ORDER NO.29706 BUDGET AMENDMENT LATE BILL INDIGENT HEALTH CARE Came to be heard this the 22nd day of May, 2006, with a motion made by Commissioner Williams, seconded by Commissioner Letz, the Court unanimously approved by vote of 3-0-0 to transfer the following expense codes and issue hand checks in the amounts of $$499.60 & $119.15 to Vericlaims, Inc. for May 10, 2006 and May 11, 2006 Fee on Paid Claims. Expense Code Description 50-641-486 Third Party Administration Amendment Increase/QDecrease + $618.75 50-641-200 Eligible Expense - ($618.75) COURT ORDER # BUDGET AMENDMENT REQUEST FORM DEPARTMENT NAME: Indigent Health Care a97Db 3 ~3 05/22/2006 3-D -J CURRENT CURRENT BUDGET EXPENSE CODE LINE ITEM DESCRIPTION BUDGET EXPENSE BALANCE AMENDMENT INCREASE/QDECREASE 5041-486 third party administration $ 25,162.60 $ 618.75 $ - $ 618.75 50-641-200 eli ible ex ense $ 735,837.40 $ - $ 134,588.31 - $ (618 75} 17-May-06 DATE ~~~O:S i> Si': FOR AUDITOR'S OFFICE USE ONLY LATE BILL FOR 5/22/06 WILL NEED A HANDCHECK 2741 VENDOR # INVOICE # PAID TO: VERICLAIMS INC AMOUNT: $119.15 EXPENSE CODE: 50-641.486 DESCRIPTION: 5/11!06 CLAIMS PAID INV. NUMBER 060511 CLAIMS PAID INV. DATE: 05/01/2006 RCVD DATE: 5/0106 DUE DATE: 05/22/2006 VERICLAIMS INC VERIFICATION DATE FROM ~ 1~EF'ICLRIhiS FRX fJO. :c8144594P~4 May. 81 ?FiF'Jn 12:28PM P2 207 Meadowgrove Houston, Texas 77037-4303 ~-~-os Kerr County Auditor's Once Attention. Mindy Williams '700 Main Street Kerrville, Texas 78028 Indigent Health Gare 05111/2006 Claims Payments $2641.92 ° 4.5%'= 5119.15 Please remit to address shown above. Tl.ark you. ~~ ~9~\ / ---------------------------------- ---------------------------------- FORAUDITOR'S OFFICE USE ONLY ---------------------------------- ---------------------------------- LATE BILL FOR 5/22/06 WILL NEED A HANDCHECK 2741 VENDOR# INVOICE # PAID TO: VERICLAIMS INC AMOUNT: $499.60 EXPENSE CODE: 50-641-486 DESCRIPTION: 5/10/06 CLAIMS PAID INV. NUMBER 060510 CLAIMS PAID INV. DATE: 05/01/2006 RCVD DATE: 5/0106 DUE DATE: 05/22/2006 VERICLAIMS INC 207 MEADOWGROVE HOUSTON TX 77037-4303 VERIFICATION DATE FRLfI : 'vERICLtaIllS FF%{ N0. : 281 aa584E~x flay. yl 2ClGJ6 12: 2BPM P3 VeriClaims, Inc. 207 Meadow~yrove Houston. Texas 77037-4303 5-7-06 Kerr County Auditor's Office Attention: Mintly Williams 700 Main Sheet Kerrville, Texas 78028 Indigent Health Care ~11~ It~.~ ~~I~. ~uŽ 05/TO12006 Claims PaymcnCS ~ ~` 4.5%= $ Please remit to address shown aboee. Thank you. ~~ ~~ ~~,I~~