COURT PERSONNEL TRAINING -ST (1005',7502-20740 $ - $ - $ - $ - DRUG& ALCOHOL COURT PROGRAM -COUNTY 7390-20610 $ - $ - DRUG& ALCOHOL COURT PROGRAM -STATE 7390-20740 $ - $ - STATEELECFRONICFILINGFEE -CIVIL 7403-22887 $ - $ - $ - $ - STATEELECTRONICFILINGFEECRIMINAL 7403-22990 $ - $ - EMS TRAUMA -COUNTY (10%) 7405-20610 $ 342.67 $ 342.67 EMS TRAUMA -STATE (90%) 7405-20740 $ 38.07 $ 38.07 CIVIL INDIGENT FEE -COUNTY 7480-20610 $ - $ - $ - CIVIL INDIGENT FEE -STATE 7480-20740 $ - $ - $ - JUOICIALFUNDCOURTCOSTS 7495-20740 $ - $ - JUDICIAL SALARY FUND - COUNTY (10%) 750S-20610 $ - $ - JUDICIALSALARYFUND -STATE (90%) 7505-20740 $ - $ - JUDICIAL SALARY FUND (CIVIL&PROBATE) -STATE 75OS-20740-DOS $ - $ - $ - TRAFFIC LOCAL (ADMINISTRATIVE FEES) 7538-22884,1000-44359 $ 0.44 $ 0.44 COURT COST APPEAL OF TRAFFIC REG)1P APPEAL) 7538-22885 $ - BIRTH -STATE 7855-20780 $ 185.40 $ 185.40 INFORMAL MARRIAGES -STATE 7855-20792 $ - $ - JUOICIALFEE 7855-20786 $ - $ - $ - $ - FORMAL MARRIAGES -STATE 7855-20788 $ 300.00 $ 300.00 NONDISCLOSURE FEE - STATE 7855-2079D $ - $ - $ - $ - $ - TCLEOSECOURT COST -COUNTY (10%) 7856-20610 $ - $ - TCLEOSECOURT COST - STATE (90%) 7856-20740 $ - $ - JURYREIMBURSEMENTFEE -COUNTY (10% 7857-20610 $ - $ - JURY REIMBURSEMENT FEE -STATE (90%) 7857-20740 $ - $ - CONSOLIDATED CRT COSTS - STATE (PA, FAM, CV) SB417858-20740 $ 137.00 $ - $ 137.00 STATE TRAFFIC FI N E -COU NTY(5%) 7860-20610 $ - $ - STATE TRAFFIC FINE- STATE (95%) 7860-20740 $ - $ - STATE TRAFFIC FINE - COUNTY (496) 91112019 7860-20610 $ 0.30 $ 0.30 STATE TRAFFIC FINE- STATE(96%) 91112029 7860-20740 $ 7.12 $ 7.12 1 OF N.W REPORT&MONTRL'MU9ROR AND TREASURER REPORTD2024093024.TREAEURER REPORTS 1M1.24 CALHOUN COUNTY CLERK MONTHLY REPORT RECAPITUATION SEPTEMBER 2024 OFFICIAL PUBLIC DESC GLCODE CIVIL/FAMILY CRIMINAL RECORDS PROBATE TOTAL INDIGENT DEFENSE FEE -CRIMINAL - COUNTY (IO%) 7865-20610 $ - $ - INDIG ENT 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 TOAPPEAR -STATE 7970-20740 $ - DUEPORTLAVACAPD 9990-99991 $. - $. DUE SEADRIFT PD 9990-99992 $ - $ - DUE TOPOINT COMFORT PD 999099993 $ - $ - DUE TOTEXAS PARKS & WILDLIFE .. 9990-99994. $ $. - DUE TOTEXAS PARKS& WILDLIFE WATER SAFETY 999099995 $ - DUETOTABC 999099996 $ - DUE TOATTORNEY ADLITEMS 9990-99997 $ - DUE TOOPERATING/NSF CHARGES/DUE TO OTHERS 712020759.E $ 500.00 $ $ 892.00 $ 500.00 $ 1.892.00 $ 1,180.00 $ 4,348.00 $ 18,552.50 $ 931.00 $ 25,011.50 TOTAL FUNDS COLLECTED $ 25,011.50 - FUNDS HELD INESCROW: $ - AMOUNT DUE TO TREASURER(2DR'S): I$ 23,119.50 TOTAL RECEIPTS: F$ 25,011.501 AMOUNT DUE TO OTHERS (LESS SF'S): $ 1,892.00 FUND RECEIVED DISBURSEMENTS ENDING BOOK BALANCE ENDING BANK BALANCE OUTSTANDING DEPOSITS" OUTSTANDING CHECKS" OF DEPOSIT $ 68808.62I $ 3:000.00 -BALANCE OF CASH BONDS^ 57.808.62 I "OTHER REGISTRY ITEMS" 'IBC CASH BOND CHECKS" 9/30/2024 $ 67,973.62 ( -TOTAL REGISTRY FUNDS^ $ 1,500.00 ReconclleC: $ rCRTICIrGTFC Oc M1FGr1ClTC MFI r11N TRI ICT. RRrICRPRIW RGNN CD's Date Issued -Balance. Purchases/ Withdrawals Balance. 813112024.' : Interest 09/30/24 10440 1/24/2018 $ - $ - $ - 10441 1/24/2018 $ $ 10442 1/24/2018 $ 1,324.06 $ 1,324G6 10443 1/25/2018 $ 1,324.06 $ 1,324.06 10444 1/25/2018 $ 9,998.88 $ 9,998.88 10445 1/25/2018 $ 9,998.88 $ 9,998.88 10446 1/25/2018 $ 9,998.88 $ 9,998.88 10449 6/9/1955 $ 21,224.73 $ 21,224.73 10454 3/2/2018 $ $ 10455 3/2/2018 $ $ 10486 8/26/2020 $ 6,136.65 $ 6,136.65 10495 12/22/'2021 $ 35,495.78K$254.29 $ 35,750.07 10496 12/22/2021 $ 35,495.76 $ 35,750.05 10504 2114/2023 $ 11.395.03 $ 11,395.03 10606 2/14/2023 $ 9,664.95 $ 9,664.95 TOTALS: $152,057.66 $ $ 152,666.24 / V v•'•'� / I� OV "`I,Iw�' 101812024 1 Submittetl by: Anna M Goodman, County Clerk Date Ia— R4.,,rlhoun GODnty 3udg Date 2012 U:10REPORTSV ONTHI-MUDTOR MD TREASURER REPORTM2024.COMTREASURER REPORTS 1018120N ENTERCOURTNAME! _ DISTRICT CLERK - - ENTER MONTH OF,.REPORT SEPTEMBER , IuaERYEAROFREPORT _ _., _•._ _ .. 2024 .- '. CODE - - AMOUNT Revised 0410310 -. CRC-CCC - 1b1 CR- STATE CCC-2020 $7229 ,- CR-LOCAL CCC-2020 324.76 , CR- CRIMINALJUSH_CE PLANNING FUND CR-CLERKS FEE SAS - CR-CMI CR-CRIMESTOPPERS 12.98 - CR- COURTHOUSE SECURITY Q68 _ - CReCVCIj 0.12 - OR:-CJPT - CR-DRUGCRT.PROGFFE 3.72 -. CR+FA 0.01 CR'-JCO CR-JCPT CR- JURY .REIMBURSEMENT FEE JRF 0.35 CR- JUDICIAL SUPPORT FUND-JSF0.07 CR-TAW ENFORC. SOLD FUND ' CR- IND LEGALS SVCS(IDF) 0.01 CR'-DUETO'STATE - NONDISCLOSUREFEE CR-TIME PAYMENTw .0.34 CR. TIME' PAYMENT REIMBURSEMENT. 2W& 4S.94 CRFBREATHALCOHOL'TESTING - CR-=CO CHILD ABUSE PREVENTION FUND 6BAS - -_ oft -CLERKS FEE1 CR-RECOROSMANAGEMENT 3A0 _ CR- BOND FORFEITURES CH -PRETRIAL DIVERSION FUND CR- REBATES ON PREVIOUS EXPENSES 3.15 CRdREIM9' CRTAPPOINTEDADYFEES 648.77 OR TECHNOLOGY FUND(DIST&CO OLK) 0.64 CR- STATE -ELECTRONIC FILING EEE Q64 -' CR-CDUNTYELECTRONICFILINO FEER' CR-EMSTRAUMA FUND 19.74 CR-DNATESTINGFEE 1.98 CR..FAMILYVIOLENCE FINE CR-RESTTTUTIONFEE 161.18 CR-TCLEOSE-MVF '• CR-STATETRAFRCFINE „ OR -OVERPAYMENTS - CR.SHERIFF 291.50 CR-:D.A. CR-PINES 428.211 CR-SUSTOTAL $2.498.32. CV-STATE:REIMB-TTTLE,IV DCOURT COSTS CV -COPIES - 455.80 �. CV -CLERK'S FEES 2,383.88- CV- COURT RECORDS PRESERVATION FUND Wm RECORDS MGMT FEE -DISTRICT CLERK CV -STENOGRAPHER 719.72 CV- SHERIFFS JURY FEE, ' CV-LAWLIBRARY 1,007.59 CV -(STATE) DIV. & FAMILY LAW"." CW(STATE) OTHER THAN OIV/FAM.LAW ' CV{STATE) OTHER CIVIL PROCEEDINGS CV-JURY.FEE 287.88 CV- COUNTY DISPUTE RESOLUTION KIND 431.82 CV- RECORDS MGMT PRSRV FUND +CLERK 1.114.85 CV- COURTHOUSE SECURITY 575.76 Y':CV:LANGUAGE ACCESS FUND 65.37 CV -SHERIFFS SERVICE FEE 2,117.78 '^CV-DUETOOTHERS CV-CRTAPP.OINTED ATV FEES -CHILD SUPPORT CVJUOICIAL& COURT PERSONNEL TRAINING•FEE .. GV-JUDICIAL SALARIES - CV-AJSF 143.94 - CV!COURTFACILITYFEEFUND .. 575.77 ' CV O FORFEITURES . CV -STATE ELECTRONIC FILING FEE ELECTRONIC CV.=COUNTY ELECTF40NIC FILING FEE CV- FAMILY PROTECTION FEE - .CV • ADOPTION -BUREAU OF VITAL STATS FEE CV -DUE TO STATE- NONDISCLOSURE; FEE •".y CV -DUE .TO STATE- CONOSOUDA7EDFEE2022 2,49208 - CV -OVERPAYMENTS �- CV.OUT-0E-COUNTYSVCOFCITAT1ON CVSUBTOTAL $1240124 TOTAL CASH RECEIPTS $14,899.56 NSF CHECKS AMOUNT DUETOOTHERS! ATTORNEY. GENERAL -RESTITUTION - iNMUDE P.D,REa MMOW6DDB,BIDR OUT-0FCOUNTY SERVICE FEE' O.UD EWMWE P. D.REDDEEIW6N�IM1HIRP REFUNDS OF OVE1jPAYMJENTS '` 0.00 EWMWE P. U. REDUF,IWDWIWEP w OUETOOTHERS `crime stoppers', .reStituti0d) TOTALOUETOOTHER$ EASURERS RECEIPTS FOR MONTH:. CASH, CHECKS, M.O.S&CREDIT CARDS I 14,899.560aIMaW Dom ACTUAL T.n.e. RWaiph -- * Treasurer Receipt Numbers F2024SEP005, 007,017,026.031 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS ACCOUNT NUMBER COURT NAME: DISTRICT CLERK MONTH OF REPORT: SEPTEMBER YEAR OF REPORT: 2024 ACCOUNT NAME DEBIT CREDIT 1000-001-44190 SHERIFF'S SERVICE FEES $2,409.28 10OD-001-44140 JURY FEES $297.88 100D-001-44045 RESTITUTION FEE $0.00 1000-001-44020 DISTRICT ATTORNEY FEES $0.00 1000-001-49010 REBATES -PREVIOUS EXPENSE $3.15 1000-001-49030 REBATES -ATTORNEYS FEES $548.77 1000-001-44058 DISTRICT CLERK ELECTRONIC FILING FEES $0.00 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEES $45.94 1000-001-43049 STATE REIMB- TITLE IV-D COURT COSTS $0.00 DISTRICT CLERK FEES CERTIFIED COPIES $455.80 CRIMINAL COURT $5.48 CIVIL COURT $2,383.88 STENOGRAPHER $714.72 CN FEES DIFF $0.00 1000-001-44050 DISTRICT CLERK FEES $3,564.88 1000-999-20771 FAMILY VIOLENCE FINE $0.00 1000-999-10010 CASH -AVAILABLE $6,869.90 2706-001-44055 FAMILY PROTECTION FEE $0.00 2708-999-10010 CASH -AVAILABLE $0.00 2740-001-45055 FINES - DISTRICT COURT $428.20 2740-999-10010 CASH - AVAILABLE $428,20 2620-001-44055 APPELLATE JUDICIAL SYSTEM $143.94 2620-999-10010 CASH - AVAILABLE $143.94 2648-001-44055 COURT FACILITY FEE FUND $575.77 2648-999-10010 CASH - AVAILABLE $575.77 2670-00144055 COURTHOUSE SECURITY $576.44 2670.999-10010 CASH -AVAILABLE $576.44 2673-001-44055 CRT RECS PRESERVATION FUND- CO $0.00 2673-999-10010 CASH - AVAILABLE $0.00 2725-001-44055 LANGUAGE ACCESS FUND $86.37 2725-999-10010 CASH -AVAILABLE $86.37 2739-001-44055 RECORD MGMT/PRSV FUND - CLERK $1,117.91 2739-999-10010 CASH - AVAILABLE $1,117.91 2737-001-44055 RECORD MGMT/PRSV FUND -DIST CLRK $0.34 2737-999-10010 CASH -AVAILABLE $0.34 2731-001-44055 LAW LIBRARY $1,007.59 2731-999-10010 CASH - AVAILABLE $1.007.59 2663-001-44050 CO &DIST CRT TECHNOLOGY FUND $0.54 2663-999-10010 CASH-AVAILASL $0.54 7040-999-20740 BREATH ALCOHOL TESTING - STATE $0.00 7040-999-10010 CASH -AVAILABLE $0.00 2667-001-44055 CO CHILD ABUSE PREVENTION FUND $68.65 2667-999-10010 CASH -AVAILABLE $68.65 7502-999-20740 JUDICIAL & COURT PERSONNEL TRAINING FUND -STATE $0.00 7502-999-10010 CASH-AVAILABE $0.00 7383;999-20610 DNA TESTING FEE - County $0.20 7363-999-20740 DNA TESTING FEE - STATE $1.78 7383-999-10010 CASH - AVAILABLE $1.98 7405-999-20610 EMS TRAUMA FUND - COUNTY $1.97 7405-999-20740 EMS TRAUMA FUND - STATE $17.77 7405-999-10010 CASH - AVAILABLE $19.74 7070-999-20610 CONSOL. COURT COSTS - COUNTY $0.19 7070-999-20740 CONSOL. COURT COSTS - STATE $1.75 7070-999-10010 CASH -AVAILABLE $1.94 7072-999-20610 STATE CONSOL. COURT COSTS- COUNTY $57.23 7072-999-20740 STATE CONSOL. COURT COSTS- STATE $515.05 7072-999-10010 CASH -AVAILABLE $572.29 2698-001-44030-010 DRUG CRT PROG FEE - COUNTY (PROGRAM) $1.86 2698-999-10010-010 CASH -AVAILABLE $1.86 7390-999-20610-999 DRUG COURT PROG FEE -COUNTY (SVC FEE) $0.37 7390-999-20740-999 DRUG COURT PROG FEE - STATE $1.49 7390-999-10010-999 CASH -AVAILABLE $1.86 7865-999-20610-999 CRIM - SUPP OF IND LEGAL SVCS - COUNTY $0.00 7865-999-20740-999 CRIM - SUPP OF IND LEGAL SVCS - STATE $0.01 7865-999-10010-999 CASH - AVAILABLE $0.01 7760-999-20790-010 CRIM - DUE TO STATE - NONDISCLOSURE FEE $0.00 7760-999-10010-010 CRIM - DUE TO STATE - NONDISCLOSURE FEE $0.00 7950-999-20610 TIME PAYMENT - COUNTY $0.17 7950-999-20740 TIME PAYMENT -STATE $0.17 7950-999-10010 CASH -AVAILABLE $0.34 7505-999-20610 JUDICIAL SUPPORT-CRIM - COUNTY $0.01 7505-999-20740 JUDICIAL SUPPORT-CRIM - STATE $0.06 7505-999-10010 CASH -AVAILABLE $0.07 75D5-999-20740-010 JUDICIAL SALARIES -CIVIL -STATE(42) $0.00 7505-999-10010-010 CASH AVAILABLE $0.00 2740-001-45050 BOND FORFEITURES $0.00 2740-999-10010 CASH -AVAILABLE $0.00 2729-001-44034 PRE-TRIAL DIVERSION FUND $0.00 2729-999-10010 CASH - AVAILABLE $0.00 7857-999-2061 D JURY REIMBURSEMENT FUND- COUNTY $0.04 7857-999-20740 JURY REIMBURSEMENT FUND- STATE $0.31 7857-999-10010 CASH -AVAILABLE $0.35 7860-999-20610 STATE TRAFFIC FINE- COUNTY $0.00 7860-999-20740 STATE TRAFFIC FINE- STATE $0.00 7860-999-10010 CASH - AVAILABLE $0.00 7403-999-22888 DIST CRT - ELECTRONIC FILING FEE - CIVIL $0.00 7403-999-22991 DIST CRT - ELECTRONIC FILING FEE - CRIMINAL $0.64 CASH - AVAILABLE $0.64 1000-001-44050 DISTRICT CLERK FEES $123.72 1000-999-10010 CASH - AVAILABLE $123.72 2739-001-44055 RECORD MGMT/PRSV FUND - COUNTY $77.32 2739-999-10010 CASH -AVAILABLE $77.32 2669-001-44050 COUNTY JURY FUND $3.09 2669-999-10010 CASH -AVAILABLE $3.09 2670-001-44055 COURTHOUSE SECURITY $30.93 2670-999-10010 CASH - AVAILABLE $30.93 2663-001-44050 CO & DIST CRT TECHNOLOGY FUND $12.37 2663-999-10010 CASH -AVAILABLE $12.37 2676-001-44050 COUNTY SPECIALTY COURT FUND $77.32 2676-999-10010 CASH -AVAILABLE $77.32 7855 999-20784r010 DIST CRT - DIVORCE & FAMILY LAW - STATE $0.00 7855-999-20657-010 DIST CRT - DIVORCE & FAMILY LAW - COUNTY $0.00 7855-999-20792-010 DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - STATE $0.00 7855-999-20658-010 DIST CRT -OTHER THAN DIVORCE/FAMILY LAW - COUNTY $0.00 7B55-999-20740-Q10 DIST CRT - OTHER CIVIL PROCEEDINGS - STATE - 7855-999-20610-010 DIST CRT - OTHER CIVIL PROCEEDINGS - COUNTY - 7855-999-20790-010 DUE TO STATE - NONDISCLOSURE FEE $0.00 7855-999-10010-010 CASH - AVAILABLE 0.00 2677-001-44050-999 COUNTY DISPUTE RESOLUTION FUND $431.82 2677-999-10010-999 CASH -AVAILABLE $431.82 7858-999-20740-999 DIST CLK - DUE TO STATE CONSOLIDATED FEE 2022 $2,492.08 7858-999-10010-999 CASH AVAILABLE $2,492.08 TOTAL (Distrib Req to Oper Acct) $15,050.15 $14,725.39 DUE TO OTHERS (Distdb Req(s) attached) ATTORNEY GENERAL (RESTITUTION) 0.00 OUT -OF -COUNTY SERVICE FEES 0.00 REFUND OF OVERPAYMENTS 0.00 DUE TO OTHERS 174.17 TOTAL DUE TO OTHERS $174. 77 REPORT TOTAL -.ALL FUNDS 14,899.55 PLUS AMT OF RETURNED CKS� 0.00 LESS: TOTAL TREASURER'S RECEIPTS (14,699.56) Revised 04/03/23 OVER / (SHORT) $0.00 DISTRICT COURT SEPTEMBER STATE COURT COSTS REPORT 2024 SEPTEMBER SECTION I: REPORT FOR OFFENSES COMMITTED COLLECTED COUNTY STATE 01/1120 - Present I $572.29 57.23 515.06 01101/04-12131119 $1.51 0.16 1.45 09/01/01-12/31103 0.33 0.03 0.30 09/01/99 - 08/31/01 •"l fw" ir{?taP?i ^"" ; _ _ 09101/97 - 08/31/99 09/01/95-08131/97 09101/91-08131/95 DNA TESTING FEES 1.98 0.20 1.78 EMS TRAUMA FUND 19.74 1.97 17.77 JUV. PROS. DIVERSION FEES JURY REIMBURSEMENT FEE $0.35 0.04 0.31 INDIGENT DEFENSE FUND $0.01 0.00 $0.01 STATE TRAFFIC FEES $0.00 - $0.00 DRUG CRT FROG FEE $3.72 $2.23 1.49 SECTION II: AS APPLICABLE STATE POLICE OFFICER FEES FAILURE TO APPEAR/PAY FEES JUD. FUND-CONST. CO. CRT. JUD. FUND -STATUTORY CO. CRT. MOTOR CARRIER WEIGHT VIOLATIONS TIME PAYMENT FEE $0.34 0.17 0.17 DRIVING RECORD FEE JUDICIAL SUPPORT FEES $0.07 0.01 0.06 ELECTRONIC FILING FEE -CR $0.64 $0.64 NONDISCLOSURE FEES - CR $0.00 $0.00 TOTAL STATE COURT COSTS $601.08 $ 62.04 $ 539.04 CIVIL FEES REPORT SEPTEMBER COLLECTED COUNTY STATE BIRTH CERTIFICATE FEES MARRIAGE LICENSE FEES DECL. OF INFORMAL MARRIAGE ELECTRONIC FILING FEE -CV $0.00 $0.00 NONDISCLOSURE FEES - CV 0 $0.00 $0.00 JUROR DONATIONS JUSTICE CRT. INDIG FILLING FEES STAT PROS CRT INDIG FILING.FEES STAT PROB CRT JUDIC FILING FEES STAT CNTY CRT INDIG FILING FEES STAT CNTY CRT JUDIC FILING FEES STAT CNTY CRT -JUDICIAL SUPPORT CONST CNTY CRT INDIG FILING FEES CNST CNTY CRT JUDIC FILING FEES DIST CRT DIV & FAMILY LAW 0 $0.00 - - DISTCRT OTHER THAN DIV/FAMLAW 0 $0.00 - - DISTCRT.OTHERCIVIL FILINGS 0 $0.00 - - FAMILY PROTECTION FEE JUDICIAL SUPPORT FEE $0.00 $0.00 JUDICIAL & COURT PERSONNEL TRANING FEE 0 $0.00 - $0.00 2022 STATE CONSOLIDATED FEE 14 $2,492.08 $2,492.08 COUNTY DISPUTE RESOLUTION FUND 431.82 431.82 TOTAL CIVIL FEES REPORT $ 2,923.90 $ - $ 2,923.90 TOTAL BOTH REPORTS $ 3,524.98 $ 62.D4 $ 3,462.94 CALH OU N DISTRIBUTION COUNTY REQUEST 201 West Austin DR# 420 A45573 PAYEE PAYOR Name: Calhoun County Oper. Acct. Official: Anna Kabeia Address: Title: District Clerk City: State: Zip: Phone: ACCOUNTNUMBER- DESCRIPTION AMOUNT 7340-999-20759-999 District Clerk Monthly Collections - Distribution $14,725.39 SEPTEMBER 2024 V# 967 TOTAL 14,725.39 r Signature of Official Date .. ENTER MONTH OF REPORT SEPTEMBER ENTER YEAR OF REPORT 2022 2S024 CODE AMOUNT CASH BONDS REVISED 02/02/2021 ADMINISTRATION FEE -AOMF 10.00 BREATH ALCOHOL TESTING -BAT CONSOLIDATED COURT COSTS -CCC 80.00 STATE CONSOLIDATED COURT COST- 2020 938.19 LOCAL CONSOLIDATED COURT COST-2020 214.81 COURTHOUSE SECURITY .-CHS 8.00 CJP CIVIL JUSTICE DATA REPOSITORY FEE -CJDR 0.10 CORRECTIONAL MANAGEMENT INSTITUTE -CMI CR CHILD SAFETY -CS CHILD SEATBELT FEE -CSBF -. CRIME VICTIMS COMPENSATION -CVC -OPSC/FAILURE TO APPEAR - OMNI - DPSC ADMINISTRATION FEE FTA/FTP (aka OMNI)- 2020 30.00 ELECTRONIC FILING FEE -EEF FUGITIVE APPREHENSION - FA GENERAL. REVENUE -GR CRIM = IND LEGAL SVCS SUPPORT -.IDF - JUVENILE CRIME.& DELINQUENCY- JCD JUVENILE CASE MANAGER FUND-JCMF 10.00 -JUSTICE COURT PERSONNEL TRAINING -JCPT JUROR SERVICE FEE -JSF 8.00 LOCAL ARREST FEES - LAP 27.96 LEMI -LEDA LEOC OCL .'PARKS& WILDLIFE ARREST FEES -PWAF STATE ARREST FEES - SAP 57.71 - SCHOOL CROSSINGICHILDSAFETY .FEE -SCF :SUBTITLE C-SUBC STATE TRAFFIC FINES -EST 9.1.19- STF 315,96 TABC ARREST FEES =TAF TECHNOLOGY FUND--TF 8.00 TRAFFIC -TFC LOCAL TRAFFIC FINE- 2020 18,95 TIME PAYMENT -TIME TIME PAYMENT REIMBURSEMENT FEE-2020 6.25 TRUANCY. PREVENTION/DIVERSION FUND -TPDF 4.00 LOCAL & STATE WARRANT FEES - WRNT 219.08 COLLECTION SERVICE FEE-MVBA = CSRV 315.11 -. DEFENSIVE DRIVING COURSE-DOC 20.00 DEFERRED FEE - OFF 212.00 DRIVING EXAM FEE- PROV DL FILING FEE -FFEE STATE CONSOLIDATED CIVIL FEE -2022 LOCAL CONSOLIDATED CIVIL FEE - 2022 FILING FEE SMALL CLAIMS -FFSC JURY FEE -JF COPIES/CERTIFED COPIES -CC INDIGENT FEE -CIFF or-INOF 4.00 JUDGE PAY RAISE FEE -JPAY 12.00 SERVICE FEE -SFEE OUT -OF -COUNTY SERVICE FEE ELECTRONIC FILING FEE -.EEF CV EXPUNGEMENT FEE -EXPG EXPIRED RENEWAL -EXPR .ABSTRACT OF JUDGEMENT -AOJ ALL WRITS -WOP/WOE / OPS FTA.FINE -DPSF `LOCAL FINES - FINE 1,160.58 LICENSE& WEIGHT FEES -LWF PARKS & WILDLIFE FINES-PWF SEATBELT/UNRESTRAINED CHILD FINE -SEAT 'JUDICIAL & COURT PERSONNEL TRAININGJCPT • OVERPAYMENT (OVER $10)-OVER • OVERPAYMENT($10 AND LESS) -OVER .RESTITUTIONS -REST PARKS &WILDLIFE -WATER SAFETY FINES-WSF MARINE SAFETY PARKS & WILDLIFE -MSO TOTAL ACTUAL. MONEY RECEIVED $3,680.70 TYPE:. ; AMOUNT TOTAL WARRANT FEES 219.0E ENTER LOCAL WARRANT FEES REC/CPDONTOT& PAGE OFHLL COUNTIV SOFi}4PAEMO. REPORT STATE WARRANT FEES 0.00 RECORD ON TOTAL PAGE OF HILL COUNTRY SOFIWARE MO. REPONT DUE TO OTHERS: AMOUNT DUE TO CCISD-50% of Fine on JV cases 0.00_ PUMEINIXUDE all FEMMTINGDIEUMEMENT _ _ _ DUE TO DA RESTITUTION FUND. -0.00 FLMEINMUDE OR REWCSTINcasauRseaENT REFUND OF OVERPAYMENTS 0.00 PUMEINGLUDE OR REQUMTINGOoOURSEMENT OUT -OF -COUNTY SERVICE FEE 0.00 FLEASE INCLUOE OR REQUESTINGDISSURSEMENr CASHBONDS0.00 PLEASE INCLUOE OR REOUESTING DISBURSEMENT (IF REQUIRED) TOTAL DUE TO OTHERS 0. TREASURERS RECEIPTS FOR MONTH: AMOUNT AS _ ,_M_. .s&C A BD.70 Calculatelrom ACTUAL Treasurer's Receipts rTOTAL TOTAL TREAS. RECEIPTS 3 80. 0 No MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 10/1/2024 COURT NAME: JUSTICE OF PEACE NO.3 MONTH OF REPORT: SEPTEMBER YEAR OF REPORT: 2024 ACCOUNTNUMBER ACCOUNTNAME AMOUNT CR 1000-001-45013 FINES 1,160.58 CR 1000-001-44190 SHERIFF'S FEES 293.21 ADMINISTRATIVE FEES: DEFENSIVE DRIVING 20.00 CHILD SAFETY 0.00 TRAFFIC 18.95 ADMINISTRATIVE FEES 252.00 EXPUNGEMENT FEES 0.00 MISCELLANEOUS 0.00 CR 1000-001-44363 TOTAL ADMINISTRATIVE FEES 290.95 CR 1000-001-44010 CONSTABLE FEES -SERVICE 0.00 CR 1000-001-44063 JP FILING FEES 0.00 CR 1000-001-44090 COPIES / CERTIFIED COPIES 0.00 CR 1000-001-49110 OVERPAYMENTS (LESS THAN $10) 0.00 CR 1000-001-44322 TIME PAYMENT REIMBURSEMENT FEE 6.25 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 315.11 TOTAL FINES, ADMIN. FEES & DUE TO STATE $2,066.10 CR 2670-001-44063 COURTHOUSE SECURITY FUND $81.18 CR 2720-001-44063 JUSTICE COURT SECURITY FUND $2.00 CR 2719-001-44063 JUSTICE COURT TECHNOLOGY FUND $69.37 CR 2699-001-44063 JUVENILE CASE MANAGER FUND $10.00 CR 2730-001-44063 LOCAL TRUANCY PREVENTION & DIVERSION FUND $76.72 CR 2669-001-44063 COUNTY JURY FUND $1.53 CR 2728-001-44063 JUSTICE COURT SUPPORT FUND $0.00 CR 2677-001-44063 COUNTY DISPUTE RESOLUTION FUND $0.00 CR 2725-00144063 LANGUAGE ACCESS FUND $0.00 STATE ARREST FEES DPS FEES 11.54 P&W FEES 0.00 TABC FEES 0.00 CR 7020-999-20740 TOTAL STATE ARREST FEES 11.54 CR 7070-999-20610 CCC-GENERAL FUND 8.00 CR 7070-999-20740 CCC-STATE 72.00 DR 7070-999-10010 80.00 CR 7072-999-20610 STATE CCC- GENERAL FUND 93.82 CR 7072-999-20740 STATE CCC- STATE 844.37 DR 7072-999-10010 938.19 CR 7860-999-20610 STF/SUBC-GENERAL FUND 0.00 CR 7860-999-20740 STF/SUBC-STATE 0.00 DR 7860-999-10010 0.00 CR 7860-999-20610 STF- EST 9/1/2019- GENERAL FUND 12.64 CR 7860-999-20740 STF- EST 9/1/2019- STATE 303.32 DR 7860-999-10010 315.96 Page 1 of 2 MONTHLY REPORT OF COLLECTIONS AND DISTRIBUTIONS 10/1/2024 COURT NAME: JUSTICE OF PEACE NO.3 MONTH OF REPORT: SEPTEMBER YEAR OF REPORT: 2024 CR 7950-999-20610 TP-GENERAL FUND 0.00 CR 7950-999-20740 TP-STATE 0.00 DR 7950-999-10010 0.00 CR 7480-999-20610 CIVIL INDIGENT LEGAL-GEN. FUND 0.20 CR 7480-999-20740 CIVIL INDIGENT LEGAL -STATE 3.80 DR 7480-999-10010 4.00 CR 7865-999-20610 CRIM-SUPP OF IND LEG SVCS-GEN FUND 0.00 CR 7865-999-20740 CRIM-SUPP OF IND LEG SVCS-STATE 0.00 DR 7865-999-10010 0.00 CR 7970-999-20610 TUFTA-GENERAL FUND 0.00 CR 7970-999-20740 TL/FTA-STATE 0.00 DR 7970-999-10010 0.00 CR 7505-999-20610 JPAY- GENERAL FUND 1.20 CR 7505-999-20740 JPAY-STATE 10.80 DR 7505-999-10010 12.00 CR 7857-999-20610 JURY REIMB. FUND- GEN. FUND 0.80 CR 7657-999-20740 JURY REIMB. FUND- STATE 7.20 DR 7857-999-10010 8.00 CR 7856-999-20610 CIVIL JUSTICE DATA REPOS: GEN FUND 0.01 CR 7856-999-20740 CIVIL JUSTICE DATA REPOS: STATE 0.09 DR 7856-999-10010 0.10 CR 7502-999-20740 JUD/CRT PERSONNEL TRAINING FUND- STATE 0.00 DR 7502-999-10010 0.00 7998-999-20740 TRUANCY PREVENT/DIV FUND - STATE 2.00 7998-999-20701 JUVENILE CASE MANAGER FUND 2.00 DR 7998-999-10010 4.00 7403-999-22889 ELECTRONIC FILING FEE - CV STATE 0.00 DR 7403-999-22889 0.00 7858-999-20740 STATE CONSOLIDATED CIVIL FEE 0.00 0.00 TOTAL (Distrib Reg to Oper Acct) $3,680.70 DUE TO OTHERS (Distrib Reg Attchd) CALHOUN COUNTY ISD 0.00 DA - RESTITUTION 0.00 REFUND OF OVERPAYMENTS 0.00 OUT -OF -COUNTY SERVICE FI 0.00 CASH BONDS 0.00 PARKS & WILDLIFE FINES 0.00 WATER SAFETY FINES 0.00 TOTAL DUE TO OTHERS $0.00 TOTAL COLLECTED -ALL FUNDS $3,680.70 LESS: TOTAL TREASUER'S RECEIPTS $3,680.70 REVISED 02/02/2021 OVER/(SHORT) $0.00 Page 2 of 2 NOTICE OF MEETING -.. 10/16/2024 15. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 12 of 13 ao c 0 z G) 3 a z m m z z 0 m O a r N N T z Y a ' J A m T° W lelis�' W O N Z z ox m o D p !ME < m�cn m Z= mm 9 O W a = cn zCc o Z=_ mT, eia Z N am = � m ao�_ oa ° m= 20 G) G) 3 C a - ) 3 m T m �= m T ° v C= -0 z 3 z o v G_ m Q3 Ca! �c = z cfOo c(Oo c(Ooe cy= m nco co z z z i _ mzz 000 N 1 Z O O G;ff))1 0GA)) C �Z = z 3 GAA) G��)77 z z z ea _ m y Z Z = D 2 A O O T d = a a e _ r r O O OTT 'mod= O O O O T T m= MR 'MR O O O ;.m= O O O O JZ - T coo T I O O O T pA O 0 ^+ OJ E9 W V -� W ¢9 peppyy = �N fA ipiq WW w vO � i�.I IL � = O O O O c m= z Z m x i Z 'Es n, m Z = 4� y Z ? a= tn 3= � < = 11 0 3= n O C z coo a m: § ) « I ) � §2§ § 222 k ) 0m> ■ \\k § _m CO `cn/8 ® § ` ; a � n § §§K G ■ I 3§� Co kz § ■ § m ■ \§ §) § ; %) ® m &] � ■\ S ■ m m , » ) ; =:B _ \ §§ , | z(■ m ; k 0 ( A m A 2 ) § § M it % m:z �, »� ■ m ; m ■ ■ ) ° �; �; z: 0 ■ z: z % »EI 2 m m: ; ° §n: r m: .1; § n © t Z: ■� ; ■ : . § § 2 � § § . 0: m! i§§ m U ) (\ B §\■ $ § �2 0 f■ ■ \� ■ ■ a § !2§ 0 00 zz §��§ a ) § ( m %' 2§ U $. ®: ) m ■ � m ■ » a� @ 0 ■ +: z )§° -:m p: § m k: B k� � 0 | 2m§ ! z _ � ) §3 | )) § ; - --®kB - ---�§ ■§ �§ � gm§ � k : o / : k : q A ; f : 'n : § M\ =0M \ §§ \\� Cl) m) \}\[ z§ ®§2§ z; T® �) \ § m■ § § BB m r| ) § ) M § j § �§§§§7 = m 0 ,zzzz § 60000 . / ■once ■ CD 2§222 \ | 4 G ) / / BB v| mB - ° m ■! m= Z) 0\ ■ :_, ( \�� ■ z / 0§ 000 z z z � © § }\)§B■ § ) � k 0 2 A % A 2 § § `c N 1 0 m 0 T 0 m m m z 0 1 O D r ty: m: m: Z:: Z ol A= w: 03 ooe 0= Z O Wo m O -o :o 0 via Oc� c y w - 3 m T y 0 i g O Cs Cf 0 C q N! F O D r O bl b r J Vm�mW� <n000 Y o < < m D 0 m m C 1 z0 z y m m y I ry co- <Dm ccn m O < K m m e � C D { z A 0 z m A e z z z z z 30000 zzz z z z z N C� A EH EA EA Pmif T 'a 0 0 0 IMF O 0 0 (T N J m a g• z N • N a Cf 0 C Z CA In z Z m m Z C v ■ 2 0 § § 0 § � m § \ 2 ) ) __■ £m_ � 2 {§ -/ | � ) � m ; m \ ) (\� §§ m m t k m k 2 k k k ■ % ! o » aE m 0 §� ) § n § t§ § v: m: a: m Z: Z: U: ul: 0: X OD 0 z 0 W z O m m i z m n z 0 1 O D r O T N N N R N O O N O 0 O 00 m D r C D 0 0 m m p Z O D az20cn Z Ra A N C7 > A � < D y cn r mN N � 3 T m (n Dow co co OW D o 0(O (O (p y D 0 cp (0 tp t0 z O z z z z z z D 0 0 0 0 0 :) G) G) G) G) G) z �Zzz§z zzzz a 3 T i ONRON M fA fA Efl EA EA fA EA T O o 0 0 0 0 0 0 a O o 0 0 0 0 0 0 �Wef O O O 4A O O O Efl T O O O O O O O O T O T O O O O O O O O T fA fR 0 0 0 0 0 0 O O O O O O O O m a z N 1 0 m 0 m m 'D m v m m z 0 N O D r V N N Ca9 N tOli N Z O O N O m 0 00 m� cn m D a7 1 � m� ca-a z N Z m m 0_j m"' z 9 (OO (OD O 0 0 Z0 7 o o zzzz a 3 T z � ri. fA ffl EA EA ffl T O o 0 0 0 T � M fA fA fA 6A T O O O O O C m zz 1T cz n m G) Z nIn C v A § ■ § § 0: m: »: q) ■; m: z! z! o| ■: ,j! o; k § § ) § z m z § R ' c § . k § § \ ) § ) 0 � � k v 2 A m A 2 ) § � k §!©§;§ SaƒG@■ > Cl) /mzm 0U)m 2 mg�m <jk§�® �m 2 \\ / §§ ■ m # s@»@@@�■ 7\§B� # s\�\}/��■ m z § k 0 ( k % % 2 § § k In 0 § d woo ) k § ) z � O z O� ° m Z a y ]�J Z Z CS9 o m m Z O 0 m D 1 m m z 1 0 1 D r OVI O I NOTICE OI= MEE SING — 1.0/16/2024 16. Approval of bills and Davroll. (RHM) Indigent Healthcare: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: ` Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hail, Lyssy, Behrens, Reese MMC Bills: RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County Bills: RESULT: APPROVED[UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner' Hall, Lyssy; Behrens, Reese Adjourned 10:25am Page 13 of 13 fA b9 <A IfA IV IO I� V ViOHLOOZ H $L cl xH xH wyH 3 gmR nO zn m NOm xo roW H nnz w xz mH HH [7 H x RJ H CHI zT3 0 ox tAl 00 O m m �Zz o w� Hn N ci LZi1H x m ro n x H d m C ro 0 0 z H 12 �O] O Imo 12 b b b b bb O O H O 0 0 0 N O N mmo W000000 �zwoznrner+nr 00 N OIH N H H H H H H m O O C 0 0 0 0 N N y N \ \ \ \ \ \ �P A O iP H H H H H H W nn HHHH HF+ SOV N'Oy' IT N NNNNNN m.�4, NNNNNN H X 5 n H iP �P iP iP �P iP m mrG]N y b] W m pa C m y 0 n m n L� ro h 7 b ro ro ro ro ro ro ro \ \ \ \ \ \ \ \ \ \ \ xrororozzzzzxz N H m a w a H m H m A W H w m m W r m �1 N J W m O O W W N 1p H m �D m O O �1 UI l0 W UI m m N U i O O H O m N i P P ;ONy y y Cc:y z D C z a p 9 C y C H y H y aC, °z0 zn �Oz� "Oz z °z uo, N m N M N m N m N m N m 's m y yM O o m m F A H y m m O p iP N y p G < M Omn w _i CN N r m N v a a y N W P P P P P P P P P U O O O o O O O O O O O O O N N n O m SO SO SO SCE SC y 7c y DC 9G aC C ,ybC C C $ < yE� Fp �O EO FO E� �yO m z n ➢ D Z 9 pa pa �9 �9 y�9 R. 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Reimbursement from Medicaid 0.00 l\✓JC E 1\4 t: ) R.I.A.L MEDICAL Qo;;Q# CENTER i 815 N. Virginia St. Port Lavaca, Texas 77979 (361) 552-6713 Date: 10/7/2024 Invoice # 400 For: Sep-24 Bill To: Calhoun County Funds to cover Indigent program operating expenses. APPROVED ON OCT 10 2024 CALHUI)N COUNTYD'MAS Total i hooa ro )n+(p�.1dn � Andrew De Los Santos Controller 1411Of1NT. 4,166.67 4,166.67 01HS Source Totals Report Issued 10/10/24 Calhoun Indigent Health Care Batch Dates 10/0112024through 10/01/2024 For Vendor. All Vendors Source Description Amount Billed Amount Paid 02 Prescription Drugs 42.84 42.84 Expenditures 42.84 42.84 Reimb/Adjustments Grand Total 42.84 42.84 Expenses 4,166.67 Co Pays < 0.00> 4,209.51 APPROVED ON OCT 10 2024 CA&Yo°U'&oU4WriP9,s hHS Source Totals Report Issued 10/10/24 Calhoun Indigent Health Care Batch Dates 02/01/2024 through 10/01/2024 For Vendor: All Vendors Source Description Amount Billed 02 Prescription Drugs 08 Rural Health Clinics 14 Mmc - Hospital Outpatient Expenditures Reimb/Adjustments Amount Paid 103.86 90.21 240.00 246.00 6,969.00 3,613.07 7,337.74 3,968.16 -24.88 -24.88 Grand Total 7,312.86 3,943.28 Expenses 37,500.03 Co Pays <20.00> 41,423.31 q'a, Calhoun County Indigent Care Patient Caseload 2024 Approved Denied Removed Active Pending January 0 3 2 1 7 February 0 3 0 1 5 March 0 4 0 1 4 April 1 0 0 2 0 May 1 6 0 3 0 June 0 1 0 3 2 July 0 1 1 2 2 August 0 0 0 3 2 September 0 2 0 3 2 October 0 0 0 0 0 November 0 0 0 0 0 December 0 0 0 0 0 YTD 2 20 3 19 24 Monthly Avg 0 2 0 2 2 December 2023 Active 4 Number of Charity patients 237 Number of Charity patients below 50 FPL 118 Number of Charity patients who meet State Indigent Guidelines 107 Calhoun County Pharmacy Assistance Patient Caseload 2024 Approved Refills Removed Active Value January 6 18 0 7 $9,662.15 February 0 0 0 30 $0.00 March 3 9 0 17 $8,345.67 April 5 15 0 20 $8,332.53 May 5 15 0 22 $13,588.44 June 1 3 0 26 $3,567.00 July 2 6 0 28 $2,872.47 August 1 3 0 29 $1,706.64 September 0 3 0 30 $5,169.00 October 0 0 0 0 $0.00 November 0 0 0 0 $0.00 December 0 0 0 0 $0.00 YTD PATIENT SAVINGS $53,243.90 Monthly Avg 2 6 16 $4,436.99 December 2023 Active 36 I v 4 PROSPERITY BANK THE COUNTY OF CALHOUN TEXAS CAL CO INDIGENT HEALTHCARE 202 S ANN ST STE A PORT LAVACA TX 77979 13132 09/01/2024 Beginning Balance 2 Deposits/Other Credits 3 Checks/Other Debits 09/30/2024 Ending Balance Total Enclosures 30 Days in Statement Period Statement Date 9/30/2024 Account No '""4551 Page 1 of 2 $5,505.48 $4,205.62 $4,206.89 $5,504.21 4 DEPOSITS/OTHER Date Description 09/04/2024 Deposit Amount $4,196.10 V 09/30/2024 Accr Earning Pymt Added to Account .! $9.52 Check Number Date Amount Check Number Date Amount Check Number Date Amount. 12644 09-20 $4,166.67 12645 09-20 $30.25 12646 09-20 $9.97 ENDING BALANCE ,.-DAILY Date Balance Date Balance 09.01 $5,505.48 09.20 $5,494.69 09-04 $9,701.58 09.30 $5,5D4.21 EARNINGS SUMMARY " Below is an itemization of the Earnings paid this period. •` Interest Paid This Period $9.52 Annual Percentage Yield Earned 1.51 % Interest Paid YTD $98.03 Days in Earnings Period 30 Earnings Balance $7,739.44 MEMBER FDIC ' �enoex NYSE Symbol "PB" COUNTY, TEXAS DATE: CC Indigent Health Care VENDOR # 852 ACCOUNT NUMBER DESCRIPTION OF GOODS OR SERVICES QUANTITY UNIT PRICE TOTAL PRICE 1000-800-98722-999 Transfer to pay bills for Indigent Health Care $4,209.57 approved by Commissioners Court(on 10/1,E/2024 1000-001-46010 $ep'tember ,30, 2024 Snterest ($9,52) $4,199.99 COUNTY AUDITOR APPROVAL ONLY THE ITEMS OR SERVICES SHOPM ABOVE ARE NEEDED IN THE DISCHARGE OF NY OFFICIAL DUTIES AND I CERTIFY THAT FUNDS ARE AVAILABLE TO PAY THIS OBLIGATION. I CERTIFY THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY HE IN GOOD CONDITION AND REQUEST THE COUNTY TREASURER TO PAY THE ABOVE O TION. BY: r �-}' 10/16/2024 APPROVED ON OCT 10 2024,, gy 00��7y p�/l�/n,'�p LHOUN COUNTY, TEXAS DEPARTMENT HEAD DATE MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---October 16 2024 TOTALS TO BE APPROVED - TRANSFERRED FROM ATTACHED PAGES '[i9zAL-:PAXABLES,fAYRQWA..d ELEtTR'O,fVI�"�ANI,iP.TVY'MfrIShFfr .... �_...__ _ __...1 .s .iB�,iil'fr,74!✓ ITdTAL;TRANSF.ERRiBB'l W,ttN.iP,%r4DS �TbT�6�N1UR51NEa`M®ME Upk EXPENSES, �____1�Z'48 b�l 84.E ✓ ,_.._ _..._ — T Tf�TAt�71NTER'6p\7eRA4—Igork.TF�AF�S ItS'." ......_,,... _ — .. 69ANU r&ALAS4SOUMEMENS$r'APV.iii/6,OcWbeF4 t44 MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---October 16, 2024 PAYABLES AND PAYROLL 10/10/2024 Weekly Payables 427,574.97 10/10/2024 Patient Refund 65,643.85 10/10/2024 Citibank Credit Card -see attached (Erin( 851.93 10/10/2024 CitlBank Credit Card -See attached (Steve) 646.92 10/14/2024 McKesson-3408 Prescription Expense 6,026.69 10/14/2024 Amerisourre Bergen.3408 Prescription Expense 3,025.37 10/10/2024 Payroll Liabilities -Payroll Taxes 130,000.00 10/10/2024 Payroll 395,000.00 10/14/2024 Health Equity. Wage Works employee FSA 6,531.87 Prosperity Electronic Bank Payments 10/14/2024 90 Degree Benefits - employee Insurance claims 2,910.42 10/14/2024 90 Degree Benefits - employee insurance claims 17,800.64 10/14/2024 90 Degree Benefits - employee insurance claims 20,801.00 10/14/2024 Sales Tax - September 2024 2,177.37 10/1412024 Pay Plus -Patient Claims Processing Fee 294.05 10/14/2024 Credit Card Fee 4,347.30 10/14/2024 Credit Card Lease Fee 335.53 10/1412024 Health Equity-HSA Contributions 1,447.83 11QT14 iPlkYABL�i�t+A_R01!iTAN_[HELRCFRLINIBjBAtN[NB/C/MENmS TRANSFER BETWEEN FUNDS FROM MMC TO NURSING HOMES 10/10/2024 MMC Operating to Ashford -Correction of insurance payment deposited into MMC Operating in error & UHC QIPP July 2024 46,619.08 10/10/2024 MMC Operating to Solera- UHC QIPPJulV 2024 1,438.01 10/10/2024 MMC Operating to Fort bend-UHC QIPP July 2024 1,776.12 10/10/2024 MMC Operating to Broadmoor-UHC QIPP July 2024 1,750,55 10/10/2024 MMC Operating to The Crescent -Correction of insurance payment deposited into MMC Operating in error & UHC QIPP July 2024 9,108.48 10/10/2024 MMC. Operating to Golden Creek Healthcare -Correction of insurance payment deposited into MMC Operating In error & UHC QIPP July 2024 31,148,00 10/10/2024 MMC Operating to Tuscany Village -Correction of insurance payment deposited into MMC operating in error & UHC QIPP July 2024 30,871.59 10/10/2024 MMC Operating to Bethany -Correction of Insurance payment deposited into MMC Operating in error & UHC QIPP July 2024 47,906.50 LTO,TFtEII'RAftIBPERS^SE1T W EBIWKUN b5 NURSING HOME UPL EXPENSES 10/14/2024 Nursing Home UPL-Cantex Transfer 10/14/2024 Nursing Home UPL-Nexion Transfer 10/14/2024 Nursing Home UPL-HMG Transfer 10/14/2024 Nursing Home UPL-Tuscany Transfer 10/14/2024 Nursing Home UPL.HSL Transfer QIPP CHECKS TO MMC 10/14/2024 Ashford - Wellpoint YR6 ADl2 10/14/2024 Broadmoor -Wellpoint YR6 ADJ2 10/14/2024 Crescent - Wellpont Y116 ADJ2 10/14/2024 Fort Bend. Wellpoint YR6 ADJ2 10/14/2024 Solera - Wellpoint YR6 AD12 10/14/2024 Tuscany - Wellpoint YR6 ADJ2 TRANSFER BETWEEN FUNDS FROM NURSING HOMES TO MMC 10/14/2024 Solera-Q3 Interest Earned remaining balance due to MMC 684,722.50 246,915.03 42,522.28 241,044.37 23,669.38 4,350.18 1,115.66 654.45 942.22 1,353.58 1,950.43 384.87 11084}905 IZ 5 ANN I`f0T'I sNUR51Nt5aEfQMPWPLI�C;;X_TN5ES'� - _. _. 5 1a ' i82M1c9 �.rR' I"Q.t`d0AI'4iU$�C--111'U�IY'f5;�b°P'F'lilt7 -.. 4024'- R CIVID DY THE rt) NVAUDITIMON 10/10/2024 OCT 1.0 2024 MEMO-R,x, MEDICAL CENTER 12:43 AP Open Invoice List 0 Due Dates Through: 11/01/2024 ap open_involce.template Vendor# Nem�''ALHDUN CfiUNTi'r fi�kAs /Vendor Class pay Code 10950 ./ ACUTE CARE INC Invoice# Comment Tran Dt Inv Dt Due Ot Check DI Pay Gross Discount No -Pay Net 4 INV2010 10/08/202 10/20/202 10/20/202 1,400.00 0.00 0.00 1,400.00 � J -�' AAmm Vendor Totals: Number NpmF-E `"" Gross Discount No -Pay Net 10950 ACUTE CARE INC 1,400.00 0.00 0.00 1,400.00 Vendor#/Vendor Name Class Pay Code A1705.J ALIMED INC, M Involoek Comment Tran Dt Inv Dt Due Dt Check Dt Pay RPSVO04344234 Gross Discount No -Pay Net 09/25/20210/02/2021Oil 71202 109,46 0.00 0.00 109.46 Vendor Totals: Number Name Gross Discount No -Pay Net Al 705 ALIMED INC. 109.46 0.00 0.00 109.46 Vendor# J Vender Name Class Pay Code 14028 .f AMAZON CAPITAL SERVICES Invoice4 Comment Tran Dt Inv Dt Due Ot Check Dt Pay Cross Discount No -Pay Net J 1DPNVGDMPH3C 10/02/202 09/27/202 10/27/202 74,98 0.00 0.00 f 74.96 ./ ITTX79NT63PO 10/02/20209/30/20210130/202 149.36 0.00 0.00 149,36 J IM7D3GRL19QM 10/02/20209/30/202101301202 102.56 0.00 0.00 102,56 J 1P9G7TQ3C6XH 10/02/20210/02/20211/01/202 116,19 0.00 0.00 11619 Vendor Totals: Number Name Gross Dlscount No -Pay Net 14028 AMAZON CAPITAL SERVICES 443.07 0.00 0.00 443.07 Vendow /vendor Name Class Pay Code At 36U ^�/ AMERISOURCEBERGEN DRUG CORP W Invoico# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 3190813191 10/07/20210/03120210125/202 Gross Discount No -Pay Net 25.57 0.00 0.00 25.57 Vendor Totals: Number Name Gross Discount No -Pay Net A1360 AMERISOURCEBERGEN DRUG CORP 25,57 0.00 0.00 25.57 Vendor# Vendor Name Class Pay Code 81220 BECKMAN COULTER INC M Invoice# Comment Tran Dt Inv DI Due DI Check DI Pay Gross Discount No -Pay Net J5492627 08/271202 08/25/202 10/31/202 1,337.05 0.00 0.00 1,337,05 j{t 111590172 09/30/202 09/26/202 10/26/202 538.42 0.00 0.00 538.42 J J111606436 10102/20210/03/20210/28/202 185.58 0.00 0.00 185.58 W J 111605201 10/02/202 10103/202 10/28/202 1,049.64 0100 0.00 1,049.64 J111602021 10107/202 1010PJ202 10/27/202 2.292.74 0.00 0,00 2,292.74 J 111602061 10/07/20210102/20210/27/202 249.15 0,00 0.00 249,15 Jl 111601798 10/07/20210/02120210/27/202 87.50 0.00 0.00 07.50 .( 111601575 10/07/20210/02/20210/271202 569.32 0.00 000 589.32 ./ 111601385 10107/202 10102/202 10/27/202 584.30 0.00 0.00 584.30 J 7370217 10107/202 101021202 11/01/202 8.080.23 0.00 0.00 8,000.23 .J 111609811 10/081202 10106/202 10/31/202 309.54 0.00 0.00 309.54 Vendor Totals: Number Name Gross Discount No -Pay Net B1220 BECKMAN COULTER INC 15,303A7 0.00 0.00 15,303.47 Vendor# Name Class Pay Code /)y��endor B7320 . BEEKLEY CORPORATION M Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Not J MIN0144764 10109/20210/04/20210/09/202 `✓ 696.50 0.00 0.00 696.60V Vendor Totals: Number Name Gross Discount No -Pay Net 81320 BEEKLEY CORPORATION 696.50 0.00 D.00 696.50 Vendor# Vendor Name Class Pay Code 11072 -„� BIO•RAD LABORATORIES, INC Invoice# Comment Tran Dt Inv Dt Due Dt Check DI Pay Gross Discount No -Pay Net j 9071323727 10/08/202 091191202 10/08/202 11338.00 0.00 0.00 1,338,00 J! J 907639936 10/08/202 09/25/202 09/30/202 271.00 0.00 0,00 271.00� Vendor Totals: Number Name Gross Discount No -Pay Net 11072 BIO-RAD LABORATORIES, INC 11609.00 0.00 0.00 1,609.00 Vendor# Vendor Name Class Pay Code B1650JBOSART LOCK & KEY INC M Invoice# Comment Tran Dt Inv DI Due Dt Check Dt Pay J128814 Gross Discount No -Pay Net 10/081202 10/08/202 10/31/202 42.00 0.00 0.00 42,00 Vendor Totals: Number Name Gross Discount No -Pay Net B1650 BOSART LOCK & KEY INC 42.00 0.00 0.00 42.00 Vendor# !/Vendor Name Class Pay Cade CIO 46 ^.� CALHOUN COUNTY yy Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net J .,� 53143140 09101/20209126/202 797.79 0.00 0.00 797.79 -I01 N.Vir9ir��rA 5i .1/53112545 09101/20209/26/20210/2M02 8.47 0.00 0.00 8.47 f j �1S N-\/irgN'e-N�C'_' ./ 53147642 09/01/20209/26/20210/26/202 8.47 0.00 0.00 8,47 ✓ &1SN.v�r5�11�Ct `t, 53142882 09/01/20209/26/20210/25/202 19,84 0,00 0.00 19.84 % W OS,P� A-c,u � U'v L J 53142876 09/011202 09/261202 10/26/202 41,154.65 0.00 0.00 / 41,154.65 V 4)spP "taA , 5t . ✓ 53142911 09/01120209126/20210/26/202 1,767.18 0,00 0.00 / 1,767.18 \UUt N.ViC"St VendorTotals: Number Name - Gross Discount No -Pay Net C1048 CALHOUN COUNTY 43,756.40 0,00 0.00 43,756.40 Vence r# J'Vendor Neme Class Pay Code 11088 � CANTEX HEALTH CARE CENTERS LLC Invoice# Comment Tran Ot Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 001324 09/24120209/13/20210109/202 816.00 0.00 0.00 816.00 .J 1 (5."'OCUL'p.1nh7 fY` t, bpt'in Qf(or J 093024 091241202 09/30/202 10109/202 7,703.90 0.00 0.00 / 7,703.90 / Vendor Totals: Number Name Gross Discount No -Pay Net 11088 CANTEX HEALTH CARE CENTERS LLC 8,519.90 0.00 0.00 8,519.90 Vendor#/Vendor Name Class Pay Code 14064 `+ CAPITAL ONE Comment Tran Dt Inv DI Due DI Check Dt Pay Gross Discount No -Pay Net �Invoice# 091924 09/30/202 09/191202 10/19/202 1,173.44 0.00 0.00 1,173.44 SUPPLIES ,r ./ Vendor Totals: Number Name Gross Discount No -Pay Net 14064 CAPITAL ONE 1.173.44 0.00 0.00 1,173.44 Vendor# prVendor Name class Pay Code C1325"'J CARDINAL HEALTH 414, INC. W Invoice# Comment Tran Dt Inv DI Due Dt Check Ot Pay Gross Discount No -Pay Net 8003636608 10/07120209/22/20210/30/202 279.32 0.00 0100 279.32 Vendor Totals: Number Name Gross Discount No -Pay Net Vl C1325 CARDINAL HEALTH 414, INC. 279.32 0.00 0.00 279.32 Vendor# lVendor Name Class Pay Code 10541 CARESFIELD Invoice# Comment Tran Ot Inv Ot Due Dt Check Dt Pay Gross Discount No -Pay Net J200027978 09/25/202 09/24/202 10/24/202 77,07 0.00 0.00 77.07 Vendor Totals: Number Name Gross Discount No -Pay Net 10541 CARESFIELD 77.07 0.00 0.00 77.07 Vendor#I Vendor Name Class Pay Code 142367 CARRIER CORPORATION invoice# Comment Tran Dt Inv Dt Due DI Check DI Pay Gross Discount No -Pay Net 1400025500002 09/18/20209/25/20210/31/202 -12,830.00 0.00 0.00 •12,8 0. 0 YlO �nV 0tC-k, ,f 90399155 10104/202 09127/202 10/27/202 12,830So - 0.00 0.00 12,830.00 ../ RENTAL 6/17-7/14/24 JCHILLER 90399166 101041202 09/27/202 10/27/202 12,630.00 0.00 0.00 12,830.00 J CHILLER RENTAL 5/20.6116/24 Vendor Totals: Number Name Gross Discount No -Pay Net 14236 CARRIER CORPORATION 12,830.00 0.00 0.00 12,830.00 Vendor# /Vendor Name Class Pay Code 13264 .J CERVEY, LLC Invoice# 31123 Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net 10103120210105120210/30/202 1.650.00 0.00 0.00 1,660.00 Vendor Totals: Number Name Gross Discount No -Pay Net 13264 CERVEY, LLC 1,650.00 0.00 0.00 1,650.00 Vendor# Vendor Name class Pay Code C1600� CITIZENS MEDICAL CENTER W Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Not ,J 202425 0210/06/202101061202 55,112.20 0,00 0.00 55,112.20,/ C..09910�1_12 t�" 10_e ' �o Vendor Totals: Number Name Gross Discount No -Pay Net C7800 CITIZENS MEDICAL CENTER 55,112,20 0.00 0.00 55,112.20 Vendor#i Vendor Name Class Pay Code 15188 CLARITY ENROLLMENT SOLUTIONS Invoice# 1780 Comment Tran Dt Inv Dt Due Or 09/011202 Check DI Pay Gross Discount No -Pay Net 10/01/202 10131/202 346.50 0.00 0.00 346.50,j Vendor Totals: Number Name Gross Discount No -Pay Net 15188 CLARITY ENROLLMENT SOLUTIONS 346.50 0.00 0.00 346.50 Vendor# Vendor Name class Pay Code 10723`r CILIA LABORATORY PROGRAM J Invoice# Comment Tran DI Inv Ot Due Dt 082024 09/01/202 10/03/202 10/04/202 Check DI Pay Gross 248,00 Discount 0.00 Vendor Totals: Number Name -- "" Gross Discount 10723 CLIA LABORATORY PROGRAM 248,00 0100 Vendors endor Name Class Pay Code 11030 COMBINED INSURANCE Invoice# Comment Tran Dt Inv DI Due Dt Check Dt Pay Gross Discount 100124 10104/20210/01/20210101/202 501.72 0.00 Vendor Totals: Number Name Gross Discount 11030 COMBINED INSURANCE 501.72 0.00 Vendor# Vendor Name Class Pay Code 15116 VCOMPUGROUP MEDICAL -EMUS INC. Invoico4 Comment Tran Dt Inv Dt Due Or Check Dt Pay Gross Discount 9090081841 10104120210/04/202 10/04/202 11,308.50 0.00 SERV PERIOD 10/l/24-12/31/24 Vendor Totals: Number Name Gross Discount 15116 COMPUGROUP MEDICAL -EMDS INC. 11,308.50 0.00 Vendoriit Vendor Name Class Pay Code C1970 CONMED CORPORATION M Invoices Comment Tran Dt Inv Dt Due Dt 10716992 10108/202 10/011202 Check Ot Pay Gross Discount 10/01/202 215.10 0.00 J 10717197 10/08/20210/01/20210/08/202 243.90 0.00 Vendor Tntals: Number Name Gross Discount C1970 CONMED CORPORATION 459= 0.00 Vendor#endor Namo Class Pay Code C2150 COOK MEDICAL INCORPORATED M Invoices Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount V26556786 10/02/202 09/26/202 10126/202 720.90 0.00 Vendor Totals: Number Name Gross Discount C2150 COOK MEDICAL INCORPORATED 720.90 0.00 Vendors Vendor Name Class Pay Code 15656 J - Invoice# Comment Tran DI Inv Dt Due Dt 310CRY0001A Check Dt Pay Gross Discount _/ 10/01/202 08/12/202 10/09/202 20.00 0,00 Vendor Totals: Number Name Gross Discount 15656 20.00 0.00 Vendor# 12044- Vendor Name Class CULLIGAN ULTRAPURE INC. Pay Code Comment Tran DI Inv Dt Due Dt Check.Ot Pay Gross Discount .,fInvoices 093024 10/07/20209/30/20210/22/202 684.65 0.00 Vendor Totals: Number Name 12044 CULLIGAN ULTRAPURE INC. Vendor#/ Vendor Name Class Pay Code 10368 J DEWITT POTH & SON Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay J 7696660 10/08/202 10101/209 10/26/202 7697790 10/08/20210/02/20210/27/202 Gross Discount 684.65 0.00 No -Pay 0.00 No -Pay 0100 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 Nei 248.00 / Net✓ 248.00 Net 501.72 / Net 501.72 Net i t1308.50V Net 11.308,50 No -Pay Net 0.00 215.10 JJ 243.90 0.00 No -Pay Net 0.00 459.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 Net 720.90,j Net 720.90 Net 20.00 J Net 20.00 Net 684.65� Net 684.65 Gross Discount No -Pay Not / 365,06 0.00 0.00 365,05 671.21 0.00 0.00 671.21 J Vendor Totals: Number Name 10368 DEWITT POTH & SON Vendor#/ Vendor Name Class Pay Code 1f011 .J DIAMOND HEALTHCARE CORP Invoice# Comment Tran Dt Inv Of Due Dt Check DI Pay „/ IN20056377 09101/20210/01/20210/26/202 SEPTEMBER '� " (�(rV/v`t IN20056378 X!Y 09101/202 SEPTEMBER Gp� Vendor Totals: Number Name 11011 DIAMOND HEALTHCARE CORP Vendo,41 Vendor Name Class Pay Code 15240 ECLINICAL WORKS LLC invoica# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 0003054861 10107/20210101 /20210/31 /202 AUG 2024 MESSENGER SERVICE Vendor Totals: Number Name 15240 ECLINICAL WORKS _LC Vendor#% Vendor Name Class Pay Code 11091 J ECOLAB Invoice# Comment Tran Dt Inv Ot Due Dt Check Dt Pay 6348274646 10/04/20210/01/P02101311202 OCTOBER SERVICE PERIOD Vendor Totals: Number Name 11091 ECOLAB Vendor# Vendor Name Class El000 j EDWARDS Pay Code LIFESCIENCES M Invoice# „I 13434350 Comment Tran Dt Inv Dt Due Dt 10/081202 101081202 10/08/202 Check Of Pay Vendor Totals: Number Name E1090 EDWARDS LIFESCIENCES Vendor# Vendor Name Class Pay Code 14708�. EQUALIZE RCM SERVICES Invoice# Comment Tran Dt Inv Dt Duo Of Check Dt Pay .f 538009 10/07/202 10/01/202 10/31/202 OCTOBER FEES Vendor Totals: Number Name 14708 EQUALIZE RCM SERVICES Vando,4d Vendor Name Class Pay Code 11944 EQUIFAX WORKFORCE SOLUTIONS Invoice# Comment Tran Dt Inv Dt Due Of Chack DI Pay 2062406369 10/04/202 09/30/20210130/202 Vendor Totals: Number Name 11944 EQUIFAX WORKFORCE SOLUTIONS Vendor# i Vendor Name Class Pay Code R7185 J FARAH JANAK Gross Discount No -Pay Net 1,036.26 0.00 0.00 1,036.26 Gross Discount No -Pay Not 35,498.91 0.00 0.00 35,498.91 J 19,166.67 0.00 0.00 19,166,67 Gross Discount No -Pay Not 54,665.68 0.00 0.00 54,665.58 Gross Discount No -Pay Net 474.80 0.00 0.00 474.80 j Gross Discount No -Pay Net 474.80 0.00 0.00 474.80 Gross Discount No -Pay Net 231.38 0.00 0.00 231.38 J Gross Discount No -Pay Net 231.38 0.00 0.00 231.38 Gross Discount No -Pay Net 133.20 0.00 0.00 133.20 . Gross Discount No -Pay Net 133.20 0.00 0.00 133.20 Gross Discount No -Pay Net 5,649.03 0.00 0.00 5,640.03t Gross Discount No -Pay Net 5,649.03 0.00 0.00 5.649.03 Gross Discount No -Pay Net 10.99 0.00 0.00 10.99 Gross Discount No -Pay Net 10.99 0.00 0.00 10.99 Involca# Comment Tran Dt Inv Dt Due DI Check Of Pay Gross Discount No -Pay 092724 10101120209/27120210/30/202 90.60 0.00 0.00 W con 5 t('.e�fa ZCA,� Vendor Totals: Number Name Gross Discount No -Pay R1185 FARAH JANAK 90,60 0.00 0.00 Vendor# Vendor Name Class Pay Code 1008Z FASTHEALTH CORPORATION Net �gp0" Net 20M Comment Tran DI Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Nei JInvoice# 08A24MMC 08/13/20208/01/20210/31/202 -545.00 0.00 0.00 -545.00 09A24MMC 09110/20209/01120210/31/202 545.00 0.00 0.00 545.00 J IOA24MMO 10/04/20210/01120210/31/202 1,090.00 0.00 0.00 1.090.00 J Vendor Totals: Number Name Gross Discount No -Pay Nei 10689 FASTHEALTH CORPORATION 11090.00 0.00 0,00 1,090,00 Vendor#%Vendor Name Class Pay Code F1400 FISHER HEALTHCARE M Invoice# Comment Tran Ot Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Nei 2831129 09/01/20205/09120206/03/202 697.23 0.00 0100 607.23 SUPPLIES .- 5690949 10/08/20209/26l2tl210/21/202 479.32 0.00 0.00 y 479.32 5690948 10108/202 09/26/202 10/211202 1,288.62 0.00 0.00 1,288.62 /88.62 �./ 5728185 10/08/202 09/271202 10122/202 142.30 0.00 0.00 142.30,% �.1 5762166 10108/202 09/301202 10125/202 1,248.36 0.00 0.00 1.248.36 5762165 10/08/202 09/30/202 10/25/202 743.51 0.00 0.00 743.51 J 5798625 10108/202 10/01/202 10/26/202 852,56 0.00 0.00 852.56 J J5798628 10/08/202 10/01/202 10/26/202 1,280.76 0.00 0.00 1.280.76 1/ Jf 5798626 10/08/20210/01120210/26/202 50.68 0.00 0.00 50,58 J 5798627 10/08/202 10/01/202 10/26/202 144.65 OAO 0100 144.65 .� 5430767 10109/202 08/161202 09/10/202 737.64 0.00 0.00 737.54 J Vendor Totals: Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 7,665,43 0.00 0.00 7,665.43 Vend or#( Vendor Name Class Pay Code 12404 ,J GE PRECISION HEALTHCARE, LLC I Invoice# Comment Tran 01 Inv DI Due Dt Check Ot Pay Gross Discount No -Pay Net �.! 6002778050 101061202 10/01/202 10/31/202 86.67 0100 0.00 86.67 j OCTOBER BILLING PERIOD 6002778419 10/08120210/01/20210/31/202 998.34 0.00 0.00 998.34 JOCTOBER 6002778056 BILLING PERIOD 10/08/202 101011202 10/31/202 5,665.63 0.00 0.00 5,665.83 OCTOBER BILLING PERIOD I �r 6002778051 10/081202 10/01/202 10131/202 2,422.50 0100 0.00 2,422.50 ./ OCTOBER BILLING PERIOD J6002778049 10/08/202 10/011202 10/31/202 3,688.68 0.00 0.00 3,580,50 J OCTOBER BILLING PERIOD 6002778052 10/08/202 10101/202 10/31/202 61.67 0.00 0.00 61.67 J OCTOBER BILLING PERIOD Vendor Totals; Number Name Gross Discount No -Pay Net 12404 GE PRECISION HEALTHCARE, LLC 12,823.59 0.00 0.00 12,823.59 Vendor Vendor Name Class Pay Code 12948 GREAT AMERICA FINANCIAL SVCS Invoice4 Comment Tran Dt Inv DI Due Dt Check Dt Pay Gross Discount No -Pay Net 37576008 10/0 ,JJ 1/202 10/02/202 10/09/202 10,433.95 0.00 0.00 10,453.95 Vendor Totals: Number Name Gross Discount No -Pay Not 12940 GREAT AMERICA FINANCIAL SVCS 10,433.95 0.00 0.00 10,433.95 Vendor 8/ Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Nei 2678313 10/081202 10101/202 10/31/202 995.62 0.00 0.00 995.82 Vendor Totals: Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 995.82 0.00 0.00 995.82 Vendorll Vendor Name Class Pay Code 103&I HEALTH CARE LOGISTICS INC j Invoice# Comment 309639745 Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net .1 10/02/202 10/021202 11/01/202 64.86 0.00 0.00 64.86� Vendor Totals: Number Name Gross Discount No -Pay Net 10334 HEALTH CARE LOGISTICS INC 64,86 0.00 0.00 64,66 Vendor# Vendor Name Class Pay Code 11552'7 HEALTHCARE FINANCIAL SERVICES Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net .J 100939451 09101/202 09/271202 11/01/202 4,610.62 0.00 0.00 4,610.52 Vendor Totals: Number Name Gross Discount No -Pay Net 11552 HEALTHCARE FINANCIAL SERVICES 4,610.52 0.00 0100 4,610.52 Vendor# Vendor Name Class Pay Code H0031 HEB CREDIT RECEIVABLES DEPT308 Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 4556 09/30/202 09/251202 101091202 1,809,92 0.00 0.00 1,809.92V/ Vendor Totals: Number Name Gross Discount No -Pay Net H0031 HEB CREDIT RECEIVABLES DEPT308 1,809,92 0.00 0.00 1,809.92 Vendor# /Vendor Name Class Pay Code H04i8 HOLOGIC INC Invoice# Comment 11068776 Tran Dt Inv of Due Dt 09125/202 09/12/202 10/27/202 Check Dt Pay Gross 236.25 Discount 0.00 No -Pay 0.00 Net 236,25,,�/ Vendor Totals: Number Name Cross Discount No -Pay Net H0416 HOLOGIC INC 236.25 0.00 0.00 236.25 Vendor# 1 Vendor Name Class Pay Cade 10922 HUNTER PHARMACY SERVICES Invoice# Comment 6198 Tran Dt Inv Dt Due Ot 1010 11202 09/30/P02 Check Dt Pay Gross Discount No -Pay Net .,� 10/20/202 14.902.91 0.00 0.00 14,902,911 Vendor Totals: Number Name Gross Discount No -Pay Net 10922 HUNTER PHARMACY SERVICES 14.902.91 0.00 0.00 14,902.91 Venda r#) Vendor Name Class Pay Code 12228 INNOVATIVE STERILIZATION Invoice# Comment 32076 Tran Dt Inv Dt Due Dt 10/09/202 10/02/202 Check Dt Pay Gross Discount No -Pay, Net 10109/202 1,108.70 0.00 0.00 1,108.70 Vendor Totals: Number Name Gross Discount No -Pay Net ) 12228 INNOVATIVE STERILIZATION 1.100.70 0.00 0.00 11108.70 Vendor�Vendor Name Class Pay Code 14364 JACQUELINE HERRERA Invoice# Comment Tran Dt Inv Dt Due Dt Chock Dt Pay Gross Discount No -Pay Net 100924 10/01/202091251202 69.68 0.00 0.00 69.68 Vendor Totals: Number Name Gross Discount No -Pay Net 14304 JACQUELINE HERRERA 69.60 0.00 0.00 69.68 Vendor# (Vendor Name Class Pay Code 14540 j JINDALX LLC invoice# Comment Tran Dt Inv Dt Due On Check Dt Pay Gross Discount No -Pay Net 202425050 09101/20210/01/20210109/202 9.000.00 0,00 0.00 9,000.00,/ SEP SERVICE PERIOD Vendor Totals: Number Name Gross Discount No -Pay Not 14540 JINDAL X LLC 9.000.00 0.00 0.00 9,000,00 Vendor# Vendor Name Class Pay Code 14244 LONESTAR COMMUNICATIONS, IN Invoice# Comment Tran Dt Inv Di Due DI Check D1 Pay Gross Discount No -Pay Not 1,93458 10/02i202 09/30/202 10/30/202 721,60 0,00 0.00 721.60 .J Vendor Totals: Number Name Gross Discount No -Pay Net 14244 LONESTAR COMMUNICATIONS, IN 721.60 0.00 0.00 721.60 Vendor# Vendor Name Class Pay Code L1640 ,� LOWE'S BUSINESS ACCT/SYNCB W JInvoice# 092824 Comment Tran Dt Inv Dt Due Dt 09/30/202 09128/202 Check Dt Pay Gross Discount No -Pay Net 10/10/202 632,54 0.00 0.00 632.54,/ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net L1640 LOWE'S BUSINESS ACCT/SYNCB 632.54 0.00 0.00 632.54 Vendor# endor Name Class Pay Code 10972 M G TRUST Invoice# 092024 Comment Tran Dt Inv Dt Due DI 10/10/20209/20/20210/31/202 Check Dt Pay Gross Discount No -Pay Net 895.00 0.00 0.00 695.00� Vendor Totals: Number Name Gross Discount No -Pay Net 10972 M G TRUST 895.00 0.00 0.00 895.00 Vandor# Vendor Name Class Pay Code M21 , MCKESSON MEDICAL SURGICAL INC J22711758 Invoice# Comment Tran. Dt Inv Dt Due Dt 10/09/20210/09/20210/24/202 Check Dt Pay Gross Discount No -Pay Net 128.08 0.00 0.00 128.06t / Vendor Totals: Number Name Gross Discount No -Pay Net M2178 MCKESSON MEDICAL SURGICAL INC 128,08 000 0.00 128,08 Vendor# Vendor Name Class Pay Code M2470 MEDLINE INDUSTRIES INC M J Invoice# Comment Tran Dt Inv Dt Due Ot Check Ot Pay Gross Discount No -Pay Not 2336820927 09/25/2W 09/25/202 10/30/202 42.00 0.00 0.00 42.00 2336820926 09/251202 09/251202 10/31/202 59346 0.00 0.00 593.46 2337922885 10/02/202 10/02/202 10/27/202 106.78 0.00 0.00 106.78 .1 Vendor Totals: Number Name Gross Discount No -Pay Net M2470 MEDLINE INDUSTRIES INC 742.24 0.00 0.00 742.24 Vender#lVendor Name Class Pay Code 10963^J MEMORIAL MEDICAL CLINIC Invnlce# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Not 100324 10/07/202 10/01120210/011202 76,73 0.00 0.00 76.73 J Vendor Totals: Number Name Gross Discount No -Pay Net 10963 MEMORIAL MEDICAL CLINIC 76.73 0.00 0.00 76,73 Vendor# f Vendor Name Class Pay Code G0333 V MICHAEL GAINES yV Invoice# Comment Tran Dt Inv IN Due Dt Check Dt Pay Gross Discount No -Pay Net 100324 09101/202 10/031202 10/08/202 129.00 0.00 0.00 129m ,10 V L�m"Q'� r �"uC�+`ZSGs �`"�"'No-Pay Vendor Totals: Numherne Discount Net G0333 MICHAEL GAINES 129.00 0.00 0.00 129.00 Vendor# (Vendor Name Class Pay Code 10546 „J MITCHELL AUTO GLASS, INC Invoice# Comment Tran Dt Inv Ot Due Ot 10109/202 09/13/202 10109/202 Check Dt Pay Gross Discount No -Pay Net 1I18016 6,250.00 0.00 0.00 6,250.00,-f / Vendor Totals: Number Name Gross Discount Plc -Pay Net 10546 MITCHELL AUTO GLASS, INC 8,260.00 0.00 0.00 6,250,00 Vendor#t Vendor Name Class Pay Code 1053; MORRIS & DICKSON CO, LLC Invoice# 8116 Comment Tran Ot Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net / 10/07/202 09/301202 10/101202 -102.69 0.00 0.00 -102.69 J J2495731 10/07/202 09/30/202 10/10/202 7.813.15 0.00 0.00 7,813A5 j „J SC6093 10/07/20209/25120210/05/202 284.03 0.00 0.00 284,03 J/ SC6092 10/07/202 00125/202 10105/202 53.14 0.00 0.00 53.14 J JSC6094 10107/202 09125/202 10/05/202 241.29 0.00 0.00 241.29 .J 2494222 10/07120209/291202 10/09/202 23.82 0.00 0.00 2182 „1 2494220 10/07120209/29/20210/09/202 33.94 0.00 0.00 33.94 J2494219 10/07/20209/29120210/091202 298,22 0.00 0.00 258.22 / J2494221 10/07/202 09/291202 10/09/202 1,666.80 0.00 0.00 1.666,80 J/ 2498538 10/07/20209/30/20210/10/202 17,579.80 0.00 0.00 17,579.80 J/ 2504004 10/07/20210/01/20210/11/202 408.04 0.00 0.00 408.04 J/ ,J 2500981 10/07/202 10101/202 10/11/202 217.06 0.00 0.00 217.06-/ 2504005 10/07/20210/01/20210/11/202 601.11 0,00 0.00 601.11 J 2500982 10107/20210/01/202 10/11/202 71.67 0.00 0.00 71.67 ,j 2502637 10/07/202 10/01/209 10/11/202 1,490,14 0.00 0.00 1.400.14 J2602638 10107/20210/01/20210/11/202 2,457,08 0.00 0.00 2,4.57.08 / 2600983 10/07/20210/01120P 10/11/202 39.87 0.00 0.00 39.87 Vendor Totals: Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON 00, LLC 33,136.47 0.00 0.00 33,136.47 Vendor Vendor Name Class Pay Code 01500.J OLYMPUS AMERICA INC M Invoice# Comment Tran DI Inv Dt Due Of Check Dt Pay Gross Discount No -Pay Not / 36089838 10108/20204/17/20206/12/202 '145,00 0.00 0,00 145,00 J 36963669 10/08/202 10/07/202 1 11011P02 1,126.00 0.00 0.00 ,�J,.b259tl Y f O� nv ol; ere_. - v e m can Vendor Totals: Number Name Gross Discount No -Pay Net 01500 OLYMPUS AMERICA INC 1,270.00 0.00 0.00 1,270.00 Vendor# Vendor Name Class Pay Code 01416 ORTHO CLINICAL DIAGNOSTICS Invoice# Comment Tran Of Inv Of Due Di Check Of Pay Gross Discount No -Pay Net 185$736395 10102/202 091301202 10/30/202 2,286.17 0,00 0.00 2,286.17� Vendor Totals: Number Name Gross Discount No -Pay Net 01416 ORTHO CLINICAL DIAGNOSTICS 2,286.17 0100 0.00 2,286.17 Vendor Vendor Name Class Pay Code 11155 PARAREV Invoice# Comment Tran Ot Inv Ot Due Dt Check Dt Pay Gross Discount No -Pay Net 920860 10/07/20210/01/20210/31/202 3,084.00 0.00 0.00 3,084.00 Vendor Totals: Number Name Gross Discount No -Pay Nei 11155 PARAREV 3,084.00 0.00 0100 $,084.00 Vendor#/Ventlor Name Class Pay Code PP'l a. PORT LAVACA WAVE W JInvoice# Comment Tran Dt Inv DI Due Dt Check Ot Pay Gross Discount No -Pay Net 092624 10/08/202 09/26/202 10/21/202 736.00 0.00 736.00 / Vendor Totals: Number Name Grass Discount No -Pay Not P2100 PORT LAVACA WAVE 736.00 0.00 0,00 736.00 Vendort! Vendor Name Class Pay Code 10372 PRECISION. DYNAMICS CORP (PDC) Involcert Comment Tran Dt Inv DI Due Dt Check Of Pay Gross Discount No -Pay Net 9357240666 09/25/202 09/241202 10/24/202 306.54 0.00 0.00 306.54�/ Vendor Totals: Number Name Gross Discount No -Pay Net 10372 PRECISION DYNAMICS CORP (PDC) 306,54 0.00 0.00 306.54 Venda,"' Vendor Name Class Pay Code 11932 ^/ PRESS GANEY ASSOCIATES, INC. Jinvoice# Comment Tran Of Inv Ot Due Dt Chock Of Pay Gross Discount No -Pay Net IN000670801 10/07/202 09130/202 10130/202 2,838,92 0.00 0.00 2,838.92 Vendor Totals: Number Name Gross Discount No -Pay Net 11932 PRESS GANEY ASSOCIATES, INC. 2,838.92 0.00 0.00 2,838.92 Vendar# Vendor Name Class Pay Code 11080 RADSOURCE Involce# Comment Tran 01 Inv DI Due Ot Check Ot Pay Gross Discount No -Pay Net PS1003186 10/011202 09/301202 10/30/202 4,000.00 0.00 0.00 41000.00� Vendor Totals: Number Name Gross Discount No -Pay Net 11080 RADSOURCE 4.000.00 0.00 0.00 4,000.00 Ventlor# Vendor Name Class Pay Code 1125Q RAPID PRINTING LLC JInvolce# Comment Tran Of Inv Of Due Of Check 01 Pay Gross Discount No -Pay Net 25654 10104/20210/07120P 10/17/202 24.00 0.00 0.00 24.00 ` Vendor Totals: Number Name Gross Discount No -Pay Net V! 11251 RAPID PRINTING LLC 24.00 0.00 0.00 24.00 Vondor# Vendor Name Olass Pay Code 50900 •. SAMS CLUB DIRECT W Invoice# Comment J092024 Tran Dt Inv Dt Due Dt Check Dt Pay 10/01/20209/20/202 10/09/202 Vendor Totals: Number Name $0900 SAMS CLUB DIRECT Vendor# Vondor Name Class Pay Code 10936 SIEMENS FINANCIAL SERVICES Invoice# Comment Tram Dt Inv Dt Due Dt Check Dt Pay 56382500000089 10/08/202 101011202 10121/202 OCTOBER RENTAL Vendor Totals: Number Name 10936 SIEMENS FINANCIAL SERVICES Ventlor# Vendor Name Class Pay Code S2001 JSIEMENS MEDICAL SOLUTIONS INC M Comment Tram Dt Inv Dt Due Dt Check DI Pay /Invoice# V 116611464 10/04/202 09/24/202 10/19/202 Vendor Totals: Number Name 52001 SIEMENS MEDICAL SOLUTIONS INC Ventlor# Vendor Name Class Pay Code 11296 SOUTH TEXAS BLOOD & TISSUE CEN Invotco# Comment Tram Dt Inv Dt Due Dt Check Dt Pay 092324 09/231202 09/17/202 101311202 107044130 10/02/20209130120210/30/202 _ CM13287 10/02/202 09/301202 10131/202 Vendor Totals: Number Name 11296 SOUTH TEXAS BLOOD & TISSUE GEN Vendor# Vendor Name Class Pay Code 10845 +• STAPLES Invoioelt Comment Tram Dt Inv Dt Due Dt Check Dt Pay 16013246817 10/02/202 09130/20210/30/202 Vendor Totals: Number Name 10645 STAPLES Vendor# endor Name Class Pay Code T2539 T-SYSTEM, INC W Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay J920059 10/04/20210/01/20210/30/202 Vendor Totals: Number Name T2539 7-SYSTEM, INC Vendor# Vendor Name Class Pay Code 15244�TEXAS ELITE THERAPY TEAM LLC Invoice# Comment 093124 Tran Dt Inv Dt Due Dt Check Dt Pay 091011202 101011202 10/091202 Vendor Totals: Number Name 15244 TEXAS ELITE THERAPY TEAM LLC Ventlor# Vendor Name Class Pay Code 51801 TRACI SHEFCIK W Invoice# Comment Tram Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 398.73 0.00 0.00 396,73 J Gross Discount No.Pay Net 398.73 0.00 0.00 398.73 Gross Discount No -Pay Net 1,333,33 0.00 0.00 1.333.33� Gross Discount No -Pay Net 1,333.33 0.00 0.00 1,333,33 Gross Discount No -Pay Net 3,507.72 0.00 0.00 3,507.72 1 Gross Discount No -Pay Net 3,507.72 0.00 0.00 3,507.72 Grass Discount No -Pay -Net -34.00 0.00 0.00 -34.00 6,558.00 0100 0.00 6,55s.00 V -3,089.00 0.00 0.00 -3,089.00 Gross Discount No -Pay Net 3,435.00 0.00 0.00 3,435.00 Gross Discount No -Pay Net 152.36 0.00 0.00 152,36 J Gross Discount No -Pay Not 152.36 0.00 0.00 152.36 Gross Discount No -Pay Net 6,130.42 0,00 0.00 6,130,42 Gross Discount No -Pay Net 6,130.42 0.00 0.00 6,130,42 Gross Discount No -Pay Net 16,375,00 0.00 0,00 16,375.00� Gross Discount No -Pay Net 16,375.00 0.00 0.00 16.375.00 Gross Discount No -Pay Not J091024 0910V20209/10/20210/08/202 Vendor Totals: Number Name - S1801 TRACI SHEFCIK Vendor# jVendor Name Class Pay Code 10841 VJ TRUBRIDGE, LLC Invoice# Comment Tian DI Inv DI Due Ot Check Dt Pay JA2410071378 10101/20210107/20210/09/202 Vendor Totals: Number Name 10841 TRUBRIDGE, LLC Vendor# endor Name Class Pay Code 11002qTRUSTAFF Invoice# Comment Tran DI Inv Ot Due Dt Check Ot Pay 2267082 10/07/202 10103120210/31/202 Vendor Totals: Number Name 11002 TRUSTAFF Vendor# endor Name Class Pay Code U1064 UNIFIRST HOLDINGS INC Invoice# Comment Tran Dt Inv Dt Due Dt Check DI Pay J 2921043660 10107/202 10/031202 10128/202 „I 2921043668 10/07/202 10/03/20210128/202 .J 2921043657 10/07/202 10/03/202 10128/202 J2921043659 10/07/202 10/03/20210/281202 J2921043662 10/07/202 10/03120210/28/202 J2921043664 10/07/20210/03/20210/28/2% 2921043661 10/07/20210103/202 10/28/202 2921043663 10/07/202 10/03/202 10/28/202 2921043897 101081202 10107/202 11101/202 •,,/ / 2921043896 10/08/202 101071202 11101/202 Vendor Totals: Number Name U1064 UNIFIRST HOLDINGS INC Vendor# %Vendor Name Class Pay Code U2001 ^ / US POSTAL SERVICE W Incite# Comment Tran Ot Inv Ot Due Ot Check Dt Pay 10072024 10/09/202 10/07/202 10/091202 Vendor Totals: Number Name U2001 US POSTAL SERVICE Vendor# Vendor Name Class Pay Code 15616 UTHEALTH CQHII .� Invoice# Comment Tran DI Inv Dt Due Dt Check Dt Pay 3118 10107/202 10/02/202 11/011202 Vandor Totals: Number Name 428.76 0.00 Umea uiticuunr 428.76 0.00 Gross 19,040.00 Gross 19,040.00 Gross 3,124,00 Gross 3,124.00 0.00 No -Pay Net 0.00 jatl7k ` Discount No -Pay Net 0.00 0.00 19,040.00 V Discount No -Pay Net 0,00 0.00 19,040.00 Discount No -Pay Net DIM 0.00 3,124.00 Discount No -Pay Net 0.00 0.00 3,124.00 Grass Discount No -Pay 34,04 0.00 0.00 212.63 0.00 0.00 128.47 0.00 0.00 1,955.20 162,14 142,22 372.12 181.78 122.69 2,516.03 Gross 5,827,32 nxrt.�rxriu 0.00 0.00 0.00 0,00 0,00 0.00 0.00 0.00 0.00 9,00 0.00 0.00 Discount No -Pay 0,00 0.00 Net 34.04 212.63 128.47 1,955.20 1I 102.14 142.22 I 372.12 J 181.78 122.69 J 2,516.03 ,% Not 5.627.32 Gross Discount No -Pay Net 2,200.00 0.00 0.00 2,200,00� Gross Discount No -Pay Net 2,200.00 0100 0.00 2,200,00 Gross Discount No -Pay Net 900.00 0.00 0.00 900.00,/ Gloss Discount No -Pay Net 15616 UTHEALTH COHII Vendor) //Oandor Name Class Pay Code V1056-�IVICTORIA AIR CONDITIONING LTD W j/ / Invoico# Comment 214228 Tran Dt Inv Dt Due Dt 10/04/202 10/04/202 101041202 Check Dt Pay ""JJJ Vendor Totals: Number Name V1056 VICTORIA AIR CONDITIONING LTD Vendor) Vendor Name Class Pay Code V1471 VICTORIA RADIOWORKS, LLC W Invoice# Comment 24090141 Tran Dt Inv Dt Due Dt 10/04/20209/30/202 10/01/202 Check Dt Pay Vendor Totals: Number Name V1471 VICTORIA RADIOWORKS, LLC Vendor) Vendor Name Class Pay Code 12208 VWAGEWORKS Invoice# Comment Tran Dt Inv DI Due Dt Check Dt Pay INV7016322 10/01/202 09/25/20210/091202 Vendor Totals: Number Name 12208 WAGEWORKS Vendor# endor Name Class Pay Code 12548 YWAGEWORKS, INC Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay f v 0924TR116665 09/011202.001251202101091202 SEPTEMRER SERVICE PERIOD Vendor Totals: Number Name 12548 WAGEWORKS, INC Vendor# Vendor Name Class Pay Code 11 i 10 WERFEN USA LLC Involceli Comment Tran Dt Inv Dt Due Dt Check Dt Pay 9111629643 09/04120210/02/202 10/27/202 Vendor Totals: Number Name 11110 WERFEN USA LLC Vendor# Vendor Name Class Pay Code 105567 WOUND CARE SPECIALISTS Invoice) Comment Tran Dt Inv Dt Due Dt Check DI Pay JWCS00006951 10/01120210/011202 10/30/202 Vendor Totals: Number Name 10556 WOUND CARE SPECIALISTS Grand Totals: Gross Discount 415,960.57 0.00 APPROVED ON or] r a r0211 CALHOI.19U ::OUN�� AUDIT? 900.00 0.00 0.00 900.00 Grass Discount No -Pay Net 355,00 0.00 0.00 355,00,/ Gross Discount No -Pay Net 365.00 0.00 0.00 365.00 Gross Discount No -Pay Net 100.00 0.00 0.00 160.00� Gross Discount No -Pay Net 160.00 0.00 0.00 160.00 Gross Discount No -Pay Net 559.25 0.00 0.00 559.25 ./ Gross Discount No -Pay Net 559.25 0.00 0.00 559.2.5 Grass Discount No -Pay Net 131.25 0.00 0.00 131.25 Gross Discount No -Pay Net 131.25 0.00 0.00 131.26 Gross Discount No -Pay Net 475.00 0.00 0.00 475.00�j Grass Discount No -Pay Net 475.00 0.00 0.00 475.00 Gross Discount No -Pay Not 9,760.00 0.00 0,00 9,750.001/ Gross Discount No -Pay Net 9,750.00 0.00 0,00 0,750.00 No -Pay Net � 0.00 4 60-67% }.,�. � i ncor•�e c,�- cur,w� c - r.e7v,o.,.� �� nyumvvLi BY No VOUNYY AUDITC9B ON RUN DATE: 10/10/24 OCT 10 2U24 MEMORIAL MEDICAL CENTER TIME; 13:02 EDIT LIST FOR PATIENT REFUNDS AF,IU=0001 PATIENT CALHOUN WONMIYAS PAY PAT NUMBER PAYEE NAME DATE MOUNT CODE TYPE DESCRIPTION ..........--------------------------------- .............. ................. .......... J 150435 0� 092524 56,18 2 REFUND TX 77979 092.924 „ / 284.69 2 REFUND FO WI 531077937 092524 ,3042.49 2 REFUND FO WI 537017937 092524 .1512,46 2 REFUND FO WI 537077937 j 092524 V 240.18 2 REFUND FO WI 537077937 092524 I 2704.60 2 REFUND FO WI 537077937 101024 J 63.00 2 REFUND FO TX 77979 092524 J 1495.17 2 REFUND FO WI 537077937 092524 /4743.99 2 REFUND FO WI 537071937 101024 J 368,90 2 REFUND FO TX 77979 092524 J 25230,84 2 REFUND FO WI 537077937 101024 , HMO 3 REFUND FO TX 77979 J 101024 ,/ 113.45 2 REFUND FO TX 77979 092524 J10996.91 2 REFUND FO WI 531017937 092524 ./ 3744,50 2 REFUND F0. WI 537077937 092524 J4042.26 2 REFUND FO' WI 537077937 101024 .1 176,71 5 REFUND FO, NO 631952366 PAGE 1 APCDEDIT RUN DATE: 10/10/24 TIME: 13:02 PATIENT / NUI4RER J TOTAL PAYEE NAME ARID=0001 TOTAL -------------- APPROVED ON ON 17y0g12�0p2}4pp CAI M31JN1'Y IPAS MEMORIAL MEDICAL CENTER PAGE 2 EDIT LIST FOR PATIENT REFUNDS ARID=0001 APCDEDIT PAY PAT DATE AMOUNT CODE TYPE DESCRIPTION GL 1IL1.4 092524 2575.17 2 REFUND FOR Ill 53707 101024 J 217.35 2 REFUND FOR EI 537088957 092524 136.42 2 REFUND FOR TX 77995 / 092524 �j 1500.00 1 REFUND FOR TX 17979 101024 109 , 3 REFUND FOR TX 779791-X•-+'0RcLMcAckt, -tD 11Jt (•� 092524 424.17 2 REFUND FOR TX 77979 101024 J869,ff1 2 REFUND FOR TX 71465 101024 / 100.00 5 REFUND FOR TX 77465 V 092524 J 945,00 3 REFUND FOR TX 77979 101024 2 REFUND FOR NM 871251409 YY tt) W -On(D ................................................................................................. 66864.73 .......... ............... ................................ .............................. ....... F CITIBANK CORPORATE CAR® Account Statement Commemlol car4AcwuM ERINCLEVENam ��'"��Account Inquiries: � � -,fix' Tall Frea: 1-(88M-2404553 International: 1-(904)-954-7314 Account Number• XXXX-XXXX-XX)OC-6228 TODMY: 1-(877)-505.7276 " ronary of Account Activity Total AaDvOy $85L99 Send Notice or Billing Errors and Customer Service Inquiries to: CITIBANK, N.A. PO BOX 6125. SIOUX FALLS SD 57117.6125 Transactions Dais Not an invoice. For your records only, Credil Limit $20.000 Cash Advance Limit $5,000 Statement CroSing Date ID10312024 Days in Billing Period 30 "''""'"'""..... NOTICE MEMO rrEM(S) LISTED BELOW •"'•"•'"''•'•'""' 09105 09105 6999 55432864249205802321999 1 AMA'CREDENTIAING SONS2143351L 60611 Mal 09105 9399 05134374260600MOS72147 2 NPDB NPnS.HRSA,GOV FAIRFAX VA 22033 N113959871 09110 09109 9399 05134374254=60608384 3 NPOBNPDS.HRSA.GOV FAIRFAX VA 22033 N114059755 09118 0917 9399 5548872426201621277e172 4 TXDPSCRIMERECS AUSTIN TX 78752 720278118 09126 0=3 7011 75120714268940714790712 5 KALAHARI RESORT -TX ROUNDROCK TX 78665 RBFLGSYZN CHECKIN:091=2024 10102 1=1 9399 051343742760000694MOM 6 NPDBNPDB.HRSA.GOV FAIRFAX VA 2203n N115503324 1=2 Mill 9300 05434374276SX069493113 7 NPDBNPD8.HRSAGOV FAIRFAX VA 22D33 N11SS03756 _ ID/02 10102 8999 55432864276204607835505 8 AMA-CRE0ENTtAUNG 800,6214M5IL 60611 10103 10102 9399 05134374277600057841718. 9 NPD13NPDB.HRSA.GOV FAIRFAX VA 22033 NIISUB144 1W03 IC102 9399 06134374277600067841890 10 NPDB NPDB.HRSA.GOV FAIRFAX VA 22033 N115545803 """ "' """" TOTAL AMOUNT OF NOTICE: SEE REVERSE $IDE FOR 9APORTANT INFORMATON Pagel or at,y a CITIBANK N.A PO BOX 6125 SIOUX FALLS ED 571IM125 ERIN CLEVENGER 202 S ANN ST., STE A PORT LAVACA TX 77979-42D4 ,r'f'FNJVED ON ou 1 U 2024 HY COUNTY AUDI'Cyy CALL-10lJN COUP7Ty.. XrAS USA USA USA USA USA USA USA USA USA USA 44.00 ti- 2.60 260 L' 153,63 };'I 62180 L 75.00 250 MA0 ✓ 260 2.50 L' Account Number XXXX-XXXX-XXXX 6228 Statement Closing Date October 03, 2024 00010079643 Not an Irmolce. For your records only. MEMORIAL, MEDICAL, CENTER PURCHASE ORDER Bill To: 815 N. VIRGINIA ST PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX:" (361) 552-0312 Vendor Nante: Vendor Address: Vendor Phone #: Vendor Fax #: Ship To: 815 N' VIRGINIA ST, PORT LAVACA, TX 77979 PHONE: (361)552-6713 FAX: (361) 552.0312,/ , Date: P.O, # Account # Initiated Bv: Dnte Required Expense# DLpanment Deliver To P°rm#9401 Line Qty. Catalog Number Description Unit Cost Unit Extended No, Mos. Cost ' Vll ('-i 2 (I 1YIrn� Cf1Y�f y� /1i "1{y�%�{Vy�( 4 �IDID i Pf�-OAe-s„ 6nroI 5 1`/K C) 6 On av11 Y7G { {}c CMG s -{mod B HOW -Str,� --Tu9-4,-'H Cn-tf� tee.. l u1 04 to - N PD1b - 1 12N.It �J 2 5C) NOTES: Est. Freight Est. Total Cost TOTAL COST SC) d.113 Contact: Quoted By: Buyer: Date: E.T.A. Dept. Director_ Dir. Nursing Dir. Clinical Services Administrator MEMORIAL MEDICAL CENTER PURCHASE ORDER Bill To: 815 N. VIRGINIA ST. PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX:' (361)552-0312 ,— Vendor Name: I ob,,w) Vendor Address; Vendor Phone N: Vendor Fax #: Ship To: 8 IS N. VIRGINIA ST, PORT LAVACA, TX 77979 PHONE: (361) 552-6713 FAX: (361) 552-0312 Date: (v 10 ( rt-u p-q- P.0, # Account # Initiated BY: Date Required Una Catalog Number Extended No. Description unit co-3—t Unit I Ph 14H.D0 2 ptI M( fry', prt) V, nnq( 4 D 1�) - Pro v 14ek- f I 1 7: Ci 3 7 CIF S . . ....... . 9 10 NOTES: hat. weight Est. Total Coat- TOTAL COST 41 -oc) i fyw(e- -tv erlds MC--- Contact: Date: Dept Director�..._ Quoted By: Dir. Nursing Buyer. 9N.A. Dir. Clinical Services CITIBANK CORPORATE CARD vAccount Statement CnMNCRIMOId Accaw 40�m Account Inquiries: STEW BROCK atiTell Free: 1-(800)-248.4553 International., 1-(904)-954-7314 Account Number: XXXX- XXX-XXXX_1615 TODn7y: 1-(Br7)605.7275 Summary of Account Activity Not an invalca_ Fnr vnr.r roe r r� a. Send NQUeO Of Blling Errors and Customer Service fnquldes to: CITIBANK. N.A., PO 130)(6125, SIOUX FALLS SD 57117-6125 Transactions I Pan—r��-`.�------' ----._ "'•"'•""'•NOTICE MEMO ITEM(S) LISTED BELOW•••••••••'•••••••••• �"^ 00r25 oM 7011 75120714268S00014795748 1 KAWIARI RESORT -TX ROUNOROCK TX r R8T2TWMWY 76685 USA 522.60 CHECK IN, owwom 09(30 09/26 7011 76120714271800078789833 2 KALAHARIRORT. TX ROUNDROCK TX 78655 USA 124.12 ROT2TW14Ud1' CHECKIN:OMW024 APPROVED ON OCT 10 n)' , CAaiouNUCQurri D1TFXAS NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION CITIBANK N.A. e S OUX FALLS SD 67117-6125 STEVE BROCK 202 S ANN ST. STE A PORT LAVACA TX 779794204 Pagel oft ............................................................ Account Number XXXX•XXXX-XXXX-1615 Statement Closing Dato October 03, 2024 00010079654 Not an invoice. Foryourre dsonly. MEMORIAL MEDICAL CENTER PURCHASE ORDER Bill To: 815 N. VIRGINIA ST. Ship To: 815 N. VIRGINIA 57, PORT LAVACA, TX 77979 PORT LAVACA, TX 77979 PAX:' (361)552-03)2, PHONE: 1) 552-6713 PHONE: (361) 552.6713 FAX: d (361) 552.0312 Vendor Name: Vi� `'r�2�{�/l¢ice (�Cg 61)55 -0312 Date: 9 Vendor Address: P.O. # Vendor Phone #: Account# Vendor Fax #: Initiated By: Date Required Expense# Department Form4 9401 Deliver To Uua Qly. Catalog Number No. Description Unit Cost Unit Extended 1 Meas. Cost �-�f - �e vet I�Wz5i Lvf' (for+ . 4 i C\ A 3 c1I.-at �1 6 7 APPROVED ON g Ilf'I1_ i) 2U2d � BY t:�U T'i AI�JDIT Fl 10 Est. Freight Est, Total Cost TOTAL COST �J (41,q Contact: Dept. Direct Quoted By: Din Nursing Buyer. I E.T.A. l I Die Clinical o(iiIiDocu U...... I, lit, .u.. n. .a.. .., s U .. ...,.. ¢n. "I'll ,n nnm a Lx U _...� I. it .w.. 71,11, of zdillm o :_..... I: I- ,.. ,,,., ,.. wx .....,.. 4t, .. .. .., tl}w•Ae ,i. ttX L� WE) eVnV OnOw IY.W C,r lNnl ..,t., ,'.,. ,... ,": ✓ ,. I. _ . it .. ,>.. it, it if,. ,:il t, J Vile dcd no- qc.-tVcl(e.s.Son. I cb,sc See altztc�e�l QV�u 1 '�cv&i du �nfirr� 1�� S�S Grr. "ftir\a- 0'i,odo C-r-S a (t�c.4,eci a e- W1Vurt will AC H ee, . TnGnlaS-WAI'4 LL- OCT 14 2024 ArnerisourceBergen' STATEMENT Statement Number: 68384512 l of J Date: 10-11-2024 AMERIBOURCE13ERGEN DRUG CORP WALGREENS #12494 340B / 12727 W. AIRPORT BLVD, MEMORIAL MEDICAL CENTER ✓ 1001352841037028186 SUGAR LAND TX 774784101 13M N VIRGINIA ST PORT LAVACA TX 77979-2509 DEA: RA0289276 Sol - Fri Due In 7oays 866-q51-9665 AMERISOURCESERGEN Not Vet Due: 0.00 PO Box 906223 CHARLOTTE NO 28290.5223 Current: 3,025.371/ Past Due: (6,851.39) Total Due: (2,820.02) Account Balance: (2826 02) Account Activity Document Due Reference Purchase Order Document Original Last Receipt Amount Received Balance Date Date Number Number Type Amount OB-102024 09-15-2024 -mea 09 27.2024 0A-27-2024 moau08a62 31SH08883 318B66B684 7097604734 7007694734 Invoke Invoke 261.36 1.18 (� („(' 0.00 �I'� J((/r{I� 0.00 261.36 ma 09-15.2024 OB-2'1-2024 3188660885 7007615443 70076IM71 Invoice 162.58 Yr 0.00 762.58 n5-2024 loll 09.2]-2024 3188608886 7007615471 Invoice 53.65 O j)1t� (Lul) 53.55 09-052024 09.27.2024 3188608887 7007625239 Involve Invoice 3.00 42.47 /lr V d'/ 0.00 0,00 3.00 42.47 0:46a 2024 0947$U24 0&27.2tl24 3188]69005 ]007632041 Invoice 22.90 /S (T� 0.00 2i.90 09-t 8:Z02A OB-2l•2024 O9.27-2024 3188064241 7007642080 Invoice Ic7340 n 3189027180 7007640387 Invoice 88.87 \ 0.00 96 B7 OB-08.2024 OB•272024 31139112716l 7UW649650 Invoice 63.77 0.00 63.77 0849.2024 09.27-2024 3189269361 7007657077 Invoice 10.12 0.00 10,12 09-TO.2024 U&27-2024 3189423747 7007686238 Invoice 19676 l ocul 191515 09-2;i-Z024 1004-Z024 3189694902 .I p O�dld� coo 7007681977 Invoice 152.83 ' H'�,>'h 0.00 52.03 1•v203 09-23.2024 09-2J-2024 10.042024 10042024 3189594803 3189594804 ]0%693546 70U7671903 Invoice Invoke 27.00 Q n G �/ (.0r1 2i.60 09.23-2024 1O.OA-2024 3189594805 100]881830 Ilrvol. 1.35 12.06 ,�,-n��l7et� W, ODO 1.35 OB-24-2024 09.24.2024 205568 3184764668 Customer Payment 72.71 L/M1 011A 2.2024 0.00 14542 12,06 (72.71)1 09-24-2024 09-24-2024 205568 3165267235 Customer Payment 03.11 08.15.2024 18022 t93G1) 09.24-2024 09.24-2024 205568 3185601051 Customer Payment 1,113.39 08-10.2024 2.226.78 (1.113.39) 09-24-2024 09-24-2024 205560 3185600879 Customer Payment 3,75963 08-11)4024 7,519.26 (9,75A.fi31 09-24-2924 09-24.2024 205568 3184945100 Customer Payment 233,46 0&13.2024 466.92 t133.46) 09-24-2024 09-24-2024 205568 3184944579 Customer Peymenl 137.30 08-13.2024 274.80 (137.30) 09.24.2024 09-24.2024 205560 3185601952 Customer Payment 3,673.3E 08-19-2024 71146.76 (3,673.381 09-24-2024 09 24-2024 20556E 3184784687 Customer Payment 75.)0 08d2-2024 150.20 DSIZ 09.24-2024 09-24-2024 205568 3185098913 Customer Payment 17,61 08-14-2024 35.22 (17.61)' 09-2d-2024 09-242024 205668 3184784685 Customer Payment 2 26836 08-12.2024 4,576 72 (2 208 36)' AmensourceBergen- STATEMENT Number: 68384512 Dute: 10-11-2024 2 of 3 Account Activity Document Date Due Date Reference Number Purchase Order Number Document Type Original Amount Last Receipt Amount Received Balance 69.24.2024 09-24.2024 205568 3104784606 Customer Payment 23B.09 08-12-2024 476.18 (238.09) 09-242024 09.244024 205568 3105601953 Custamer Payment 61.66 0&19-2024 123.32 (61.66) 09.242024 09,244024 206500 3186601950 Custamer Paymonl 162.58 00-19-2024 325.16 (162.58) 00.242024 W24-2024 10-04-2024 10-04.2024 3189762327 3109762328 7007698509 7007098509 Invoice Invoke 19.34 1,18 CU / 1 0m 1934. lie 09.26-2024 1044-2024 3180016026 7007706639 Invoice 31.25 I O a� 0.00 31.25 09.28.2024 10.042024 3189916029 7007796638 In.[.f.00 0000 00 L00 09.26-2024 10-04.2024 318091M70 7007707386 Invoice 96.87 0.00 96.87 09-26.2024 10-04.2024 3/90003221 7007716200 Iavoire 4.35 0.00 4.35 09-27-2024 1044-2024 3190232253 7007727328 Invoice 1.110.64 0.00 1,110.64 09-27-2024 10-04.2024 3190232254 7007725674 Invoice 135 000 1.35 DS-29.2024 1041-2024 3190406450 7007738674 Invoice 14.58 W 14.58 09-29.2024 10-11-2024 3190405451 7007746624 Invoice 36.17 ,,//� 0 / t 0 00 38. 17 09-29.2024 10-11-2024 3190406452 700775343D Invalce 16.88 pp 0.00 10.88 09-29 2024 W14024 10-114024 10.11-2024 3190405453 3190582373 7007746628 7007759822 Invoice 2.62 (/y rovab 0/w G� 0.00 62 2..62 8 Invalce 9.28 r%� C 000 10-02-2024 10-11.2024 3190747625 7007768917 Invoice 64.69 IO 0r00 69259 10-02-2024 f0-T1-2024 3190747626 700TI69170 Involve 2.09 0,00 2,09 10-03-2024 10-11-2024 3190934087 7007777237 Involve 96.90 0.00 9600 1103-2024 10.11-2024 3100934088 7007780503 Invalce 2,147.16 0,00 2.147.16 W-042024 1041-2024 3191071129 7007767813 Invoice 103,61 0,00 103.61 t0-06-2024 10-18-2024 3191224054 7007799292 Invoice 122.90 0.00 122.90 ✓ 10.06-2024 10-18-2024 3191224055 7007809180 Invoice 9,54 0,00 9,54 ✓ 10-06-2024 104B-2024 3191224056 7007809180 Invoice 15.87 0.00 16.87✓ 10.06-2024 10-18-2024 3191224057 7007809819 Invoice 48.45 000 48,45 ✓ W-M-2024 10.18.2024 3191224058 7007817826 Invoice 1.070.15 0.00 1,070.15 ✓ 10 08.2024 10-18-2024 3191406697 7007824281 Invoice 90.58 0.00 90.58 10-09.2024 10-18-2024 31M559704 7007832789 Invoice 43972 Oct) 433.72./ 10.10-2024 10-18.2024 3191715005 7007a42634 Invoice 472.66 0,00 47266 ./ 10.10.2024 10-18.2024 3191716006 7007842634 Invoice 737.00 0.00 737.00 10-11-2024 10-16.2024 3191861327 7007852204 Invoice 14.95 0.00 14,95 ✓ 10.11-2024 10-18-2024 3191861328 7007652204 Invoice 5.94 0.00 5.94 ✓ 10-11-2024 10 10.2024 3191861329 7007851959 Invalce 3.61 0.00 3.61 ✓ AmerisourceBergen- STATEMENT Number: 68384512 Date: 10-11-2024 3of3 Current 1-15 Days 16.30 Days 31.60 Days 61.90 Days 91.120 Deys Over 120 Days 3,025,37I 5.974.99I (11.82638)I 0,00 0.00 0.00 0.00 APPROVM ON gg OCCC�1I 14�/py20244p� CAHOWNIC� Nik"1Tl'�A5 Reminders Due Date Amount 09-24.2024 (11,826,38) 09.274024 1,987.96 10-04-2024 1,493.15 W-114024 2,493.98 10-18-2024 3,025.37 Total Due: (2,826.02) i o l t 4 12o-2# Gracie Orta From: Sent: To: Cc: Subject: CAIJTION Hello, aflores@mmcportlavaca.com (Andrie Flores) <aflores@mmcportlavaca.com> Thursday, October 10, 2024 3:26 PM Gracie Orta Caitlin Clevenger RE: No Commissioners' Court 10/23/24 originated from outside of the nize the sender and knout is safe. MMC PayrolLnet,pa estimate for=payroll.ending 10/17/2024: $395;000:00 , MNtC`Payrollstax depositestimate'for payroll ending 10/17/2024:,$;130,000,00_ not click links or open attachments unless Please let me know if this is sufficient information in regards to our payroll for court on 10/16/2024. Thank you, Andrie Tfores Human Resources Manager Memorial Medical Center 815 N Virginia St, Port Lavaca, TX 77979 P: 361-552-0399 1 F: 361.551.4505 aflores@mmcoortlavaca com From: Gracie Orta <Gracie,Orta@calhouncotx.org> Sent: Wednesday, October 9, 2024 8:31 AM To: Caitlin Clevenger <cclevenger@mmcportlavaca.com>; Gregory Morales <gmorales@mmcportlavaca.com>; Pam Fikac <pfikac@mmcportlavaca.com>; Michelle Cumberland<mcumberland@mmcportlavaca.com>; Andrie Flores <aflores@mmcportlavaca.com>; Andrew DeLosSantos<adelossantos@mmcportlavaca.com> Subject: RE: No Commissioners' Court 10/23/24 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. Okay, sounds good. 'Thank yoit, Gracie Orta Calroitn County .Assistant Att&tor 202 S..Ann, Suite B Port Lavaca, TX 7797,o Phone:361553-4463 Memorial Medical Center Transfer Request 6,531.87 Z Account: Operating_ US BANCORP FSA/HRA/DC ACCT ACCi Invoice numbers 6936806, 6960427, 6982261, 6999302, 7031958 by: Caltiln Clevenger Date: 8/19/2024 APPFtOM ON Ot 1140a,4 cnSHS, - ctawIA iSIM Date: I g 2074 Date: j-I--u&-2- i APPROVED ON OCT 14 2074 (',Ai&)&�WUkii?'�p los 7630 3 28 0 3T6." '63W _ 28, , _0 '"PROVED ON Oct 14 ?01,1 OV5 F 9I9I3034 ovS , r , wwxw� [•.'IiTixt,(T�.C.t_*•'."w2'. w'"CLt3IU.'O;:EiT�.G:t9n$"E75"u+6*:Lr'RLL'di kiLPewzuA:bi.2'u7e'frvd7Lk:7a^'"miieeAaG�L:.' n'ablhiN7S9&:^ Fs#eiuw"uic'd:^uyi:3'. uaz iezw 3 0 ,_ s. w z zsgmini.. a a/m/)pia,5?,0.W�� s sresercounsis v¢rox�e r pes a xw s el4uu e/ees/mla i6uiensi SiMCiW✓. _. •. 1G� I41202-+ APPI?OV ON 00j ff 4 ., MEMORIAL MEDICAL CENTER PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT-- 0LL 7 2024. 0ct 13, 2024 CPSI "FlandwrlHen Dae Bank tlescriAOon MMCNotes unt, Check"N 10/11/2024 PAY PLUS ACHTana 394779231o1M0695422393 P - 3rd Party Payer Fee :wghoa.� 901380 10/11/2024 NEALTHEQUITY INC HeaIthC,LI 1356888910[M17 Empoeduct/Employer Conlrlbut 1,447.834 WO600 10111/2024EXPERTPAY EXPERTPAY 74600341191000013090234 .CIIIId Support Payment 870Ag 8M601 10/1 V2074 MEMORIAL MEDICAL PAYR0LL74W03411113122650 -Payroll 367,036.11✓ 10/10/2024 STATE C0MPTRLR TEXNET08396102/430092100002 0SHIGT 567,507.19 I10089 10/10/2024 PAY PLUS ACHTran139290241101"69,"WU3 P 3rd Party Payer Fee -4649Ai 901390 10/10/2024 TSYS/TRANSrMST MERCH FEES 3930098254161661 Credit Card Processing Fee A,024.32/ 901391 10/10/20M TSYS/TRANSFIASTMERCH FEES 4139900133241961 . Credit Card Processing Fee •480.00' 901392 10/1012024 TSY5/TRANSFIHST MERCH FEES 4199980133240161 Credit Card Processing Fee 11097.9Y 901393 l0/10/2024 TSYS/TNANSFIRST MCRCH FEES 4139980133239361 - Credit Card Processing Fee '1,450.80� 901394 10/10/2024 TSY5/FN.NSFIRST MERCH FEES 4139990133 2385 62 - Credit Card PrOrezaing Fee Lail 901395 10/10/2024 TSYS/TRMSFIR5T MERCH FEES 4139980136839761 - Credit Card Processing Fee Mi,.76, 901396 10/9/2024 PAY PLUS ACHTOO, 39133580101000692756545 P 3rd Party Payer Fee �.' 53011 901397 IO/8/2024 PAY PLUS ACHTrnns 380668M 10IM6915W880 P 3rd Party Payer Fee v15:0V 901399 10/8/2024 MCKESSON DRUG AUTO ACH ACH06199720910000126 340E Drug Program Expense 8,141.90��k- $OM43 1017/2024 PAY PLUS ACIITMns 3881316E immu0120029 P 3rd Party Payer fee ,30d8i 901399 101712024 FBUEAALEXPRESS OF.UIT EP4721415292100002318 -Fed Or Pymt 707.71%.3(- 7M139 10/7/207.4 FDMS FDMS PYM1052-20005E MD 41=12413211 - Credit Card Machine Lease Fee aafir4l 901400 1t1/7/2024 FDMS FOMS PYMT 052-2182557"410 12414867 - Credit Card Machine Lease Fee 901401 10/712024 FOMS TOMS PYMT 052-2182545-M0410M12414867 Credit Card Machine Lease Fee t2out 901402 W/7/2024 FDMS FDMS PYMT O52.1601830 M 41M012411126 .Credit Card Machine Lease Fee .BBMS 901403 950,37B.21,/ 0ctober14,2024 Antlrew Oe LOz Santos Memorial Medical Center , vpp�YC' ecA_O� 10-C .1y Cc' PROSPERITY BANK -W � ' �qr "T' -f pL U ri % o1 ..aq &C+ ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT.. ESTIMATED ACHS Dale oregiRSL M M C HOW Amount !/ 10/18/2024 - WEBFILE TAX PYMT OD . Sales Tax 0,17.37 ✓ iL\,iN. C `o IL n� P LL,y+9e`4S, October 14, 2024 AndrewGO Santos Memrial ol Melidical Center WHOM ON OCT 14 824 0, 41iOlfFIYFJ;0LINil:lWOM U I COMPTROLLEVEXAS.GOV en 0 Confirmation: You Have Filed Successfully Sales and Use Tax Period Ending 09/30/2024 (2409) Taxpayer ID: Taxpayer Name: Entered By: Caitlin Clevenger User ID MEMORIAL MEDICAL CENTER ✓ Email Address: Reference Number:- Taxpayer Address: Date and Time of piling: 815 N VIRGINIA ST PORT LAVACA , TX Telephone Number: (361) 552-0272 10/0812024,10:46:20 AM 77979.3025 IF Address- PAYM ENT SUMMARY Electronic Check Payment Reference Number Type of Bank Account: Checking State Amount: $1.649.52 Trace Number_ Accountholder Name: Local Amount: $527 85 Memorial Medical Center Amount to Pay: $2,177.37 Bank Routing Numbe- Electronic Check: 82,177.37 Bank Account Numbar:- Payment Effective Date: 10/18/2024 CREDIT SUMMARY Credits Taken Are you taking credit to reduce taxes due on this return? No Licensed Customs Broker Exported Sales Did you refund sales tax for this filing period on items exported No outside the United States based an a Texas Licenced Customs Broker Export Certifications? LOCATION SUMMARY LocB TotatTexas Sales Taxable Sales Taxable Subject to State State Tax Due subjectto Local Tax Rate Local Tax Due Purchases Tax(Rate.062S) Local Tax 00004 26,525 26,525 0.00 26,525 1,657.81 26,525 0.02 530.5 Sub7otat 16,525 26,525 0 26,525 1,657,81 26,525 530.5 Total Tax for Locations 2,188.31 Total Tax Due: $2.188.31 Timely Filing Discount: • $10.94 Balance Due: $2.177.37 Pending Payments: - S0.00 Total Amount Due and Payable: $2,177.37 ,/ ( State amount due Is 81,649.52 ) ( Local amount due is $527.B5 ) Gracie Orta From: afiores@mmcportlavaca.com (Andrie Flores) <aflores@mmcportlavaca.com> Sent: Tuesday, October 15, 2024 8:19 AM To: Gracie Orta Cc: Caitlin Clevenger Subject: RE: No Commissioners' Court 10/23/24 CAu'riON: 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.' Hello, Yes, I can give you an estimate for HSA as well. MMCbHSA:eatimate7forpayrollsending 10/1712024: $1,447.83 Thank you, Andrie Flores Human Resources Manager Memorial Medical Center 815 N Virginia St, Port Lavaca, TX 77979 P:361-552-0399 1 F: 361.551,4505 aflores@mmcr)ortlavoca.com From: Gracie Orta <Gracie.Orta@calhouncotx.org> Sent: Monday, October 14, 2024 4:22 PM To: Andrie Flores <afiores@mmcportiavaca.com> Cc: Caitlin Clevenger <cclevenger@mmcportiavaca.com> Subject: RE: No Commissioners' Court 10/23/24 �i AIWTfC>f+1 Thi§ eFeiditoCigtmeCeFhrotr(uautfsid�pf>hgrowgani atlo t po n2t lick inks,o'raap F� al-ayltt��htt', , l�s3pyau< 'eao�mr�epUhe�s-ender�ndWt�awrt'thtf'eon�enf'is+safe: ___,..; - - ....- Andrie, I almost forgot. Are you able to send an email or some sort of estimate as well for the HAS contributions? That way I can include that as well and it can be approved this Wednesday in court. -Phank you, Gracie Orta Calhoun County Assistant Audi -tor 202 S. Ann, S1,tite B Port Lavaca, 7X 77979 PG1 one:361-553-4463 1 COUNTYA NTONON MEMORIAL MEDICAL CENTER 10/10l2024 OCT 1 Dp;i4 12:49 AP Open Invoice List CALHOUN MUNiY� TftifAA Due Dates Through: 11/02/2024 Vendorit endor Name Class Pay Code 7ASHFORD 11816 GARDENS Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 11/ 091324 09113/20209/13/20211/02/202 41,848.55 �, 1�J.�'rL 'lr�Y•��t� r r MG DV01r-s_2r�nr J100724 10/07/20210/07/20211/02/202 4,770.53 U►� G QzPP Jury cqoa-L! Vendor Totals: Number Name Gross 11816 ASHFORD GARDENS 46,619.08 .,zorl Stjn,s;-r,. Grand Totals: Gross Discount No -Pay APPROVED ON46,619.08 0.00 0.00 OCT 1 oq�202y4 g p rAl-H�1N �fn5l1NTV.'Y�%k,�, 0 ap_open_Mvoice.lem plate Discount No -Pay Nei / 0.00 0.00 41,848.55 J 0.00 0.00 4,770.53 f Discount No -Pay Net 0.00 0.00 46,619.08 Net 46,619.08 RECEIVED BY THE COUNTY AUDITOR ON 10/10/2024 OCT 10 2024 MEMORIAL MEDICAL CENTER 12:49 AP Open Invoice List CALHOUN COUNTY, TEXAS Due Dates Through: 11/02/2024 Vendor#/ Vendor Name Class Pay Code 11828 1 SOLERA WEST HOUSTON Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 100724 10/07/202 10/07/202 11/02/202 U"G Qmep TU �b Vendor Totals: Number Name 11828 SOLERA WEST HOUSTON _ r in Grand Totals: Gross Discount 1,438.01 0.00 APPFIOV90 ON g OCT 10 2�002{4�p CAKH01. ifNBLI�JT�7�I N8 0 ap_open_invoice.template Gross Discount No -Pay Net 1,438.0/ 0.00 0.00 1,438.01 J Gross Discount No -Pay Not 1,438.01 0.00 0.00 1,438.01 No -Pay Net 0.00 1,438.01 RECEIVED By COUNTY A AUDITOR 10/10/2024 OCT 10 2024 MEMORIAL MEDICAL CENTER 12:49 AP Open Invoice List CALHOUN COUNTY, TEXAS Due Dates Through: 11/02/2024 Vendor# Vendor Name 11820 J FORTBEND HEALTHCARE CENTER Class Pay Code Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 4100724 10107t/20210/07120211/021202 1,776.32 l l V � V Q—_T'PY Vendor Totals: Number Name Gross 11820 FORTBEND HEALTHCARE CENTER 1,776.32 r .... ih.;�nin: ry Grand Totals: Gross Discount No -Pay 1,776.32 0.00 0,00 APP00%j) ON OCT 10 2024 0 ap_open_invoice.template Discount No -Pay Net 0.00 0.00 1,776.32,/ Discount No -Pay Net 0.00 0.00 1,776.32 Net 1.776.32 RECEIVED BY THE COUNTY AUNTOH ON 10/10/2024 OCT 10 2024 MEMORIAL MEDICAL CENTER 12:49 AP Open Invoice List �/� gALHOUN COUNTY, TIE Due Dates Through: 11/02/2024 Vendor�# /)� ndor Na a Class Pay Code 11832 1,J 13ROADMOOR AT CREEKSIDE PARK Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 100724 10/07/20210/07/20211/02/202 U c sk Vendor Totals: Number Name ew -1-0k(--t 0 02,k 11832 BROADMOOR AT CREEKSIDE PARK Grand Totals: Gross Discount 1,750.55 0.00 APPROVED ON OCT 10 2024 cALHOUNU COUNI�, TEzns 0 ap_open_Invoice.tomplate Gross Discount No -Pay Net 1,750.55 0.00 0.00 1,750.55 J Gross Discount No -Pay Net 1,750.55 0.00 0,00 1,750,55 No -Pay Net 0.00 1,750.55 RECEIVED BY THE COUMY AUDITOR ON 1011012024 MEMORIAL MEDICAL CENTER tr. 1 OCTy O 2024 12:49 ,l AP Open Invoice List Due Dates Through: 11/02/2024 Vendor# Vendor Name CALHOUN COUNTY, TEXAS Class Pay Code 11824 �/ THE CRESCENT J Invoice# 100324 Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount �! 10/02120210/03120211/02/202 7,560.00 0.00 \ �5.` M-b.CUP.in-b fn nC� � r% -e-rr or //100724 10/02/20210/07/20211/021202 1,548.48 0.00 U"c, tawV 7Yvk4-. al72L4 Vendor Totals: Number Name Gross Discount 11624 THE CRESCENT 9,108.48 0.00 Grand Totals: Gross Discount No -Pay 9,108.48 0.00 0,00 APPROVED ON OCT N1 0gq2024 CAT LI Ot1NUrK. UN'r`l9QAS 0 a p_open_i nvofoe. template No -Pay Net 0.00 7,560.00 e� 0.00 1,546.48✓ No -Pay Not 0.00 9,108.48 Net 9,108.48 11110110101 BY THE COUNTY AUDITOR ON 10/10/2024 MEMORIAL MEDICAL CENTER 12:50 9 OCT 10 2024 AP Open Invoice List Due Dates Through: 11/02/2024 Vendolu /Vendor NECALNUUN ODUNfY, ` ftXA9 Class Pay Code 11836 �/ GOLDENCREEK HEALTHCARE JInvoice# Comment Tian Of Inv Of Due Of Check Of Pay Gross Discount 091324 09/01/20209/13/202 11/02/202 5,820.00 0.00 i nS- yovr�6 c�e�o.�n (,rtmc oeb.:n surd J 0917248 09/01/202 09/131202 11102/202 841.70 0.00 J 093024 09/01/20209118/20211/02/202 6,324.00 0,00 .,% 093024A 09/011202 09/30/202 11102/202 1.654.27 0.00 \ 100324 10/011202 10/03/202 111021202 467.18 0.00 092724D 10102/20209/201202 11/02/202 259.26 0.00 J100324A r� J100324B t� J 100324C rt nO ''0itnCch_)r_e. Cwprojo_A. 10/09/202 10/03120211102/202 6.324.00 10/09/202 10/03/202 11/02/202 10/09120210/03/20211/02/202 100724 10/09/20210/07/202 11/02/202 U-i\L Vendor Totals: Number Name 11836 GOLDENCREEK HEALTHCARE Grand Totals: Gross Discount 31.407.26 0.00 ApPF#t=Vtb bN OCT jUM24 CARoi�N,d�1��y��a,� 2,856.00 4,267.72 2,593.13 0.00 0.00 0.00 0.00 0 ap_open_Invoice.tempiate No -Pay Net j 0.00 6,820.00 0.00 841.70 J i 0,00 6,32 W - / 0.00 1,654,27 J 0,00 467.16 J 0.00 3�"6 0.00 6,324.00 0.00 2,856.00 0.00 4,267.72 J 0.00 2,693.13 -./ Gross Discount No -Pay Net 31,407.26 0.00 0.00 31,407.26 No -Pay Net 0.00 36" i ,ly g uO RECEIVED BY THE COUNTY AUDITOR ON 10/10/2024 OCT 10 Z0Z4 MEMORIAL MEDICAL CENTER 12:50 AP Open Invoice List COUNTY, TEXAS Due Dates Through: 11/02/2024 DUN Vendor# /yendor ts� Class Pay Code 13004 V TUSCANY VILLAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount //091324 09/01/20209/13/20211/021202 5,555.00 0.00 pm--- CKte. into Mry� :, DP/✓ . %(\ tCr 0r .� 093024 09/01/202 09/30/202 111021202 1,224.00 0.00 100324 10/01/20210/03/20211/02/202 21,575.00 0.00 J100724 10/011202 10/07/202 11/021202 2,57T59 0.00 Vendor Totals: Number Name Gross Discount 13004 TUSCANY VILLAGE 30,871.59 0,00 Grand Totals: Gross Discount No -Pay APPROVED ON 30,871.59 0.00 0.00 1�.ury�2-a+r�Qry OC((11T N17`(0 r nBY�nC(1F•N COUr`r1r.t `CXAS 0 ap_opsn_invoice.template No -Pay Net 0.00 5,555.0o 0.00 1,224.00 J 0.00 21,515.00 0.00 2,577.59 No -Pay Not 0.00 30,871,59 Net 30,871.59 COUNTY AUDITOR ON OCT 10 2021. 10/10/2024 MEMORIAL MEDICAL CENTER 12:50 CALHOUN COUNTY, TEXAS AP Open Invoice List Due Dates Through: 11/02/2024 Vendor# Vendor Name Class Pay Code 12792 V/BETHANY SENIOR LIVING Invoice# Comment Tran Of Inv Of Due Dt Check Of Pay Gross J 091324 09/01/202 09/13/202 11/02/202 7,090.34 1TS. Pm-b,C-C4p ln+b MMG 01pb ir\ .2rr0e- Jo91324A 09101/202 09/131202 11/02/202 8,849.80 J093024 09/01/202 09/30/202 11102/202 305.42 J 100224 10/02/202 10/02/202 11/02/202 28,168.98 J 100224A 4 10102/202 10/02/202 11/02/202 569.07 .I , J 100424 10102/202 10104/202 11102/202 0.27 , 100724 10102/202 10107/202 11/02/202 2,922.62 l� N C as:ee a0c�y Vendor Totals: Number Name Gross 12792 BETHANY SENIOR LIVING 47,905,50 Grand Totals: Gross Discount No -Pay 47,906.50 0.00 0.00 APPROVpb ON OCT 1 0200244] CAgLHOl1N"4NL, ��iiF/!7E} g^ 0 ap_ope n_invoice.template Discount No -Pay Net 0.00 0.00 7,090.34 J/ 0.00 0.00 8,849.90 ./ 0.00 0.00 305.42 0.00 0.00 28,158.98 0.00 0.00 569.07 J 0.00 0.00 0.27 0.00 0.00 I� 2.932.62 J Discount No -Pay Net 0.00 0,00 47,906.50 Net 47,906.50 Memorial Medical Came, Nunlnv Nome UPt Weekly ClntdB Tunster P.".HM A9PPunn 10/2e/2024 / J r.«, Ww� o.tr N.unl ]l.9w.n 1uw w.wio Ioo.aBl.evl M.waaf Iw.us.n N..Mn aa..n swan m.r..Nmmrnm.nnxmna.m..[ wnroYxneaeu / ✓ [.voaa 1Nlore WeM rm hnxrtrl4 /O Af[rymdwlwe px Ff[nfl Ns[FNrnl Pw Fmm Jaalwl ulM[[rtr[.Yx Bwl tudu.le s/ iluuo I,LnIn�MPY ]a/ Iw,tu,ro /� 1uAb.w /✓ eosenM<. 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J 61R19 6)6.19 1, MMCPORfmN '11"ICamp.,.. INT .., inn j9Ci qMP/CmmpL •qpM gIPPIDmpl OMP/CpmpllLapsa gIPP 91 NNPRRNOR 1310d3 4.410.09 J L174ld1.9,196.s ,M 1,n45f .,INN :.Ls3.a1 i.G9 10.916Ip vi - '±. J .:..L1iL![.. 6r39d%[' �' � . [�Lk, i/' LS[1 S[. ✓�:. :%2[J9'i ✓•9! J6MW � 3,66P6J Luxel Idl].11 11.071.75 15 N,pS.M 10,10556 301105.81 103,06 1.39SM J 1,39J00 1.50SOU ...•.. I J.45500 .:wawauvn..nose.oloa.mmmw.nm...avol.�anaewwH emw oewa..e lain. to nu wut iuinu al."ll5 RIMS, iIM.14 SAMM 6MIMI Balances Overview Account Name *4357 MEMORIAL MEDICAL- $1,548,479,34 $1,527,978.21 $1,548,479.34 $1,745,261.57 OPERATING *4305 MMC •CLINIC SERIES 2014 SERIES $547.27 $547.27 $547,27 $547.27 WAIVER CLEARING 373 MMC -PRIVATE WAIVER $440.58 $440.58 $440.58 $440.58 `4381 MEMORIAL / MEDICAL INH ✓ $194,691.98 $204,271.98 $194,691.98 $111,78B.68 ASHFORD `4403 MEMORIAL MEDICAL/NH $190,164.70/J $190,164.70 $190,164.70 $112,023.21 BROADMOOR *4411 MEMORIAL MEDICAL NH $143,883.62 $158.222.49 $143,883.62 $125.926.36 CRESCENT `4438 MEMORIAL MEDICAL/SOLERA @ $107,587.78 J $129,376.21 $107.587.78 $89,094.58 WEST HOUSTON *4446 MEMORIAL MEDICAL/NH FORT $57,695.38 $60.584.82 $57.695.38 $41,093.42 BEND 04454 MEMORIAL MEDICAL GOLDEN CREEK GOLDE $247,015.03 $252,865.03 $247,015.03 $245,220.40 HEALTHCARE %551 CAL CO INDIGENT $12,701.74 $12,701,74 $12,701.74 $12,701,74 HEALTHCARE •5433 MMC -NH GULF POINTE PLAZA - $5.816.68 $5,816.68 $5,816.68 $5,816,68 PRIVATE PAY •5441 MMC -NH GULF POINTEPLAZA- $35,905.60 $36,905.60 $36,905.60 $30,857.69 MEDICAREIMEDICAID 65506 MMC -NH BETHANY SENIOR $44,435.65 $45,922.33 $44,435.65 $42,574.44 LIVING *3407 MMC NH TUSCANY VILLAGE TUSC $243,094.80 $243,094,80 $243,094.80 $209.371.52 13660 SIR LIVING • DACA MMC •BETHANY SR LIVING $100.00 $100.00 $100.00 $100.00 *2998 MMC -MONEY MAR MARKET FUND $5,048.56 $5,048.56 $5,048.56 $5,048.56 Total Balance $2,838,608.71 $2,874,041.00 $2,838,608.71 $2,777,866.70 Report generated on 10/14/2024 10:08:46 AM CDT Page 2 of 2 Memorial Medical Center Nursing Home UPL Weekly Nexion Transfer Prosperity Accounts 10/14/2024 Pmvlaus account Beelnnine Pendiq T.d.Y'Etud- tlna NuNn Nome NnmFrr eabnm Tnnaler-0ut Trandanin ne mils Baba'. t 24.367.84 24,167.04 146,915.03 . 34],016.03 eankealanm 247,01503 v.dmce leave In Balanm 100.00 ., Intn..t RouNn4lnkrmafvn /4r GaldenCmk' NvvinteroH NWOA H.ahh at Ga(dan creek 0e11n01ne Well, fm,. Bank N.A. Adjust Balsw/Tr.nrrer Aral = 146,%S.01 Note:OnNbalenaa a/ova d5,ig0 wiBbe tronafena 3a 1M1e nunfne home. Nme 1: fv'A anvunt M1aa a hv4e bvfanrr v/S1NaAa[MMCdsavnYrtl [oaornvavunt. p• -fl b G ' OCT 14 2024 CALLROUhI �C'0'UI��1`f.iT a m Be Trambradta Nunm{ ./ Homo 246,915.03 / I/k, '��/�1 at. 0 1\ APProv.d: ra `r,n.J Vni� `. andraw0to, 5anlel 10h4/2024 IANH WeOl, Tr.nden\NH UK Tomhr swnmaryp024\NH uol rnnJn summary 10,14,1. - x p�n .. MMCPORSIQN y,.Wh' 5biR"� �h f� g11P/CpmN t b y Jjap+ienOul ! glPp/CemPl glpP/Cempl gIPP/Camps 6hry. QIPPTI NNPOR910M Ipll l/1m94.M.I I9 W"M5RCOE11)1p1.... Y1919 J 119i61 lononoa LM.nn1 / n.n 1..796.63 . 10/10/]OIe .01RRRM9NA3)U m DU y1619f1511691) 91 ,/ a.5l.m 10/101M.Am10SNUEE9M5µ)MBRLOFIIIM)f IeW J I,161.m 4.15].m 39 51 10/10/Im9 AmNeNlAttvgvM[Ni 11f311e101p3m)A9l ll0mm 3.16I0] Ip/9/tm1 WIRE pVi XEIION N[Al1N CA/e 00mEX CRFFRMt / }1.I10.11✓ 13.00p.00 IorynOle OnemII. - IOy6m15 191,630.11 W/9nple CO 14911613]91 1.191,19 1.398.]0 4..FNdLEMiµ1 COLDIMMfeIRHEM NC DIP 9 fIEI.tlm169l.112 el5m - 475.11 .n=. C. W19h01I NVVI5K 50W110X MCWIMIMipl9m)9]CGAIIi 1.1959) 10/." I .1- ELNpKC1AIMPMI).6mIK111.1ilt) 1.895.9} 10/5/1014 GQZDMUCCR1IEµlMLRC O11 IMIS. II il)1 .15..1 10]9tl0. 4DI MCRIPIIIAlt MERC 0IP 1]Sm5691mC01I]9 - 1.]1900 875.13 10/10MGUIPINUEERNIA1t MLRC DIP -- II.M119) LS19.00 00102.Pt..MVMNVCMI71m191110112 10n/Im.RU m DU 1.11.551)ml191 m7. I<6313.,10 .)10 ..n1mnnANfORft U. I, .M51111, 811 1105Am1 ]On/]pN 4DmtNLRttRNUI) WAIMpI]]D1f691p4(L11110 S4,26)1l �/ A6.96OI ✓ 3969R.Oh Balances Overview Account Name •4357 MEMORIAL MEDICAL- $1,548,479.34 $1,527,978.21 $1,548,479.34 $1,745.261.57 OPERATING *4365 SERIES 201 CLINIC SERIES 2014 $547.27 $547.27 $547.27 $547.27 *4373 MMC -PRIVATE WAIVER WAIVER CLEARING $440.58 $440.58 $440.58 $440.58 `4381 MEMORIAL MEDICAL INH $194,691.98 $204,271.98 $194,691.98 $111,788.68 ASHFORD *4403 MEMORIAL MEDICAL/NH $190,164.70 $190,164.70 $190,164.70 $112,023.21 BROADMOOR •4411 MEMORIAL MEDICAL INH $143,883.62 $158,222.49 $143,883.62 $125,926.36 CRESCENT *4438 MEMORIAL MEDICAL ISOLERA@ $107,587.78 $129,376.21 $107,587.78 $89,094.58 WEST HOUSTON `4446 MEMORIAL MEDICAL I NH FORT $57,695.38 $60,584.82 $57,695.38 $41,093.42 BEND •4454 MEMORIAL MEDICAL I NH GOLDEN CREEK ✓ / $247,015.03 t/ J $252,865.03 $247,015.03 $245,220.40 HEALTHCARE *4661 CAL CO INDIGENT $12,701.74 $12,701.74 $12,701.74 $12,701.74 HEALTHCARE *6433 MMC -NH GULF POINTE PLAZA - $5,816.68 $5.816.68 $5,816.68 $5,816.68 PRIVATE PAY *6441 MMC -NH GULF POINTE PLAZA - $36,905.60 $36,905.60 $36,905,60 $30,857.69 MEDICAREIMEDICAID •5506 MMC -NH BETHANY SENIOR $44,435.65 $45,922.33 $44.435.65 $42,574.44 LIVING *3407 MMC NH TUSC TUSCANY VILLAGE $243,094.80 $243,094.80 $243,094.80 $209,371,52 MMC •BETHANY SR LIVING SR LIVING • DACA $100.00 $100.00 $100.00 $100.00 •2806 MMC -MONEY MARKET FUND $5,048.56 $5.048.56 $5.048.56 $5,048.56 Total Balance $2,838,608.71 $2,874,041.00 $2,838,608,71 $2,777,866.70 Report generated on 10114f2024 10:08:46 AM COT Page 2 of 2 Memorial Medical Center Nursing Home UPI Weekly HMG Transfer Prosperity Accounts 10/34/2024 / J � .,txmrr J Ampm11.8. Aawrm upnnlry rtnelns J uIr,111W 1. xonln Hun. Numb, a<bn« Troml— el rnmanln sr [x.ne xt xu roar let nnl uxno. x unln xpn. /� t{l�fp$dN1.41�y" <.eaS.As ess Ss - s,elc ce s,35e.0 ✓ ems as, s,elcsa IervNin B<1<nef IWgI J / Aeiu•1 wlm..pr<ne..Am3 � s.na.u./ enxorm JI Ameomme. xglnnlry V.nalns mnrn..n. xunlnsxxll. Numb.. a<M<. rn Nre<me /Tnnxr,.m /flu Ouxe oroorx TNr:retrinn e..n[. J X urxryx.ma� sHnsii +tear N13 6,]H13 [0 60 ./ 6.90's60 / 36,e03.60 % e<nkerlrn,e )69a560 ✓ ✓ WmmIr a<umpm rmn�.nre. oareo•1. n...: xon:cn" W.. es ef.'slaW'.. 1, be nm 1..M.... "Rune. ua< 3: s«b.tm.m n.<. b.l a eolm�ee a 53ao u,a rAA3e eeAoutm ro <an x<w.nl APPROVED ON OCT 14 2024 CALH0%%UNrRLA VWXR4S (.....real.... Ieb. Aaux erl.nee/M..nrAm1 SRSOSM Toro SMNnSIR H 5l3 3e Anor.sw.t��N[Z��l'1 4�U L-R..Vh . Ana.x.w3ws.mo, sef� rW x w<ON T..mn nW n xM u<u4, wn.<q\pfiwrr uoanmbr winwn w.l a}< MMC pORT10N Y d„iM1! OIPP/Comp QIPP/Conp4 Tnnfl¢p 0ut Tpansf r- QIPP/CpnPI 2 Qlpp/COmp3 Supfe QIPPTI Nil pORTItlN 10/ID/2024 HNB•ECHO HCCIAIMPMT246003431440WW13360 4DD0 qDW 10/1012024 HNB • ECHO MCCIAIMPMT 74WO3411 MIM$213366 240.12 240 1017/2024 HNB - ECHO HCCIAIMPMT 746003411440000278543 / 525.13 / 575.13 MMC PORTION rim. u� QIPP/Gump QIPP/Comp4 _.. .:, 1 TranslnAut Tnnfle,.l QIPP/CPmpl 1 QIPP/COmp3 ►la0n QIPP TI "PORTION 10111IM21 MERCHANTSANRCOOEPOW49W98513889910MI 6.04291 6,042.91 10/9/2024 WIRE OUT HMO WMn SNE, 1P. Connerinl 6.284,13✓ IOINMZ4 MERCNANTOANK DDEP051T48642851808991W001 6339.13 - 1.339.13 IQ'2/2024 MERCHANTMNNCDOEPOSIT49678980699100W1 / 29,4MS6 - 29,418.56 6.284.1D 36.605.fi0 MAS6O 62".19 32,660.15 326608% Balances Overview Account Name `4357 MEMORIAL MEDICAL- $1,548,479.34 $1,527,978.21 $1,548,479.34 $1,745,261.57 OPERATING *4365 MMC - CLINIC SERIES 2014 $547,27 $547.27 $547.27 $547.27 •4373 MMC - PRIVATE WAIVER CLEARING $440.58 $440.58 $440.58 $440.58 *4381 MEMORIAL MEDICAL INH $194,691.98 $204,271.98 $194,691.98 $111,788.68 ASHFORD '4403 MEMORIAL MEDICAL INH $190,164.70 $190,164.70 $190,164.70 $112,023.21 BROADMOOR •4411 MEMORIAL MEDICAL INH $143,883.62 $158,222.49 $143,883.62 $125,926.36 CRESCENT *4438 MEMORIAL MEDICALISOLERA@ $107,587.78 $129,376.21 $107,587.78 $89,094.58 WEST HOUSTON `4446 MEMORIAL MEDICAL/NH FORT $57,695,38 $60,584.82 $57,695.38 $41,093,42 BEND *4454 MEMORIAL MEDICAL I NH GOLDEN CREEK $247,015.03 $252,865.03 $247,015.03 $245,220.40 HEALTHCARE `4651 CAL CO INDIGENT $12,701.74 $12,701.74 $12,701.74 $12,701.74 HEALTHCARE `5433 MMC -NH GULF / POINTE PLAZA - $5,816.68 ,/ ..J $5,816.68 $5,816.68 $5,816.68 PRIVATE PAY `5441 MMC-NH GULF POINTE PLAZA - $36,905.60 $36,905.60 $36,905.60 $30,857.69 MEDICAREIMEDICAID •5506 MMC -NH BETHANY SENIOR $44,435.65 $45,922.33 $44,435.65 $42,574.44 LIVING USCMMC NH USC TANY VILLAGE VILLAGE $243,094.80 $243,094.80 $243,094,80 $209,371.52 *3660 SRLIVI -BETHANY SR LIVINGG - DACA $100.00 $100.00 $100.00 $100.00 `2688 MMC -MONEY MARKET FUND $5,048.56 $5,048.56 $5,048.56 $5,048.56 Total Balance $2,838,608.71 $2,874,041.00 $2,838,608.71 $2,777,866.70 Report generated on 10114/2024 10:08:46 AM COT Page 2 of 2 Memorial Medical Center Nursing Home UK Weekly Tuscany Transfer Prosperity Accounts 10/14/I024 f ameuntme / � aWnum emm�W o.eel xmtler xom x.n,b., u a.om x AakXILMMX" JR/W._ �� 58.721,39 sell, 39, ]a)9yae0 )S5.&ia0 &N SNnn M.09110 ViAm,i Lave lnetlinu 3MW WNlvoint YrOAtllx 3.950e]✓ Mild etlm<.ttnmp, nmt xn.wax]✓ Hxeeiee:}: fete Meercnwnne I hol abole Phole, I nIS1.1h., MAec tlnevpneauxd1. ovnarcvnt i—c— AnOnwpelmSinter APPROVED ON 04LH'OUN't�OUAR" RAS Transhr•Out J// 22.761,62 ✓ 35,865 72 fey t ✓a��y3 � as 1�i a �; �d �, 10/1112024 HN9• ECHO HCCMIMPMT746003411440000255839 10/10/2024 Cheek 1173 10/10/2024 HN9- ECHO HCCMIMPMT 746003411440000213369 I0/1012024iWEVAOINT CO APEiPAYMENT 902675554 JAOW0. 10/10/2024 NOVITAS SOLUTION HCCMIMPMT 676ZOI 42=122 10/9/2024 WIRE OUT VIIM6E POST ACUM HEALTH SERVICE 10/9/2024 Deposit 34,11300 34,123.00 10/9/2024 Deposit 40,123.20 49,125.20 10/9/2024 NNE -ECHO HCCMIMPMT 746003411440000275293 1 999.90 J - 989.90 IOIW2024 Deposit J 9.eola5 J 8,801.35 10/11i HNO • ECHO HCCMIMPMT' 7460034114400002"687 1979.00 1.1. io, 56.627,99 292,994.80 1,314.49 l.zn,99 3 950.43 243 044.37 / MMCPORTION QIPP/COMP QIPP/Compl, QIPP/Comp QIPP/Comp Translerin 1 34&Lapse 3 441 QIPP TI NH PORTION 33.72518 33,723.28 742426 / / 7,424.26 2:11SZ7 /1,314.49 � 1.272.,88 1,950A3 ,/ 636i94 104,253,64 104,253b4 Balances Overview Account Name '4357 MEMORIAL MEDICAL• $1,548,479.34 $1,527,978.21 $1,548,479.34 $1,745,261.57 OPERATING MMC - CLINIC SERIES 2014 SERIES $547.27 $547.27 $547.27 $547.27 '4373 MMC -PRIVATE WAIVER CLEARING $440.58 $440.58 $440.58 $440.58 '4381 MEMORIAL MEDICAL INH $194,691.98 $204,271.98 $194,691.98 $111,788.68 ASHFORD '4403 MEMORIAL MEDICAL INH $190,164.70 $190,164.70 $190,164.70 $112,023.21 BROADMOOR '4411 MEMORIAL MEDICAL INH $143,883.62 $158,222.49 $143,883.62 $125,926.36 CRESCENT '4438 MEMORIAL MEDICAL I SOLERA $107,587.78 $129,376.21 $107,587,78 $89.094.58 WEST HOUSTON '4446 MEMORIAL MEDICAL I NH FORT $57,695.38 $60,584.82 $57,695.38 $41,093.42 BEND '4464 MEMORIAL OLDEN CREEK G OLRE $247,015.03 $252,865.03 $247,015.03 $245,220.40 HEALTHCARE 64651 CAL CO INDIGENT $12,701.74 $12,701.74 $12,701.74 $12,701.74 HEALTHCARE '6433 MMC -NH GULF POINTEPL.AZA- $5,816.68 $5,816.68 $5,816.68 $5,816,68 PRIVATE PAY '5441 MMC -NH GULF POINTE PLAZA - $36,905.60 $36,905.60 $36,905,60 $30,867.69 MEDICAREIMEDICAID '5506 MMC •NH BETHANY SENIOR $44,435,65 $45,922.33 $44,435.65 $42,574.44 LIVING *3407 MMC-NH TUSC TUSCANY VILLAGE $243,094.80 ^.� $243,094.80 $243,094.80 $209,371.52 '3680 MMC •BETHANY SR LIVING - DACA $100,00 $100.00 $100.00 $100.00 *2998 MMC -MONEY MARKET FUND MAR $5,048.56 $5,048,56 $5,048.56 �$6,048.56 Total Balance $2,838,608.71 $2,874,041.00 $2,838,608.71 $2,777,866.70 Report generated on 10/14/2024 10;08:46 AM CDT Page 2 of Memorial Medical Center Nursing Home UPL Weekly HSLTren9/er Prosperity Accounts 10/14/2024 Jm. J J venei.3 Petbvm eetlnnlN McOlure xumbr "no.innahoM hnnrlmn �Q led Pewrnen Ud56 el ]1,5k9.)i 21.0938 J Na1Fl OntyOelawn a/avn fS,IXOrxh EE M1on]Irrt[d10 lhenwlrrphCmr, Hale): FONaffnnlnoioMl<kelen!/N910EMtt MML tlepYxdboMn mowl. OCT 14 ?W4 CALHOUNU�C(�SU av0)Wg5 BEnk Wpnte 0.U5.65� le 1— Mull, 1W.Oa SupAwlelylMY6PGE E0.666.]l✓ 011 lnlewn xW lnlnl Polm t lrrnl ddiY)Ia 11 .R�X_ if 1!<MI Ead69.)9 dndrlry OetwLnlw 10/ OEd /J J !UX WnYylnn)Ien".up11rIn11er Su+m),y\SaIEµN I@l i........ry 101d.]d v� r-• °b YM MMCINIM {Y91@J� W r4nII4en9/ f110)/WmPI ginlCOm0i Ulpp/(em03 p>Gm1aM QVPii NN O11Ni616C1]N 101111]01C laarl" OtWNN111122651O101 0O12O1. dI0] 10)/01/0g/]1O011 MW0OIPY6IJWASf01U]IOUNVNK[A[4N1NMiM)b]4lI1EWAt11 10/0" NNO.ECHO K[WMOM4Mlllb SHJ ., I1..01S 6 108/2024 NNb.l[NO4CCWMSM74MI"P JBM.O IOP/SOP NO(SCpDAYdf 1111696910350SWEEP PH �1)UJIE i2f69Aa J 11,IN.A 116W JB y Balances Overview Account Name *4357 MEMORIAL MEDICAL- $1,548,479.34 $1,527,978.21 $1,548,479.34 $1,745,261.57 OPERATING *4365 MMC - CLINIC $547.27 $547.27 $547.27 $547.27 SERIES 2014 *4373 MMC -PRIVATE $440.58 $440.58 $440.58 $440.58 WAIVER CLEARING 4361 MEMORIAL MEDICAL/NH $194,691.98 $204,271.98 $194,691.98 $111,788.68 ASHFORD *4403 MEMORIAL MEDICAL/NH $190,164.70 $190,164.70 $190,164.70 $112,023.21 BROADMOOR '4411 MEMORIAL MEDICAL/NH $143,883,62 $158,222.49 $143,883.62 $125,926.36 CRESCENT *4438 MEMORIAL MEDICAL I SOLERA Q $107,587.78 $129,376.21 $107,587.78 $89,094.58 WEST HOUSTON *4446 MEMORIAL MEDICAL / NH FORT $57,695.38 $60,584.82 $57,695.38 $41,093.42 BEND *4454 MEMORIAL MEDICAL I NH $247,015.03 $252,865.03 $247,015.03 $245,220.40 GOLDEN CREEK HEALTHCARE 04551 CAL CO INDIGENT $12,701.74 $12,701.74 $12,701.74 $12,701.74 HEALTHCARE *5433 MMC -NH GULF POINTE PLAZA - $5,816.68 $5,816.68 $5,816.68 $5,816,68 PRIVATE PAY *5441 MMC -NH GULF POINTE PLAZA - $36,905.60 $36,905,60 $36,906.60 $30,857.69 MEDICARE/MEDICAID *5506 MMC •NH BETHANY SENIOR $44,435,65 ✓ J $45,922,33 $44,436,65 $42,574.44 LIVING *3407 MMC -NH $243,094.80 $243,094.80 $243.094.80 $209,371.52 TUSCANY VILLAGE *3660 MMC -BETHANY $100.00 $100.00 $100.00 $100.00 SR LIVING - DACA *2608 MMC -MONEY $5,048.56 $5,048.56 $5,048.56 $5,048.56 MARKET FUND Total Balance $2,838,608.71 $2,874,041.00 $2,838,608.71 $2,777,866.70 Report generated on 10/14/2024 10:08:46 AM CDT Page 2 of 2 Ashford Q MMC Operating A MEMORIAL MEDICAL CENTER CHECK REQUEST Date Requested: 10/14/2024 Y E APPROVED ON ;T 14 20M E ^.��, C NU Cf1UPITYI�XAS AMOUNT: EXPLANATION: $ 4,350.18 ,/ Wellpoint Yr6 Adj 2 FOR ACCT USE ONLY ❑ Imprest Cash EJ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept GA NUMBER: 10255040 REQUESTED BY: Michelle Cumberland AUTHORIZED BY:IenAhc.?;�. P A Y E E WTIRITIM MEMORIAL MEDICAL CENTER CHECK REQUEST MMC Operating Date Requested; 10/14/2024 APPROVER) ON OCT 14 2024 Av c n'th a=Y voi A.� U iY. $ 1,115.66 J EXPLANATION: Wellpoint Yr6 Adj 2 / FOR ACCT USE ONLY ❑ Im prest Cash ❑ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept G/L NUMBER: 10255040 REQUESTED BY: Michelle Cumberland AUTHORIZED BY: 10� Crescent MEMORIAL MEDICAL CENTER CHECK REQUEST P MMC Operating Date Requested: 10/14/2024 A Y APPROVED 'ON E nrT 14 2024 E ^' 'Y)x7`( �ph+'U LYI ' CALHaOU'l:01MY.. ; SS AMOUNT: $ 654.45,/ EXPLANATION: WellpointYr6Adj2./ FOR ACCT USE ONLY ❑ Imprest Cash ❑ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept G/L NUMBER: 10255040 REQUESTED BY: Michelle Cumberland AUTHORIZED BY: io�I��ZbZ� Fort Bend P MMC Operating A MEMORIAL MEDICAL CENTER CHECK REQUEST Date Requested: 10/14/2024 Y E APPROVED ON E OCT 147Q?�I CA HO .,��YyyCJt.1ppt10948 AMOUNT: EXPLANATION: FOR ACCT USE ONLY ❑ Imprest Cash ❑ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept S 942.22 ✓ G/L NUMBER: 10255040 Wellpoint Yr6 Adj 2 REQUESTED BY: Michelle Cumberland AUTHORIZED BY: l 0 1 l 020 ZV Solera P A Y E E AMOUNT: MEMORIAL MEDICAL CENTER CHECK REQUEST MMC Operating Date Requested: 10/14/2024 APPROVED ON 4 ro/4 r• nT%lnl�li CCIUNIY, I�ExAg 5 1,353,58 EXPLANATION: Wellpoint Yr6 Atli 2 z FOR ACCT USE ONLY ❑ Imprest Cash ❑ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept G/L NUMBER: 10255040 REQUESTED BY: Michelle Cumberland AUTHORIZED BY: r.., IU�l��2G2� P A Y E E AMOUNT: MEMORIAL MEDICAL CENTER CHECK REQUEST MMC Operating Date Requested: 10/14/2024 APPROVED ON OCT 14 2024 CA HO UC(7UM ITEXAS FOR ACCT USE ONLY ❑ Imprest Cash ❑ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept $ 1,950,43 ✓ G/L NUMBER: 10255040 EXPLANATION: Wellpoint Yr6 Adj 2 REQUESTED BY: Michelle Cumberland AUTHORIZED BY: OIPP PMTS TO MMC 10,14.24 QIPP PNymant to MMC from Nurslna Facilities NX Nema Prom 0an4 Palp Ckp Pn a Glp wxPekxrm M3S •TO}M:. ,Gate 8,M1IOrtl -Pro, We n MMC'Pr05 tF10,.rnh MM6P105 lrlln MMLflov rlln MMC4mt enlneli, MMLPru eln1A53 MMC-Pr.,,1n MMC Ar05 erla MMGPmS arin 4,350.16 c.350.10 6/3034 Oroadm00r .Pm, !tll Cre,ttd PIOr eri Oentl .WOi erle Gdtlen tr<Ok �Pmf etll BeltranPmv aril impn -pms enl 1,115,66 65445Potl 1950.43 115.66 0/16/2024 sa 10/6/2024 16/204 1950.43 1 /2014 161a1: 10366.52 10,366.52 Approved: ANDREW DE LOS SANTOS 10/14/20u J J J J Solera P MMC A MEMORIAL MEDICAL CENTER CHECK REQUEST Date Requested: Y APPROVED ON E Il LU Cp�N q`1�024 E CALH8 C JJlipY'WPA5 AMOUNT: EXPLANATION: 10/14/2024 FOR ACCT USE ONLY ❑ Imprest Cash ❑ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept $ 384.87 VI G/LNUMBER: Q3 Interest- remaining balance due to MMC / REQUESTED BY: Michelle Cumberland AUTHORIZED BY: 10255040 +I- 11112o'2-4- Updaled.QTD Interest- 03202E TO MMC Interest To MMC From NH rvB Name From ePSleank A<etp CBp Pa a GLp Aml Data Ashford-prospedt MMC Fros erlt Spending1W MMGPros sill 0 ¢r811n MMC 'formally Operate, MAIC " adt 0 eralin MMGPros eril Opemtln MMC �Prdsphllry Operating MMC Poor sill 0 ratio de tember Broadmoor - pros loll Cre"ord .Prot still Fast Send Prospent Solem -0ros eri Golden Creek .Plot and BetM1an Pros sill ' lul •SB lumber 3uN3x tember IBI 5! (ember lul Se ldrol reembilla Insiders for Q3 Interest 380.8 10/1C/ZO2E lul de [ember lul Sp [ember 380.B] 1Note: Approved: (NAL4 10/lA/]02d Andrew De Los Santos