ORDER NO. 29809
BUDGET AMENDMENT
INDIGENT HEALTH CARE
On this the 24"' day of July, 2006 came to be considered and upon motion made by Commissioner Baldwin,
seconded by Commissioner Nicholson, (Commissioner Williams and Letz left the room) The Court
unanimously approved by vote of 2-0-0 to transfer the following items:
					REQUESTED
				UNEXPENDE	AMENDMENT
EXPENSE	LINE ITEM	CURRENT	CURRENT	D BUDGET	INCREASE/QDECREAS
CODE	DESCRIPTION	BUDGET	EXPENSE	BALANCE	E
	Third Party				
50-641-486	Administrator	$29,048.96	$2,127.54	$0.00	+ $2,127.54
		$731,951.0	$47,672.8		
50-641-200	Eligible Expense	4	2	$58,066.23	($2,127.54)
	With a hand check to VeriClaims, Inc for $338.01 and $1,789.53	
COURT ORDER # .~~~(~`
# 4
(07/24/06)
BUDGET AMENDMENT REQUEST FORM
DEPARTMENT NAME: INDIGENT HEALTH CARE

CURRENT CURRENT
EXPENSE CODE LINE ITEM DESCRIPTION BUDGET EXPENSE	UNEXPENDED
BUDGET
BALANCE		REQUESTED
AMENDMENT
INCREASE/QDECREASE
50-641-486	Third Pa Administrator	$29,048.96	$2,127.54	$0.00	+	$2,127.54
50-641-200	Eli ible Ex enses	$731,951.04	$47,672.82	$58,066.23		($2,127.54)
						
						
						
						
						
						
						
						
July 14, 2006
DATE

~ ~
LATE BILL FOR
2741
VENDOR#
INVOICE #
07/24/06
WILL NEED A HANDCHECK
PAID TO: VERICLAIMS, INC.
AMOUNT: $338.01
EXPENSE CODE: 50-641188
DESCRIPTION: VERICLAIMS,INC.14.5°~ fee for claims
processed for 7/7/06
INV. NUMBER	070706/process fee
INV. DATE:	07/06/06
RCVD DATE:	07/06/06
DUE DATE:	07/24/06
VERIFICATION DATE
FROh1 ~ VERiCLRIMS
7!8106
Ken• County AuditoPS Office
Attention: Mindy 1N'ittiams
700 Main Street
Kerwiite, Texas 78028
FHX h10. 281445L~40~1 al = ~! ~
VeriClaims, Inc.
207 Meadcwgrove
Houston, Texas 77037-4303
8n 2GF76 ~J8: 31RI~ P2
REMITRANCE COPY
Indigent Healtn Care
711.3 fo
07~7i200b Claims Payment $ ~-t3S~~` 4.5% =
Please remit to addrass shown above. Thank y®c.
~ 338.p I
REMITTANCE COPY
LATE BILL FOR O7/24/OB
WILL NEED A HANDCHECK
VENDOR # INVOICE #
SAID TO: VERICLAIMS, INC.
1MOUNT: 51,788.53
?XPENSE CODE: 50~41~86
)ESCRIPTION: VERICLAIMS,INCJ4.5% fee for claims
processed for 7!3106
NV. NUMBER 070306/process fee
NV. DATE: 06/29/06
!07
VERIFICATION DATE
~_ ___=-____------~ -rte __
FROM VER[CLfaIMS FqX N0~ ~ 2714458404
VerlClaims, Inc.
207 Meado~vgrove
Houston, Texas 77037-4303
6(25!06
Kerr County Auditor's Office
Attention: Mindy Williams
700 Main Street
Kerrville, Texas 78028
Indigent Health Care
~l;1 ei. 5t6
07/3;?Up(~ Ctaims Payments $~3-r4fi~-~3* ~-5°~~ -
Please rcntit to address shown above. ThanK Lou.
Tun. 29 2Fi06 2?:59AM P2
RFMItrq~~f COpY
) ~ goo. a7
Srt-f3~rEY-~1-
Less adjustment for refund from Sid Peterson Hospital (see attached sheet)
394 • l~
39,767.32
X 4.5~
__1, 789.53_=
;>
- 17.74
1,789.53
~"E~1/]~qNC~ COPY