ORDER NO. 18575
MOTION TO APPROVE THE HIRING OF BARBARA A. BODE
IN COUNTY COIJRT AT LAW IN THE COUNTY CLERK'S OFFICE
On this the 10th day of April 1989, upon motion made by
Commissioner Holekamp, seconded by Commissioner Baldwin, with
Commissioner's Holekamp, Baldwin and Morgan, and County Judge
Edwards voting "AYE", and Commissioner Ray voting "NAY", said
motion to approve the hiring of Barbara A. Bode in County
Court at Law in the County Clerk's Office, effective April
17, 1989, at Pay Group 11, Step 1, $12,721.00 annually,
$1,060.08 monthly, and $530.04 semi-monthly, was approved by
a majority vote.
COMMISSIONEF:S' COURT AGENDA REQUES'Y'
_ E'LEASE FLJRNISI-; ONE ORIGINAi. AND "EIGHT" COi~II?S OF TI-IIS REQUi;ST AND
DOCUMENTS TO BE REVIE6'VED I3Y THE COURT.
MADE BY: pat Dye OFFICE: County Clerk
METING DATE: April 10,. 1989 TIME PREFERRED: 2 P.M.
SUBJECT: (PLEASE BE SPECIFIC: Approve hiring Barbara A. Bode as Deputy
County Clerk in County Court at Law.
ESTIMATED [.ENGTH OF PRESEN"r'ATION: 5 minutes
IF PE SONNEL MATTER: NAA4E OF EMFLOYI:E:: Barbara A. Bode
NAR~E OF PERSON ADDI?vSSING THE COUI;T: Pat Dye
TIPJIE r'OR SUBR4ITTING THIS REQUEST FOK COUR'II' TO ASSURE THAT THE MATTE^ IS
POSTED IN ACCORDANCE WI'T'H AP.TICLE 6252-17 IS AS FOLI.OZ/S:
P~4EETINGS HELD ON SECOP.iD MONDAY: 12:00 P.M. PRT:VIQUS WEDNESDAY
MI;CTTN.^,S HELD ON THURSDAYS: 5:00 P. M. PREVIOUS THURSDAY.
IF PI'EFERABLE, AGENDA REQUESTS PJIAY BE AJIAD;F. ON 04 FICc STATIONERY WITH THE
A60~JE INFORMATION ATTACHED.
THIS REQUEST RECEIVED BY:
"fI-IIS RF..QUEST RECEIVED ON: ~ A.M. P.Ni.
AI.I. AGENDA REQUF.S T S V`/ILL EE SCRENED BY THE COUNTY JUI?LEI;' S OI: FICE TO DT:-
'1'[~:I~?viINE IF ADEC)UATE INFORT9/`~a ION HAS F3I;EN PI:~:P/'~r~vD FOIE 'CHL' COUR"T"S FOIZMAI.
CONSIDERATION AND ACTIO~J AT TIME OF COURT h^.EI'I'INGS. YOUR COOPERATION
~"TILT. BE APPRECIATED AND CONTRI[~UTE 'T'OWARDS YOUR RE:QUF.S7' 13I:ING ADDRF:SSF.1)
A'I' THE f?ARE.IEST OPPOR'I'(_JNI'I'Y.
• •T6 Oe ••.
v ~~:
~atn~C~a dye
COUNTYCIERK KERRCOUNTY
KERRVILLE, TEXAS 78028-5389
(512) 896-2844
M E M O
DATE: April 3, 1989
T0: Hon. Commissioners' Court
i ~ ~~ ~ ~i
FROM: Pat Dye, Kerr County Clerk ,~~~~ '~~
SUBJECT: Hiring Barbara A. Bode
Due to the opening as Asst. Bookkeeper, Marilyn Fritz desires to
transfer to this position from County Court at Law. I recommend
Barbara A. Bode to fill this position. Please see the attached
physical forms and resume.
Marilyn Fritz is an 11/1, with yearly amount $12,232 and semi-
monthly is $509.67. The position in bookkeeping is the same.
The effective date for hiring Barbara A. Bode and for Marilyn
Fritz to transfer is April 17, 1989. Barbara A. Bode will be-
gin with Pay Group 11/1, yearly amount $12,232 and semi-monthly
is $509.67.
Barbara A. Bode
P. 0. Box 903
Kerrville, Tx.
Phone: 896-4255
EXPERIENCE:
July 1988 Craig Sebek's State Farm Insurance
to present 1005 Sidney Baker St.
Kerrville, Tx.
June ~
July, 88
1978 to
June, 88
1977 to
1988
Position: Secretary/Receptionest- Job Description:
Greeting and directing clients, answering the phone,
screening and directing phone calls and answering
service questions. Also, taking payments made in
the office, preparing all outgoing mail, recording
all health bills and health payments. Computer work
includes giving auto and health quotes, processing
all auto and fire policies, making all auto changes,
(new cars, coverages changed, cancellation and rein-
statements, etc.).
Sunday House Motor Inn
2124 Sidney Baker
Kerrville, Tx.
Relief Front Desk Clerk - Job Description: (Part time)
Help check guests in and out of the motel, operate the
switchboard, run errands for guests.
Bode Feed & Sup ly, Inc
P. 0. Box 176
Harper, Tx.
Position: Bookkeeper/Clerk - Job Description: Genera
bookkeeping, included cash balancing, accounts receiv-
able, preparing monthly balance sheets, some experience
in payroll. Clerical work included typing, filing,
answering the phone, taking feed orders, waiting on
customers and writing sales invoices.
Substitute Mail Carrier,
Harper, Tx.
Job Description:
route. Averaged
year, three hours
Sort, case and deliver mail on rural
three days per week during the last
per day.
S]<ILLS: Typing, IBM computer, and 10-key calculator and post-
ing machine by touch. Also, cash register, switch-
board and office copier.
~~~
PROSPL;C'1'1VF iiA1PLUYESL' Mr;DICAL EXAMINA'('LUN I'OFIM
C'OR KERB COUNTY
APPOINTMCNT TIb1E: March 29, 1989
10:30 A. M.

DATE:
I NAME OF APPLICANT:
Di:i'AR"I'MF?N"I' FN'1'I:ItVIt'.WI~U rOit: Kerr Count Clerk's Office
POSI'CION [N'I'EI2VII;WI:D I'OI.: Deputy in Filmin De artment
DI3SK JUF3 `~
~ - - -
I
' SI'ECIAi, '1'I:S'1'INC;:
E3LOOI) '1'I?5'I': DEPENDS... ON. MEDICAL HISTORY)
~_^__
I URINALYSIS
I _ X-RAY - BACK _
X-I2AY - C11[•:S'1'•(DEPEND_S ON MEDICAL HISTORY)
i
DRUG TCSTINC;: ,S
NO
~ APPLICANT'S SIGNA'I'URR FOR CONS(:NT nF DRUG TCSTING
X
TAKE rOi2M 'I'O:
DIZ. AEZTURO GONZAL1iS
715 IIILL COUNTRY DRIVE, SUITE 4
K.E~:E2RVJLLI;, "TEXAS 713028 (512) 89G-2977
FROM: 'KERB CO 'I'Y
TITLE: a ricia bye
Kerr County Cler
A['1'ER MEDICAL EXAM IS I:OMI'I.1:1'ED, I'1.[:ASE RI'fURN PHYSICIANS' Tf;S'I' RL•'SUI:I'S
TO TlIC: K1{RI2 COIJN'IY ('OI:tZ"I'HOUSI:, 7OU MAIN S'1'IZl•:l:'(', KI:Ri:VIl.1.G, TIiXAS.
ATT: PATRICIA DYE -----~

- - - -_ - -
_AM e•eo CLINICAL DATA
-_ _ -- ~
- -~ ~==-r==-= --t- ~---~ _ _--~_ ------- _-_------ - ~-- --- 1----- _
NAME_ /[.~~ /~{(~" i(. •I Q~\/~(?.`~.~~~}' ~S AGE ~SEZ r SI~w
ADDRESS ~Jtir(/~ ~l.' .~/~/I / [/ /~-~~~~/"`---`~~-~~~ ~-' -/iP~i PHONE DATE ~ ~J
SPONSOR	ADDRESS '~,
OCCUPATION	REF fV
ACKN
FAMILY HISTORY FATHER	MOTHER
BROTHERS	SISTERS
TB OIAf MALIG HT DIf NEPM EPIIEP PSYCH
OTHER	
PAST HISTORY GENERAL HEALTH	
DISEASES OF CHILDHOOD	RH -EV sc •[v POLID TrrH
PNEU NEPH ^Ollf ASTHMA HT OI5 Tf HYPERTENSION V O AIIERGI Lf
TRAVMA-SURGERY	
MENSTRUAL ONSET	Pt RIO DI CITr rrPE DURATION PAIN
MARITAL CHILDREN LIVING	D[AD f • MARRIED YRf rOU NG EST CMILO '~
HABITS COFF[[ TEA	ALC TOfACCO WATER APP[TI7[ I
	
	
	

.Z
CHIEF COMPLAINT	
_-	
	
	
	
PHYSICAL EXAMINATION EIGHT	HEIGHT TEMP PULSE ~ RESP (..(J B P ./.~~ G
GENL APPEARANCE	
SKIN	MUCOSA
EYES VI IOH ~(	• PU PIlS FUNGI
i EARS	
NOSE	THROAT ~~ PHARYNX
CHEST ~~/Z!< ~ ~ f	~ BREASTS
HEART	
IU NGS	
ABDOMEN	
	LABORATORY
GATE
/~
n ~
GENITALIA /(	FLOOD
	
RECTUM	
EXTREMITIES	
LYMPH NODES A/~if~T	

R EiLEX ES	URINE
	1~. -
REMARKS	~
	
	
	
	
	/OPM e1f0 GOL w~LL CO C~AYFA~pr
PiEASE DO NOT
STAPEE IN
THIS AREA
HEALTH INSURANCE CLAIM FORM FORM APPROVED OMB NO. os38-0008
READ INSTRUCTIONS BEFORE COMPLETING OR SIGNINf. TMIC FORI1.1 If'41crr a RI c o
MED CARE NO. ~ MED CAI D NO. ~ SPONSOR'S SSN ~ CHAMPVA O SSN BLACK LUNG ~ ~ ERT FICATE SSN
VA FILE NO.
PATIENT AND INSURED (SUBSCRIBER) INFORMATION
1. PA NT'S NA E (LAST NAMElF) RST NAME, IDDLE INITI
AL)
)
~	2. PATIENT'S DATE OF BIRTH	3. INSUREO'S NAME (LAST NAME, FIRST NAME, MIDDLE INITIALI
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d. PATIENT'S ADDRE (STREET, CITY STATE, ZIP CODE)
(,(/,/"/~ ~-y/~~`11~ ~~(//1
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~~	5. PATIENT'S SEX	8. INSURED'S ID NO. IFOR PROGRAM CHECKED ABOVE, INCLUDE ALL
LETTERSI
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_''	MALE ~ ~ FEMALE	
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~	7. PATIENT'S RELATIONSHIP TO INSURED	8. INSURED'S GROUP N0. (OR GROUP NAME OR FECA CLAIM NO.I
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/	SELF SPOUSE CHILD OTHER	
_
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TELEPHONE NO.
7		EMPLOYER HEAITH
PLAN
9. OTHER HEALTH INSURANCE COVERAGE (ENTER NAME OF POLICYHOLDER	10. WAS CONDITION RELATED TO	11. INSURED'S ADDRESS (STREET, CITY, STATE, ZIP CODE)
AND PLAN NAME AND ADDRESS AND POLICY OR MEDICAL ASSISTANCE
NUMBER)	A. PATIENT'S EMPLOYMENT	
	YES a a NO	
		TELEPHONE NO.
	8. ACCIDENT	11A. CHAMPUS SPONSOR'S
	AUTO ~ ~ OTHER	1 ~ DUTY E ~ DECEASED
STAT
S	BRANCH OF SERVICE
		U
I
I ~ RETIRED	
12. PATIENT'S OR AUTHORIZED PERSON'S SIGNATURE (READ BACK BEFORE SIGNINGI	13. 1 AUTHORIZE PAYMENT OF MEDCAL BENEFITS TO UNDERSIGNED
I AUTHORIZE THE RELEASE OF ANY MEDICAL INFORMATION NECESSARY TO PROCESS THIS CLAIM. I ALSO REQUEST PAYMENT OF	PHYSICIAN OR SUPPLIER fOR SERVICE DESCRIBED BELOW.
GOVERNME T BFNEfITS EITHER TO MYSELF OR TQ THE PARTY WHO ACCEPTS ASSIGNMENT BELOW.
~
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SIGNED -
w DATE	SIGNED (INSURED OR AUTHORIZED PERSON)
PHYSICIAN OR SUPPLIER INFORMA	TION
14. DATE OF:	ILLNESS IflRST SYMPTOM) OR INJURY	15. DATE fIRST CONSULTED YOU FOR THIS	18. If PATIENT HAS MAD SAME OR SIMILAR	18A. IF EMERGENCY
	(ACCIDENT) OR PREGNANCY (LMP)	CONDITION	ILLNESS OR INJURY, GIVE DATES	CHECK~HERE
17. DATE PATIENT ABLE TO	18. DATES OF TOTAL DISABILITY	DATES OF PARTIAL DISABILITY
RETURN TO WORK		
)1 rf!t'lft	R THROUGH	FROM THROUGH
1Y.TYMIIE ~~fiEFER1{ING PMNS1CIMhOR OTHER SOURCE IE.G.. PUBLIC HEALTH AGENCY)
" ` UIIIY (fl l Ufl
I	20. FOR SERVICES RELATED TO HOSPITALIZATION GIVE HOSPITALIZATION
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~
# 4	DATES
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C	ADMITTED DISCHARGED
21. ~(igFIE;J~ DR SB~oi ~AC ~Q'~5FtF1ERE SERVICES RENDERED IIF OTHER THAN OFFICEI
4!"~, ~ . .	22. WAS LABORATORY WORK PERFORMED OUTSIDE YOUR OFFICE?
	YES ^ ^ NO CHARGES
23A. DIAGNOSIS OR
NATURE OF ILLNESS O
R INJURY; RE
A
TE DIAGNOSIS TO-yP/ROCEDURE IN COL. D BY REFERENCE NOS. 1, 2, 3. ETC. OR D% CODE
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t.,C~)~7V/~~CC ~7/	EPSDT VES ^ ^NO
2~ /	FAMILY PLANNING YES ^ ^ NO
3.	
- ----- ----------------'--

4'	PRIOR
AUTHORIZATION NO.
24. A.
DATE OF SERVICE	B.•
PLACE
F	C. FULLY DESCRIBE PROCEDURES, MEDICAL SERVICES OR SUPPLIES FURNISHED
FOR EACH DATE GIVEN	D.

DIAGNOSIS	E.

CHARGES	f.
DAYS	G.•	
H. LEAVE BLANK

FROM TO	O
SERVCE	PROCEDURE CODE
IDENTIFY:	
(EXPLAIN UNUSUAL SERVICES OR CIRCUMSTANCES(	
CODE		OR
UNITS	T.O.S.	
					I			
								
								
					I			
					I
I			
					I
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					1			
25. SIGNATURE OF PHYSICIAN OR SUPPLIER (INCLUDING DEGREEfSI OR	26. ACCEPT ASSIGNMENT (GOVERNMENT	27. TOTAL CHARGE	2B. AMOUNT PAID	29. BALANCE DUE
CRE DF NTIALS) 11 CERTIfY THAT THE STATEMENTS ON THE REVERSE
APPLY TO THIS BILL AND ARE MADE A PART THEREOF	CLAIMS ONLY) (SEE BACK(	1
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AND~OR GROUP NAME, ADDRESS, 21P CODE
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~	30. YOUR SOCIAL SECURITYNO.	'
7) NIL( ~~~A7 py
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DATE	
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KERRVIlIE, TEXAS 78Q?B
32. YOUR PATIENT 5 ACCOUNT NO.
~G ~~	33. YOUR EMPLOYER ID NO.	
J '
'
		
ID NO
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•PI ACF OF Sf RVICE AND TYPE OF SERVICE IT.O.S.I CODES ON BACK APPROVED BY AMA COUNCIL FORM HCFA-150011-841 FORM OWCP-1500
REMARKS ON MEDICAL SERVICE fi!B3 FORM CHAMPUS-501 (1 84) FORM RRR-1500
APPR(1VFn RV TNF HFAI TN feRF FINANCING ADMINISTRATInN A f.M4MPi IC
E3E~4USE ?N!5 FORM {S ~+~ED , ~,~^: ~ .
ANn PPIVATE HEPL TH .~4h"' S"c .. `.F~ :F'.~,'
INSTRliC710NS ISSUEU r ,,t~"~ICAS:F ~TC~.:"'".".'
	F'r! f-1; , ~~; G ...+!-"i~.','.rf:fJ ; I'iit) 'f;APJIS U2JL1'
		
tn-t• .	-'- " ~t~r -, , re:^~;'; Cyr ^~ ::i In arm ~r -	(~F'yr'^r.• for heai?h cenei',t~ Crc>vided throuSit rnenlLersi,:p and z,ft ,l.rt,~n
,ary -	- ~cm;-. ' .c:, t:'s si ,:, ,:.	.,..,: the iSnlforml: i ,erg Information : n the ;anent"s spons..~ ;!I~ui
a .	;,r. ;] the in ,••"r~r or t. {er-ci shr,vn. In	be providec! in than, items caPtlcred 'Insured", I e-items 3, 6, 7, 8, 9
		
' ~	~ . , n, CFI. '. 'U:.	
__., ._. ,. _ _	,:_ _., _ _ ... _, ...c {, ., , i:, .~_, _r ..,Ic _.- , ~_„	Q~AC!; l_Uf,';i Af~D f ECA CL41NS: The p;o~.idc 1 ,.grew;, to accc,:t +hs
t`r~ ,.- + ..	-'-- ~"- - .e, c.: . ~ _ ..: , _ ,, ..	amount nail by the G:'.rr.-.ment as payment !r. full See 61]ck Lung FK:-~
• ,= .	~ .. t .., ~, _ , , ,,,, ~^ea c -. ,~	Insuuc' ~ , re ;~I~:inn, re ; .ed {.recedure and dlagncsa rcding syste. ~.,.
		
S	; _' .-. ~.~ .~- ?ii'~fS~rr:?r^.^J Gi; S:~r L4EF~ (MEUlGAS-'.E, CH~',i'Jif'US, FECA Afii;7 BLACi~ LUNG)
i ,. ~ y _ ....,.. a.	c., ..- _ _..~ ..;~: ~-:'~~' - _ ~,_, ~ rn~~... -'`•,• a fl;_,,.rd _rc'	
a covered _h ,~n race. 3, be
akhor';` ,,c:ac,,,_ p,:rt cf r ys:~ se ` t;,ey rnu;t
n--- -_. ~_	~_.. ~ f ,~,_ _, ., anc! ~;" _ i:sn. n~.:r c u:.,le,. ~	of ku;c!s ..cn--r,uniy f.:rr„shed in phys,cn s offic ,, and ~,} the sarvic;., of
rr - .,-	_ - t• {-: `~esr:~.ra! c^r>, ., :rY r-, ero.~'n;ee	nenF,!';~~ci]ns must be included on the physlc!an s bills.
lJr : -~f ~ ~~	~ _. - f!Y'_'C ,_ ~ 3'~ C `'1CI i...,, j ^,1}'	
per?; : ~ , ,.~	_ i:,,. ~ re,..iotions.	Fa- C. i.AF/,Pl:.~ _,a~ms, 1 further certify that neit!.:I '; nor any emp!c;;ee
		who rendered ',r' son cos are employees or mer, Hers of the i/'n.fcrr-;ed
F~.r - . _ ~ .., ..	_~ ,:. cic.ent to a p!~ys..".,... ,:r~,_ssl:. ;,l	. C~ ..Cc's (refer to 5 US: 5536). For Black-sung c!a,rrs i fu; iher _ertify
se..	n-..at .._ lerl ,...~r the phy'~. .., :r ;`. .. ..	that Ine ~e:.'_es;'erf:;r- .-!'.vero f„r o Beck, `cc~ a:a..._ _.,_.or.._
	t':~ -	
,+	- _ . -.. .. ~ . ~, ..;I .,. , .. , , . ,, o n. v ~. _..!r:	.. 4„ . e ; .. _ :' b, e:cs, ag :a: ~ end re,u'ac'„ns {20 C:=R 432 51 C?
~. .''CE' vrn~ c-	r- .. s.-r-rep:; .; ;?r fa!s:iiea c;~on:i~l Ir;fornst:~n to re	celee paymen: from Fedora? funds requ°sted by this form may upon ccr:i_t`on
		
W~.• CC "	"' r'=,`"~~N~~ A~~ '_•T ?YE CCLLECT!G1V Af:D USE JF !~".E	Di:.ARi=, CH/+h~FUS FECA, ADdD EiACK LUiaG INFORMATION
We are a,:;`~cr~._- .	.. , H ;F,'~, CF's.".'r iJS and Q~^:'C° to r._ :you for infor-	Fode: t:' a;enc,'ss as neces_ary to adm;nlster t?tesa ,:•r _ ;ran•.s. For exa G!e,
-rati ,-.-	'__ ~ cf tc, Mr'...aIF~ ~, '. ,:~. ~ ~,	it rr~,• ._, ; to f'isc!o.,., informs _.,.-;n a:; ;'.! the .,r tr`:?, _. hc~n
and .._L.. ~. _~	- -. "..., r i col! .f,,,, .._ , . s:' _	~~. ! ., ;!i ^r ccc':r.
		
U:,~. -. .. , .	_ -- 1:5c' .'73 a,',d _, . L ._ .-,	.. .., t'.t, ~;,e crc:; ..n ,.....use.„d Le!or, them ore no ,,^.ec:,!ties .~^drr
E''G1 et s.-,a ar:,1	`. - :;,~ `-'~-, Fr ~-eq.	these 'ro~rirr-,s for ,~.us:r,y to supply rnformaticn. However, failure to
		f.:r:,.. ~ L,formc _ . -~,]r - ~ *',~ ma::;cal serv:cos ren:;er:; cr the art',or:r,t
		- :r _ ra.'.i m~^: r r^; of clai'rs I n~~r t' r~s^ ;.-cyr ^t]. Fc,:.ire
		
'	'	nl furn;s,, any G. i..l infor n...ron, such as name ur cla;;n number, v:o].d
..
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d,';I„y i,,:y t'.;nt of tnc ~. u
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d~~ :I,	~ .r:J s .,- r re..y .cd err: i~Y t `"- -	
		It i : m]nda.ory tiat you '~!I us if you are berng treated for a work ~etate._
		• r.o we can iletermi:; ~ w;.:alre: wort:ors' corr~pens,:..ar. r..ii rn:.y °cr
		
in'eru t	=:' .~~; ,; hr•': and - r',' ::• .• I - "-.
__	c.:r- , a. , ~...., .;r ..,. _ "i:r g :ors r' fc „ :..
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	M.~, :A!:? V':~Yi,":ii.'J'iS FRL,`'/!"JLR ^_ER? dl'iCA? h~i:l
rlrr~r., ~,	;.., -. - ~	~..., .., .. ^~ Pri1'IC_ .,,"J 'CR _ _. -~It:r, f ::c;:;y th;a t'ne _ , .e~
'	...... ±i... ,...e .., ...	!isL .....,.,. , r~er:. ,e:.:. ?•, indiraled a- ., r;c~c~=_ . y ..- *h^ ., _.,.. tr.;
_._,, -	it ._ , ~ ' r .-	, ... .,C1 .. .. r'" ~. 'E,1:!C . L , ;f r:-. f.,-,, ~ -' ,..
		
		
		
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ORD~ NO. 1855
~ HIRING
I~ ZO APP ~ E ~ COUP
0 ~ A• Its ,~ COUP
A~~ S 0~'ICE
APrll 10. 1989
295
Vol• R. F9