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HomeMy WebLinkAboutPACKET AUGUST 26 2003 b �J City Of Beaumont REGULAR MEETING OF THE CITY COUNCIL COUNCIL CHAMBERS AUGUST 26,2003 1:30 P.M. AGENDA CALL TO ORDER * Invocation Pledge Roll Call * Presentations and Recognition * Public Comment: Persons may speak on scheduled agenda items/Consent Agenda * Consent Agenda GENERAL BUSINESS 1. Consider authorizing the City Manager to execute a contract for the rehabilitation of the Elevated Water Storage Tank at Sabine Pass and Harriot Street WORKSESSION * Review the Proposed FY2004 Capital Improvement Program COMMENTS * Councilmembers/City Manager comment on various matters * Public Comment (Persons are limited to 3 minutes) Persons with disabilities who plan to attend this meeting and who may need auxiliary aids or services are requested to contact Pat Buehrle at 880-3725 a day prior to the meeting. 1 August 26, 2003 Consider authorizing the City Manager to execute a contract for the rehabilitation of the Elevated Water Storage Tank at Sabine Pass and Harriot Street b City of Beaumont Council Agenda Item TO: City Council FROM: Kyle Hayes, City Manager PREPARED BY: Joseph G. Majdalani, Water Utilities Manager MEETING DATE: August 20, 2003 AGENDA MEMO DATE: August 26, 2003 REQUESTED ACTION: Council approval of a resolution authorizing the City Manager to execute a contract for the rehabilitation of the Elevated Water Storage Tank at Sabine Pass and Harriot Street. RECOMMENDATION Administration recommends approval of a contract with Utility Service Co.,Inc., Houston, Texas, in the amount of$328,650.00 to furnish and install all labor, materials, and equipment to repair, rehabilitate, abrasive blast interior and exterior,paint interior and exterior, and disinfect the existing 1,000,000 gallon elevated water storage tank located at Sabine Pass and Harriot Street. BACKGROUND The existing elevated storage tank was built in 1941. In 1997 the inside of the tank was cleaned and painted and the outside of the tank received two (2) spot coats of paint. The field investigation conducted by Schaumburg and Polk, Inc. concluded that the inside and outside paint of the tank have deteriorated, and must be abrasive blasted and painted in order to stay in compliance with Texas Commission on Environmental Quality(TCEQ) regulations. The primary goals of the project are to restore the integrity of the interior and exterior surfaces of the elevated storage tank, repair any structural damage, and provide customers with safe, adequate and uninterrupted service. BUDGETARY IMPACT Funds for the project are available in the Capital Improvement Fund. PREVIOUS ACTION None. SUBSEQUENT ACTION None. RECOMMENDED BY City Manager, Public Works Director, and Water Utilities Manager. W UElevStorSabinePassHarriot.wpd August 20,2003 b Sent By: city of beaumont; 8604672; Aug-21 -03 3:15PM; Page 313 ' 865 College SL.: wite-160,SEh811b1rg & P0lkq Inc.Inc• Beaumont. Tex-i's 7'7707 CONSULTING ENGINEERS mono (409))•f:6'rS••,034d':. FAX (409}. 866-0337• August 19,2003 Mr.Joseph G.Majdala i*P.E. Water Utilities Ivlartlager :....City of kow tam't P.O. Box 3827 Bemwi t,Texas 77704 Re: City of BMW% Rebabi'litation of the Elevated Water Storage Tank at Sabine Pass and Harriot Street Rewmmsendadion of lwr+rrd Dear Mr.NlgjdalaW, Based on a review of"received on Thursday,August 14,2003,it is our recommMbtiva t .06: above rekmwed project be awarded to Utf Bw vke Co,.,Inc,in the amount ofll2t M`.'T! award will include the Base aid ph s Additive Bid Item 1. Please call if you have any questions or ragi'm any additional infornmion. Sincerely, Schaumburg& Polk,Inc. J y G. ver,P.E. Vice President Atuchments: Bid TahAntion Schedule of MBE Par icipa&n(Schedule Q Minority Business Utiliaatiod Comrniblxrent DMT—&OUTM TANK 'BPI"NV.1002-GC*R pF:F:BMiU0a2U0e001ea0nOA.CpC MINIM "'"' Bid Tabulation CITY OF BEAUMONT REHABILITATION OF THE ELEVATED WATER STORAGE TANK AT SABINE PASS&HARRIOT STREET Bid Date: August 14,2003 at 2:00 PM f BIDDERS UTILITY SERVICE CO.,INC. ANGELOS PAINTING,INC. DMS PAINTING,INC. GULF STATES PROTECTIVE N.G.PAINTING,LP s P,O,BOX 41304 8830 AMANDA LANE 5327 PINE AVE. P.O.Box 313 MILL RUN HOUSTON,TX 77241 MANVEL,TEXAS 77578 PASADENA,TEXAS 77503 P.O.SOX 160a L1 POR TEXAS 77571 KERRVILLE,TEXAS 78028 Iteni Description Ouant Units Unit Price Total Price Unit Price Total Price Unit Price Total Price Unit Price Total Price Unit Price Total Price 1.Mobilization cost, including payment bond, 1 LS $26,000.00 $26,000.00 $25,000.00 $25,000.00 $31,150.00 $31,150.00 $20,000.00 $20,000.00 510,000.00 $10,000.00 performance bond,insurance,and moving equipment to project,... 2.Furnish and install all labor,materials,and equipment 1 LS S290,650.00 S290,650.00 $290,860.00 $290,860.00 $310,650.00 5310,650.00 $333,000.00 t $333,000.00 5437,600.00 $437,600.00 to repak. rehabilitate, abrasive blast interior & exterior, shrouding, repaint interior& exterior, and disinfect the existing 1,000,000 gallon elevated water storage tank as required in the Special Provision to the Technical Specifications(SP-1).... 3.Furnish and install all labor,materials,and equipment 1 LS $4,000.00 54,000.00 $6,000.00 $6,000.00 $4,200.00 54,200.00 $20,000.00 $20,000.00 $20,000.00 $20000.00 to remove and reinstall the existing GE , Communications antenna including new coax cable, cable conduit, reconnection to the existing communication box and antenna, all in strict accordance with the glans and gggtions for, yy�aa ,ri A"" 2 Xrayt3$2y86OD0Yy aa+ 3X53)ODADr}"4�"` x S3Jay3,7►QO �wyj er. __ ADDITIVE BID ITEM 1.If the soluble salt content is above 100ppm,furnish 1 LS 58,000.00 $8,000.00 $3,000.00 53,000.00 $8,500.00 $8,500.00 $15,000.00 S15,000.00 55,000.00 $5,000.00 and install all labor, materials, and equipment to pressure wash per SSPCSP-1 all blast cleaned areas as required in the Special Provisions to the Technical S eci5cations(SP-2),... Contract Documents Acknowledge Addendum No.l YES YES YES YES YES Bid Bond YES YES YES YES YES Bid Breakdown YES YES r YES YES YES Corporate Resolution YES YES YES YES YES Information Required of Bidder YES YES YES YES YES MinotityBusiaess Utiliation Commitment YES NO YES NO NO Schedule C(MBE) YES NO YES NO NO r The Bid Breakdown submitted by Angelos Painting,W for Bid Item No 2 does not match the amount shown in the Bid Proposal. The Bid Proposals submitted have been reviewed,and to the best of my knowledge this is an accurate tabulation of the Bids received. BY: DATE: 8-19-03 Bid Tab 1 of 1 Schaumburg &Polk,Inc. CONSULTING ENGINEERS City of Beaumont REGULAR MEETING OF THE CITY COUNCIL COUNCIL CHAMBERS AUGUST 26,2003 1:30 P.M. CONSENT AGENDA * Approval of minutes * Confirmation of committee appointments Adrian Hudspeth would be appointed as Chairman of the Parks and Recreation Advisory Committee. The term would commence August 26, 2003 and expire August 25, 2004. (Mayor Evelyn M. Lord) Myra Clay would be appointed as Vice-Chairman of the Parks and Recreation Advisory Committee. The term would commence August 26, 2003 and expire August 25,2004. (Mayor Evelyn M. Lord) Laurie Leister would be reappointed as Chairman of the Planning Committee. Her current term will expire August 25, 2004. (Mayor Evelyn M. Lord) Greg Dykeman would be reappointed as Vice-Chairman of the Planning Committee. His current term will expire August 25, 2004. (Mayor Evelyn M. Lord) Jayne Bordelon would be appointed as Vice-Chairman of the Keep Beaumont Beautiful Commission. The term would commence August 26,2003 and expire August 25, 2004. (Mayor Evelyn M. Lord) A) Authorize the settlement of a claim B) Authorize the acceptance of two (2)water line easements providing access for fire prevention services C) Authorize the acceptance of a water line easement providing access for fire prevention services D) Approve the write-off of uncollectible delinquent accounts for EMS charges A City of Beaumont 'w Council Agenda Item TO: City Council FROM: Kyle Hayes, City Manager PREPARED BY: Matt Martin, Liability Administrator MEETING DATE: August 26, 2003 AGENDA MEMO DATE: August 20, 2003 REQUESTED ACTION: Consider a resolution authorizing the settlement of the claim of Shyla Johnson. RECOMMENDATION Council approval of a resolution authorizing the settlement of the claim of Shyla Johnson. BACKGROUND Council authorized the settlement of this claim in Executive Session August 12, 2003. BUDGETARY IMPACT There are sufficient funds in the Liability Trust Fund to pay the settlement amount of$6,500. PREVIOUS ACTION None. SUBSEQUENT ACTION None. RECOMMENDED BY City Manager and City Attorney. S:IAGENDAIAGENDA ITEM MEMOSWOHNSON-6-03.wpd RESOLUTION NO. WHEREAS, the claim of Shyla Johnson has been discussed in an Executive Session properly called and held Tuesday, August 12, 2003; and, WHEREAS, the Council desires to authorize the settlement of the claim; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF BEAUMONT: THAT the City Attorney be and he is hereby authorized to settle the claim of Shyla Johnson in the amount of Six-Thousand Five-Hundred ($6,500) Dollars payable to Shyla Johnson. PASSED BY THE CITY COUNCIL of the City of Beaumont this the 26th day of August, 2003. - Mayor Evelyn M. Lord - S:WGENDXCITY CLERK\08-26-03.wpd B . f City of Beaumont Council Agenda Item TO: City Council FROM: Kyle Hayes, City Manager PREPARED BY: Joris P. Colbert, City Engineer MEETING DATE: August 26, 2003 AGENDA MEMO DATE: August 18, 2003 REQUESTED ACTION: Council consider a resolution authorizing the acceptance of two (2) water line easements providing access for fire prevention services. RECOMMENDATION Gateway Senior Housing, LTD., has agreed to convey two (2) ten foot (10') wide water line easements to the City of Beaumont. The easements are described as being out of Lots 1-12, Block 33A and Lots 11 and 12, Block 32A, College Acres Extension Addition, and will serve facilities located on Twelfth (12th) Street. These easements will provide mandatory access for fire prevention services. Administration recommends acceptance of the easement. BACKGROUND The easements are to be used to provide exclusive access to the water lines and fire hydrants for the property named above. They would also allow for the construction, alteration, operation and maintenance of the said water lines and appurtenances. BUDGETARY IMPACT None. PREVIOUS ACTION None. SUBSEQUENT ACTION None. RECOMMENDED BY City Manager, Public Works Director and City Engineer. fire gateway-ib.wpd August 18,2003 SUBJECT — I Shopping a j c1tv Ba t Cr Hos I a �COCLEOf 2 - 10' WATER LINE EASEMENTS •ELwdr *Aw l�e� LOTS 1-12,BLOCK 33A �� a auW"WE and LOTS 11 & 12,BLOCK 32A `"�""" ` 4 COLLEGE ACRES EXTENSION H a N now ADDITION O YARN I ELl NOR" (TWELFTH STREET) 7fR WA A DERK 5_ A p 70RS � R OWNER: f AK GATEWAY SENIOR HOUSING, LTD. a� ''' ► fLMM LOCATION MAP N.T.S. Vol vos �� o vol I vol 1 j R06ERTS AbE" A2749'19TE I AHM/OONfD 02-14-84 t32.74' CALC. �I g "'ol^o '`Oi SET 5/8"1 ROD ORIRNANCE NO. 84-26 CORNER - 01t ' STAMPED F.C. N0. 100-51-1390 / / ' I'ES,�'1 Of=ANO RETAINED ALL A89.51591E 323.38 � AS A URUT1'EASEMENT I FAD N89'51•�7't / 32J 33�_ _ I N CO C 12TH STREET "�51„ 2 .°°i` , 4217 2,��6 PPBERTS AVENUE �fND 1/2 4` (50'ROW) �°� — rN89.5i�7f4333 - -1 ROD f . PER VOL. 14. PC. 239 1,8180 ACRES' I j MRX A DEVELOPMENICORP. ^ice}_ EASEMENT 'i o'n CNO. 200?203y602 A � OPRJC I Qo� L 14, P& 2.39--�;:=f%` APPRO1oMATE ti ` ^ MRdC�+"`-" LOGTK)N Z�I EASEMENT B ALT tODB � ;i {;SFND i' OF ft00D ZONE / i 1 1 PIP£ FAD CONC. - �TAMP£D ,Z 1N CONC.-. °' SET 518'1. ROD/ /MONU ?8'LS 3636 A, c_� STAMPED RPLS N895!'47� 37684" $$ i M. Vol v EASEMENT �,�OZ x L0�r FiISEMENT it' -�° y °� s ` `8.8487 ACRES cau 240.00• a r�r r 4801 TE 240.29' 1 1( j��ZJSS 1 SAP 1.00 S0. f FNO 1 I. PIPf TFWAY SEN10R 11OG51NG LTD IN CONC. c Ij"` N°�NQ a��C;` 18 No 17002037602 tJC o 1 I. `{. �EASEAIEM '9� y°��1 I i^ q 1 " Id�tk► i • m �o g EASEMENT 2 I„ N71 14 PC 239 EASEAfENT�''^ of n °S, 'j�2 I 1� LOTS 11 & 12 MRJCI �� , C. °{ °, :: BLOCK 31A SET 5��8" .... c GATEWAY SENIOR HOUSING L I. R6D 58953331Y 239.83 No. 2002037602 OPRJC STAMPED 589.50 41 725.41 CALL 240.00 l?PLS 3636" uW~FW RREIAL A VENUE n1P 1" i NDP<PE 1.FND t' 1 PIPE EASEMENT B EXHIBIT"A" C City of Beaumont Council Agenda Item TO: City Council FROM: Kyle Hayes, City Manager PREPARED BY: Joris P. Colbert, City Engineer MEETING DATE: August 26, 2003 AGENDA MEMO DATE: August 18, 2003 REQUESTED ACTION: Council consider a resolution authorizing the acceptance of a water line easement providing access for fire prevention services. RECOMMENDATION Wesley United Methodist Church, Beaumont, Texas, has agreed to convey a ten foot (10') wide water line easement to the City of Beaumont. The easement is described as being a 0.0697 acre tract out of the Wesley B. Dyches Survey, Abstract 17, and is located at 3810 North Major Drive. This easement will provide mandatory access for fire prevention services. Administration recommends acceptance of the easement. BACKGROUND The easement is to be used to provide exclusive access to the water lines and fire hydrants for the property named above. It would also allow for the construction, alteration, operation and maintenance of the said water lines and appurtenances. BUDGETARY IMPACT None. PREVIOUS ACTION None. SUBSEQUENT ACTION None. RECOMMENDED BY City Manager, Public Works Director and City Engineer. fire_wesley-ib.wpd August 18,2003 SUBJECT Cllr � = POSE6ElE � I V IE LUK 3541 10' WATER LINE EASEMENT IE~ 3 8 0.0697ACRE OUT OF EAU O WESLEY B. DYCHES SURVEY ��� ABSTRACT 17 a . (3810 NORTH MAJOR DRIVE) OWNER: WESLEY UNITED METHODIST CHURCH, BEAUMONT, TEXAS LOCATION MAP N.T.S. I I I NOW OR FORMERLY NOW OR FORMERLY CLERKS FILE C E NO. 2 2000 0112. O.P.R.R.P.J.C. J.C.D.D. NO. 6- LERKS FILE NO. 20010404445, 0.P.R.R.P.J.C. TRACT THREE- 0.987 ACRES 10' GSU EASMENT CLERKS FILE N0. 96-9606079. O.P.R.R.P.J.C. - -- I I WESLEY UNITED METHODIST CHURCH, I I BEAUMONT, TEXAS Q I .CLERKS FILE NO. 2000033509, I O.P.R.R.P.J.C. I 0 I I � NOW OR FORMERLY S I I J.C.D.D. NO. 6 CLERKS FILE NO. 2001044625, I 0 O.P.R.R.P.J.C. 10' WATER LINE I J EASEMENT I 0 FOUND I I 0.0697 ACRES LL- CAPPED(006) FOUND IRON ROD I I CAPPED (1306)IRON ROD 50'UTILITY EASEMENT 20'UTILITY EASEMENT - VO1,. 1793, PG. 223, D.R.J.C. VOL 1745, PG. 445, D.R.J.C. i 25' EACH SIDE 956.83' 126.11' N 02'53'22" W 1092.94' N 04'58'00" W 420.87' N 02'45'12" W 80.24' (CALLED N 02'51'34"W) (CALLED N 04'58'00' W 4(BASIS OF BEARING'S (CALLED N 02'51'34"W) NORTH MAJOR DRIVE POINT OF (AKA F.M. 364) BEGINNING 10' WATER LINE EASEMENT EXHIBIT"A" 4 City of Beaumont Council Agenda Item TO: City Council FROM: Kyle Hayes, City Manager PREPARED BY: Kandy Daniel, Treasurer MEETING DATE: August 26, 2003 AGENDA MEMO DATE: August 20, 2003 REQUESTED ACTION: Council consider a resolution to write-off uncollectible delinquent accounts for EMS charges totaling $54,552.41 for which each individual account exceeds $1,000. A detailed listing of each account is attached. RECOMMENDATION The administration requests approval of a resolution to write-off uncollectible delinquent accounts for EMS charges totaling $54,552.41 for which each individual account exceeds$1,000. BACKGROUND This request is in accordance with the write-off policy approved by City Council on December 21, 1999. The policy gives Council the final authority to write-off any individual account receivable identified as uncollectible when the balance due exceeds $1,000. $35,287.05 are Medicaid accounts,$18,038.36 are Medicare and$1,227.00 are insurance accounts. Of the $54,552.41 writeoff requested, approximately $32,439 represents the unallowed portion of Medicare/Medicaid claims which is never billable. The remaining claims were not discovered until they were past the filing deadline due to problems with previous EMS software. They are now too old to pursue and Medicare/Medicaid rules do not allow billing to eligible patients. If at any time an account becomes collectible after having been written-off,the receivables ofthe City shall be adjusted accordingly. The balance of the account shall be reinstated and payments shall be applied to that balance. BUDGETARY IMPACT None. G PREVIOUS ACTION Council approved a resolution to write-off uncollectible delinquent account totaling $16,072.66 on March 27, 2002. SUBSEQUENT ACTION None. RECOMMENDED BY City Manager and Finance Officer. EMS accounts that are either not billable or are not collectible. Request approval for write off of these account balances is submitted. Incident Date Customer# Customer Name Customer Charge Type Amount 08109/2001 01-005835 Baptiste, Othello EM 405.00 Medicaid eligible, past deadlines 09/25/2001 01-007027 Baptiste, Othello EM 300.00 Medicaid eligible, past deadlines 0211612002 02-001048 Baptiste, Othello EM 619.00 Medicaid eligible, past deadlines 12122/2001 02-009254 Berwick, Marvin EM 658.00 Ins info available, filled past deadline 02/14/2002 02-000988 Berwick, Marvin EM 569.00 Ins info available, filed past deadline 03/12/1998 98-006622 Blount, Mary EM 330.00 Medicaid eligible, past deadline 06/0111999 99-003627 Blount, Mary EM 405.00 Medicaid eligible, past deadline 12/2412000 00-009156 Blount, Mary EM 300.00 Medicaid eligible, past deadline 03/11/2001 01-001914 Blount, Mary EM 405.00 Medicaid eligible, past deadline 04/24/2001 01-003077 Blount, Mary EM 405.00 Medicaid eligible, past deadline 05102/2001 01-003238 Blount, Mary EM 300.00 Medicaid eligible, past deadline 05122/2001 01-003767 Blount, Mary EM 300.00 Medicaid eligible, past deadline 05/25/2001 01-003909 Blount, Mary EM 300.00 Medicaid eligible, past deadline 06/10/2001 01-004241 Blount, Mary EM 300.00 Medicaid eligible, past deadline 0611412001 01-004342 Blount, Mary EM 300.00 Medicaid eligible, past deadline 06/16/2001 01-004424 Blount, Mary EM 300.00 Medicaid eligible, past deadline 07/01/2001 01-004870 Blount, Mary EM 300.00 Medicaid eligible, past deadline 07/16/2001 01-005252 Blount, Mary EM 300.00 Medicaid eligible, past deadline 08/1712001 01-006180 Blount, Mary EM 405.00 Medicaid eligible, past deadline 09/22/2001 01-006956 Blount, Mary EM 300.00 Medicaid eligible, past deadline 09/29/2001 01-007110 Blount, Mary EM 300.00 Medicaid eligible, past deadline 07130/2002 02-004925 Blount, Mary EM 534.00 Medicaid eligible, past deadline 0912412002 02-006380 Blount, Mary EM 600.00 Medicaid eligible, past deadline 04/0912001 990016375 Bums, Sadie EM 300.00 Medicaid eligible, past deadlines 08/15/2001 990016375 Bums, Sadie EM 405.00 Medicaid eligible, past deadlines 04/12/2002 990016375 Bums, Sadie EM 534.00 Medicaid eligible, past deadlines 10119/2002 990016376 Bums, Sadie EM 611.00 Mcare/Mcaid eligible, past deadlines 12/10/2001 01-008972 Crochet, Ardey EM 587.00 Medicaid eligible, past deadlines 12/17/2001 01-009127 Crochet, Ardey EM 657.00 Medicaid eligible, past deadlines 08/22/2000 00-006002 Franklin, Cathy J. EM 300.00 Medicaid eligible, past deadlines 08/3012000 00-006194 Franklin, Cathy J. EM 300.00 Medicaid eligible, past deadlines 12/30/2000 00-009329 Franklin, Cathy J. EM 405.00 Medicaid eligible, past deadlines 01/18/2001 01-000517 Franklin, Cathy J. EM 300.00 Medicaid eligible, past deadlines 03/24/2001 01-002520 Franklin, Cathy J. EM 405.00 Medicaid eligible, past deadlines 0411612001 01-002817 Franklin, Cathy J. EM 300.00 Medicaid eligible, past deadlines 05/31/2001 01-003976 Franklin, Cathy J. EM 405.00 Medicaid eligible, past deadlines 07/21/2001 01-005423 Franklin, Cathy J. EM 300.00 Medicaid eligible, past deadlines 09/03/2001 01-006477 Franklin, Cathy J. EM 300.00 Medicaid eligible, past deadlines 09119/2001 01-006892 Franklin, Cathy J. EM 300.00 Medicaid eligible, past deadlines 06120/2000 00-004297 Garrett, Ella EM 405.00 Medicaid eligible, past deadlines 02122/2003 03-001212 Garrett, Ella EM 550.00 Mcare/Mcaid eligible, past deadlines 03/13/2002 990008272 Garrett, Ella L. EM 545.00 Medicaid eligible, past deadlines 0112912001 990017498 Green, William EM 300.00 Medicare eligible, past deadlines 0512712000 990012036 Green, William J. EM 300.00 Medicare eligible, past deadlines 10/24/2002 148067 Green, William J. EM 542.00 Medicare eligible, past deadlines l EMS accounts that are either not billable or are not collectible. Request approval for write off of these account balances is submitted. Incident Date Customer# Customer Name Customer Charge Type Amount 02/07/2000 00-000806 Harris, Ethel L EM 25.00 MedicarelMedicaid eligible, past deadlines 12/19/2000 00-009014 Harris, Ethel L EM 300.00 Medicare/Medicaid eligible, past deadlines 01/20/2001 01-000571 Harris, Ethel L EM 300.00 Medicare/Medicaid eligible, past deadlines 02/15/2001 01-001269 Harris, Ethel L EM 300.00 Medicare/Medicaid eligible, past deadlines 06/08/2001 01-004218 Harris, Ethel L EM 300.00 Medicare/Medicaid eligible, past deadlines 08/12/2001 01-005942 Harris, Ethel L EM 300.00 Medicare/Medicaid eligible, past deadlines 08/28/2001 01-006379 Harris, Ethel L EM 300.00 Medicare/Medicaid eligible, past deadlines 09114/2001 01-006763 Harris, Ethel L EM 300.00 Medicare/Medicaid eligible, past deadlines 07/31/2000 00-005439 Lewis, Doris M. EM 95.00 Medicare/Medicaid eligible, past deadlines 08/11/2000 00-005750 Lewis, Doris M. EM 405.00 Medicare/Medicaid eligible, past deadlines 05/1912001 01-003692 Lewis, Doris M. EM 405.00 Medicare/Medicaid eligible, past deadlines 05/24/2001 01-003826 Lewis, Doris M. EM 405.00 Medicare/Medicaid eligible, past deadlines 12/25/2001 01-009324 Lewis, Doris M. EM 100.00 Medicare/Medicaid eligible, past deadlines 02/04/2002 02-000760 Lewis, Doris M. EM 611.00 Medicare/Medicaid eligible, past deadlines 05125/1999 99-003436 Manning, Jesse EM 170.00 Medicaid eligible, past deadline 06/01/1999 99-003624 Manning, Jesse EM 170.00 Medicaid eligible, past deadline 06/02/2000 00-003816 Manning, Jesse EM 300.00 Medicaid eligible, past deadline 06/08/2000 00-004009 Manning, Jesse EM 350.00 Medicaid eligible, past deadline 07/28/2002 02-004884 Manning, Jesse EM 100.00 Medicaid eligible, past deadline 09/18/2001 01-006805 Miller, Will EM 300.00 Medicaid eligible, past deadlines 10/28/2001 01-007851 Miller, Will EM 510.00 Medicaid eligible, past deadlines 12/30/2000 00-009333 Miller, William D EM 300.00 Medicaid eligible, past deadlines 0112312001 01-000671 Miller, William D EM 300.00 Medicaid eligible, past deadlines 0211712001 01-001333 Miller, William D EM 300.00 Medicaid eligible, past deadlines 02/24/2001 01-001504 Miller, Wiliam D. EM 300.00 Medicaid eligible, past deadlines 10/14/2002 02-006883 Miller, William D. EM 642.00 Medicare/Medicaid eligible, past deadlines 10/16/2002 02-006920 Miller, William D. EM 518.00 Medicare/Medicaid eligible, past deadlines 10/18/2002 02-006959 Miller, William D. EM 634.00 Medicare/Medicaid eligible, past deadlines 02103/2003 03-000771 Miller, William D. EM 542.00 Medicare/Medicaid eligible, past deadlines 02/03/2003 03-000769 Miller, William D. EM 534.00 Medicare/Medicaid eligible, past deadlines 02/0512003 03-000804 Miller, William D. EM 634.00 Medicare/Medicaid eligible, past deadlines 02/23/2003 03-001242 Miller, William D. EM 642.00 Medicare/Medicaid eligible, past deadlines 02124/2003 03-001265 Miller, William D. EM 650.00 Medicare/Medicaid eligible, past deadlines 05/04/2000 00-003099 Moore, Djuana M. EM 380.00 Medicaid eligible, past deadlines 0311012001 01-001881 Moore, Djuana M. EM 405.00 Medicaid eligible, past deadlines 03/14/2001 01-001983 Moore, Djuana M. EM 405.00 Medicaid eligible, past deadlines 04/08/2001 01-002614 Moore, Djuana M. EM 300.00 Medicaid eligible, past deadlines 04/11/2001 01-002701 Moore, Djuana M. EM 300.00 Medicaid eligible, past deadlines 04/12/2001 01-002826 Moore, Djuana M. EM 300.00 Medicaid eligible, past deadlines 04/26/2001 01-003199 Moore, Djuana M. EM 350.00 Medicaid eligible, past deadlines 06/06/2001 01-004174 Moore, Djuana M. EM 300.00 Medicaid eligible, past deadlines 06/16/2001 01-004448 Moore, Djuana M. EM 380.00 Medicaid eligible, past deadlines 0611712001 01-004473 Moore, Djuana M. EM 300.00 Medicaid eligible, past deadlines 08/23/2001 01-006185 Moore, Djuana M. EM 300.00 Medicaid eligible, past deadlines 09/21/2001 01-006945 Moore, Djuana M. EM 300.00 Medicaid eligible, past deadlines EMS accounts that are either not billable or are not collectible. Request approval for write off of these account balances is submitted. Incident Date Customer# Customer Name Customer Charge Type Amount 09/27/2001 01-007063 Moore, ©Juana M. EM 300.00 Medicaid eligible, past deadlines 06/0912000 00-003984 Ned, Martha EM 380.00 Medicaid eligible, past deadline 08/09/2000 00-005603 Ned, Martha EM 380.00 Medicaid eligible, past deadline 10/12/2000 00-007280 Nerd, Martha EM 405.00 Medicaid eligible, past deadline 11/30/2000 00-008492 Nevi, Martha EM 405.00 Medicaid eligible, past deadline 03/06/2001 01-001795 Rainey, Mack EM 405.00 Medicaid eligible, past deadlines 01/31/2002 990014275 Rainey, Mack EM 587.00 Medicare replacement eligible, past deadlin, 02/08/2003 990014275 Rainey, Mack EM 50.00 Medicaid eligible, past deadlines 05/24/2000 00-003573 Reese, Jamod EM 405.00 Medicaid eligible, past deadlines 05/29/2001 01-003947 Reese, Jarriod EM 405.00 Medicaid eligible, past deadlines 06/05/2001 990023986 Reese, Jarriod EM 405.00 Medicaid eligible, past deadlines 02/23/2003 142633 Sais, Marie W. EM 595.00 Medicare replacement eligible, past deadlin4 07/08/2001 01-005048 Shilo, Jessica EM 405.00 Medicaid eligible, past deadlines 10/16/2001 01-007325 Shilo, Jessica EM 587.00 Medicaid eligible, past deadlines 01/18/2003 03-000388 Shilo, Jessica EM 192.85 Medicaid eligible, past deadlines 02/16/2002 142633 Sias, Marie W. EM 587.00 Medicare replacement eligible, past deadlh 12/30/2002 02-008627 Stewart, Evelyn EM 526.00 Medicare/Medicaid eligible, past deadlines 01/1612003 03-000339 Stewart, Evelyn EM 550.00 Medicare/Medicaid eligible, past deadlines 01/18/2003 03-000396 Stewart, Evelyn EM 534.00 Medicare/Medicaid eligible, past deadlines 01/19/2003 03-000410 Stewart, Evelyn EM 534.00 Medicare/Medicaid eligible, past deadlines 01/20/2003 03-000423 Stewart, Evelyn EM 534.00 Medicare/Medicaid eligible, past deadlines 01/21/2003 03-000467 Stewart, Evelyn EM 526.00 Medicare/Medicaid eligible, past deadlines 01/24/2003 03-000542 Stewart, Evelyn EM 534.00 Medicare/Medicaid eligible, past deadlines 05/26/2000 00-003560 Stoglin, Ruby EM 121.96 Medicaid eligible, past deadline 08/25/2000 00-006080 Stoglin, Ruby EM 300.00 Medicaid eligible, past deadline 11/01/2000 00-007851 Stoglin, Ruby EM 300.00 Medicaid eligible, past deadline 01/23/2001 01-000669 Stoglin, Ruby EM 330.00 Medicaid eligible, past deadline 05122/2001 01-003764 Stoglin, Ruby EM 300.00 Medicaid eligible, past deadline 08/2112001 01-006136 Stoglin, Ruby EM 330.00 Medicaid eligible, past deadline 09/05/2001 01-006493 Stoglin, Ruby EM 435.00 Medicaid eligible, past deadline 10/24/2001 01-007730 Stoglin, Ruby EM 627.00 Medicaid eligible, past deadline 1012$/2001 01-007849 Stoglin, Ruby EM 592.00 Medicaid eligible, past deadline 12130/2001 01-009444 Stoglin, Ruby EM 550.00 Medicaid eligible, past deadline 02/1512002 02-001010 Stoglin, Ruby EM 534.00 Medicaid eligible, past deadline 11/2712002 02-007864 Stoglin, Ruby EM 382.43 Medicaid eligible, past deadline 06/06/2000 00-003958 Walton, Christine EM 405.00 Medicaid eligible, past deadlines 09115/2000 00-006638 Walton, Christine EM 375.00 Medicaid eligible, past deadlines 03/11/2001 01-001916 Walton, Christine EM 300.00 Medicaid eligible, past deadlines 04116/2001 01-002920 Walton, Christine EM 405.00 Medicaid eligible, past deadlines 09/08/2001 01-006586 Walton, Christine EM 300.00 Medicaid eligible, past deadlines 02/17/2001 990024412 Weitzel, Charlene EM 118.30 Medicaid eligible, past deadlines 11/16/2001 140168 Weitzel, Charlene EM 550.00 Medicaid eligible, past deadlines 12/19/2001 140168 Weitzel, Charlene EM 584.00 Medicaid eligible, past deadlines 04/30/1997 990019581 Wise, Eugene EM 271.36 Medicare eligible, past deadlines 06/22/1997 990019581 Wise, Eugene EM 330.00 Medicare eligible, past deadlines G EMS accounts that are either not billable or are not collectible. Request approval for write off of these account balances is submitted. Incident Date Customer# Customer Name Customer Charge Type Amount 04102/1998 990019581 Wise, Eugene EM 355.00 Medicare eligible, past deadlines 06/28/1998 990019581 Wise, Eugene EM 330.00 Medicare eligible, past deadlines 06/19/2000 00-004310 Woodward, Zina EM 88.85 Medicaid eligible, past deadlines 02/08/2002 02-000850 Woodward, Zina EM 640.00 Medicaid eligible, past deadlines 06/07/2002 990010994 Woodward, Zina EM 417.66 Medicaid eligible, past deadlines 54,552.41