CJL MBMMAS03 08/15/2012 10:06 Board Minutes PAGE 2 Minute … › bm › 20120806.pdf · 2012-09-12 · CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 454 OPENING FOR 8-6-12 Date 8/ 6/2012 AGENDA FOR 8-6-12

AUGUST 6, 2012

The Board of Supervisors met at 9:00 a.m. the 6th day of August, 2012, in the Supervisor's Board Room, in the Chancery Court Facilities Building at the Pearl River County Courthouse in the City of Poplarville, Mississippi, with the following members of said Board and officers of said County were present to-wit:

President, J. Patrick Lee, member from District Four; Vice-President, Sandy Kane Smith, member from District Five; Anthony Hales, member from District One; Dennis Dedeaux, member from District Three; County Administrator, Adrain Lumpkin, Jr.; Board Attorney, Joe Montgomery; Chancery Clerk, David Earl Johnson; Sheriff, David Allison.

The following proceedings were had and entered of record to-wit:

PAGE 2

Meeting Agenda Pearl River County Board of Supervisors

August 6, 2012 Welcome & Call to Order 9:00 A,M, (President)

Public Hearing: Objections on Assessment Rolls for 2012

Routine Business: '" Sheriff:

• Personnel • MDOC reimbursement request of housing - June 2012 • Declaration of Forfeiture

'" County Engineer: • Update • Final acceptance of lSBP 55(28) Jackson landing Rd Bridge Replacement Project

.. Planning and Development: Consider payment of invoice to JEM Mechanical Services for Energy Improvements - Criminal Justice Center

'" Tax Assessor/Collector: Tax Sale Strikes

• Acknowledge Department of Revenue Certificate • Application of Certification to expend the one (1) mill

" Emergency Management: • Projected 2012 EMPG funding • MEMA Special Project funds

.. Road Department - Personnel 10:00 .. International Paper Company Representative: Update 10:15 "Senior Center Representative - Update

" Dungan Engineer invoices on Safe Rooms .. Basco Associates invoices on Safe Rooms .. Hanca Corporation invoices on Safe Rooms .. MEMA reimbursement on Safe Rooms (#3) .. MEMA reimbursement #100 on Hurricane Katrina " MEMA reimbursement on Hazard Mitigation Plan Update, Revised Admin Payment .. letter from SMPDD Area Agency on Aging services .. Pearl River Valley Oppartunity Memorandum of Understanding/Partnership Agreement " Authorize destruction and disposal of records • Picayune School leases .. Pearl River County School District Amendment of lease " Central landfill host fee check - 2,d quarter 2012 " Charter Communications franchise fee check - 2"" quarter 2012 • Acknowledge receipt of United Healthcare rebate for Year 2011 " ConSider approving Board Minutes - July 2012 " Approve Claims Docket " County Administrator monthly reports - July 2012 " Furlough Report - #2

Travel: .. Election Commissioners (3) to Training on August 30, 2012 in Biloxi, MS. • Tax Assessor/Collector and Office Manager to Collector Certification Program in

Hattiesburg, MS on August 13-17,2012,

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 456 PUBLICATION NOTICE ON TAX OBJECTIONS Date 8/ 6/2012 OPEN TAX OBJECTION PUBLIC HEARING

ORDER TO ACKNOWLEDGE PROOF OF PUBLICATION OF PUBLIC NOTICE CONCERNING OBJECTIONS TO TAX ASSESSMENTS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of Public Hearing publication on tax objections.

Upon motion made by Sandy Kane Smith and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to acknowledge receipt of Proof of Publication of Public Hearing notice concerning objections to tax assessments.

Ordered and adopted, this the 6th day of August, 2012.

Voting AYE:

Voting NAY: Absent:

Anthony Hales, Dennis Dedeaux, Patrick Lee, and Sandy Kane Smith None Joyce Culpepper

ORDER TO OPEN PUBLIC HEARING FOR OBJECTIONS TO TAX ASSESSMENTS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter to open Public Hearing.


Be It Ordered by the Pearl River County Board of Supervisors to open Public Hearing for Objections to Tax Assessments for 2012. (Sign In Sheet attached)


Voting AYE,

Voting NAY, Absent:


PAGE 4

SIAIE OF MISSISSIPPI COUNTY OF PEARL RIVER

PEftSONAllY CAMEOO!(I(l) fl)$, tOO undQrnloJll~. a oo,.-y pOOl~'.t) and imPEARL RIVER County, Mi>s;ss~ppl, It-lDAGILMORE. PUBtlSBER, (lflHE P!CA't'i,.k"iE ITEM, a lWN5paper ptAA;~l)OO I~ lMll}\\n 01 Picayune. Peal ru .. fr Cw'lly, In.s~fd $~le, IMlO I:e~~ rilly SWOIII" 4epos'l1 ard sey:l\h1lt Tho Pk:ayuoo Item l$a r,OW$p1l:per il$dQi~ end ~"ibed Yl Sef/ain B~! No. 10) ooa:@dill file regvf<tf ~s!Qn QJ LI\IJ "'iss!$si~ ~slall.{<lI)J 194 8, amending Secl'f.lfl 10sa, of Ihe "~ss!ss'Ppl Code of 1942. 1100 thai tho p"b!ica~Ofl aI a notice, oll'ihlch tile 8lU'~~a(nsato,l'/J)lham3l1el~1 ~. . "F ~ ~

';:U6I!HV Y2~itL!'t),H:' Ttlitptl ~ I-U) has l'eft~ made III said paper I OOI\secuUvely

On Ton O(}The ___ ~

On Thft ___ .. _

TOPUBtlSHlHG

C3~lIcl

."

day or JI(,[~~-."'r .. _____ _ "1" _____ _ '''01 _____ _ .,,01 ____ _ ."01 ___ _

~

"''' ~J~_

20f2

2012"

""2

,-/ '57

To the Public and to the Taxpayers of Pearl River County, Mississippi: . You are hereby notified that the real and personal property assessment rolls of the above named county for the year 2012 have been equalized according to law, and 1I1at said rolls are ready for inspection and examination and that any ObJections to said rolls or any assessment therein contained; shan be made In writing and flied with the clerk of the Board of Supervisors of said County, on or before the 6th of August, 2012, at his office In the Courthouse of said county, and that all assessments \0 which no' objection Is then lind there made, will be finally approved by said Board .. of Supervisors, and the all assessments 10 which objection Is made, and which may be corrected and properly determined by this Board, will be made final by this Board of Supervisors, and that said rolls and the assessments contained therein will be approved by this Board of Supervisors; and that,

1. This Board will be In seSSion, for the purpose of hearing objections to the said assessmerits which rriay be flied, at the courthouse in the City of Poplarville, said County and State on the 6th day of August, 2012.

2. This Board of Supervisors will remain In session from day to day until all ObJections, lawfully filed, shall have been disposed of and all proper corrections made in the said rolls.

Witness the signature and seal of the said Board of Supervisors this the 18th day of July, 2012, and.

The Board of Supervisors of Pearl River County.

By: J. Patrick Lee President, Board of SupervIsors David Em'l Johnson Clerk, Board 01 Supervisors

I ~5~ ,

... ---~~~J~-2?~~ --:£,/~:~:!I~~= ___ ~_~ ------~.--~+ .... -.. ---.. ---.--.--.-/-.tl-.,x------. t2 &. .J:E r..C'£/2Y ~ .. _

. · - .. ~ ZR..L Z _ .. _ ...... _ ... ___ ..... __ .. __ _

.~~~. ~I ~""--';J'~-"''''-''''.'''''"'-'' ........ -.. -............ -.~-- ...... --.-......... ~.-... . ~ ............ ·~· .. - .. -+h-_!-''-:L~

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 461 RECEIPT OF OBJECTIONS TO ASSESSMENTS Date 8/ 6/2012 CLOSE PUBLIC HEARING ON TAX OBJECTIONS

ORDER TO ACKNOWLEDGE RECEIPT OF OBJECTIONS TO 2012 TAX ASSESSMENT ROLLS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of receipt of objections to 2012 Tax Assessment Rolls.

Upon motion made by Anthony Hales and seconded by Sandy Kane Smith, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of supervisors to acknowledge receipt of attached objections to 2012 Tax Assessment Rolls.


voting AYE:

Voting NAY: Absent:


ORDER TO CLOSE PUBLIC HEARING ON OBJECTIONS TO 2012 TAX ASSESSMENT ROLLS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter to close Public Hearing.


Be It Ordered by the Pearl River County Board of Supervisors to close Public Hearing for objections to 2012 Tax Assessment Rolls.


voting AYE:

Voting NAY: Absent:


PAGE 6

PROPERTY TAX ASSOCIATES INC. !U/JIf II \,/.,1;1}

August 2, 2012

Mr. David Earl Johnson Chancery Clerk, Pearl River Coullty 200 South Main Street Poplarville. MS 39470

Dear Mr. Johnson:

info@lllainc,net Office: 601.206,1433

Fax: 601.206,1435

Bcof: 0158 Pa9~ 462

The owners of the below referenced properties have requested a protest to be flled to protect their right to appeal the value for the 2012 tax year. These properties fall under Senate Bill 3100 that states low income hOllsing propc!1ies are to be valued based Oll the actual income and expense attributable to the properly.

Picayune Apts lI. LP Elmwood Associates, LP Cedarstone Associates, LP Regency Apartments/Ozark Assoc. Colonial Apartments

25538 32253 32478 6930 54922

This is a protective measure in cnsc (he property owner decides to seek legal counsel.

William Ward Cc: Jim Martin

Taggart, Rimes, & Usry, PLLC RECEIVED

AUG 03 2012 PfARl RIVER CO. TAX ASSESSOR/COllECTOR

GARY BEECH

P.o, Box 1545 Ridgeland. MS 39157·1545 I 795 Woodlands Parkway. Suite 110 : Ridgeland, MS 39157

JOi-fNSON, RA'fLWF' 8: HAYS, PL.'-C

S. Joel Johnson Michael V. Ratliff a.Adam Hays

VIA FED EX

Attorneys at Law Second Floor

Great Soulhern Nal10nal Bank Bul1ding 1300 Hardy Sireel

Haltl.abuf\). MS 39401

August 1,2012

Pearl River Counly Board of Supervisors 207 West Pearl Street Poplarville, MS 39470

Re: Deako Corporation Protest of Property Assessment for 2012 Tax Year

Dear Sirs and Madams:

Telephone: (601) 582.4553 Tol.lax: (601) 582-4556

E-Mail: [email protected]

Fool; 01G9 P.QO 4&3 P.O.-Sox 17738

Halllesburg, MS 39404·7738

Enclosed herewith please find a Protest of Property Assessment for 2012 Tax Year on behalf of my client, Deako Corporation. I am also enclosing herewith an extra copy which I would appreciate you sta~lping "filed" and returning to me in the enclosed self-addres~ed stamped envelope_ .

Thanking you in advance for your assistance in this matter, I remain

SJlllef Enclosures

Sincerely yours,

JOHNSON, RATLIFF & HAYS, PLLC

II" .1' ...... (;! '.z,E-)!;.~,v---. S.Joe/-1ohnson

PROTEST OF PROPERTY ASSESSMENT FOR 2012 TAX YEAR

DATED: AUGUST 1,2012

TO: PEARL RIVER COUNTY BOARD OF SUPERVISORS 207 WEST PEARL STREET P. O. BOX 569 POPLARVILLE, MS 39470

PPrN: 6909

PARCEL #2159310010500900

Gentlemen:

It is requested that you review the assessment of my property as identified by the above referenced numbers. My property tax is appraised at a True Market Value oUI ,888,610.00 on the 2012 Tax Roll.

I believe a fair True Market Value of my property would be $1,056,000.00.

S. JOEL JOHNSON (MB #3151) JOHNSON, RATLIFF & HAYS, PLLC Attorneys At Law P. O. Box 17738 Hattiesburg, MS 39404-7738 Telephone: 601-582-4553 Telefax: 601-582-4557 Email: jj(tlljhrlaw.net

Respectfully submitted,

DEAKO CORPORA nON

BY; JOHNSON, RATLIFF & HA YS, PLLC

c::J c::J ru c::J

rn rr rr c:Q

fedex.com 'B03.Gof"e, 1.600'<63.3339

~ I

-"I' i~ k z:i." ",'

~H' ~ ,- ~ L. . '"

Ij~ j , j

I I ., i 1

i ., 1 , J ; 1. } i 1

J 1

.J

Yk5

i I I Boof; 0158 , Pagp. 46.

I I

I ;; I ~ , I I I i

I , , , t ~ , • •

Objection To Personal Property Assessment

Massey, William Floyd Jr. 94 Beaverwood Rd. Picayune, MS 39466

Parcel Identification #; 6161110000001103

Aug. 6, 2012

",/:+,;,,,~

Bldg. # 2; Listed as Bam built in 1994. It was buill by a prior property owner as a dairy bam in 1973 & 1974, almost 40 years ago,

Bldg. # 3; Listed as a patio built in 1994. Is a slab poured at the same time as above bam to keep cows from tracking mud into milking parlor, It is cracked and has holes in it and is a nuisance rather than an asset.

I have been told dne reason my property tax went up $238.56 this past year ( an increase of over 30 % ) was that my taxes had been reduced after Katrina due to damage to the above mentioned bam. You can see by the attached tax bills and also by checking the past tax rolls, the only reduction I have ever received was due to reacWng the ripe old age of65.

Yours Truly

.~~ In. '. ,".~"" .. (,/ t--i:;~h~( ():;-;: ... >7 •

William Floyd Mas , .

--, SCHOOL •• - CI f ' .•

__ . i

~~~~>I ! ;

.;~ !~'n ~ CLA;:,;

. ;::-.!_.E :\i'f:'~ :]~:}470 , ::':i·:·:~'\."·~ ('~.:' Rf:::QUEi;;"f€

PArMEt(J$ill5r mt,uIL ' C(SCRPfI-:lN 'r .

_COUNTY! _~ .. t'JC' .',,1

',,': : ..... \ !.:.; r· ~ .. ':

1404C 61bl11(}OOOOD1l03

COUNTY

1---''-'" '.}, "." SCHOOL

},1. 063 ,1.bW TOTAL TRUE

.L L~,)~"j ;".1

;j_~-;:'VE:r.· !.-ICO!) r:-;I't

i'ieo

c.~ YL:r .. ;E ~ •. ;r.;; :.?s·' 4t~HS

,I,I, "1,.1.11,,, lil,I..II,IIIII,II"I. 1,1, I, ,.1, .Il",11

ASSESSED J. ·q. ... ~tJ2

~~eIPT I'lUMIlER

;;!Of}08 PRE-SORTED FIRST CLASS US POSTAGE PAID

Yf.All I5PlN POPLARVILLE 118 39470 2006 :330 t 5

I' PERi1IT 1* i . RETUFlN SERVICE REQUESTED

'.;', ··:,:':.~:;O( ),:1220 ,\~;}Ar"'ll!rMI't 6161110000001103

N:s.:!fPOOU

22. 17AC(D) IN E1/2 8E1/4 013 583 DP 558

[ E

comITY SCHOOL . ' i'lA88EY, WILLU"M FLOVD JR ET,4L

94 BEAVER I!lOOl) RD PICAYUNE MS 39466

, .1 .. II" t .11111 Il'IJlli" 1I,".Ii"I.I.i, I III 1,,1111,11

.. , -

PRE-SORTED FIRS'r CLASS US POSTAGE PAW POPLARVILLE I1S 39~ PERt1IT # 1 RETURN HERI.lICE REQ\)ESTE

6161110000001108

22. 17AC(D) IN E1f2 SEl/4 DB ;'IB3 DP:5 58

~.~. J~£E~T~A~L~-. __ -*1~1~O~6~8~lJ~~W~~ , " , TOTAL TRUE

..;,; , l COUNTY SCHOOL CITY

13717

. ':'"

b· ,I;; I 1 . ,

r--NASSEY, WILLIAi'l FLOYD JR ETP,L I

I 94 BEAVER WOOD RD PICAYUNE ~18 39-%6

, :1. I.'., " •• ,.11,1.'1., , •• , •• 1/,., !lJ~k"llIW %tt II ~{,~j

20261 PRE-SORTED FIRST US POSTMf PAlD

CL'1SS

~J8 394 1JY£~A~R+=;~P~PI~N~:1 POPLARVILLE ;:;: " PERMIT # 1 2005 38015 RETURN SERVICE REQUESTE

!) ,Jr<, Hill 11 068 16W Mea 108

t·ji.,8SEV, I,JILLI AM FLOYD JR ETAL

94 BEAVER WOOD RD PICAYUNE r'18 ~594.!,6

!) I •• , I , ! I. II •• ,Ii" i. , ! ,.l!, I , .! I, .1.1 , 1,1,. ,I, , II,.) Ii

"'1'-/ ,'.7 J\C ( lJ :1 D~i' -58::J 'DFl

GARY BEECH PRE-SORTED FIRST CLASS 'PEARL RIVER CNTY 20261 US POSTAGE PAID POBOX 509 394'7q~~~~~~ POPLARVILLE M8 3947( POPLARVILLE MS PERMIT # l.

~~~~:;:;;;~~~~~~f8i3iO;i~5~ RETURN SERVICE REGUESTED 6161110000001103

22. 17AC(D) IN E1I2 SE1J4 DB 588 DP 558 14631

PAYABLE DEC 1, 2005 DELINE! FEB L 2006 , MASSEY, WILLIAt1 FLOW;' JR ETAL 11 068 16W Meo 108 ~ .. , 1 .1, TOT I ' ASSE,<iiiE% "~

.. I ~",y,,,,'t'J I ~ "'''''' 'AOVAlOREM TAX-I-- y~ '9· ',1<;; ,cPU~l]'Y' "

, ,SCHOOL' CIl'Y L~1~t1~~¥Nl~tf "HoMESTEAD, CREDIT "!'" .", _''''e', ''''''1 " ,'=:L

~~;, -

I . ,~ ~1A8SEY, mLLIAt1 FLOYD JR ETAL

'i. 'l'. '!': .. -~ f' . --~~,- 94, BEAVER WOOD RD ~:;;~,: -1;>;' $1, Lv" . ..,' ' PICAYUNE t1S 39466

1,,11 ;I.".,! ,.1./1'11 fI •• t" J "II".,II,,'.'.'.I .. ! IJ, 1!.'11i

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 470 APPROVE JULY 2012 BOARD MINUTES Date 8/ 6/2012 SHERIFF'S DEPARTMENT PERSONNEL

ORDER TO APPROVE JULY 2012 BOARD MINUTES

There came on this day to be considered by the Board of Supervisors of Pearl River County. Mississippi, the matter of July 2012 Board Minutes.


Be It Ordered by the Pearl River County Board of Supervisors to approve July 2012 Board Minutes.

Ordered and adopted. this the 6th day of August. 2012.

Voting AYE: Anthony Hales, Dennis Dedeaux. Patrick Lee, and Sandy Kane Smith

Voting NAY: None Absent: Joyce Culpepper

ORDER TO ACCEPT SHERIFF'S DEPARTMENT PERSONNEL

There carne on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of personnel changes in the Sheriff's Department.


Be It Ordered by the Pearl River County Board of Supervisors to approve the following and attached personnel changes in the Sheriff's Department:

Eddie Pack Roy Allen Alex Ford Terry Poe Michael White Ann Hansford

Correction Officer Terminate Part-time Corrections to Full-time Correction Sgt. to Correction Officer Correction Officer to Correction Sgt. Part-time Corrections Remove Dispatcher Resign

Ordered and adopted. this the 6th day of August, 2012.

Voting AYE: Voting NAY: Absent:

Dennis Dedeaux, Patrick Lee, and Sandy Kane Smith Anthony Hales Joyce Culpepper

PAGE B

July 31, 2012

PEARL RIVER COUNTY SHERIFF'S DEPARTMENT DAVID ALLISON, SHERIFF

(601) 403-2500 Fax (601) 403-2344

To: The Honorable Board of Supervisors of Pearl River County, Mississippi.

Please acknowledge upon the minutes the following personnel matters concerning the Sheriff's Department:

Please terminate Eddie Pack, Correction Officer effective July 25,2012 and stop direct payroll deposit if applicable.

Please move Roy Allen from part-time correction officer to full-time correction officer effective July 25, 2012 at a pay rate of $11.57 per hour. Roy is replacing Eddie Pack.

Thank: you,

David Allison, Sheriff GG?MY

'If God We Tn.st

July 31, 2012

PEARL RIVER COUNTY SHERIFF'S DEPARTMENT DA VID ALLISON, SHERIFF

(6ot) 403·1500 Fn1< (601) 403·2344 Book (!i58 Pag.. 472



Please move Alex Ford from Correction Sgt. to Correetion Officer effective August 2, 2012 at a pay rate of$11.57 per hour.

Please move Terry Poe from Correction Officer to Correction Sgt. effective August 2, 2012 at a pay rate of $13.42 per hour.

Thank you,

Gee:? c;m~ David A II ison, Sheriff

111 God We Trust

AuguSI 1.2012

PEARL RIVER COUNTY SHERIFF'S DEPARTMENT DAVID AI>LISON, SHERIFI~

(601) 403-2500 Fax (601) 403.2344

To: The Honorable Board of Supervisors of Pearl Rivet County, Mississippi.

Please acknowledge upon the minutes the following personnel mailers concerning the Sheriff's Department:

Please remove Michael White from the part-time correction officer !lSI and stop direct payroll deposit if applicable.

Thank you,

David Allison. Sheriff

III God lVe Trust

August 2, 2012


(601) 403·2500 Fa. (601) 403·2344

To: The Honorable Board of Supervisors of Pearl River County, Missli~iPllts PS9! 474


Please accept the resignation of Aim Hansford, Dispatcher effective end of business day July 28, 2012 and stop direct payroll deposit if applicable.

Thank you,

9&L::2~ David Allison, Sheriff

111 God We Trust

CJL MBMMAS03 08/15/2012 10:06 Board Min~tes Minute Book Text Detail Book 0158 Page 475 MDOC JUNE 2012 REIMBURSEMENT REQUEST Date B/ 6/2012 DECLARATION OF FORFEITURE

ORDER TO APPROVE MISSISSIPPI DEPARTMENT OF CORRECTIONS JUNE 2012 REIMBURSEMENT REQUEST FOR HOUSING FOR JAIL

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of Mississippi Department of Corrections reimbursement request for housing inmates at Jail.


Be It Ordered by the Pearl River County Board of Supervisors to approve execution of attached June 2012 reimbursement request to Mississippi Department of Corrections for housing inmates at Jail.


Voting AYE: Anthony Hales, Dennis Dedeaux, Patrick Lee, and Sandy Kane Smith

Voting NAY: None Absent: Joyce Culpepper

ORDER TO ACCEPT FORFEITURE AND ADD VEHICLE TO COUNTY INVENTORY

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of forfeiture from the Sheriff's Department.


Be It Ordered by the Pearl River County Board of Supervisors to accept the attached Declaration of Forfeiture under Mississippi Law from Pearl River County Sheriff's Department and the 15th Circuit Court District Attorney's Office and add vehicle to the County Inventory.

DECLARATION OF FORFEITURE Lemuel Bowden

VEHICLE One (1) 2001 Ford Expedition VIN # 1FMRU15W11LA26892

Declared that the above described property is forfeited under the provisions of Mississippi Law to the Pearl River County Sheriff's Department receiving eighty (80%) percent and the 15th Circuit

(CONTINUED ON NEXT PAGE)

PAGE 10

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 475 MDOC JUNE 2012 REIMBURSEMENT REQUEST Date 8/ 6/2012 DECLARATION OF FORFEITURE

Court District Attorney's Office receiving twenty (20%) percent of the proceeds of the property from the sale thereof. (See attached documents)


Voting AYE:

Voting NAY: Absent:


PAGE 11

PEARL RIVER COUNTY SHERWF'S DEPARTMENT DAVID ALLISON, SHERIFF

(601) 403-2500 Fax (601) 403-2344

July 25,2012


Please acknowledge upon the minutes the following matters concerning the Sheriffs Department:

In and for your consideration approval of and signature by Board President and Sheriff Allison for reimbursement of housing:

MDOC Pearl River CSWP MDOC Pearl River CJ

Thank you,

Ot-.0 ~ David Allison, Sheriff

$32,520.00 $10,300.00

June 2012 June 2012

Itl God We Trust

/t>(~U Page 108 of 154

C-MISSISSIPPI DEPARTMENT OF CORRECTIONS 7-/9"-12- 14:14 Moneay, July 2, 201

REPORT, COOllTY .)JUL PAYMENTS

C-:::r-

OATE= ,,= l'<:SJ:><:a~

Nl\ME

><DOC __ DOl> """"" sS>/ ORDER .m;:CEIV'£D DAYS """""'" MEDICAL cos~

Lo<:.a t.i.'I!!' ~ B.IVERC,J" ] Reimb~rsemen~ MQnth~ June 2.012. r-~

BANNER, :If.DS!:Y M 121567 12/13/197"1 ""H 06/16/2P06 24 S 490.00 --.~~'.~.

'" BARNES,OWESLEY T 170981 10/09/1977 Wll 17 S 340.00 --~-.

"'" 10/16/198' BREWER. :3'ILLY 132473 WI! 08/20/2008 25 $ 500.00 .=. BROCKET~ JOSE?" ° 160984 05/03/1990 WH 05/09/2012 • $ 80.00

0 CAUSEY,~ERRY LOUIS 141914 09121/1987 BL 06/0112012 25 $ 50Q.00

CAVIG'NAC f JI:NNlFER LEA 176283 06/07/1982 WE! 06/07/2012 12 $ 240.00

CHAOPET'tE", "!"ROY 176409 01/16/1965 WH 06/13/2012 18 $ 360.00

EAVES, LEO 176169 01/20/1956 W>! 06/05/2012 26 $ 520.00

li',AZENDE, ,JASON CJ:iJUU.ES L54Se 05/11(1977 Wll 06/01(2012 25 $ 500.00

HA.'UUS f DANIEL M466 06(26/1992 WI! 05/U/2012 IB $ 360.00

EU:i.R'l', KA!..E:B L 154877 02/22/1989 BL 06/01/2912 25 $ 500.00

liAR':rFIELD, SEIBERTE ROY 01628 12/2l/1956 WE! 06/11/2812 20 $ 400.00

BILL, CHAD LAMAR 112267 04/15/1984 WH 25 $ 500.00

ISRAEL, BOBSY JO~ LOlS4 03/06/1973 WI! 04/2612012 4 $ 80.00

~ONES, MARSHALL R~ 176386 09/02/1990 ar. 06/13/2012 16 $ 360.00

.KELLAR~ HELEN 40231 03/01/1955 WH 10/05/2010 a $ 160.00

KINLER~ .JOSEPH A 176305 09/17 /1970 w:< 06/11/2012 20 $ 400.00

KAAU'l'NER, DANIEL !.£WIS 141766 02/11/1965 WH 05/0912012 4 $ 80.00

LEMOS, KRISTIE N 176410 09/09/1988 WE 06/13/2012 6 $ 120.00

MCCOY, LOUIS C 111116 02/24/1973 WH 4 $ 60.00 --_ . . MITCHELL, SHANNON E 10650' 02/26/1978 IIH OS/24/2012 18 $ 360.00

NE>IIlEAAY, DE.l<OYCE ANT<:lNIO 103011 10/21/1980 flL 06/01/2012 30 $ 600.00

PoaTILLA, ~CISCO 118165 12/24/1975 SP 06/01/2012 30 S 600.00

RICHMOND, FE.RNEU.. Mw 159044 01/26/1976 BL 06/2812012 3 S 60.00

STOCKSTILL, MARlON LERO~ 157307 07/11/1964 Wl! 06/13/2012 19 $ 360.00

S'l'CGNER~ WAU.ACE 151865 06/04/1978 WH 06/0S/2012 25 $ 500.00

mOMAS ~ TAMMY 133954 01/04/1965 WH 06(1512012 4 $ 60.00

TOBIAS, WILLI.AM VAN 108575 11/11/1982 BL 06101/2012- ,. S 360.00 KA'l'TS, AAllON 157457 03/31/1996 WE 06(08/2012 23 $ 460.00

HELLS, CHARLES J. 176387 08/10/1980 WH 06/13!20~2 18 S 360.00

cQ c:r -

s~s:r:~:

MIlOC_N1lM !lOB

:l2 -

MISSISSIPPI DEPARTMENT OF CORRECTIONS REl?ORT: COUN1'Y JAIr., PAYMENTS.

RACE ss>! DATE SEN'"l:E:Na 0R.IlER BZCErv.EO

s= DAYS

TotaJ.

£>~ f~~ BOAJU') OF SUP'ERV'XSOR SIGNA'J:'Ol'U::

3': ,.... e

-E '" =

'>:7 ----

Page 109 of 154

14:14 Monday. July 2, 201

ll>:~

~

0-r::r- - MDOC_NtlM DOl!

MISSISSIPPI DEPARTMENT OF CORRECTIONS REJ?OP.T: COUNTY JAIL PAYMllNTS

!lACE SSN r>ME """"""CE OMYI1:R RECE:t'VED

I~on! PEARt. ~ CSliIP Reim.bt!rsero.ent Month: ,june 2012

.' ,~,

AV.PJjlT, REGINALD JA~ = Bl\.TES, CHRISTOPHER ~ICllEAL co'

BOLAR, JAMIE LYNN ..:...::

" BRADLEY, SAMUEL JOsgPH

BURKS, .:JEROME

~, ,JE~y LEE

Ci1AR.LES, ~y DANIEL

COBB, CORDRRYL LYNN

CtINNINGHAM2 WlOALL P

DANTZLER, LAURtNCE

DO~LE, TERENCE DEWAYNE

otJCKSWORTH~ DANNY

DUNN. STEVEN LAMONT

E1UU., DION

EVE'.RETTE" :O~ON KE'fON

f7\..I RLE¥ I RE;NO

,OX, mNT~ LES!il\.WN

E"REEMAN, BREUNn Q.

GOILLOTTE, ~~TON

HALL, DONTA CORAL

HALL, J'OHN WII.!.IA..~

I:iA.RSHBAAGER, PE..~Y 1illTRONY

AAYBS" JEREMY OZWAYNE

K.EW'IT'l' ~ GEoRGE DARRn

HILL I GeORGE

HINES, JAMEs EOWAAD

HINTON, OEMlllUON

HOOGES~ NICHOLAS lL~HON'f

HOW'A:RD~ JEFFERY

JAMES, MXCHAEL

JOHNSON, ROY LEE

JONES, JAa,'q,Dl DEMETRIS

54585

155713

76375

53446

71563

167641

170626

169997

106Sg6

109026

1<7961

99088

123349

175203

134123

146202

114314

127649

1(7049

159073

137175

NOSSO

MS437

17S4!11

96044

173545

129810

145335

73297

62722

44604

170353

08/23/1973

04/28/1979

06/01/1961

02/27/1976

05/03/1948

08/26/1963

06/21/1983

09/10/1989

07/13/1966

01/01/1960

06/06/1966

07/05/1%6

05/30/1970

06/15/1983

1110311985

06/0211979

07n3/1964

09/0211984

03/13/1977

10/13/1986

10/16/1961

12/03/1980

06/05/1981

lllZ3/1959

12110/1961

03/16/1993

06/04/1989

06/29/1983

09/09/1970

12124/197l

09/16/1967

12/1811983

1;1.

"" BL

BL

BL

"" 9L

BL WH

BL

WI!

9L

81.

9L

EL

8L

SL

8L

BL

SL

WI!

WI<

BL

WI!

BL

WI!

BL

"" WI!

BL

BL

BL

07/09/201q

01/11/2010

03/1412006

09/19/2007

1111012006

05/23/2011

04/26/2012

04125/29 12

06/26/2011

OS/23/2011

02111/2011

03111/2011

12/02/2011

04/25/2012

OS/28/2010

11/01/2011

05/31/2011

03/13/2q07

04/10/ZG12

10/29/2011

07/02;20l(j

04/23/2012

11/15/2010

05/0S/2012

10/10/2011

04/26/2012

11/01/2011

01/06/2~1l

09/1112003

1210912006

04/10/2009

1>:1:1=

""".

30

30

30

30

30

11

12

12

30

30

30

30

9

16

9

30

30

9

19

20

30

16

9

12

30

12

26

30

30

30

30

30

Page 110 of 154

14:l4 Monday, JulY 2, 201

BEIMBtlBSEMlmT ~7 MEDrC1!.L COST

$ 600,00

$ 600.00

$ 600,00

$ 600.00

$ 600,00

S 220,00

S 240,00

$ 240,00

$ 600, 00

$ 600. 00

$ 600,00

$ 600.00

$ IS0.00

$ 360.00

$ 180.00

5 600.00

5 600.00

5 180,00

$ 360.00

$ 400,00

$ 600.00

$ 360.00

$ 190,00

$ 240,00

$ 600,00

$ 240.00

5 520.00

$ 600,00

$ 600.00

$ 600.00

5 600.00

5 600.00

~ ::r- -K:E:!7'H" JOSHUA CECIL

KIDO t ANGELO

KNIGHTON, BRIAN M

LEE, ROBERT LOUIS

e. ,., "" ~,

~ ro

0..

0>

LEWIS, ~TZPATRICK ~NE C>

LEWIS, aODERICK RODRIQ~

LIVINGSTON f SAM o

00

MONTGOMERY" BOBBY CAN'!'aELL

~RE, BOBSY DANTE

MOORE, DARELL W\01UCE:

MOY'S, TORIANO RASH1I.DO

PA'I'RICI<, OTTO

PE~NS, CORtY LAMON

P.£MY, G£fIJ'!.LD

POLK r ~CUS D~YNE

REED, SAMOEL EVAMOn.

RUPERT, LAMARCUS OSRRSLL

Sl\NO:El<S, CHIAl\O TARIK

SHORTER, DONJ\LO

SISTRUNK, JOEL

SPI1L~, CORTEZ ISIAB

s.rO'il"E'J'{, JESSE WI:t.r..IPJi

THOMPSON, ARCHIE LEE

TOMLIN. oomu.:o EDWARD

TRAN , HUE v.t\N

WALLACE, DW1>.YNE DAMn

WEA~B~¥, DAVID ARVIN

WE!S~, STEPHEN SCOTT

wrLDER~ ANTONIO MONTEZ

~ILLl~, AN'!aONY JERMAINS

WILLIAMS, PEDRO MENGEL

WOOD, CARLTON

WOODS; JEFFREY MTCHAEL

lmOC_NllM

152545

R2140

L5320

33168

163016

155980

172293

161426

51513

169725

105571

164360

105019

163463

M5829

K1l59

122270

70274

41093

40244

34315

131380

12220B

122840

ln5,"

135759

17l21B

167480

126915

Kl061

36154

RB67S

1,44950

MISSISSIPPI DEP~~TMENT OF CORRECTIONS l<EI?ORT, ~UNn JAIL PAYME;NTS

DOll

07/05/1997

01/05/1979

12/29/1962

11/10/1959

0812411988

10/09/1987

07/30/1962

05/0611977

0./15/1977

08/21/1972

OS/17/1979

05/02/1987

U/05/1SS0

07/14/1972

03/23/1975

OS/26/1977

07/14/1978

05/15/197.

02123/1963

01/08/1S63

07/26/1976

03/1S/19SS

04/24/1987

11106/1977

oe/28/l976

Oe/2S/1SG3

01/0$/1982

07/11/1975

oa/25/~98Z

11/26/1976

08/09/1955

09/19/1967

OS/30/US8

!!ACE SSN

WH

BL

BL

BL

IlL

BL

B1

BL

BL

B1

SL

SL,

SLI I

:1 BLI

SLI

BLI

BL

WI!

BL

WI!

:\ ASI aL I lOll I WI!

6L

BL

BL

BL

8L

I':lA!l'E~

o.an:ER RECE:tvJm

10/04/2010

06/08/2010

0812912007

OS/21/2002

06/1712011

12/02/ZQ11

09/13/2010

07/2312007

08/3112011

03125/2010

01/1312011

06/10/2011

11/1612010

04/2012&U

05/12/2011

07/31/2006.

10/07/2011

10126/2011

10/14/2009

02113/2009

08/10/2007

12101/2006

OS/09121l,l.1

11/0712011

04/2312012

10/20/2011

10/2812011

09/07/2007

08/17/2011

05123/2011

11/16/2010

08/16/2010

,,= !lAYS

30

30

30

30

30

30

30

30

30

30

19

30

30

11

30

30

30

30

30

30

30

11

30

30

30

12

30

30

30

19

30

30

9

Page ill of 154

l4:14 Monday~ J~y 2, 201

R'::n,,,,u~

lII<OlONT

$ 600,00

$ 600.00

S 600.00

$ 600.00

$ 600,00

$ 600.00

S 600,00

$ 600,00

$ 60Q,00

$ 600.00

S 360.00

S 600.00

S 600,00

$ 220.00

$ 600,00

S 600.00

$ 600.00

S 600.00

S 600.00

$ 600.00

$ 600.00

$ 220.00

$ 600.00

S 600,00

$ 600.00

S 240.00

$ 600,00

$ 600.00

$ 600.00

$ 360.00

$ 600.00

S 600.00

S 180,00

MEOICAL COST

--.~--

cO :::r

Nl\MJ!;

~

oX>

~_m:IM DOE

MISSISSIPPI DEPARTMENT OF CORRECTIONS REPORT: COUNTY J~L PAYMENTS

RACE SSM =~ OlIDElt RECE:rvED

,,= DA:r5

TotaJ.

SlmlUYE SXGAATUU; ~ ~ ,~ :ao.ARI:i Ol' st:r.:!?'E-aVISO,;t SIGNATt;JR!:;

." :::! e· ~

'" .:::.>

'"

page 112 0:: 154

14:14 MondaYr July 2, 201

""~ AX"""'" MED:tOL,

July 31, 2012


(601) 403-2500 Fax (601) 403-2344

BQof: 015B hge 482

To: TIle Honorable Board of Supervisors of Pearl River County, Mississippi.

Please acknowledge upon the minutes the following matters concerning the Sheriff's Department:

Please accept the following Declaratioll of Forfeiture regarding a seized vehicle. Please add to inventory if applicable.

Seized From Description Vin # Lemuel Bowden One (1) 2001 Ford Expedition IFMRUI5WIILA26892

Thank you,

0(AO ~Q2MP' David Allison, Shed

III God We TnlSf

DECLARATION OF FORFEITURE.;

STATE OF MISSISSIPPI

COUNTY OF PEARL RIVER

WHEREAS the Pearl River County Sheriffs Department, on the 27th day of March,

2012, in Pearl River County, Mississippi, seized from Lemuel Bowden property described

as ONE (I) 2001 FORD EXPEDITION VIN IFMRUlSWI1LA26892 which property has an

approximate value of $ 3,500.00 and

WHEREAS notice has been provided to parties as required by law, and

WHEREAS there was no petition to claim an Interest in the property or to contest

the administrative forfeiture In the manner or within the time provided by law, Now,

therefore, be it

DECLARED that the above described property Is forfeited under the provisions of

MississIppi law to the Pearl River County Sheriff's Department and the 15th Circuit Court

District Attorney's Office, to be used or disposed of according to law with the Pearl River

County Sheriff's Department receiving possession of the vehicle and the 15th Circuit Court

District Attorney's Office receiving 20% of the proceeds of the property from the sale

ther~~ DECLARED on this, the cfty/-.. d~y of JUNE, 2012.

LA EN BARNES HARLESS ASSISTANT DISTRICT ATTORNEY 15t1l Circuit Court District Attorney for the Forfeiting Law Enforcement Agency

•


COUNTY OF PEARL RIVER

B~o\; 0158 hge 484

Tbis day personally appeared before me, the undersigned autherity in and for the state and

county aforesaid, the above named Lauren Barnes Harless, who solemnly and truly declared and

affirmed before me that the matters and facts set forth in the foregoing Declaration of Forfeiture are

true and correct as herein stated.

Affirmed and subscribed before me on this the ~~ay of JUNE, 2012.

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 485 MENTAL HEALTH AGREEMENT FOR JAIL Date 8/ 6/2012 ISSUE CHECK TO A & D TEACHERS AT JAIL

ORDER TO SIGN MENTAL HEALTH SERVICES AGREEMENT FOR PROVIDING MENTAL HEALTH CARE FOR INMATES IN THE PEARL RIVER COUNTY JAIL

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of mental health care for inmates.

Upon motion made by Sandy Kane Smith and seconded by Anthony Hales, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to sign attached mental health services agreement between Pearl River County and Health Assurance, LLC for Obtaining and providing reasonably necessary mental health care for the inmates in the Pearl River County Adult Detention Facility.


Voting AYE:

Voting NAY: Absent:


ORDER TO ISSUE CHECKS TO FACILITATORS FOR SUBSTANCE ABUSE PROGRAM AT JAIL

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of facilitators for substance abuse program at jail.

Upon motion made by Sandy Kane Smith and seconded by Anthony Hales, the following order was adotped, to-wit:

Be It Ordered by the Pearl River County Board of supervisors to issue checks to facilitators Teddy L. Lewis and Carl Heberg for substance abuse program at Jail as attached.


Voting AYE:

Voting NAY: Absent:


PAGE 13

MENTAL HEALTH SERVICES AGREEMENT

THIS AGREEMENT between Pearl River County, Mississippi (hereinafter

referred to as the "Client"), and Health Assurance, LLC, (hereinafter referred to as

.. :'HALLC'~)ris entered.intoupon entered into as of the dayof.July,·2012. Services under ---"

this Agreement shall commence 12:01 A.M. an the date set out above, and shall

continue in accordance with Section 7.1.

WITNESSETH:

WHEREAS, the Client is charged by law with the responsibility for obtaining and

providing reasonably necessary mental health care for the inmates in the Pearl River ,

County Adult Detention Facility, (hereinafter known as the "Facility"); and

WHEREAS, the Client desires to provide for mental health care to these inmates

in accordance with applicable law; and

WHEREAS, the Client, which receives funding for the Facility as approved by the

Pearl River County Board of Supervisors, desires to enter into this Agreement with

HALLC to promote this objective; and

WHEREAS, HALLC is in the business of providing correctional mental health

care services and desires to provide such services for the Client under the terms and

conqitions hereof,

NOW, THEREFORE, in consideration of the covenants and promises hereinafter

made, the parties hereto agree as follows:

ARTICLE I: HEAL THCARE SERVICES

1.1 General Engagement. The Client hereby contracts with HALLC to provide

for the delivery of reasonably necessary mental health care services ("Services") to

inmates under the custody and control of the Client at the Facilities. HALLC enters into

this Agreement according to the terms and provisions hereof.

1.2 Scope of General SelVices. The responsibility of HALLC to deliver

. '. -- selVices .. to inmates commences wilh Ihe booking and. physical. placement of -said .....

inmales into the Facilities. HALLC shall provide SelVices for all persons committed to Sook 0158 P.9~ 491

the custody of the Facilities.

HALLC shall provide Ihe following SelVices, which shall constitute Reasonable

Mental Health Care SelVices in accordance with NCCHC standards:

a. Onsite Psychiatrist selVices (2) days per month [(24hr)ndays

consult]* [*Does this phrase mean an additional psychiatrist consultation

service around the clock, 24 hours per day, 7 days a week? If so, please

clarify.]

b. Onsile Social Worker (4) hours per day, (5) days per week;

c. Mental Health Assessments as requested by Client;

d. Mental Health Sick Call, where HALLC shall respond within twenty-

four (24) hours of notice from Client;

e. Crisis intelVention, where HALLC shall respond within thirty {30}

minutes of notice from Client;

f. Manage mental health drug cost;

g. On-Site Clinical Laboratory SelVices: and

HALLC will be responsible to assure that all menial health medicalions will be

passed to the correct inmates two times per day allhe Facility Of as deemed medically

necessary by HALLe. Medications prescribed by HALLC physicians andlor Psychiatrist

2

on an as-needed (HPRNH) basis will be distributed per Ihose instructions. HALLC

medical staff will prepare and distribute all medication within the Facility. A

deputy/correctional officer will escort the medical staff while distributing medications at

the Facility.

1.3 Book 0159 f'ag~ 4SS

Responsibility for Off-Site Costs. HALLC shall have no responsibility for

costs associated with any mental health off-site services, including, but not limited to,

off-site specialty clinics, ambulance services, off-site radiology services, emergency

room visits, inpatient hospitalization or anyon-site medical services not provided for in

this Agreement. These services shall be arranged for by HALLC in coordination with the

jail administrator or his designee, however, HALLC shall not be liable for any costs

associated with these services.

1.4 Further Exceptions to Treatment. HALLC wilt not be financially responsible

for the cost of any medical treatment or health care services provided to any inmate

prior to the inmate's formal booking and physical commitment into the Facilities.

The Client will maintain financial responsibility for pharmacy services, including

the cost of medications.

The Client will maintain financial responsibility for the cost of any mental health

treatment or health care services provided to medically stabilize any inmate presented

at booking with a life threatening injury or illness or in need of immediate emergency

medical care.

Once an inmate has been medically stabilized and physically committed to the

Facility, HALLC will be financially responsible for the cost of Services set forth in this

Agreement regardless of the nature of the Illness or injury or whether or not the illness

3

or injury occurred prior or subsequent to the individual's incaiceration at the Facility. An

inmate shall be considered medically stabilized when, in the judgment of a licensed

medical provider, the medical condition no longer requires immediate emergency

medlcaLcare.or.oulside.hospitalizalion so that the inmatereesonably.can be housed ...... .

inside the Facility. HALLC will not be responsible for the cost of any health care seNlces

not provided at the Facility.

The Client will maintain financial responsibility for any medical testing or

obtaining samples, which are forensic in nature.

1.5 Change in §tandard of Care or Scope of SeNices. The price in Section 8,

• • below, reflects compensation for the scope of SeNices as finally agreed upon by the

parties to this Agreement. This final, negotiated Agreement represents the total and

completed agreement between the parties and all prior proposals, correspondence and

understandings whether written or oral, are superseded by this written Agreement.

Should there be any change in standards of care/treatment or scope of SeNices that

results in sustained and material increase in prices to HALLe, the increases in price

related to such changes are not covered in this proposal and the parties will renegotiate

the terms of this Agreement which are affected by the material change.

1.6 Inmates Outside the Facilities. Inmates outside the Facilities shall not be

the responsibility of HALLC, nor shall such inmates be included in the daily population

count. Inmates on any sort of temporary release, including, but not limited to, inmates

temporarily released for the purpose of attending funerals or other family emergencies,

inmates on escape status, inmates on work release, furlough, pass, parole or

supervised custody who do not sleep in the Facility at night, will not be included in the

4

daily population count, and will not be the responsibility of HALLC with respect to the

payment or furnishing of health care services The cost of mental health Services

provIded to Inmates during temporary release will not be the financial

responsibility of HALLC.afteUheJr return to the Facilities. HALLC .shall only be .

financially responsible for the cost of Services provided at the Facilities. * [*Even

though an illness or injury may be incurred while outside the Facility, a/l costs

associated with medica! treatment provided inside the Facifity once the inmate

returns shall be the responsibility of HALLC.1

Inmates in the custody of other police or other penal jurisdictions at the request , .

of the Pearl River County ("County") are likewise excluded from the population count

and are not the responsibility of HALLC for the furnishing or payment of Services.

1.7 Elective Medical Care. HALLC will not be responsible for providing

elective medical care to inmates. For purposes of the Agreement, "elective medical

care" means medical care which, if not provided, would not, in the opinion of HALLC's

Medical Director, cause the inmate's health to deteriorate or cause definite harm to the

inmate's well being, Such decisions concerning medical care shall be consistent with

general NCCHC standards. Any referral of inmates for elective medical care must be

reviewed by the Client prior to provision of such services.

ARTICLE II: PERSONNEL

2.1 Staffing, HALLC shall provide medical, technical and support personnel as

necessary for the rendering of Services to inmates at the Facility as described in and

required by this agreement, Staffing pattern shall be based on the assumption that there

will be on the average up to 370 inmates. Should the inmate population increase to a

5

level greater than 370 inmates average daily population on a monthly basis, HALLe will

charge a variable cost in accordance with ARTICLE VII, Section 8.2 to cover the

incremental variable costs of providing Services to this additional population (this does

noLr.eflecLany .. additional staffing.costs).~Should a sustained. increase in the Inmate .

population occur, HALLC reserves the right to review the staffing and contract price

and, with the Client's participation and approval, which shall not be unreasonably

withheld, make necessary adjustments in staffing and contract price in order to

accommodate any additional staff positions, which may be needed to serve the

increased inmate population. Rook olsa fa'l" 491 . , 2.2 Licensure, Certification and Registration of Personnel. HALLC ensures

that all personnel provided or made available by HALLC to render Services hereunder,

shall be licensed, certified or registered as appropriate, in their respective areas of

expertise as required by applicable lew. HALLC shall provide to the appropriate,

designated office or department a copy of the license, certificate or registration of

personnel employed by HALLC at the Facilities. HALLC shall promptly notify the Client

• in the event any personnel rendering Services hereunder: (a) license is suspended,

denied, or revoked, (b) is subject to disciplinary proceedings by any governmental

entity, or (c) is convicted of a felony.

2.3 Client's Satisfaction with HealthCare Personnel. The Client reserves the

right to reject any HALLC personnel, whether employee or subcontractor, whether

employed now or in the future. Any such rejection shall be given to HALLC in writing

and shall not be unreasonably exercised by the Client. The Client may do background

investigations on all prospective HALLC employees before such personnel shall perform

6

'111"

Services hereunder. In the event the Client rejects any HALLC job applicant, employee

or subcontractor, it agrees to inform HALLC, on a confidential basis, the reasons for

said rejection. Due to the sensitive nature of the jail environment, HALLC agrees that in

... _the event .the .. Client .is dissatisfied with .anyof the personnel. provided under. this

Agreement, it may deny access of such personnel into the correctional Facility. Should

removal of an individual become necessary, HALLC will be allowed reasonable time,

prior to removal, to find an acceptable replacement, without penalty or any prejudice to Soof; 015a Pa9O, 492

the interests of HALLC.

2.4 Use of Inmates in the Provision of Health Care Services. Inmates shall not

• • be employed or otherwise engaged by either HALLC or the Client in the direct rendering

of any health care services. Upon prior written approval of the Client, inmates may be

used in positions not involving the rendering of health care services directly to inmates.

2.5 Subcontractor and Deleaation. In order to discharge its obligations

hereunder, HALLC will engage certain heath care professionals as independent

contractors rather than as employees. Subject to the approval described in Section 2.3

above, as if such persons were HALLC employees, the Client consents to such

subcontracting or delegation. As the relationship between HALLC and these health care

professionals will be that of independent contractor, HALLC will not be considered or

deemed to be engaged in the practice of medicine or other professions practiced by

these professionals. HALLC will not exercise control over the manner or means by

which these independent contractors perform their professional medical duties.

However, HALLC shall exercise administrative supervision over such professionals

necessary to ensure the strict fulfillment of their obligations contained in this Agreement.

7

For each employee, agent and subcontractor, including all medical professionals,

physicians dentists and nurses performing duties as employees, agents or independent

contractors of HALLC under this Agreement, HALLC shall provide the Client proof, if

..... requested, that there is·in·effect a professional liability or medical malpractice insurance .

policy covering all professional activities of such individuals at the Facility, with limits of

at least One Million Dollars ($1,000,000) per occurrence and Three Million Dollars

($3,000,000) aggregate. Such policy(ies) shall also meet the reqlllirEil1561AI~slllt3forth in

Section 9,1 hereof,

2,6 Discrimination. During the performance of this Agreement, HALLC, the

Client, its employees, agents, subcontractors, and assignees agree as fOllows:

(a) None will discriminate against any employee or applicant for

employment because of race, religion, color, sex or national origin except where

religion, sex or national origin is a bona fide occupational qualification reasonably

necessary to normal operation of the contractor. Each will agree to post in

conspicuous places, available to employees and applicants for employment, notices •

setting forth the provisions of this nondiscrimination clause.

(b) In all solicitations or advertisements for employees each will state

that il is an equal opportunity employer.

(c) Notices, advertisements and solicitations placed in accordance with

federal law, rule or regulation shall be deemed sufficient for the purpose of meeting

the requirements of this section.

ARTICLE !II: STANDARD OF CARE

3.1 Obligation of HALLC. HALLe's Services shall be provided in accordance

8

with the standards promulgated by the National Commission on Correctional Health

Care (NCCHC) for Mental Health Services in Facilities (2011 Edition) and standards in

the community.

ARTICLE IV:·REPORTSAND RECORDS Book 0158 P.l9< 494

4.1 Medical Records. HALLC shall case and require to be maintained

complete and accurate medical records for each inmate who has received health care

Services. Each medical record will be maintained in accordance with applicable laws,

NCCHC standards and the Client's policies and procedures. The medical records shall

be kept separate from the inmates confinement records. A complete legible copy of the

applicable medical record shall be available at all times for access by authorized

individuals. A medical transfer sheet shall accompany each inmate who is transferred

from the Facility to another location for off-site services or transferred to another

institution) Medical records shall be kept confidential. Subject to applicable law

regarding confidentiality of such records, HALLC shall comply with Mississippi law and

the Client's policy with regard to access by inmates and Facility staff to medical records. I

No information contained in the medical records shall be released by HALLC

except as provided by the Client's policy, by a court order, or otherwise in accordance

with the applicable law. HALLC shall, at its own c04 provide all medical records, forms,

jackets, and other materials necessary to maintain the medical records. At the

termination of this Agreement, such medical records shall be delivered to and remain

with the Client. However, the Client shalJ provide' HALLC with reasonable ongoing

access to all medical records even after the termination of this Agreement for the

purposes of defending claims and litigation.

9

HALLC shall immediately notify Client in the event an inmate needs emergency,

off·site medical attention to prevent likely death or imminent bodily harm. HALLC shall

also promplly notify Client when, in the best medical judgment of HALLC's medical

professionals, an inmate requires further off-site medical treatment or in the event an

inmate's condition necessitates dietary changes, seclusion, or any other routine change

in Client procedures. Book 0158 P';9~ 495

Regular Reports by HALLe to the client and the County. HALLC shall 4.2

provide to the Client, on a date and in a form mutually acceptable to HALLC and the

Client, monthly and annual reports relating to known costs and Services rendered under

this Agreement and shah also provide reports approving claims for payment by the

County for Services to inmates for which neither the Client nor HALLC is financially

responsible under this Agreement. The review and approval of such claims for payment

by the County shall be in accordance with terms agreed to by the County and HALLC

and shall be performed in accordance with standard HALLC's business practices.

4.3 Inmate Information. Subject to the applicable state law, in order to assist ,

HALLC in providing the best possible Services to inmates, the Client will provide HALLC

with information pertaining to inmates that HALLC and the Client mutually identify as

reasonable and necessary for ;HALLC to adequately perform its obligations hereunder.

4.4 HALLC Records Available to the Client with Limitations on Disclosure.

Subject to Section 4.1 HALLC shall make available td the Client, at the Client's request,

all records, documents and other papers relating tot the direct delivery of Services to

inmates hereunder. The Client understands that many of the systems, methods,

procedures, written materials, computer programs and other controls employed by

10

Y'15

HALLC in the performance of its obligations hereunder are proprietary in nature and will

remain the property of HALLC. After the termination of this Agreement, information

concerning such may not, at any time,] be used, distributed, copied or otherwise utilized

by the Client .. except·as permitted or· required by law or in accordance with the terms of-'

this Agreement, unless such disclosure is approved in advance writing by HALLC.

4.5 Client's Records Available to HALLC with Llmlt'lygn~330A~Pimlosure.

During the term of this Agreement and for a period of three (3) years thereafter, the

Cilent will provide HALLC, at HALLC's request, the Client's records relating to the

provision of Services to inmates as may be reasonably requested by HALLC or as are

pertinent to the investigation or defense of any claim related to HALLC's conduct and

performance. Unless otherwise prohibited by law, the CHent will make available to

HALLC such records as are maintained by the Client, hospitals and other outside health

care providers involved in the care or treatment of inmates (to the extent the Client has

any control over those records)as HALLC may reasonably request. Any such

information provided by the Client to HALLC that the Client considers confidential shall , be kept confidential by HALLC and shall not, except as may be required by law, be

distributed to any third party without the prior written approval of the Client.

ARTICLE V: SECURITY

5.1 General. HALLC and the Client understand the importance of security

services to the safety of the agents, employees and Subcontractors of HALLC as well

as for the security of inmates and Client's staff, consistent with the correctional setting.

Accordingly. both the Client and HALLC will cooperate with each other in addressing

security issues. Nothing herein shall be construed to make the Client, its deputies or

11

employees a guarantor of the safety of HALLC employees, agents or subcontractors,

including their employees.

5.2 Loss of Equipment and Supplies. The Client shall not be liable for loss of

. or damage to· equipment-and ··supplies of HALLC; itsagents,-employees"or'"

subcontractors unless such loss or damage was caused by the intentional conduct or

grossly negligent act or omission of the Client or its employees.

5.3 Security During Transportation Off-Site. The Client will provide security as

is customary in connection with the transportation of any Inmate between the Facility

and any other location for off-site services as contemplated herein.

ARTICLE VI: OFFICE SPACE, EQUIPMENT,

INVENTORY AND SUPPLIES

6.1 General. The Client agrees to provide HALLC with office space, facilities,

equipment, utilities (including all focal telephone costs, but excluding long distance

telephone costs which HALLC shall reimburse monthly to the Client). The Client will

provide necessary maintenance and housekeeping of the office space and facilities . •

HALLC agrees it has inspected the Facility and medical office space and facilities and

that such space and facilities are sufficient for its agents, employees and subcontractors

to perform all of the obligations required under! this Agreement. Client shall be

responsible for providing substitute space should the designated facilities become

inadequate for the purposes hereof as mutually determined by the parties.

6.2 Delivery of Possession. The Client will continue to provide to HALLC,

beginning on the date of commencement of this Agreement, possession and control of

all Client medical and office equipment and supplies in place at the Facility's health care

12

unit that are in the possession of the Client. At the termination of this Agreement,

HAlLC will return to the Client possession and control of all supplies, medical and office

equipment, in working order, reasonable wear and tear excepted, which were in place at

. _ .. - ~-the-F-acillty!s --health-care--unit--prior -to the commencement-of- services"under-- this-

Agreement.

6.3 Maintenance and Replenishment of Equipment. Theabt.V.E!R~a"¥Y~fQR~nue to

maintain all Client equipment necessary for the performance of this contract by HALLC

In working order during the term of this Agreement. If HALLC requires additional

equipment and instruments with a cost under $500 per piece during the term of this

Agreement, it shall be the responsibility of HALLC to purchase such items at its own

cost. At the end of this Agreement, or upon termination, the Client or the County shall

be entitled to purchase HALLC's equipment and instruments priced upon HALLC's

depreciation schedule based upon generally accepted accounting practices.

6.4 General Maintenance Services. The Client will provide for each inmate

receiving health care services the same services and facilities provided by the Client for •

all inmates at the Facility, including, but not limited to, the same or substantially similar

daily housekeeping services, dietary services, personal hygiene supplies and services,

and linen supplies.

ARTICLE VII: TERM AND TERMINATION OF

AGREEMENT

7.1 Term. The initial term of this Agreement shall be for thirty-six (36) months

from the start of this Agreement. This Agreement shall automatically be extended for

two additional one-year terms unless terminated by either party as provided by Section

'13

7.2.

7.2 Termination. This Agreement may be terminated as otherwise provided

in this Agreement or as follows:

~. __ ... .... .... (a) ... . Termination .by.Agreement .. ln .the·event that eachof.the· parties·

mutually agrees in writing, this Agreement may be terminated on the terms and date

stipulated therein.

(b) Termination by Cancellation. This Agreement may be cancelled Book 1)1~i1 P;;9~ 499

without cause by either party upon ninety (90) days prior written notice in accordance

with Section 10.3 of this Agreement.

(c) Annual Appropriations and Funding. This Agreement may be

subject to the annual appropriation of funds by a funding authority other than the Client.

Notwithstanding any provision herein to the contrary, if funds are not appropriated for

this Agreement, then the Client shall be entitled to immediately terminate this

Ag reemenl, without penally or liability.

7.3 Responsibility for Inmate Health Car~. Upon termination of this

Agreement, all responsibility for providing Services to all inmates, including inmates

receiving health care services at sites outside the Facility, will be transferred from

HALLC to the Client.

ARTICLE VIII: COMPENSATION

8.1 Base Compensation. The Client will pay to HALLC a first-year annual

base price of $45,000 paid in equal monthly installments of $3750.00 each: HALLC will

invoice the Client thirty (30) days prior to the month in which services are to be

provided. The Client agrees to pay HALLC on the first (1 st) day of the month in which

14

services are rendered. In the event this Agreement should commence or terminate on a

date other than the first or last day of any calendar month, compensation to HALLe will

be prorated accordingly for the shortened month. If the Client fails to make any

_. . ..... -. undispuled.paymenttoHALLC. hereunder.-within ·fifteen -(15)·business-days following~" ..

HALLC's notice to the Client of nonpayment, HALLC, among any other rights and

remedies pursuant to this Agreement or otherwise available at law or in equity, shall

have the right to terminate this Agreement immediately. Failure to terminate this

Agreement shall not waive any breach of this Agreement. A waivefofilf ~Jl{Y!ta6~a~ of this

Agreement shall not constitute a waiver of any future breaches of this Agreement,

whether of a similar or dissimilar nature. The Client shall bear the costs of any

reasonable legal or collection fees and expenses incurred by HALLC in attempting to

enforce Client's payment obligations hereunder upon any judicial determination that

such payments were due and payable.

In the event that either party should declare the other in default, Section 7.2 (b)

above shall not be available to affect the rights or obligations of either party.

8.2 Increases in Inmate Population. The parties agree that the annual base

price is calculated based upon an average daily inmate population of up to 370. If the

daily inmate population exceeds 370 inmates, then the compensation payable to

HALLC by the Client shall be increased by a per diem rate of $1.05 for each inmate

over 370. This per diem rate, which will be invoiced on the next month's invoice,

includes all of the above described services. The average daily inmate resident

population shall be determined and recorded by the Client. The Client shall provide this

information to HALLC monthly by the fifth day of thO following month. This per diem is

'15

intended to cover additional costs In those instances where minor short term increases

in the inmate population result in the higher ulilizati6 of routine supplies and services.

However, the per diem is not intended to provide for; any additional fixed costs, such as

........ new.stafflng positlons,.which-might prove necessary· If the inmate -population· grows

significantly and if the population increase is sustaln4d. In such cases, HALLC reserves

the right to increase its staffing complement and adjust its contract price In order to

continue to provide services to the increased number of inmates and maintain its quality

of care. This would be done with the full knowledge and approval of and notification to

the Client.

8.3 Compensation Escalator. The compensation (Le., annual base price and

per diem rate as defined in Sections 8.1 and 8.2, respectively) for such successive

contract year including extensions shall include a reasonable increase to insure the

delivery of the same quality and quantity of health services. HALLC's compensation will

be increased by the annual change in the Consumer Price Index, Medical Care

component for the Southern Region for March of the then current year. In the event that

there is a general market increase for insurance coverage, type and extent, required by

the Client, and/or rates for surety bonds, If applicable, or a change in the scope of

services or standard of care, the parties will negotiate a greater increase. The resultant

percentage increase shall be multiplied by the annual base price and shall also be

multiplied by the per diem rate to determine the subsequent annual price and the

subsequent per diem rate,

8,4 Inmates from Other Jurisdiclions. Services rendered within the Facility to

inmates from other jurisdictions housed in the Facility, pursuant to

16

50{

contracts between the County and such other jurisdictions, will be the responsibility of

HALLC as provided for, and limited by, Article 1 of this Agreement, Inmates from other

jurisdictions housed in the Facility will be included

..... population as .described .in.Section 8.2. . ....

the average daily inmate resident

8.5 Responsibility for Work Release inmates. Notwithstanding any other

provisions of this Agreement to the contrary, both parties agree that inmates assigned

to Work Release are personally responsible for the costs of any medical services

provided to them during such assignment. Trustees in county work proorams that are BooK OISl! Pa'ii' 502

housed in the Facilities at night are not considered "Work Release inmates" in this

section.

8.6 Changes in the Law. If any statute, rule or regulation is passed or any

order issued or any statute or guideline adopted, materially increasing the cost to

HALLC of providing health care services hereunder, HALLC and the Client will agree on

additional compensation to be paid by the Client to HALLC as a result of such changes,

provided, however, that if the parties are unable to agree on appropriate compensation,

either party may terminate this Agreement with 30 days', advance notice.

ARTICLE IX: LIABILITY AND RISK

MANAGEMENT

9.1 Insurance. In addition to the insurance Maintained as provided in Section

2:6, HALLe will at all times during this Agreement, I maintain professional liability

insurance covering HALlC, its employees, and its officers in the minimum amount of at

least One Million Dollars ($1,000,000) per occurrence and Three Million Dollars

($3,000,000) in the aggregate. HALLC shall also maintain commercial general liability

17

insurance in the minimum amount of at least 0 occurrence and Three Million Dollars

($3,000,000) the coverage changes, HALLC shall notify the Client Million Dollars

($1,000,000) per the aggregate. In the even! that n writing. HALLC shall also notify the

~~~ Client, in .. wrilingi-of --any 'reductiow~in- policy' amountsor-cancellatioO"of'insurance'~'

coverage.

9.2 Hold Harmless. To the fullest extent permitted by law, HALLC agrees to

indemnify, defend and hold harmless Pearl River County, Mississippi, its agents, Book 0158 r'9" 503

officers and employees, from and against all loss or expense, including a reasonable

attorney fee and court costs, for bodily injury, including death, and property loss or

damage (excluding loss of use thereot) arising out of the negligence, intentional

misconduct. errors or omissions of HALLC, its agents, employees or subcontractors.

The Client shall promptly notify HALLC of any incident, accident, claim or lawsuit

arising out of the negligence, intentional misconduct, errors, or omissions of HALLC, its

agents, employees or subcontractors of which the Client becomes aware and shall fully

cooperate in the defense of such claim, but HALLC shall retain control of the defense , while the action is pending.

ARTICLE X; MISCELLANEOUS

10.1 Independent Contractor Status. The Parties acknowledge that HALLC is

an independent contractor. Nothing in this Agreement is intended, nor shall be

construed to create an agency relationship, an employer/employee relationship, or a

joint venture relationship among the parties.

10.2 Assignment and Subcontracting. Except as provided in Section 2.5,

HALLC shall not assign this Agreement or any of its rights or obligations under this

18

503

Agreement to any other corporation without the prior written consent of the County and

Client, which consent shall not be unreasonably withheld provided the assignee is a

qualified provider of services such as those to be provided hereunder and shall have

., -equal or morefinaneial-resources·than HALLC, Any such'assignment or subcontract- -"'.--

shall include the obligations contained in this Agreement. Unless otherwise agreed in

writing between the parties, any assignment or subcontract shall not relieve HALLC of

its independent obligation to provide the services and be bound by the requirements of

this Agreement.

10,3 Notice. Unless otherwise provided herein, all noticeilo\1[ &tSlN~9~ 51)4

communications required or pertained to be given under this Agreement shall be in

writing and shall be deemed to have been duly given if delivered personally in hand or

sent by certified mail, return receipt requested, postage prepaid, and addressed to the

appropriate party at the following address or to any other person at any other address

as may be designated in writing by the parties:

(a) Client: Pearl River County, Mississippi Pearl River County Board of Supervisors

with a copy to:

(b) Sheriff David Allison Sheriff of Pearl River County 200 South Main street Poplarville, Mississippi 39470

with a copy to:

(c) Health Assurance, LLC Carl Reddix, M.D. 5903 Ridgewood Road, Suite 310 Jackson, Mississippi 39211-3702

with a copy to:

19

Melvin V. Priester Priester Law Firm 820 North Street Jackson, Mississippi 39202

10.4 yoverning Law. This Agreement and the rights and obligations of the

parties hereto shall be governed by, and construed according to the laws of the State of

Mississippi, except as specifically noted.

10.5 Amendment. This Agreement may be amended or revised only in writing

and signed by all parties.

10.6 Waiver of Breach. The waiver by either party of a breach or violation of

any provision of this Agreement shall not operate as, or be construed to be, a waiver of

any subsequent breach of same or other provision hereof.

10.7 Other Contracts and Third-Party Beneficiaries. The parties agree that they

have not entered into this Agreement for the benefit of any third person or persons, and

it is their express intention that the Agreement is intended to be for their respective

benefit only and not for the benefit of any non-party who might otherwise claim to be

deemed to consNtute third party beneficiaries hereof.

10.8 Severability. In the event any provision of this Agreement is held to be

unenforceable for any reason, the unenforceability thereof shall not affect the remainder

of the Agreement, which shall remain in full force and effect and enforceable in

accordance with its terms.

10.9 Force Majeure. Neither party shall be held responsible for any delay or

failure In performance (other than payment obligations) to the extent that such delay or

failure is caused by fire, riot, flood, explosion, war, strike, embargo, government

regulation, civil, or military authority, act of God, acts or omissions of carriers or other

20

505

similar causes beyond its control.

10.10 Effect of this Agreement. This Agreement and the HALLe [proposal]' {*We

have not reviewed the HALLe proposal.] constitute the complete understanding

.. betvlJeentheparties· with ~respecHo-·the ·terms and conditions· set ·forth herein and .- ......

supersede all previous written or oral agreements and representations. However, in the

event of conflict or ambiguity, the terms and conditions of this Agreement shall control

over any terms and conditions of any other document. This Agreement may be modified

only in a writing' that expressly references this Agreement and is executed by both of

the parties hereto. Book D1S9 Pa9~ 5(16

10.11 Administration of Health Services Provided Under this Agreement. HALLe

shall designate one person who shall be responsible for and have the authority to direct

all of HALLC's personnel in the provision of Services described hereunder. In cases

where professional ethics rules or laws prohibit the supervision of specific professional

judgments, HALLC shall nonetheless control all other aspects of Service provision and

administration of such Services. In administering the Services hereunder, HALLe

agrees to cooperate and interface with the Client and any of Client's committees, task

forces or designees in malters relating to HALLe's performance hereunder and the care

to be delivered. Likewise, Client agrees to be the administrative coordinator of activities

within the Facility and the personnel under his controllhere.

10.12 Limited Role of Pearl River County. Mississippi Board of Supervisors. The

parties acknowledge that the corporate body of Pearl River County is an

acknowledgment party, only and its sole responsibility hereunder is to provide funding

for the compensation which is to be provided to HALLC hereunder. Accordingly, the

21

County shall not be responsible for any other act, duty or responsibility enumerated

hereunder.

10,13 Survival. The provisions of this Agreement pertaining to the obligation to

... -.' .. pay. for Services rendered,· and ·for HAlLC'sindemnificationof ·Olient.-shali-survive-the

termination hereof,

10.14 Privacy of Personal Health Information. HALLC arJid°'tjjI~M·g'haW7comply

with all Health Insurance Portability and Accountability Act of 1996 (HIPAA)

requirements. HALLC shall use best efforts to continually advise the Client of any laws.

regulations or standards applicable to the personal identifiable health information which

is created and disseminated in the course of peiformance hereunder. HALLC agrees

that it will comply with any requirements that shall be made applicable from time to time.

IN WITNESS WHEREOF. the parties hay executed this Agreement in their

official capacities with legal authority to do so,

PEARL RIVER COUNTY. MS

B[JRD OF~PERV~~~RS (f ) ~ ctt;x~ !~ J, I?atrick Lee. President \

~e: 00· D6...- ZD L&""",,--_

SHERIFF DAVID ALLISON

=-

Dale: ~'~6' f L

HEALTH ASSURANCE, LLC

22

508

CARL REDDIX, M.D. Oate:. ____________ _

BUlkrSnow 9928 I 64v2

Boof; 015B Pa9" soa

23

August 3, 2012


(601) 403·2500 Fox (601) 403·2544

To: The Honorable Board of Supervisors of Pearl River County. Mississippi.

Please acknowledge upon the minutes the following matters concerning the Sheriffs Department.

Request to pay services rendered:

Name: Amount: Dates of Service: Service Provided:

Name: Amount: Dates of Service: Service Provided:

Teddy L. Lewis $900.00 (Invoice No 1 is attached) July 16. 2012·August 3,2012 Facilitator for Substance Abuse Program

Carl Heberg $900.00 (Invoice No I is attached) July 16. 2012-August 3, 2012 Facilitator for Substance Abuse Program

Please pay from Jail budget.

Thank You,

David Allison. Sheriff

III God We Trust

50,

,

Carl Heberg 107 Doug Lee Road

Picayune, MS 39466

Home: 601-680-2570

Cell: 60 1-770-2793

E-mail: [email protected]

To:

Pearl River County Jail

Substanee Abuse Program

DESCRIPTION

July I 6-August 3

Make all checks payable to: Carl Heberg

510

Invoice

Invoice # 1

Date: August 3, 2012

For:

Facilitator for Substance Abuse Program

B-2

I HOURS RATE AMOUNT

60 $15.00 hr $900.00

TOTAL $900.00

Date 8/3/12

Teddy Lewis 25760 PineCrest Dr Picayune, Ms 39466

Invoice # 1

Pearl River County Jail

Description

Teddy Lewis

Total Hour

Start date July 16 to Aug 3(Outy) Substance abuse 60 hr instructor for the pearl river county Jail.

'5J J

CJL MBMMAS03 08/24/2012 17:15 Board Minutes Minute Book Text Detail Book 0158 Page 512 SAP 55(53) COMPLETION ORDER Date 8/ 6/2012 LSBP 55(28) COMPLETION ORDER

ORDER TO APPROVE PROJECT NO. SAP 55(53) COMPLETION ORDER

There came on this day to be completed by the Board of Supervisors of Pearl River County, Mississippi, the matter of completion of Project No. SAP 55(53).

Upon motion made by Dennis Dedeaux and seconded by Sandy Kane Smith, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to approve attached completion Order for project No. SAP 55(53) releasing Holliday Construction Co. from further maintenance responsibility under the contract effective August 3, 2012.


Voting AYE:

Voting NAY: Absent:


ORDER TO APPROVE PROJECT NO. LSBP 55(28) COMPLETION ORDER

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of completion of Project No. LSBP 55(28).


Be It Ordered by the Pearl River County Board of Supervisors to approve attached completion Order for Project No. LSBP 55(28) releasing Pearl River Paving Co., LLC, from further maintenance responsibility under the contract effective July 25, 2012.


voting AYE:

voting NAY: Absent:

Anthony Hales, Dennis Dedeaux, Patrick Lee, and Sandy Kane Smith None Joyce Kane Smith

PAGE 2

513

ORDER OF THE BOARD OF SUPERVISORS OF PEARL RIVER COUNTY ACCEPTrNG

THE CONTRACT FOR STATE AID

PROJECT NO. SAP 55(53)

WHEREAS. the Board of Supervisors of Pearl River County, Mississippi awarded a contract to Holliday

Contructlon Co. known as STATE AID Project No. SAP 55(53) >

WHEREAS, the Pearl River Counly Enginecl' and the State Aid Engineer advise that Ihey consider the

construction portion of this contracl 10 have been completed according 10 all its provisions and recommend Ihatthe

Contractor be released from further maintenance responsibilities.

NOW, THEREFORE, IT IS HEREBY ORDERED bylhis Board that theconlractor for the project designated

above, be released from further maintenance responsibility under the contract, effective August 3, 2012.

IT IS FURTHER ORDERED that the President orlhe Board be and he is hereby authorized to sign, with the

State Aid Engineer of the Mississippi Department ofTransportatiol1, a joint letter rrna! contract acceptance 10

the Contractor, and that the Clerk of the Board transmit certifi ·opyof i r~o the State Aid Engineer.

c...---

This is to certify that the foregoing is a true and concct copy of an order passed by the Board of

Supervisors of Pearl River County, MiSSissippi, entered into the minutes of said Board of Supervisors,

Minute Book No. /6'0 _, Page No. ___ , same having been adopted at a meeting of said Board of

Supervisors on the G !t--day of---,;f-'+-"--''-"'-~.

H. Carey Webb. P.E. Sl8.le Aid Bngineer Telephone (601)llg·1150 WWW.lllsSI:l1e:lidroads,\Js

August 3, 2012

Gentlemen:

Holliday Construction, LLC 534 Highway 26 East Poplarville, MS 39470

RE: STATE AID

OFFICE 011 STATE AID ROAD CONSTRUCTION

MISSISSIPPI DEPARTMENT OfTRANSrORTAT ION P.O. BOX 1810

JACKSON. MISSISSIPPI 19Z1l·1850

PROJECT NO. SAP 55(53) PEARL RIVER COUNTY

412 Woodrow Wllson Avenue Jackson, Mississippi )1)2t6

fox (601)l59·1141 [email protected],ms.lJs

This is our formal notice that the above designated contract, including all provisions thereo f, is hereby accepted and you are released from further responsibility under this contract effective upon

:i~::.Of;" S'"" Aid \gl"~' r !j By: <:J ~

President, Board of Sup isors (/ • "j"

MISSISSIPPI DEPARTMENT OF TRANSPORTATION

By: ~----;-~.~ ...• ~-~.

H. Carey Webb, State Aid Engineer Office of State Aid Road Construction

HCWDSB

pc: Pearl River County Board of Supervisors H. Les Dungan III, P.E., County Engineer Holliday Constmction, LLC Materials Division, 72-01 State Tax Commission Project File

Date

.... Accepl3nCcSfATE (R~Y, 3-18-09}

ORDER OF THE BOARD OF SUPERVISORS OF PEARL RIVER COUNTY ACCEPTING

THE CONTRACT FOR LOCAL SYSTEM BRIDGE PROGRAM

PROJECT NO. LSBP 55(28)

WHEREAS, the Board of Supervisors of Pearl River County, Mississippi awarded a contract to Pearl Rh'er

Paving Co" LLC, known as LOCAL SYSTEM BRIDGE PROGRAM Project No. LSBP 55(28) ,

WHEREAS, the Pearl River County Engineer and the State Aid Engineer advise that they consider fhe

construction portion of this contract to have been completed according to all its provisions and recommend that the

Contractor be released from further maintenance responsibilities,

NOW, THEREFORE, ITIS HEREBY ORDERED by thlsBoard that theconlractor for the project designated

above, be released from further maintenance responsibility under the contract, effective July 25, 2012,

IT IS FURTHER ORDERED that the President of the Board be and he ls hereby authorized to sign, wifh the

State Aid Engineer of the Mississippi Department ofTra tsportation, a joint letter of fa

the Contractor, and that the Clerk ofthe Board transmit

ARt RIVER COUNTY, MISSISSIPPI

This is to certify that the foregoing is a true and correct copy of an order passed by the Board of

SUpervisors of Pearl River County, Mississippi, entered into the minutes of said Board of Supervisors,

Minute Book No. I rsB , Page No. ___ , same having been adopted at a meeting of said Board of

Supervisors on the ~ay of 'flo 'I v~f , 20 ( 2...... . I

H. Carey Webb, P,E, State Aid Engineer Telephone (60 1 )359·7150 www.msuBteaidrnsds.us

July 30, 2012

Gentlemen:

Peal River Paving Co., LLC 1 Pearson Hill Road Can'jere, MS 39426

OFFICE OF STATE AID ROAD CONSTRUCTION

MISSISSIP1'I DEPARTMENT OF TRANSPORTATION P,O, BOX 1850

JACKSON, MISSISSIPPI ;19215·1850

RE: LOCAL SYSTEM BRIDGE PROGRAM PROJECT NO. LSBP 55(28) PEARL RIVER COUNTY

412 Woodrow Wilson Avenue JackSOl'h Mississippi 39216

Pax (601)359·7141 n13il@osQrc,Slate.ms.us

This is our formal notice that the above designated contract, including all provisions thereof, is hereby accepted and you are released from further responsibility under this contract effective upon signature oflhe State Aid Engineer.

Sincerely, /,

r/ I

By:

MISSISSIPPI DEPARTMENT OF TRANSPORTATION

By: ---- ..... ~ .. ---,---.,.-----H. Carey Webb, State Aid Engineer Office of State Aid Road Construction

HCW/DSB

pc: Pearl River County Board of Supervisors H. Les Dungan III, P.E., County Engineer North America Speciality Ins. Co. Materials Division, 72·{}1 State Tax Commission Project File

Date

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 517 SAP-55(14)S ORDER FOR RESEAL ROADS Date 8/ 6/2012 JEM MECHANICAL INVOICE ON ENERGY GRANT

ORDER TO APPROVE SAP-55(14)S PROJECT TO RESEA~ ROADS

There came on this day to be considered by the Board of supervisors of Pearl River County, Mississippi, the matter of agreement for SAP-55(14)S to reseal roads.


Be It Ordered by the Pearl River County Board of Supervisors to approve attached Agreement for project SAP-55(14)S to reseal roads as attached.


Voting AYE,

Voting NAY: Absent:


ORDER TO APPROVE REQUEST TO PAY APPLICATION #3 FROM JEM MECHANICAL SERVICES ON ENERGY GRANT

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of request for payment for services on energy improvements at Jail.


Be It Ordered by the Pearl River County Board of Supervisors to approve attached request to issue check to JEM Mechanical Services in the amount of $131,623.40 for energy efficiency improvements for Criminal Justice Center.


Voting AYE:

voting NAY: Absent:

Anthony Hales, Dennis Dedeaux, Patrick Lee, and Sandy Kane smith None Joyce Culpepper

PAGE 17

SAP-SS(14)S .. CA·I Reseal Roads A through F

AGREEMENT

THIS AGREEMENT Made this the _____ day of ,2012 by and between the Board of Supervisors of Pearl River County, Mississippi, hereinafter referred to as the Board and Ihe State Aid Engineer of the Division of State Aid Road Construction, hereinafter referred to as the State Aid Engineer.

WITNESSETH That

WHEREAS under the provisions orSenale Bill No.1, Extraordinary Session of 1949, and as amended by Senate Bill No. 79, Laws of 1952, it now appears, according 10 records ill the office of the State Aid Engineer, thai unexpended and unencumbered State Aid runds in Ihe amouill of $709.250.0q are in the State Treasury to the credit of the above mentioned county as of tile date of this Agreement, and

WHEREAS the Board has complied with aillhe slate laws with alilhe rules and regulations prl)lUulgated by the State Aid Engineer under the law and has thereby become eligible to construct the hereinafter-mentioned project, according to the plans, specifications and eslimale, prepared by the County Engineer, approved by the Statc Aid Engineer and now on tile in the office of the Chancery Clerk of the county hereinbefore mentioned, and

WHER EAS the Board desires to construct the projcct with its own forces and equipment except as set out herein on Page 4, and has furnished the State Aid Engineer wit sufficient evidence that it has the necessary personnel, equipment, and other facilities for the satisfactory perfonnancc ofthe work, and

WHEREAS in the opinion of the parties hereto, this procedure will result in saving of State Aid Punds.

NOW THEREFORE, it is mutually agreecllhnt:

ARTICLE I: The work 10 be perfonned in the construction of the projecl shall consist of leveling, patching, overlaying and striping.

ARTICLE III No additionsl rights-of-way will be required or will adjustment ofulilities be required for the construction of this project

ARTICLE III: That the board shall perfOlm ollihe work described herein excepl as set oul on Page 4, and as indicated on the plans and in accordance Witll the Standard Specifications for Slate Aid Road and Bridge Construction as amended and supplemented and Wilh such special provisions as are applicable; all of which are incorporated in and made a part ofthis Agreement

ARTICLE IV: A. Thai the Board shall furnish all equipment, machinery, tools and labor and shall furnish and deliver all

materials required to be furnished delivered in and about the improvement, except as set out herein on Page 4. The Board I1lfther agrees to submit the Slate Aid Engineer satisfactory test reports of the materials incorporaled in the work.

B. The Board agrees not 10 sublet any part of the work to be perfOlmed under this Agreement, except as set out herein on Page 4.

ARTICLE V: The supervision of all phases of the construction will be the responsibility of the Board, acting throogh the Counl)' Engineer and subject to inspection alld approval orthe State Aid Engineer of his represent.tives in the manner as if the construction of Ihe projeci had been awarded to an individual contractor.

The Board's representativcs on the work shall at.11 times afford to the representalives of tile State Aid Engineer free access to all portions of the work in accordance with the plans and spccifications.

Page I

The Board further agrees that it will, when authorized by the State Aid Engineer, proceed immediately with the construction of the work.

ARTICLE VI: The Board shall receive. progress payments in an amount Ninety.Seven and One Half (975%) per cent of the value of the work pet'formed.

Progress estimates for the work shall be made and certified to the County Engineer, approved by the State Aid Engineer and submilled by him to the Board for aMcllment to the requisitions Which the Board will submit to the Slate Auditor.

Payments shall be made to the Board on the basis of the quantities of items of work perfonned at the unit prices set forth in the following schedule hereto and captioned "ESTIMA TED QUANTITIES OF WORK AND AGREED UNIT COSTS" (See Pages 3 and 4). Two and One Half(2.5) percent oft"e value oftbe work performed and materials furnished will be retained until final quantities are approved by Ihe Slate Aid Engineer.

gook 0159 P'l9' 519

Page 2

5/'1

5;';>.0

ESTIMATED QUANTlTlllS Of? WORK AND AGREED UNIT COSTS

SAP-55(4)S Reseal Roads A through !'

PAY ITEM i PAY ITEM PLAN UNIT UNIT 8 H~MSWTAL NO. QTY. PRMQ/;:J)1

ROADWAY ITEMS S·203·A Unclassified Excava"on (FM) 93 Cu. Yd. $5.74 I $533.62

$·304.A Grenul~) Material (lVM) (Clas. 4, 164 Cu. Yd. S16.53 I $2.546.92 , Group B

$·403·A Hot Mix Asphalt. ST 9.5 MM, (Base ! 348 Ton $124.20 S43,221.60 :

Repair & Edge Repair)

. $·403·8 • Hot Mix Asphalt, ST 9,6 MM, Leveling aa Ton $91.36 58,039.66 \-._ ... Polymerized - Emulsified Asphalt, S·410·C·l Grade CRS·2P 65.598 I Gel. $3.61 S309.006.78

S·410·E 5 •• 1 Aggregate Cove, Material, SI.e 7 Cu. Yd. 554.76 5115.762.64 :

(Crushed Stone or 51801 --5-410·f : BlaUer Material 302 Cu. Yd. S2.40 $724.80 ........ -$·616·A Matntenance Of Trefflc Lump Sum ump I $20,000.00 $20.000.00 I Sum -.--S·618·B Additlonat Construction Signs 0.0 Sq. f!. S10.flO SO.OO

S·621·C 4" Wid. Thermoplasflc-Edge Slripe

33.462 Mile ! $1,130.00 S37,812.06 (Continuous Wihitel (60 mils)

$·621·0 t;'Wldl! Th~~tPlast~) Traffie Stfipe Skip Yellow 90 mils 4.023 Mile $502.00 S2,019.55

S·621-E-I 4" Wide Thenmoplastlc Traffio Stripe 149,656 Un. ft. $0.30 $44.890.80 (Continuous Yellow) (90 mils) S.fi21·H·l Thermoplastic Legend (White) (120 mils) 540 Lin. Ft. $3.10 $1,674.00 II $·621-H-2 Thermo lestle leoend (White) 120 Mitl 427 $Q.Ft. $4.~5 $j)ji;7.45

$·627·L • Two·Way Yellow Reflective High 1,435 Each 54.00 $5,740.00 • Performance Raised Marker

$·63()'A Reneclorlzed Traffic Warning Sign (Encapsulated lens)' 47 Each $128.00 $6.016.00

..............

S·630·S ~enactQriZed Traffi~) Regulalory Sign Encapsulated Lens I 41 EACH $116.75 S4,786.75 _ ....

S·630·C Reflecten.ed Traffic Object Marker 16 Each S90.65 $1,450.40 (Encapsulaled Lens)(Type 3) ---""

S·830·G Rall.cterl,ed Traffic Warning Sign with 2 each $136.50 5273.00 Supp. Plate (Encapsulaled lens)

SUBTOTAL: $606,364.25 I

CONTINGENCIES \ $30,135.75 (5%):

PROJECT $636,500 00 TOTAL;

Ii

Stale Aid Funds Requested: $636,500,00 Transfer $72,750,00 in Stnte Aid Funds to Project's Engineering Fund

Page 3

The Board proposes to sublet to contract the following items which are considered ~nd approved as "Specialty Items"

PAY PLAN ITEM PAY ITEM

NO. QTY.

S·021·C 4" Wide Thermoplastic Edge Stripe (Continuous White) (60 mils) 33.402 S·621·D 4" Wide Thermoplastic Traffic Slripe (Skip Vellow) (90 mils) 4.023

S·621-E·j 4" Wide Thermoplastic Traffic Stripe (Continuous Vellow) (90 mils) 149.656 i S-621.H.l Thermoplastic Legend (White) (120 mils) 640

S-621.H.2 Thermoplasllc legand (White) (120 mils) 427 , S·627-l Two·Way Vellow Reflective High Per/ormance Raised Marker 1.435

1'--S-63D-A ...... -.-~-- .. _-"_ ....

Retleclorlzed TraffIC Warning Sign (Encapsulaled Leos) 47 S·630·8 . ~.e.flector!zed Traffic Regulatory Sigo (Encapsulated LaM) 41 S-630·C Reneelorlzed Tra.flic Object Marker (Encapsulaled Lens){Typo 3) 16

S·630·G : Raneclorized Traffic Warning SigB with Supp. PIa,e (Encap."lat.~ Lens) 2 : --._--

UNIT

MUll'

Mile Lin. PI. Li". FI.

Sq. Ft. Each Eacll

Each

each

Each

The Board hereby agrees to sublet these items by competitive bidding in accordance with governing state stalules, with the advertisement for said bids stipulaling that the work is to be accomplished as indicated 011 the plans and in accordance with Ihe Standard Specifications for State Aid Road and Bridge Constructi0'!iQok .lIse F'a')e 52!

It is further agreed and understood that the Board will be reimbursed for these items in accordance with the bid prices as received and awarded by the Board, but in no case shall the Board be reimbursed at unit prices which exceed the agreed unit prices set forth herein on Page 3.

ARTICLE VII: That aner fmal completion of the work and acceptance by the Slate Aid Engineer, Ihe [Joard will be paid on the basis of Ihe final quantities at the unit prices specified above.

ARTICLE VIII: ThaI the Board agrees 10 complete the work within 90 working days.

That the Board of Supervisors shall request by an Order Ihat Ihe State Aid Engineer transfer funds from the County's State Aid Fund to the Projcct Fund and earmarked for Ihe specific project herein names, in the amount of $636.509,00 which sum is the amollnt estimated to be necessary to conslruct the project herein agreed to,

lflhe final cost of the project, based on toe final quantities, is less than the estimate cost set up in this agreement, the State Aid Engineer will request the Stale Auditor to transfer the unexpended portion of said I1mds as being eannarked for this specific project back to the County's Slate Aid Fund for future projects.

IHhe final cost of the project exceeds the eSlimated cost as set up in this Agrecment, the Board ofSupcrvisor< agrees 10 additional nmds which may have aecrued to the credit of the counly in the State Aid Fund and earmark same for this specific projeet in an amount required to complete Ihe project. No additional SIAle Aid Funds will be allocated unless construction changes have been submitted by the County Engineer at the time and in the mallner required by Ihe Standard Specifications aftlle Division of State Aid Road Construction.

ARTICLE IX: (a) II is further agreed that the Board herewith authorizes the tesling of all materials that are to be used on Ihe projecl, as required by the specifications lind agrees to authori7'" the payment for such testing from the project fund.

(b) Iflhe tesling is done by the laboratories of the Mississippi State Highway Department, the cosl of such lesting sholl be charged at the pdces set out in their lotest schedule of cOSIS.

(c) II is further agreed that where personnel of tile State Highway laboratories a.'e used to take material andlol' roadway samples, the expenses of said personnel in obtaining said samples shall be charged to the project and will be authorized for payment by the Board, trom the project fund,

Poge 4

I "

ARTICLE X: It is further agreed that afler the completion of the project and its Rcceptance by the Stale Aid Engineer. the Board will maintain the project in a manner satisfactory to the Slale Aid Engineer.

ARTICLE XI: H is further agreed that the board shall assume all responSibility for and save the State Aid Division and the Stale A id Engineer harmless from any suits. "ctiOlts or claims of any characler urought for or on account of any injuries or damages out of any action of mission to act in the conduct of this work.

IN WITNESS WHEREOF, The parties have hereunlo affixed their signatures the Board of Supervisors on the day 2012, and the State Aid Engineer on the day of

______ ,2012.

Slate Aid Engineer

STATE OF MISSISSIPPI COUNTY OF PEARL RIVER

BOARD OF SUPERVISOHS 0 PEARL RIVER COUND

]. Pat';ick Lee, presiW'

An ny Hales

~,,~~v't--Joyce Culpepper

I, David Earl Johnson, Chancery Clerk of Pearl River County, Mississippi, do h~reby certifY thaI Ihe auove is true aod.lf,,:ct cop): of an Order passed by the Board of Supervisors of Pearl River County under date of ~. l,.. ,2012, as shown j':;'~linute Book Number,l.$Z-, Page Number __ ... ___ .

Given under my hand and Seal of office Ihis the_~ ~ay of tItg. .2012. /'/l4

i~~lp~,.) ::: ~d-.~<, (, ' • ..

Page 5

Form E-) Office of State Aid Road Construction Jackson. MS 39215·1850

De.r Sir:

Re: SAP-S5( 14)S Reseal of Various Roads

Pearl River County

This is to certilY that Pearl River Counly has Ihe following equipment, construction personnel and engineering personnel for use on the above project:

EOUIPMENT I • 12h Caterpillar Grader I • Cedar.pids Hot Mix Asphalt Sprcader I . Etnyre Centennial Asphalt Distributor 1 • Plaillefly Chip Spreader 1 . Caterpillar Double Steel Wheel Roller I . Pneumatic Roller I . Ferguson Wobble Wheel Roller 4 • Tandem Dump Trocks 3 - Trucks & Trailers I • Walden Sweepmaster Two I • Ford Backhoe 1 . Caterpillar 928G Bndloader

ENGINEERING PERSONNEL H. Les Dungan III - Co. Engineer Lawrence L. Seal - Assist. Co. Engineer Brooks Wallace -. Professional Engineer Dennis Cruthirds - Inspector Michael Whaley - T echnidan

CONSTRUCTION PERSONNEL Mike Mitchell· Road Manager Gary Nelto - A.s!. Rd. Manager Ernest Rhodes ~ Construction Foreman Gregory Moon ~ Rakeman Jeffrey Rhodes - Rakeman Chris Longino - Trock Driver Harl.n Smith - Truck DBootr 1)15S f"a'l~ 523 Braxton Smith ~ Truck Driver Richard Young - Truck Driver Anthony Smith ~ Truck Driver Lloyd Shubert ~ Truck Dri ver Brrol Cronin - Truck Driver Clifton Cameron· Operator Shannon Beckham - Operalor Jason Bullen· Operator David Ginn· Laborer Phillip Smilh - Laborer Grady Ladner - Flagmanffraffic Control Ron Stafford - Plagmanffraffic Control

The equipment and personnel listed above are not indispensable to our maintenance organizations and no interruption to nonnal maintenance will be occasioned by the proposed construction. It is also agreed that the County will leave all oflhe above listed equipment 011 the project until a release in writing Is filed with the County Engineer.

PEARL RIVER COUNTY DEPARTMENT OF PLANNING & DEVELOPMENT Ed Pinero. Dlreclor -~~l;;8;rF=~ Rtlijlnald Oliver, Planner h relephone; 601-749-7782 or

MEMORANDUM

TO: Patrick Lee, President and Board Supervisors

FROM: Reginald Oliver, Planning and Development f· O, Sook 0158 Pa'l~ 524

SUBJECT: Energy Efficiency Improvements for Criminal Justice Center Award No. DE-RW0000147 JEM Job #5054

DATE: July 17,2012

Please find an invoice entitled Application No, #3 from JBM Mechanical Services dated May 15,2012 for the amount of$I31,623.40. .

Summary: Original Contract Amount Amount Previously Paid = Invoice Regu(lSt Amount c

Remaining Balance =

$ 212,250.00 $ 41,714.00 $ 131,623.40 $ 38,912.60 (after payment)

After review of the itemized payment ledger submitted by JEM Mechanical, it has been determined by this office and project engineer that the request is in order.

Please note that ALL funds associated with this project has been deposited into the County's acrount.

Attachment: JEM Meeh Application No.3

Cc: Accounts Payable

JEM MECHANICAL SERVICES 214 Camellia Street, Suite I, Waveland, MS 89576-2041

Phone: 228-463-1261 Fax: 228-466-6249

TRANSNUTTALLETTER c

VIA ELECTRONIC MAIL & RAND DELIVERY ATTN: Dooald Thompson

Thomj)llOll BngiIleering. LLC

PO Box 249, Picayune, MS 39466 EMAIL [email protected] PBN: 601-201·1510 FAX: 512·685·0931

WE ARE SENDING TO YOU THE FOLLOWING:

DATE: OS/] 5/12 JOB 11:::;,.50:.;:5..:..4 ___ _

PROJEer: Pearl River COIlllo/ Justice Center Energy Efficiency !mprovClllfnIll

REI Pay AppUcalion #3 May '12

QTY q " , • , • 'l>E8mU:PTION,~', .. ,> , 8d6y" (1'tS8"~aiJ~.'.52S " ::,,:; ,: :,.; , ,.;. - " <'f .' .",.' , , ' 0'

j" .. 1 IApplication & Certification for Payment AlA Document 0702

1 Continuation Sheet AlA Document 0703

THESE ARE TRANSMrrrED u ehecked ~1ow!

~For Approval §For Review & Comment

X For Your Use Approved a$ Submitted

As Requemed Approved as Noted §ReviBed & RC$Ubtnit by:

Rejected

Other: ----------------ADDITIONAL REMARKS:

co: Carl AdIIir ([email protected])

JEM Mechanlcal Services, LLC [email protected]

~ r6 C)

APPUCATION AND CERTIFICATION FOR PAYMENT OWNER: PeorllUva-COIJIlIy Ilepar!montofP!:!mJing & DcW!opmCllt Z04 SomIt Juli1 S""",

Pop!orYilIo, MS 39470

StlBCONIRACl"OR.:

JEM~cal ScM.,.. Z14 c.m.n;.. S.,..... Soitc 1 W~MS39S76

CONl'RACfFOR: Mrrbal1ical Woik;

PROJECf:

~ l!ffici<mcy /I< Cooscmnioo. A1ldit-~ fur~c-.ty :ro.ticec.wr .,. .".

'" ENe+.: ~l!ngic=ing, U.C P.O. Bm: Z49 P~MS 39466

CONTRACTOR'S APPUCATION FOR PAYMENT ~""'!or_ .. _'bdow,il>_ wiJh Il>:c..n.a. Cmtjnu·tinn Sl=t,.AlA.Dc<=t0703,;'-'

!. 0Rl<llNAL OONlRACl"SUM ;>.. Netcllaop by a...g. 0t1lt::t0 3. CONIl1.ACr SUM ro DAlE (Ii><: I '" 2) 4. T01'ALCOMPlEfEI) '" Sl'ORED TO

DAn; (Cobmm(}<mG'r03) S.=AlNAGS:

a 0 %ofOm:pIdedW<d: $ ~P+B""Gm)

b. %.f_~ S (Cobmml' ... G703) T..u~(li'msS.+5b ...

Tmill C<>hmm IofG703) 6. TOTAL~I..BSS=.AlNAGB

(lli<:4 r...s I..ioe 5 1'01>1) 1. LESS PREVIOUS CER'l'II'lCA:O!S:FOR PAYMENT(Ii><:6_pOor~)

lI. CVRR:ENI' t>AYMENT J)'(Jll 9. BALt\I'IC5 TO I'JNlSB, lNCLlJDIN<) RBTA!NAGB

(Ii><: 3lesa LiM 6)

CHANGEORDEll SlJMM.oI.:RY TooiI~~ ;"prerious_ byOw='

Tct1I """""""''Ibis MOO1h

TOTALS

Nl!l: CRANGBS Otder

s

0.00

S 0.00 S 113,33'7AO

$

ADDmoNS DEDUCI!

.J1A.DOCUMENT G702

Al'PUCATION NO: 3

APPLICATION DATE:. Mo;y 15, ZOlZ l'ERIOD TO: Mo;y 31, Z012

CONl'RA<::'ril: Dakd2l0ll2

lllIoUob~S4

CONTRACf DATE:. Fdl!'wy 6, 2012

IlisttibuUoo to;

DOWNER. c::::JAttCllII'ECT DCONI:RACTOR DSUEICON'I:RACTOR

n..~C ___ "Ibe_oflhc~_lcdg<, ;,m"",ati ... __ "",W""'_by1lD>App_hr.,....u",,,bcc. """l?,,"",;"-.ho= .... ",.c-~ 1bztoll_bvcbcc.poiI! I>y 1be~h-Wod:JllrwJm:h~~""'~ __ """ ~ __ IhcOw='. ___ ~sMWl1l=:i1li""DW_

~ll: lEMH ... 1 S«W:cs ~

> n_ S - I:> - 1'2-BY'· ~ - ........ t.fj...... . ~. ~ '.<1' _'. Sl:at.f;o~~ --"'vu.... • .. ~~ __ ••• ~~ ••

==;;;PZ~a! ·1»!.}ir!t~'$···~\ .. ~ O""~ ::.

\ \.~=-::i J ARCHITECT'S CERTIFICATe FOR PAYME~:::'~;~~."'" hl.ccmtmcewilhfboCaa.tract~bascdOD~~md~~~ .. ·' "hi, .. gth .. ~""'....-"c":ili'n.1be0wnct_ .. d>e_af1lJo ....... _ •••• ~b.:Io\Vlt4gt;,;nhmation aJldbe1ief~ W'adc.ba:s:j#<>et cd =~

'\b.cI qualitrttfibl:: Wadr:: is in. • :1 ' ... with tb:r:~l'\o(::trments~ W lho: r~ is' emided topaym:atof~ AMOUNT CSl'tlm:ao.

AMOUNT CEltIlI'JEL) ........... S

~ ap/JznDJiuIr if""""'"' ctfrlified d/ffi:nform /lot......". cppIW. b<Jr/41 oIlJil:!l= "" IiIis ~ __ .~SItur_.,.dumpI"'~_ tM.-ctfrlifiirdJ AR<:Ill'I:BCI':

By. n-n!s~""'''''';.ble TbcAMOUNTCliRmlEIH"l")'lIbIooolyIDtbo C ___ .-" __ ~of~ __

~ .. """dps ofll=OwtJer .. ~ ....... l!lisCoalA<:<.

~1'JOeUI;IfIo(I"a7lli2.·N't"I.JCA1'ION.AHOt!lllmfllCA'I'IQN I"OIIIPA"/'toQ!'JoI't·t.a:mrno...~·C111C 'lJ1tAloil!NCAN 1M~0f'~. ,'mtorN'rOfIIIKAVI!.. N..W~ W~ DC~

u ...... """'(_., .... _If"" 01' __ .nt 11)''"'1-1111 a ccmplBllld AlA Document !l4ll1·CvIIIIc81lon of ~~cltym:.m IIlIol.lc:enAL

~

~ CONTINUATION SHEEI AIADOCUMENT G7Q3 PREP ARE!) BY: JEM Mee)ullric.J Services

AIADocu:ment G702, APPLICATION AND CERTIFICATE FOR PAYMENT, APPUCAlIONNO.: 3

!PROJECT: Energy Efficiency Improvements for Pearl River C011llty J1IS1ice Center APPUCATIONDATE: May 15, 2012

JEM JOB #5054 """ I'ERIODTO: May 31, 2012 '"

A B C D I E f G H I o· won COMPLETED TOTAL ro

~ .:... w.tERlALS

'" SCHEDUUD FROM l'RESEN"lLY COMPLETED

% (G BALANCBTO v, .RErAINAGE 0%

~ DESCRIPTION Of WORK - "!HIS n:.RJOD ANDSTO"RED

'" V.Al.UE PlUNlOUS srolll!!>oror IN Ie) FlNlSH (lFVAIUAllI.£

'" APPUCAnON t>OI!:lI) TODATE BAlli} " . & (D+E+l') (c.G) ,

1 . l"tlrc:b!al!e CertificaIe Sl~374.00 SlI).,374.00 $0.00 S10,374.00 100.00% $0.00 $0.00

2 Sub!!!ittal and Mobili2alion $5,000.00 55,000.00 $0..00 $5000.00 100.00"'\ $O.OIl $O.OIl 3 IA~ ~-" Insulation $20,000.00 S20,000.00 $0..00 .$20.000.00 100.00% SO.OIl $0.00 4 Lighting $46,126.00 $0.00 S41.513 • .w SO.OO S41.5l.3 • .w jl(l.OO% $4612.60 50.00 5 C0ntt01 Upm<!e S79,25o.0() $6.340.00 564,985.00 $0.00 S71.32S.00 90.00% $7,925.00 SO.OO 6 Test and Balance $5,000.00 SO.OO S{I.OO so.oo 0.00% $5000.00 SO.OO 7

. . . ss,soo.oo SO.OO $0.00 SO.OO 0.00"/. $8.so0.OO SO.OO

s UL Certilic:ation of.AHU'S $4.500.00 $0.00 SO.OO $0.00 0.00% $4.soo.OO So.oo 9 HV AC Materials $3.5OQ.OO $O..oa $2..6'25.00 $0.00 $2..625.00 75.00% $875.00 SO.OO

11> Gene:tal Omdilions $30.000.00 $0..00 $22.500.00 SO.OO . .,.,.., """.00 75.00% $7.soo.00 SO.OO

11 SO.OO so.OO SO.OO 0.00% SO.OO SO.OO 12 SO.OO $0..00 $0.00 0.00% SO.OO SO.OO 13 $0.00 SO.OO $0.00 O~ $0.00 $0.00

GRAND TOTAL: S21l,25O.00 $4L714J)O Sl31./M:Mll so.oo $173.337.40 8L67% $3II.9l.2.6II se.oo

1 of 1 G700-1992

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0~E8 Page 528 TAX SALE STRIKES Date 8/ 6/2012 REDUCTION OF TAX ASSESSMENTS

ORDER TO APPROVE TAX SALE STRIKES

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of ta~ sale strikes.


Be It Ordered by the Pearl River County Board of Supervisors to approve attached Tax Sale Strikes on the recommendation of Tax Assessor/Collector as follows:

PPIN ~5546

~5546

28277 33580

PARCEL 5166240000004100 5166240000004100 6181020000001300 5167360000002204

NAME WILKINSON CO LIEU LAND CO WILKINSON CO LIEU LAND CO BROWN FRANK M HOLIFIELD LESLIE W


YEAR 2009 2010 2009 2009

Voting AYE,

Voting NAY, Absent:


ORDER TO APPROVE REDUCTION OF ASSESSMENT

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of reduction of assessments.

Upon motion made by Sandy Kane Smith and seconded by Anthony Hales, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to approve attached petition for reduction of assessment on the recommendation of Tax Assessor/Collector as follows:

OWNER HOLIFIELD LESLIE W

PARCEL NUMBER/PPIN 5167360000002204/33580


ROLL 2009

Voting AYE: Anthony Hales, Dennis Dedeaux, Patrick Lee, and


PAGE 19

CJ~ MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 528 TAX SALE STRIKES Date 8/ 6/2012 REDUCTION OF TAX ASSESSMENTS

Voting NAY, Absent:

Sandy Kane Smith None Joyce Culpepper

PAGE 20

HONORABLE PRESIDENT BOARD OF SUPERVISORS PEARL RIVER COUNTY STRIKE FROM TAX SALE

DATE AUG 6,2012

TAX AMTPD PPIN PARCEL NAME DIST YEAR AT TAX REASON

SALE 15546 5166240000004100 WILKINSON CO LIIlU LAND CO 5049 2009 6.74 DOUBLE ASSESSED WI COUNTY ROAD

15546 5166240000004100 WILKINSON CO LIEU LAND CO 5049 2010 6.87 DOUBLE ASSESSED WI COUNTY ROAD

21>277 6181020000001300 BROWN FRANK M 4024 2009 188.93 [NAME NOT CHANGED IN LANDROLL

33580 5167360000002204 HOLIFIELD LBSLIE W 5049 2009 2011.38 PARCEL IS VACANT

aw" '.'<00 •• ~. ,.,

!

i

:

i

o ') '")

FORM 71-0263 (10/93)

STAlE OF MISSISSIPPI g ~

TAX ASSESSOR GARY BEECH " t'. ro ~ '-' ~

,g

Page Line Owner 3761 I HOLIFIELD l.ESUE W

Tax Dist

5049

PETITION FOR REDUCTION OF ASSESSMENT

PLEASE SUBMIT IN DUPLICATE

ASSESSMENT AS ON ROLL

Parcel NumberlPPIN IMPROVEMENTS LAND TOTAL

5167360000002204133580 17,420 1,414 18,834 16,732

DATE AUG 6.2012

COUNTY PEARL RIVER

REAUPERSONAL ~ ROLL

(CIRCLE ONE)

AMOUNT REASONS OF FOR

CHANGE CHANGE" PARCEL IS VACANT

TOTALS CARRIED TO FORM 71-0~ 17,420 1,414 1&,834 16,732

·RcasotIs for change ofas:se:ssment., as per Title 27-35-143, Miss. Code of 1972 TAXAMOUNTBEFORECHANGES~I~~~O~.~~ ____________ __

item number from code shown in parentheses. TAX AMOUNT AFTER CHANGES ",3~02=:.8~5,-____________ _

I

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 531 DEPT OF REVENUE CERTIFICATE ON ROLLS Date 8/ 6/2012 ONE MILL CERTIFICATION

ORDER TO ACKNOWLEDGE RECEIPT OF CERTIFICATE FROM DEPARTMENT OF REVENUE TO CERTIFY RECEIPT OF 2012 ROLLS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of Certificate from Mississippi Department of Revenue.


Be It Ordered by the Pearl River County Board of supervisors to acknowledge receipt of attached Certificate from Mississippi Department of Revenue to certify receipt from the County Assessor a correct copy of the Recapitulation of the 2012 Real and Personal Assessment Rolls.


Voting AYE:

Voting NAY: Absent:


ORDER TO APPROVE APPLICATION FOR CERTIFICATION FOR 2012-2013 FOR AUTHORITY TO EXPEND THE ONE (1) MILL

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of Application for Certification to expend the one (1) mill.


Be It Ordered by the Pearl River County Board of Supervisors to approve attached Application for Certification of Pearl River for the fiscal year of 2012 2013 for authority to expend the one (1) mill according to Section 27 39-329(b), Miss. Code Ann., as amended.


Voting AYE:

Voting NAY: Absent:


PAGE 22

-OEPARTME:NT OF-

REVENUE OFFICE OF PROPERTY TAX

STATE Of MISSISSIPPI

C E R T I FIe ATE

TO: BOARD OF SUPERVISORS Pearl River COUNTY, MISSISSIPPI

This is to certify that the MS Department of Revenue has

received from the County Assessor a correct copy of the

Recapitulation of the Real and Personal Assessment Rolls of the

above named county filed with you for 2012, and to the best of

its knowledge and belief, subject to the preparation of a

supplementary Real Roll reflecting the implementation of the

constitutional amendment (House Concurrent Resolution 41), Gary

Beech, assessor of said county, is not in default with respect

to making and filing the said assessment rolls, and that the

said Board of Supervisors may, in its discretion, make an

allowance and pay the salary of the said assessor.

This done on the 5th day of July, 2012.

Christina M. Hewitt Office of Property Tax

P. O. Box 1033 Jackson, MS 39215 www.dor.ms.gov FAX: 601.923.7637

Phone: 601.923.7631

53::t.

AP]'LICATION ]lOR CERTIJIICATION

lhe one (I) mill "ccording 10 Seclion 27-39-329(b), Mi", Code Ann" os "mended,

I. Lien d"le for properly rolls ~.t..-?A«U'I I, ,;< (1/)-. dole, {I

600k 0158 f'a~~ SJJ n, Method ofmaintnining mapping:

.-A; A contract was let with .... ..____ .... in accordance ------~----~~~

" -----------with Dep~-rtinent---o( Revenue's rules, ...... .Togflfations find guidelines which . -. ~.-

-', /" '.~ .----

requires that all recorded deitls··bc mupped, and nil necessmy corrections .. "..-,.-' '~-.

lind IIdjllslmenls'-"[;;' made according lotho ... Department of Revenue's .. ~ .. -.......• ' -----~---------

jl18mlflls, guidelines and regll1alions. (Copy of contract flHaci1ed.r-----

OR

Il A plan to Olainlflin Illflpping in-house has been devised in accordance with

the law find the Department of RevclHlC's mles, regulations fllld guidelines

and the following nmned eounty employees have the necessmy knowledge

and expertise to perform the required maintemlflce. (Copy of plan attached.)

II,L Melhod ofmoillioining Ihc real properly oppmis"ls:

A. A contract .wns let with ------------:c i1}.ac"C·ordrmec with .' .-'

the Department of Re\':enne~s .~mle5, '.:,cgnlations and guidelines which

requires lilat ull real property' hn~""'~~~Ii---Vie.wed and nny change to real .' '~

property has been made on the properly record ca-;as-anq new values . . ---.' ------

Ci,IIClllnted to reflect true value of the tax roll. (Copy of contract attach~

OR

B. A plan to mainlain the appraisal in-house has been devised in accordance

with the law and the Dcpartment of Revenue's rules, regulations and

guidelines and the following named county employees have the necess~uy

knowledge and expertise to makc the chrmges on the property record eanls

as thcy are found in the field and to calculate new values on thc tax roll.

C. Roll yeiu' 1998, or yenr sc.t by Deparllncnt or Revcl1ue scrved as the

benchmnrk yeaI' ror n rOUl'~ye?'r update cycle or the real property in e(1ch

county occording to Miss Code Ann. 27-35-113 nnd Deportmcnt of Revenue

Rule 6. The above named county lasl updated the real property dming Roll

Year '!'(J/.?--, and under the requirements or Miss Code Ann. 27-35-113

and Department orRc\,cl1ue .R.u!c 6 ',vill be required to IIpdate again on or

before Roll Ye,r ~J,"./I£ ...

IV. Mainlennnce of business pcrsonnl property:

A. A contrnct was lei with ~~)\(~(\\"'l\t nH\,\:\j'~'o,1 in nccordancc with the

Department of Revenue's IUlcs, regulations and guidelines for the

mainLenance of all the appraisals of business persoml1 propcl1y. (Copy or

contrncL attachcd.)

OR

IJ. ·-·-A plan to 1l1uinlaill t11r. appwisnl in-house has bc~n devised in accordancc

with thc law nnd the Dep0l1ment of Revenue's niles, reglllaliml~-i: and .. '

guidelines. The following namcd cOllnty __ .~mployees have the knowledge

alld expertise (0 kcep the persOJial property roll IIp-tO:(l3\o., ..... ......... ,---.

~--"--~

V. Certified appraiser according to Miss. Code Ann., 27-3-52:

A. tlCounties having not more than five thousand (5,000) applicanLs for

homestead exemption shall have alleast one (1) certified nppraiser."

n. "Collnties having more than five thousand (5,000) applicants ror homestend

exempLion s11a1l have at ICllst two (2) celtifled appraisers."

Give the numbcr ofhomcslcad appliennts for this yem·. _______ ~

A. (I) Cerlifled Apprai,er required

B. (2) Certified Appraisers rcquircd _~'LI"-:-__ _ [Ii \tl$\ C'U$\)~f C((«~ ben \\ $dh'l \ I[.{\\\C( lC~\'\s\\l"- \-\\$N;,\l

\'\.( Lc'<>.( \~ lC"-'\ \L 1 (c, n\,:f\

\\~\{\ '(v: \ :\'i,\t ')

l STATE OF MISSISSIPPI

COUNTY OF --,-A-"_=/,,.~=.;:;t!.-:.....:tf........:~r=-._.~~'-'~ ~tud~ ,£~e-, • being first duly sworn deposes, and says, that he is lite

President of tbe f",d £,"...eJ Coullty Board of Supe";'isors and that the DOllrd of

S\lpervisOl~ of AtLt-i ~L-eounty shall adopt the prope.1y vullles reOeeted by Ihe

::;~:;:;I ~;mplcted for .he ;;" date ill cOIllonn;.y with Mis.i, Code 1)27,35, Ii !Lt?7L/ ........ ~

(SEAL)

fl ' CO UNTY OF ----'';;--''''--''==-..:.A._''_·'_."-C._'L_"'_

:-U--"774Z:t.'-7:r~;Jl2.-. dZ ~:"ftZ~t~~~ci.,:

hereby eertify Ihal the within and foregoing has been recorded in Book , 5 h , Page

ofthe Supery,sor's Minute Reco.ds 011 file in the oInce ofsa1d Cle.k, r?- .

Given uuder my hand and official seal of offiee this Ihe Ld"y ofh'l..<!.il:

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 536 MEMA SPECIAL PROJECT RECEIPT OF FUNDS Date 8/ 6/2012 ROAD DEPARTMENT PERSONNEL

ORDER TO APPROVE AND ACCEPT MEMA SPECIAL PROJECT FUNDS IN THE AMOUNT OF $3,100.00.

There came on this day to be considered by the Board of Supervisors of Pearl River County,Mississippi, the matter of MEMA Special project Funds.

Upon motion made by Sandy Kane smith and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to approve and accept attached MEMA Special Project Funds in the amount of $3,100.00.


Voting AYE:

Voting NAY: Absent:


ORDER TO ACCEPT ROAD DEPARTMENT PERSONNEL

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of personnel changes in the Road Department.


Be It Ordered by the Pearl River County Board of Supervisors to approve the following and attached personnel changes in the Road Department:

Durwin C. Burks Thomas L. Johnson

Resign Resign


Voting AYE:

Voting NAY: Absent:


PAGE 24

MISSISSIPPI EMERGENCY MANAGEMENT AGENCY # 1 MEMA Drive, P. O. BOX 5644

PROGRAM NAME:

AWARD AMOUNT:

PEARL, MS 39288.

Danny Manley, Director Pearl River County EMA $3,100.00

The Mississippi Emergency Management Agency (MEMA) is proud to announce that your county has been awarded funds fur the project(s) to improve your Emergency Operations Center or enhance your capability to respond to emergencies and disasters in your county. These funds can only be used for the p1!tP.ose above: no changes can be made to this project without prior written approval from the ~MA Deputy Director or Director of Field Services. Book 0158 P'9~ S

The following conditions must be met:

I. Purchases should not be made until funds are transferred. 2. Award letter must be signed by the County EMA Director and the President of the

Board of Supervisors. . 3. The original award letter must be return to MEMA. Funds will not be issued until

this action is taken 4. After the project has been completed or equipment purchased you should submit

copies of all invoices, receipts, and pictures of the project to your Area Coordinator.

All purchases must be made within the purchasing laws of the State of Mississippi and accordance to your county procedures. There is no match requirement necessary for this project. Thc following project has been approved for the indicated amount above:

I Mobile printer, computer, Severe,-'w"-c::.:a::t.:.:h::.:er:...c::.:a::r.:::d.:::8/:.:flOly.:::e=-r __________ ~_-"

l(z?~ JJ~~ KentW. Buckley, M~ Harrell B. Neal Deputy Director, MEMA Director Field SCn'ices Bureau

CarolynN on Area Coordinator, District 9

Acceptance for the Pro/eel:

DEPAR.TMENT OF PINANCE AND ADMINISTRATION NO, 012948011 EMERGENCY MANAGEMENT AOENCY NAME

VENDOR V0002172390 ADDRESS P. O. BOX 5644 PEARL MS 3920B

PAY DATE 07-24-12 CITY ,

FOR E-PAY INFO, GO TO WWW.BANKOFAMERICA.COM/PAYMODE/MS AGY PHONE (601) 933-6362 , INV. DATE INVOICE NUMBER P.O.NUMBER DESCRIPTION I ACCOUNt NUMBER NET INVOIC AMoUNT

I

'72112 2989 IIEMPG SPECIAL PROJECT , $ 3.100.00 I

I I

pAy. TO. 1~f!¥-\ ORDER Ol'!: .. ' .'"

. ""

I

I

• WARRANT TOTAL $

\ 3,100.00

....... R..E.IA!!T:~.N.£~ ... A..~:'.IEe., .P..L.~~~ ... o.~.r.t:-.C"I.... .... ...... ................. .. ... ..... .. .... .... ........ .... ... ... ..... . ................ .

PE~RLRIyiR.·ttY:EMERGENC~MGf 530 IlWY 26 !!AS! POPLARV!LI.:II .• ;' i;MS 3947.0 .•....

,:.. , r

o' o

M&i_"N,8 flAY JJBs AMOU.l\l

('i7-2.4";12 ..•.•. $**~~*"n;*3.100,09. ".

Pearl River County Road Department

Termination Report

DATEJuly 17,2012

LAST NAME -!B"-"u"",rk,,,..s ___ FIRST Durwin MIDDLE INT, C ,

DEPARTMENT: Roa9~ TERMINATION EFFECTIVE DATE: July2iQ~laB f'39~ m

SOCIAL SECURITY NUMBER

MAIL PA Y? __ YES X NO

• TYPE OF SEPARATION (CHECK ONE) X RESIGNATION _~DISMISSAL MUTUAL AGREEMENT

__ OTHER (EXPLAIN BELOW)

• REASON FOR SEPARATION: _~_ABSENTEEISMITARDINESS X CHANGING JOB FAMILY __ HEALTH _~INCOMPETENCE REDUCTION IN FORCE __ OTHER (EXPLAIN BELOW)

STATEMENT OF HEAD OF DEPARTMENT: THIS TERMINATION OF EMPLOYMENT HAS BEEN REVIEWED FOR COMPLIANCE WITH THE PERSONNEL POLICY ADOPTED WITH THE PEARL RIVER COUNTY BOARD OF SUPERVISORS. ALL REQUIREMENTS HAVE BEEN MET,

• RECOMMENDA nON: WITHOUT RESERVATION __ WITH SOME RESERV ATION __ WOULD NOT RECOMMEND

• REHIRE? __ YES ___ NO

ADDlTIONAL COMMENTS OR EXPLANATION: __________ _

SIGNED __ -=,"~=-=-, _____ ~

WITNESS DATE.,--· ______ _

RECEI\iED Of:/02/2012 14: 30 6017352002

PEARL RIIiER COUI'Ir',' ·3/02/201201:37 FAX + ,',0 Intl ~ (10 1/003

DATE July 26,2012

Pearl River County Road Department

Termination Report

LAST NAME Johnson FIRST Thoma~ MTDDLE [/\,T. L . ---''-''=''''''-- Bo,Jl:UT51! f'.l9~ 540

DEPARTMENT: Road TERMINATION EFFECTIVE DATE: August 9. 2012

SOCIAL SECl:R1TY NUMBER

MAIL PAY? _YES X NO

• TYPE OF SEPARATION (CHECK ONE) X RESIGNATION __ DISMJSSAL __ MUTUAL AGREEMENT

__ OTHER (EXPLAIN BELOW)

I • REASON FOR SEPARATION; _~ABSENTEEISMlTARDlNESS X _~HEALrH __ INCOMPETENCE __ ,OTHER (EXPLAIN BELOW)

CHANGING JOB __ F/l.MILY ___ REDUCTION IN FORC .

STATEMENT OF HEAD OF DEPARTMENT: THIS TERMINAT ON OF EMPLOYMENT HAS BEEN REVIEWED FOR COMPLIANCE WITH THE PE ·SONNEL POLlCY ADOPTED WITH THE PEARL RIVER COUNTY BOARD OF SUPE VISORS. ALL REQUIREMENTS HAVE BEEN YlET.

• RECOMMENDATION: WITHOUTRESERVA'flON __ WITH SOME RESERVA TlO}; __ WOULD NOT RECOMMEND

• REHIRE? __ YES __ NO

ADDITIONAL COMMENTS OR EXPLANATION: ---------t---

SIGNED 2l2.:L~ ?EPAA~~ ~? _ / SIGNED~

EMPLCf'YE

DATE 2- ).tP-/Z

DATE 7- 30 ~ fa SIGNED_---:-o==-::--______ DATE, _____ _

WITNESS

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 541 DUNGAN ENGINEER INVOICES ON SAFE ROOMS Date 8/ 6/2012 BASCO INVOICES ON SAFE ROOMS

ORDER TO APPROVE DUNGAN ENGINEERING INVOICES ON SAFE ROOMS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of invoices on safe rooms.


Be It Ordered by the Pearl River County Board of Supervisors to approve attached invoices from Dungan Engineering on Safe Rooms:

Carriere Safe Room poplarville Safe Room Picayune Safe Room

$ 7,800.00 $ 5,362.50 $ 8,612.50

(#9) (#9) (#9)


Voting AYE:

Voting NAY: Absent:


ORDER TO APPROVE BASCO ASSOCIATES INVOICES ON SAFE ROOMS



Be It Ordered by the Pearl River County Board of Supervisors to approve attached invoices from Basco Associates on Safe Rooms:

poplarville Safe Room Carriere Safe Room Picayune Safe Room

$ 8,940.27 $ 13,709.24 $ 8,126.92


voting AYE:

Voting NAY: Absent:


PAGE 26

DUNGAN

Engineering, PA Consulting Engineer$

Pearl River County Board of Supervisors P. O. Box 569 Poplarville, MS 39470

Carriere Slorm Sheller 7407 Highway 1 J South Carriere, MS

Professional Seryiees for the Period: May 26.2012 to June 22. 2012

Hours

Principal Engineer

Dungan, III, Les 611312012 1.00

Participate in Conslruction Project Meetings

Dungan, JIl, Lcs 6/1412012 1.00

Participate in Construction Project Meerings

Professional Engineer

Sowell, Stephen 512912012 1.00

Site Observation of Construction Activities

Sowell, Stephen 513112012 3,00



Documentation of Construction Activities

Sowell, Stephen 6/112012 3,00


Sowell, Stephen 6/412012 2.00




Rate

150,00

150.00

125.00

125.00

125.00

125.00

125.00

125,00

July 06, 2012 Project No: Invoice No:

~oQf: 1)158 P39~

Amount

150,00

150.00

125.00

375.00

125.00

375.00

250.00

125.00

1715C367 9

m

Project 171SC367 Carriere Shelter (FEMA) Invoice 9

543 Hours Rate Amount

Sowell, Stephen 61512012 3.00 125.00 375.00

Site Observation ofConstmction Aclivities

Sowell, Stephen 6/612012 1.00 125.00 125.00


Sowell, Stephen 6/612012 2.00 125.00 250.00


Sowell, Stephen 61712012 3.00 125.00 375.00


Sowell. Stephen 6/8/2012 1.00 125.00 Bo~f50~gB Pag .. 543 Review of Materials Submittals

Sowell, Stephen 6/812012 3.00 125.00 375.00


Sowell, Stephen 6/1112012 1.00 125.00 12S.00


Sowell, Stephen 6/1112012 2.00 125.00 250.00

Site Observation ofConslntction Activities

Sowell, Stephen 6/1212012 3.00 125.00 37S.00


Sowell, Stephen 611312012 2.00 125.00 250.00

Parlicipate in Construction Pro.iect Meetings

Sowell. Stephen 6/13/2012 1.00 125.00 125.00


Sowell. Stephen 6/14/2012 .50 125.00 62.50

Participate in Construction Project Meetings

Sowe II, Stephen 6/1412012 2.00 125.00 250.00


Sowell, Stephen 6118/2012 3.00 125.00 375.00


Sowell, Stephen 6119/2012 1.00 125.00 125.00


Sowell. Stephen 612012012 .50 125.00 62.50

Documentatiof) of Construction Activities

Sowell, Stephen 6120/2012 2.50 125.00 312.50


2

Project 1715C361 Carriere Sheller (FEMA) Invoice 9

5~~ ~Iours Rate Amount

Sowell, Stephen 612112012 1.00 125.00 125.00

Site Ohservation of Construction Activities

Sowell, Stephen 612212012 .50 125.00 62.50


Sowell, Stephen 612212012 1.00 125.00 125.00

Site Ohservation of Construction Activities


Ulmer, Jason 512912012 .50 125.00 62.50

Assist with ConstrUction Administration eoo!: 0156 P.19~ 544

Ulmer, Jason 513112012 .50 125.00 62.50

Assist with Construction Administrnlion

Ulmer, Jason 61112012 50 125.00 62.50

Assist with Construction Administration

Ulmer, Jason 61412012 .50 125.00 62.50


Ulmer, Jason 615/2012 .50 125.00 62.50


Ulmer, Jason 61712012 .50 125.00 62.50

Assist witll Construction Administration

Ulmer, Jason 61812012 1.00 125.00 125.00


Ulmer, Jason 611112012 1.00 125.00 125.00

Documentation of ConstrUction Activities

Ulmer, Jason 611212012 1.00 125.00 125.00

Documcntation of Construction Activities

Ulmer, Jason 6113/2012 .50 125.00 62.50


Ulmer, Jason 6113/2012 1.50 125.00 187.50


Ulmer, Jason 611412012 1.00 125.00 125.00


Ulmer, Jason 611512012 1.00 125.00 125.00

Documentation of Constfllction Activities

Ulmer, Jason 6/1 812012 1.00 125.00 125.00


3

Project 1115C361

Ulmer, Jason 611912012


Ulmer, Jason 6120/2012


Ulmer. Jason 6/21/2012

Documentalion ofConslruction Activities


Documentation ofConslruction Activities

Totals

Total Labor

Carriere Shelter (FEMA)

Hours Rate Amount

1,00 12),00 125,00

1.00 125,00 125,00

1.00 125.00 125,00

1.00 125.00 125.00

62.00 1,800.00

Book 015B Pa9~ 54~.800.00

Billing Group Total

Total ProJeet Invoice Amonnt

$7,800.00

$7,800.00

'-' . ~ Invoice 9

4

DUNGAN

Engineering, PA Consulting Engineers

Pearl River CountY Board of Supervisors p, O. Box 569 Poplarville, MS 39470

Poplarvile Stonn Shelter Highway 26 West Poplarville, MS

Professional Services for (he Period; May 26, 201210 June 22, 2012

Hour.

Principal Engineer

Dungan. 111, Los 611312012 1.00


Dungan, Ill, Los 6/]4/2012 1.00



Sowell. Stephen 512912012 1.00

Site Observation of Construct ion Activities






Documentation of Construction Activilies




Site Observation of Construe lion Activities

Rate

150.00

150.00

125.00

125.00

125.00

125.00

125.00

125.00

Julv 06, 2012 Project No: Invoice No:

Amount

150.00

150.00

125.00

125.00

125.00

125.00

125.00

125.00

1715C366 9

Project 1115C366 Poplarville Shelter (FEMA) Invoice 9

SLJ« Hours Rate Amount

Sowell, Stephen 6/12/2012 1.00 125,00 125,00


Sowell. Stephen 6/1312012 2,00 125,00 250,00


Sowell. Stephen 611312012 1.00 125.00 125,00


Sowell. Stephen 6/1412012 1.00 125,00 125.00


Sowell, Stephen 611412012 2.00 125.00 250.00

Sile Observation of Construe lion Activities

Sowell. Stephen 6fl812012 3.00 125.00 8ogl7j)!l'ijl Pa,)e m

Site Observation ofConstruetion Activities

Sowell, Stephen 6/1912012 1.00 125,00 125.00


Sowell. Stephen 6120/2012 .50 125.00 62,50


Sowell, Stephen 6120/2012 2.50 125,00 312.50


Sowell, Stephen 612112012 1.00 125.00 125.00


Sowell, Stephen 612112012 2.00 125.00 250.00


Sowell, Stephen 6/2212012 .50 125.00 62.50


Sowell. Stephen 6122/2012 3.00 125.00 375.00



Ulmer, Jason 512912012 .50 125.00 62.50


Ulmer, Jason 5131120 I 2 .50 125.00 62.50


Ulmer, Jason 6/112012 .50 125.00 62.50

Assist wilh Construction Administration

Ulmer, Jason 61412012 .50 125.00 62.50

Assis! with Construction Administration

2

Project 17 J SC366

Ulmer, Jason


Ulmer, Jason

Assist with Construction Admin istration

Ulmer, Jason

61S12012

61712012

611112012




Ulmer. Jason 611312012



Sile Observation of Construction Activities

Ulmer, Jason 6114/2012





Documentation ofConstruclion Activities

Uhner, Jason 611912012

Documentation ofConslruction Activities



Ulmer, Jason 6121120 12




Totals

Total Labor

Poplflrville Sheller (FEMA)

HoUl's Rate Amount

.50 125.00 62.50

.50 125,00 62.50

1.00 12S.00 125.00

1.00 125.00 125.00

.50 125.00 62.50

1.50 125.00 BOf§'PsnBf'a'l~

1.00 125,00 125.00

1.00 125.00 125.00

1.00 125.00 125.00

1.00 125.00 125,00

1.00 125.00 125.00

1.00 125.00 125.00

l.00 125.00 125.00

42.50 5,362.50

Billing Group Total

Total Projeet Invoice Amount

S48

5,362.50

$5,362.50

$5,362.50

Invoice 9

5'-1'0

3

DUNGAN


Pearl River County Board of Supervisors P. O. Box 569 Poplarville, MS 39470

Picayune Storm Shelter 501 Laurel Street Picayune, MS

Professional Services for Ihe Period, May 26. 2012 to June 22. 2012

Principal Engineer

Dungan, III, Les 611312012


Dungan, III, Les 611412012

Participate in Construction Projecl Meetings


Sowell, Stephen 512912012


Sowell, Stephen 5/31/2012

Site Observation or Construction Activities

Sowell. Stephen 6/112012







Documentation or Construction Activities

HOlln

1.00

1.00

1.00

3.00

1.00

3.00

2.00

1.00

Rate

150.00

150.00

12S.00

125.00

125.00

125.00

125.00

125.00

July 06.2012 Project No: Invoice No:

Amount

ISO.OO

150.00

12S.00

375.00

125.00

375.00

2S0.00

125.00

1715C368 9

Projecl 1715C368 Picayune Shelter (FEMA) J~'OV

Invoice 9

HOlurs Rate Amollnt

Sowell, Stephen 61512012 3.00 125.00 375.00


Sowell, Stephen 6/612012 2.00 125.00 250.00


Sowell, Stephen 61712012 3.00 125.00 375.00


Sowell. Stephen 61812012 1.00 125.00 125.00

Review of Materials Submittal s

Sowell. Stephen 6/8/2012 3.00 125.00 BoollO;~OO P.9~ SSO


Sowell, Stephen 6/1112012 1.00 125.00 125.00


Sowell, Stephen 6/11/2012 2.00 125.00 250.00


Sowell, Stephen 611212012 3.00 125.00 375.00


Sowell, Stephen 611312012 2.00 125.00 250.00


Sowell, Stephen 6/1312012 1.00 125.00 125.00


Sowell. Stephen 6/]412012 .50 125.00 62.50


Sowell, Stephen 6/1412012 2.00 125.00 250.00

Site Observation of Construction Activitlcs

Sowell, Stephen 611812012 3.00 125.00 375.00


Sowell, Stephen 6/1912012 1.00 125.00 125.00


Sowell, Stephen 6/2012012 .50 125.00 62.50


Sowe II. Stephen 6/2012012 3.50 125.00 437.50


Sowell, Stephen 6/2112012 2.00 125.00 250.00


2

'-'v I Project 1715C368 Picayune Shelter (FEMA) Invoice 9

Hours Rate Amount

Sowell, Stephen 612212012 .50 125.00 62.50

Documentation of Construction Activilies

Sowell, Stephen 6/2212012 2.50 125.00 312.50



Ulmer, Jason 512912012 .50 125.00 62.50

Assist with ConstJllction Administration

Ulmer, Jason 5131120]2 .50 125.00 62.50

Assist with ConstnJclioll Administration Bool; 0158 P.~~ 55!

Ulmer, Jason 61112012 .50 125.00 62.50 .

Assist with ConstnJction Administration

Ulmer, Jason 61412012 .50 125.00 62.50


Ulmer, Jason 6/512012 .50 125.00 62.50


Ulmer, Jason 61612012 4.00 125.00 500.00


Ulmer, Jason 6n12012 .50 125.00 62.50


Ulmer, Jason 6/812012 .50 125.00 62.50


Ulmer, Jason 6111120J2 1.00 125.00 125.00


Ulmer, Jason 611212012 1.00 J25.00 125.00


Ulmer, Jasoll 6/1312012 .50 125.00 62.50

Participate In Construction Project Meetings

Ulmer, Jason 611312012 2.00 125.00 250.00

Site Obseryation of Construction Activities

Ulmer, Jason 611412012 1.00 125.00 125.00


Ulmer, Jason 611512012 1.00 125.00 125.00

Documentation ofCollstructlon Activities

Ulmer, Jason 6118/20J2 1.00 125.00 125.00

Documentation of ConstJllctlon Activities

3

Project 17 15C368


Docurnentalion of Construction Activities

U1mer,lason 6/2012012

Documentation ofConstrucUoJl AClivities

Ulmer, ,.son 6/2112012

Doeul1'1entat;oll of Construction Activities

Ulmer, Jlason 612212012

Docul1'1enta!lon of Construction Activities

Totals

Total La .. or

Pica),me Shelter (FEMA)

Hours Rate Amount

],00 125.00 125.00

],00 125.00 125.00

1.00 125.00 125.00

1.00 125.00 125.00 8001: OlSB Pa9~ 552

68.50 8,612,50

Billing Group Total

Total Project Invoice Amount

8,612.50

58,612.50

$8,612.50

V J """ Invoice 9

4

Douglas W. Graby. Architect .Iol William Scol! loercher. Arehilect

BASCO ASSOCIATES PC

Sin! 'W f Ii (' /I ir~rr CNII III 111/ i I iI's

Invoices #16 IU .. 12012

July 11, 2012

Mr. Adrain Lumpkin, County Administrator Board of Supervisors, Pearl River County P.O. Box 569 Poplarville, Mississippi 39470

RE: Poplarville Storm Shelter, BA Project #76804-01. System Invoice #81580 Carriere Storm Shelter, BA Project #76804-02, System Invoice #81581 Picayune Storm Shelter, BA Project #76804-03, System Invoice #81582

Dear Mr. Lumpkin:

Attached please find our invoices for architectural services through 6/23/12.

Project Progress (June 20121: • attended the 6/13/12 Project Meeting #6. * completed major electrical & HVAC shop drawings, expect arch interiors submittals. • review and respond to submittals, RFls, and Pay Applications. • attended the 8/27112 Project Meeting #7.

Projected Progress (July 2012): • attend the 7/11/12 Project Meeting #8. • process arch Interior shop drawings, sprinkler shop drawings • review and respond to submittals, RFls. and Pay Applications. • attend the 7/25/12 Project Meeting #9. • Project Architect is planning a site visit for Project Meeting #10, 8/8/12.

Should you have any questions or concerns regarding the project progress or invoice status, please contact me.

Sincerely yours,

BASCO Associates, P.C. 1a.:f,:A h-tJ1 Philip A. Frey, AlA f./Y,· Project Manager 717.852.1402 [email protected] Ene: Project Invoices #16.7/9/12. with a contract summary attached.

The Russell E. Hom Building II 445 We,t Philadelphia Street II PO Box 15040 II York. PA 17405·7040 T: (717) 852-1400 II F: (717) 85H401 II E:corpln[[email protected]

www.bh-ba.com

r--BASCD ~aaDCIAT&a --- Strengtliening CommunitieJ

TO: J. Patrick lea Vice President Pearl River County Board of Supervisors PO Box 569 Poplarville, MS 39470

Re: Poplarville Storm Shelter 76804-01

For Professional Services Rendered through: 6/23/2012

System 1nvolce" : Project Invoice Number: Org / Project: 021

81580 16 76804·01 ••

Invoice Invoice Date: 07/09/2012

System Invoice II: 81580

Amount Due This Invoice $8,940.27

Please Include System Invoice Number 81580 on your payment and return a copy 01 this pall''' with payment.

PLEASE REMIT PAYMENTTO: PO BOX 15055, YORK, PA 17405-7055 PAYABLE TO: BASCO Asslclates

BISSO 7680Hll .. BH00243 Philip A. Frev

"-

summary InvolcB Involoe II : 61580 ProJeotlnvolce /I: 16

ProJect: 76804·01"" Pearl River I Poplarville Storm She

Fee Type: COlli Plus 1 Default 1

7X1i00 Reimbursable Expenses I Reimbursable Expense INO Sub Markup

EXPENSES Des«dDfioo

Postage

TOTAL EXPENSES

Billoble

22.67

22.67 To D.,.: l'xp6ns.s: 4.369.65

................................................ Ii ••••••••••• , .. ,., ....................... n ....... ' ....................... ." , .... " ...................... .,

Fee Type: Cost Plu$ wltll Maximum 1 Default 1

FEE LIMITS: 8X1i1l0 Additional Sub Expense (Markup) I Additional Sub Expense (Markup)

Aulhorl~ed Fee: 0.00 Billable: 0.00 Incurred 10 Dale 386.69 Less Previous Invoices: 0.00 Over Fea Uml!: 386.69 Currenl Billing Amount: 0.00

Fee Type: Lump Sum 1 Oefault 1

6L Construction Phase Aulhorlzed Fee: 26,595.00 72.1476%

DL Dungan Materials Testing Services Aulhorlzed Fee: 10,000.00 50.0000%

EL Dungan Construction Site Layout AUlhortzed Fee: 12,500.00 50.0000%

[ Total This Invoice:

Tolal Fee Earned: Less Previous Invoices:

--":""':":~

.Qurrent!!I~_n.!lAm':~!'nt: ____ 1.i.!67.!O_

19,167.71 16,020.11

Tolal Fee Earned: Loss Previous Invoices:

5,000.00 1,000.00

Tolel Foe Earned: 6,250.00 Less Previous Invoices: 2,500.00

---........ ---Current Billing Amount; 3,750.00

8,940.21 )

Pags

D81all8d Baokap Project: 76604-01 ... Pearl River I Poplarville Storm She

Fee Type: Cosl Plus 1 Default 1

Involoe #, BISSO Project Invoice /I, 16

7X1100 Reimbursable Expenses I Reimbursable Expense (NO Sub Markup

EXPENSES Descrlpllgn Date QW BlUable

Postage FedEx 5/28/12 20.61 22,67 Postage 22.67

'" .................................................................................. , ..................................................... " .... , ......... ., Fee Type: Cost Plus with Maximum 1

Book 0158 f'3.~" 66(,

Pago

INVOICE APPROVAl FORM For Accounting Use Only. Do Not Fil In

To: PACE-~ Seq. # ~ ___ ~ '~24 IM:T)'Ile V c Y'J '-«JU~ l~tzZT""" HokU'Pay

Today'sDate

Purchase Order #

Vendor Name T otaIlnvoice Amount $

By:

Special Instructions:

!Vndr ITIV,# 7-0ue0a1e 6I13r.2012

OIsc.Pct.

o_J;ngJneering, PA, M_PI'i

___ -'77c:.SO=,OO:::.On!y ONE Invoice per InvokeApptt>'II3l Form

Phaip A Frey. AlA (* Print ~~ and SIgn Initials

Vndr, Inv, OIl!<> -_. Disc. OIl!<> Dise. AmI:.

Anth • AlA Print Name and Sign Initials

Description (Optional) Date Co GIl Account No, f'r<llec! 10 Phase Task XXfX:XfXX XX XXXX - XX XXXXX - XX XX XXX

- -Icivll EnalMaterials Testing 51311201, 01 5100 - 00 76801.\ - 01 OL 100

eM! Eng/Const Site layout 51311201> 01 5100 - 00 76804 - 01 a 100

- ., -- -- -- -- - rr 9.1 - - ./'" V'

It '0"" "': ~..c - - " 0' .-- - t-,

'" <C \11'1 I ~ - - S-

o ~>.. - - -

"" _\f'" - - .... ,"-

" " J 's '. -'" - - ';l

- -- -

Send Form to PACE Accounting

~rg Amount XXX

21 $4.000.00

21 $3.750.00

~ N)'

..x ,." r:

r-" r-~ ..

.L:Y.. ~

fmrCice~ 8HBA Q4J21n,

I , I I

(J <J1 -..J

DUNGAN


BASCO Associates P.O. Box 15040 445 West Philadelphia Street York, PA 17405-7040

Pearl RiveT County SlOnn Sheller Project Poplarville. MS

JU:I 05 lOll K PA

Professional Services fill: tbe Period: Aprllli. 2012 10 May 25. 2{)I2

Percent Phase Phase Fee Complete

Boundary and Topographic Survey 8,500.00 100.00 Geotechnical Report 9,000.00 100.00 Civil Site Design 21,000.00 100.00 Materials Testing Services 10,000.00 50.00 Construction Site Layout 12,500.00 50:00 Total Fee 61,000.00

Total Fee

Fee Earned

8,500.00 9,000.00

21,000.00 5,000.00 6,250.00

49,750.00

May 31,2012 Project No: Invo!ce No:

2443COOI 7

Book 0158 f'3~t 558

PrIor BIlling Current Fee

8,500.00 0.00 9,000.00 0.00

21,000.00 0.00 1,000.00 4,000.00 2,500,00 3,750.00

42,000.00 7,750.00 7,750.00

Total Project Involee Aroount $7,750.00

--- INVOICE APPROVAL FORM FOr Accounting Use Only, Do Not FUlln

To: 40' ", •• ~ONIACCOUNTlNG Seq. # Voucber# ti3R1..7 eve TYl" V EVe Code "3!:if Hold/Pay Vndr In •. # 7'le 2fz,,'I"ndr.lnv. Date =--/n?-Teday's Dale sl30ltz

Purchase Order#

Vendor Name

Ii:: .{"

FEOEX

Due Dale 00.,. Oat.> oo."Pct. IlIisc. A",L

TotallnliOioe Amount $ 2<lO,,*, Only ONE mVl)i<;e per Involca Approval Fonn

By: d:Yl SJ Vondran s;:rV ~ 4 . ...:M.misp", Q:dJ:::; Print Name and Sign'lnitiais (/7/, Print Name and Sign Inltlal.

Special Instructions: -

D ' ,

n Utrtional Date _ Co GiL AIxount No: ProiealD Phase Task XXIXXIXX XX XXXX -, XX XXXXX - XX XX XXX

EXPRESS -01 5t3El - 20 76804 - 01 7X 100

01 'Tl3() - 30 12012 - - 00 XE 107

01 'Tl3() - 30 12012 - 00 XF 107

01 7730 - 30 12012 - 00 XT 107

01 !l310 - 00 12012 . 00 IN 000 ---

- -- --. .., - -

GROUND /-;" \ · .. f_<-!."X 01 8310 - 00_ 12012 - 00 IN 000

I~·l it .. ~1~_ 'S:.\ - -,.... '1~ ::,.... \-' .w'J • - - ;;

"". ., \L"" ~<.: - - ~

~ \ y,r-- j'- - - .i\ ~-')., ..1:7 '"

~ - -

~r- Q:('~ ~ - -" - -

~to PACE Ao::ounting - -

O!ll XXX

021

041

041

041

099

099

p

Amount

$20.61

i

liiUIii Ht'

•

--

~

Automatioo T,ac~ln910 So",l.o Typo P .. ~,g. Typ. Zoo. PackJgsI R'tad WoIOh! O'clflr.d Volue Oollv"ed SVoAfea Signed by FodE,U ..

Automation T".~I.gIO SaNlea Type Packege Typ. Zona PSGKagn Roted Woloht Doclared VakJo O(jlJvar~d

SV. Aro. Signed by FedE<U ..

Autometion T,.cklllglD S.",I" Type Paok.ge Typo Zone Packages R.tad Wolghl Delivered SV, Am Signodby FadE,U"

Automation TIOckln9iD Sorvlt:e Typa Packallo Type Zone Packel4e$

Rated WOlght Oe.clertd ValuG

INET 718419791l\l~0 fedE, Priority OVornlght f.dE<P,k 01 1 2,0 lb., 0,9 kgs usn 100,00 M.y21,1012IUI! AM K.MCGAUOLIN 000000QiJ(I/Il(9W_

INET 718421lO45740 f.dEx Pllonly OVor.lghl CUS"lomsr Pockaglng 01 I 4,0 Ibo,1.8 kg, USD 100,00 May 22, 2011 00:14 A4 MCOWTHDnN ~61l\l(1'-

.INH 793415972193 hdE< Prl.lily Overnight fadEl< Pak 1)5

1 1,9lb .. Mkg. Moy 23, 201114:59 A6 D,aURC~ OO!XlOOQ!l(IIOO!L

INET 7004:1128.1750 FodEx Priority OV.rnlghl CuJtomaf Packaging 03 1

Continued oOJlSJ11'a1lfil

hmal KSflm$igel Buchan HOfnl Inc. 'fork 445 W •• t Phihld.lphl, s ••• t YORK PA mOl us

lWu Janice fluaJan$ Buchert Horn. Inc. Yo-Ii< m We" Philod.lphl, S~o.1 YORKPA mOl us

lWu Oabut Martin aUCHART,HO~N INC 445 W, Phn,d,lphie SII.,1 YORKPA 11401 US

VU>V

,,vj QI ~""··'l 1.l!1l1ll!¥SW"\fI 'pep:x. uogiWt:lJnV

l!iIlWlI!1 Mo, Krl,tin McLaughlln,IIIeP Sunmuy's RevItalization,l"c. 123 Moriot Slr"t SUNBURY PA 11601 US

HnlpJt.n! Mr. RI.hord G.y B.ltimor. Counly Public S.ho.1 om .. 01 Putch.slng LUTHERVILLE TlMONI MO 1109:fus

lilIJ:Wul STEPHEN SOWELL JASON ULMER DUNGAN ENGINEERING 9)5 GOODYEAR BLVD PICAYUNE MS :mila us

146;8M 'h~:itd '1,11

TO:

BASCO ASSOCIATES

----- Strengthenittg Communities

j. Patrick Lea Vice President Pearl River County Board of Supervisors PO Box 569 Poplarville, MS 39470

Re: Carriere Storm Shelter 76804-02


System Invoice II : 81581 Project Invoice Number: 16 Org / ProJect: 021 76804-02"


System Invoice #: 81581

Boor. 015B Pa9~ 561

Amount DUB This Invoice $13,109.24

Please Include System Invoice Number 81581 on your payment and reI urn a copy of this page with payment.

PLEASE REMIT PAYMENT TO: PO BOX 15055, YORK, PA 17405·7055 PAYABLE TO: BASCO ASSDClalOS

81581 76BO~-02 .. BH00243 Philip A. Frey

summary Involco Invoice # : 61561 Project Invoice # : 16

prolect: 76804·02·· Pearl River/Carriere Storm Shelter

Fee Type: Cost Plus 1

Fee Type: Cost Plus with Maximum 1 Default 1

FEE LIMITS: 8X1100 Additional Sub Expense (Markup) I Additional Sub Expense (Markup)

Aulhorlzed Fee: 0.00 Billable: 0.00 Incurred to Dale 2.42 Less Previous Invoices: 0.00 Over Fee Llmll: 2.42 Current BIlling Amount: 0.00

Fee Type: Lump Sum 1 Default 1

6L Construction Phase Aulhorlled Fee: 26,595.00 74.5228% Total Fee Earne6lil: 0158 f·J,1l,8tli214

Less Previous Invoices: 1'1,36'0'.10

______________________ .Q.u.!':ent~l!!!.nJl Amount: ____ 2~~,24_

EL Dungan Materials Tostlng Services Authorized Fee: 10,000.00 50.0000% Total Fee Earned:

Less Previous Invoices: 5,000.00

0.00

______________________ .Q.urrent~l!!!.nJl Amount: ____ 5,000.00_

FL Dungan Construction Sito Layout Aulhorized Fee: 12,500.00 50.0000% Tolal Fee Earned: 6,250.00

Less Previous Invoices: 0.00

Current Billing Amount: 6,250.00

( Total This Invoice: 13,709.24 ]

Page

To:

T ocIay's Date

Purchase Order #

Vendor Name

T otaJ lrl\lOice Amount $

By:

Special InstrucIions:

oescnPlion

Civn Ef1!lIMaterials T e>lif1!)

eivn EngiConst Site Layout

INVOICE APPROVAL FORM For Accountin

I'ACE· Acx:ounting seq. If.

6I1=t2 eve T_ V EVe COde /b;;</il HoldIPay

Vndr 1!lV.1f. .5 Vndr. Inv. Dale :R.JC!;f{ Due Dale Disc. Dale

Dlse.Pd. Disc. Am!.

Dungan En9ineetin9,I'A. M~

___ ..:.ll:.:::250=.OO,,-OnJy ONE invoice per Invoice Approval FoI11l

Phil!pA.F~,J\IA ~.f\'r ,AlA Print Name Md 5;90 1_ Print Nome and SIgn In~"!I.

Date Co GIL -Accciint No. Pi'6lecl.ID lPIiiise ITask Q!9. Amount XXJXXIXX xx XXX)( • XX XXXXX ·-XXi XX I XXX .xxx

51311201 01 5100 00 76804 02 EL 100 21 $5,000.00

513112012 01 5100 00 76804 02 FL 100 21 $6,250.00

.V,9, I J1i"" I " - "~~ ,,~ ,.\ I l _, l\\'l H~

~ ",./" ! l&.l

\l~r;:::z." M-i,/ .1'1> :y

~

~

Send Form to PACE Aocounling

f!WCIce~BHaA0U27111 a ~

. DUNGAN

Engineering, p~ Consulting Engineers

BASCO Assooiates P.O. B<>x 15040 445 West Philadelphia Stroot Y<>rk, PA 17405·7040

Pearl River County Storm Shelter Project Carriere. MS

JUN 05 2012

Professional Service! (or the Period: ARrlll1, lOll to May 15. lOU

Percent Pbase Phase Fee Complete

Boundary and Topographic Survey 8,500.00 100.00 Geotechnical Report 9,000.00 100.00 Civil Site Design 21,000.00 100.00 Materials Testing Services 10,000.00 50.00 ConslruClion Site Layout 12,500.00 50.00 Total Fee 61,000.00

Total Fee

May31,2012 . Project No: 2443COO2

Invoice No: 5

Fe. Earned Prior Billing Current Fee

8,500.00 8,500.00 0.00 9,000.00 9,000.00 0.00

21,000.00 21,000.00 0.00 5,000.00 0.00 5,000.00 6,250.00 0,00 6,250.00

49,750.00 38,500.00 11,250.00 11,250.00

Total Projeellnvolee Amount SIl,2S0,OO

•

-101;-) ABEICCIATES

CeAseD . Strengtfte.ttittg Communities

TO: J. Patrick lea Vlce President Pearl River County Board of Supervisors PO Box 569 Poplarville, MS 39470

Re: Picayune Storm Shelter 76804-03


System Invoice II : Project Invoice Number: Org / ProJect: 021

81582 16 76804·03 ••


System Invoice 1#: 81582

( Amount Due This Invoice $8,126.92 J

Please Include System Invoice Number 31582 on your payment and return a copy of this paso with payment,

PLEASE REMITPAYMENTTO: PO BOX 15055, YORK, PA 17405-7055 PAYABLE TO: BASCO Assoclales

81582 76804·03 .. BH00243 Philip A. Frey

Summai'll I.volell Invoice 1# : 81682 ProJectlnvolcl) # : 16

PJO)lIol: 76804·03·* Pearl River/Picayune Storm Shelter

Fee Type: Cost Plus 1

"" Fee Type: Cost Plus wllh MaxImum 1 Default 1

FEE LIMITS: 8x/100 Additional Sub Expense (Markup) I Additional Sub Expense (Milrkup)

AuthorIZed Fee: 0.00 Billable: 0.00 Incurred 10 Dale 6.56 !.ess Previous Invoices: 0.09 Over Fea l.lmlt: 8.58 Current Billing Amount: 0.00

fee Type: Lump Sum 1 Default 1

6L Construction Phase Aulhorlzed Fee: 26,595.00 68.6120%

Gooh 0158 ~aq~ 566 Tolal Fee Earned: 1t\,247.36

!.e5$ Provlouslnvolcos: 17,370.44

Total Fee Earned: less Provlous Involcos:

5,000.00 1,500.00

--.,,-:-:~

____ . __________________ .Q.urre..!1.t~I!'!.n.!lAm!:,!,nt:_ _ _ 3,500.00_

FL Dungan Construction Site Layout Aulhorlzed Fee: 12,500.00 50.0000% Tolal Fee Earned:

!.ess Previous Invoices: 6,250.00 2,500.00

______________________ . .Q.Uf[e..!1.t~l!!ln.!l~!:'!'!!L ___ 32l!!>·OO_

(Total This Invoice: 8,126.92)

Page 1

To:

Today's Date

Purchase Order #

Vendor Name

T oIaIlnvoice Amount $

By:

Speclallns!:n.ldions:

on al)

IcMl EngIMaterials Testing

Civil EnQIConst Site t.avout

INVOICE APPROVAL FORM For Accounting Use Only. 00 Not FiU In

::f:# 1 ~=Date 1'111 ~ H PACE - Aceounting

6/1312012 Due Date Disc:. Date Dise.Pct. Disc:. Amt

Dungan Engineering. PA, Missisoippi

___ -''1'25O=::;:.oo~Only ONE invoice per Invoice Approval Fonn

PhillpA Frey. AlA ~~ AnthonyJ. Shinsky. AlA ~ Print Name and Sign Inili3ls

Date ~-I CO -GIL Accou-iii No.

XXfXXIXX ..1 xx. XXXX - xx: -

513112012 01 5100 - 00

513112012 01 5100 · 00

------· ----· -· -

· ---· -

Print Name and Sign lnillals 7'

Project 115- I Phase I Task ala xxxxx - xxi xx: .XXX xxx

~ .-7t~H'f r ( 0.

03

03

EL 100 21

FL 100 21

V£.~ Jt./ J fi.Jt.-n IV)'

i '~"~- w'r ....

\1:.. ...nI '\ ~ III .b

t-\JA VY N d'T'~ IL

Amount

$3.500.00

$3.750.00

._-

Send Form to PACE Accounting

~Appuwd BHBA04Il:7n1

~ ~

---

DUNGAN


BASCO Associates P.O. Box 15040 445 We,1 Philadelphia Slreet York, PA 17405·1040

Pearl River County Storm Shelter Project Picayune, MS

JUN 05 2012

l'rofosslonal S!:rylm for the Period! April 21. 2012 \0 May 25. 2012

Percent Ph.se Phase Fee Complete

Doundary IUld Topographic Survey 8,500.00 100.00 Geotechnical Report '1,000.00 100.00 Civil Site Design 21,000.00 100.00 Materials Testing Services 10,000.00 50.00 Construction Site Layout 12,500.00 50.00 Total Fee 61,000.00

Total Fee

Fee Earned

8,500.00 9,000.00

21,000.00 5,000.00 6,250.00

49,150.00

May 31, 2012 Project No: Invoice No:

2443C003 7

Prior Billing Current Fee

8,590.00 0.00 9,000.00 0.00

21,000.00 0.00 1,500.00 3,500.00 2,500.00 3,750.00

42,500.00 7,250.00 7,250.00

Total Project Involee Amount $'7,250.00

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 569 HANCO INVOICES ON SAFE ROOMS Date 8/ 6/2012 MEMA HURRICANE REIMBURSEMENT #100

ORDER TO APPROVE HANCO CORPORATION INVOICES ON SAFE ROOMS



Be It Ordered by the Pearl River County Board of Supervisors to approve attached invoices from Hanco Corporation on Safe Rooms:

Poplarville Safe Room Carriere Safe Room picayune Safe Room

$ 92,461.76 $ 57,449.68 $ 268,643.64

Order and adopted, this the 6th day of August, 2012.

Voting AYE:

Voting NAY: Absent:


ORDER TO ACCEPT MEMA HURRICANE KATRINA #100 REIMBURSEMENT

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of MEMA reimbursement on Hurricane Katrina.


Be It Ordered by the Pearl River County Board of Supervisors to accept attached MEMA Hurricane Katrina reimbursement #100 in the amount of $48,624.53.


Voting AYE:

voting NAY: Absent:


PAGE 28

DUNGAN

.1 Enijlneerfng, PA

July 24,2012

Mr. Patrick Lee, President Pearl River County Board of Supervisors P.O. Box 569 Poplarville, MS 39470

Re: Poplarville Community Safe Room FEMA Project NO.1604 - #0179 Pay Application No. 5 Pearl River County, MS

Dear Mr. Lee:

925 Goodyear Boulevard Picayune, Mississippi 39466

Phone (601)799·1037 Fax (6011799·0480

www.dunganeng.com

Book 015B P~9~ 570

Enclosed please find Pay Application No. 5 from Hanco Corporation and approved by Basco Associates, PC for work completed through July 17, 2012 for the above referenced project. Basco Associates recommends payment be made to Hanco Corporation in the amount of $92,461.76 as indicated on the attached payment application, This amount reflects the total work completed to date,

If you have any questions or comments, please do not hesitate to contact me.

Sincerely,

Stephen L. Sowell, P,E. Resident Project Representative

SLS/dg

Enclosure(s)

\\d.·me ... lsdskproj\1715C300\OocumenlslFioaociaIICootractor InYoicelP,l •• - Pay Request No. ;:;

Consulting Engineers

;:)' 10

~PPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF PAGES

J ;'0 OWNER: Pearl River COUllty - Board of Sup. FROJEer, FEMA #0179, Poplarville Comm Sa: APPLICATION NO: 00005 DistributiOl'J to:

P.o. Box 569 PERIOD TO: 7/1712012

Poplarville, MS 39470 PROJEerNOS.: FEMA #()179

FROM CONTRAcroR: Hanco Corporation P. O. Box 17678 Hattiesburg, MSi:;i9404--767&

CONTRAerFOR: -l.ON7-nw~lJll~ ..

VIAARCHITEer: BASCO Associates, P.C. The Russell E. Horn Building York,PA 17401 t-····· --CO~erDATE:

~A-rn?V1LU \ M.S -:'/11 Ill. NT1'"

o OWNER

o ARCHlTEcr o CONTRAerOR o o

., CONTRACTOR'S APPLlC~TION FOR PAYMENT Applica1ion is made for payment, as snO'WIl beiw~ io connection with the contract. Continuation SOO:t. Ali\ Document 0703, is!ilbohed. Contractor for Work fi ic previous C . at for Payment were issued and pay-

1. ORIGINAl. CONTRACT SUM .................................................... .

The undersigned Contractor certifies that to the best of the Contractor's knowledge, infurmation and belief the Work covered by this application for Payment has been completed in accordance with thaCon Docum~nts, amounts have been paid by the

ments received from e ;.-and en payment shown herein i€ now ilIe. $2.660,000.00 CONTRAerOR:

;L Net change by Change Orders ............................................. ($&4.371.00) By: -...-' , q Date: '/' k,t I

3. CONTRACT SUM TO DATE (Line 1 ;!:2) .................................. $2,575,629.00

4. TOTAL COMPLETED & STOREOTO DAlE ......................... $874.416.73 SWeof: u.s (Column G 00 0703) County of: F1ltr.L5.t-

5. RETAlNAGE: SuhscnOed and sworn to bofo«

a. .lQ.QOO % ofCompl¢tt;d. Work {Columns P + E on G703)

b. l().OOO%ofSrorcdMa.t.eri.al {CoI= F o. 0703)

$87.441.67

$0.00

me this 111!> day of Cf 1A.1'1 .:;/0 IA

NotalyPublie: Q~ ~A. My Commission expires: ~I R'f, .:/01+

Toal~(Line5a+5bor ................................................ $87.441.67 ARCHITECT'S CERTIFICATE FOR PAYMENT Tola! III Columns 1000703)

6. TOTAL EARNED I..ESS RETAINAGE .......................................... $786 975 06 In accordance with the Contract Documents, based on on-site observations and the dIJla (Line 41= Lind Toal) comprising this application, the Architect certifies to the Owner that to the best of the

7. LESS PREVIOUS CERTIFICATES FOR PAYMENT Architect's knowledge, information and belief the Work has progressed as indicated. the (Line 6 from prior Certl6C31<) ..................................................... $694,513 30 quality of the Work is in accordance with the Contract Documents, and the Contractor

s. CURRENT PAYMElfl PUE ......................................................... 1 $92,461.761 is entitled to payment ofth. AMOUNT CERTIFIED.

9. BALANCE TO FINISH, INCLUOING RETAlNAGE

(Line 31"", Lin< 6) $1,788.653.94

AMOUNT CERTIAED ._ ......................................................... _ $92,461.76

(Attaeh crplaMtion if am<nurl C£lrlified dijforsfrom the amawrl applied for. IniJial all figures on this Application and on the COhlin""';",, Sheet that we cJu:vJged to

conform to lhe am<nurl t='tiJwi) A ! Cl!ANGEORDERSU~Y ADDlTIONS DEDucnONS ARCHlTEer: -f)'J!u.. A.:'fJ\.Ul

1 II-;; 7/20 tt.

T Qta] changes approved In • ~ -----J:,. Date:: forevlousmonthsbvOwner- $0.00 $&4,371.00 By. f;f\'7G!1 ~ f'.(;'. . ___ -----fTo",1 aonrovcd this Month SO.OO ~ $0.00 This Certificate is not negotiable. The MlOUNT CERTIFIED is payable only.to the

TOTAlS SO.OO $&4,.,71.00 Contractor named herein. Issuance, payment and acceptance of payment are Wlthom rNET CHANGES by Change Order ($&4,371.00) preill<llce to any rights of the Owner or Contractor under this Contract. ~ AJA DOCUMENT G702- APPUCATION AND CERTlFlCATE FOR PAYMENT" 1992 EDmON • AIA~· CI m .. 1111~ AMERICAN INsrrruT.E OF ARCHlTECTS. li35 NEW VORK. G702-1992 ~ A VENUE. hi, W '. W ASUlNGTON. D.C. 20006-5192 .. WARNING; Unlic:ensed pbotocopylng viol3'te$ u.s. cop)'right laws and will subject ~ violator to legal proaeut.ion . ...... ~ "'Tll\$tIOCuI'I'ICfttilzl3ftt\~~Mlhme~I)/~~tllSl.lM .. af~ulldef~~t(j~~lt\(. ~GI~~\II!!I!I(ItlI:~~lsoo!~ ~Tho!~~:rtAA:t!lt~

- toli'Ol'llT!MOIImIIo'Il~ar!hG~;vldIl~~·

~ .CONTINUATION SHEET AlA DOCUMENT G703 PAGE I OF 4 PAGES

") AlA Document <1102, APPLICATION AND CERTIFICATE FOR PAYMENT, containing Contr:actor's signed Cenific:ation, is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply.

A B '" C D

'" E

WORK COMPLETED "-ITEM DESCRIPTION OF WORK If.' SCHEDUISiD FROM PREVIOUS

NO. ~ VALUE APPLlCAnON THlSPElUOD ~ c (D+E)

00999 Division 1 $261,183.00 ;;

SO.OO SO.OO SO.OO Q = 01000 Taxes $93,100.00 $27,892.76 $3,761.:24 01001 Bonds $28,994.00 $28,994.00 SO.OO 0100:2 Insurance $27,879.00 5:27,879.00 SO.OO 01500 Si!e Facirllies $104,038.00 $41.61520 510.403.80 01501 Testing Laboratory $1,576.00 SO.OO $1,576.00 01502 Layout I Engineerirlg $5,576.00 $2.788.00 $1.394.00 0:2050 Division 31 $116.247.00 SO.OO SO.OO SO.OO 02200 Earthworl< $50,581.00 $42,406.70 SO.OO 02201 Silt Fence $2.230.00 $2,230.00 SO.OO 02240 Concrete Foundation Exc/BaddiH $2.788.00 $836.40 $836.40 02250 Termite Control 51,296.00 5194.40 $194.40 02400 Striping $558.00 SO.OO SO.OO 0:2600 Sidewalk Labor 55,540.00 SO.OO SO.oo 02601 Curb Labor $5,475.00 SO.OO SO.OO 0:260:2 Paving Labor ! $26.271.00 SO.OO SO.OO 02800 Gl3SSing $5,018.00 SO.OO 50.00 02001 Fine Grading $3.490.00 SO.OO SO.OO 03050 Division 3 9942,469.00 50.00 SO.OO 50.00 03100 Coru::rele Formworl< $4,461.00 SO.OO $1.338.30 03200 Concrete Reinfureement $30,109.00 $30.109.00 SO.OO 03201 Rod Busting $8,698.00 $1,304.70 $3,044.30 03202 Stands & Aa:essories $2.788.00 SO.OO $2,783.00 03300 Concrete Material $86,109.00 $12.916.35 $8.610.90 03310 ?ost Fooling Labor $1.740.00 SO.OO $1.740.00 03311 Spot Fooling Labor $1.740.00 $870.00 $870.00 03312 Continuous Footing Labor 57,718.00 $2,315.40 $5.402.60 03320 Slab on Grade Labor $21.065.00 SO.OO SO.OO 03330 Topping Slab Labor $12,461.00 SO.OO SO.OO 03370 ,Elevaled Beam Labor 51,994.00 SO.OO SO.OO 03371 !Pumpi $2.927.00 SO.OO SO.OO 03372 . £"IfIish":: $27,202.00 SO.OO 50.00 03400 I Pre<:3St Concrete walls $524.771.00 $410.338.90 50.00 03401 Precast Concrete Double Toes $126,819.00 SO.OO $0.00

APPLICATION NO.: 00005 APPLICATION DATE:

PERlODTO: 7117J2()12 ARCHITECTS PROJECT NO.: FEMA #0179

F G H I

TOTAL MAlERlAlS BALANCE ReI'AlNAGE PRESENTLY COMPlEIED % TO PF v ARlABLE) STORe'!) AND STORED FINISH

(NOT IN TOCATE (G'CC) RATE (C-G)

DORE) (D+E+F)

SO.OO 50.00 0 SO.OO SO.OO SO.OO $31.654.00 34.000 S61,446.00 SO.OO SO.OO $28.994.00 100.000 SO.OO SO.OO SO.OO $27,879.00 100.000 SO.OO SO.OO SO.OO $52.019.00 50.000 $52.019.00 SO.OO SO.OO $1,576.00 100.000 SO.OO SO.oo $Q.OO $4,182.00 75.000 51,394.00 50.00 SO.OO SO.OO 0 SO.OO SO.OO SO.OO $42,406.70 70.000 518,174.30 SO.OO SO.OO $2,230.00 100.000 SO.OO SO.oo SO.OO $1.67Z.80 60.000 51,115.20 SO.OO SO.OO 5388.00 30.000 5907.20 SO.OO SO.OO SO.OO 0 $558.00 SO.OO SO.OO SO.OO 0 $5,540.00 SO.OO SO.OO 50.00 0 $8.475.00 SO.OO SO.OO SO.OO 0 $26,271.00 50.00 SO.OO SO.OO 0 S5.018.00 SO.OO SO.OO 50.00 0 $3,490.00 50.00 SO.OO 50.00 0 50.00 50.00 SO.OO $1,338.30 30.000 $3,122.70 SO.OO SO.OO 590,109.00 100.000 SO.OO SO.OO SO.OO $4,349.00 60.000 $4,349.00 SO.OO SO.OO $2,788.00 100.000 SO.OO SO.OO SO.OO $21,5:27 .2S 25.000 $94,581.75 SO.OO $0.00 $1,740.00 100.000 SO.OO SO.OO 50.00 $1,740.00 100.000 SO.OO SO.OO $0.00 $7,718.00 100.000 SO.OO SO.OO SO.OO $0.00 a $21,065.00 SO.OO $0.00 SO.OOj a $12.461.00 SO.OO SO.OO $0.00 0 $1,994.00 SO.OO $0.00 $0.00 0 $2,927.00 SO,OO SO.OO SO.OO 0 $27.20:2.00 SO,OO SO.OO $410,338.90 78.194 SI14,432.10 50.00 SO.OO 50.00 0 $125.819.00 50.00

..

AlAOOCUMENTG7Q3· .APPUCilTlONANDCElmFICATEFORPAYMENl' • lmmmON • AlMO' Ol?'ll • TIlEAMERlCANlNSTlTUTEOFARCHlTECTS,l735Nl-:W YORK G703-1992 .. .. A Yeo1JE# N. W., W ASH!NG'TON~ D.C. 20006-Sm .. WARNING: UnUatmed pbctoeopying viWa:tes U.s. copyright laws.and wfll subject the violator to legal pros.eeut;on. ~ ... ~~PI::di-'~~ __ ~ofThe~I'l'c:IitunI>~~...vIer~97t:«'!to~~~ Repm:lUC2lofJuJlIl""~~~~io~I$_"",,",,"Hd ~n...~1~0'!~

- tQ-"'1ho:CUImnII_oI!1\<!1~aM~~~

'I') - .CONTINUATION SHEET J

AIA DOCUMENT G703 PAGE 2 OF 4 PAGES

AlA Document 0702, APPLICA nON AND CERTIfiCATE FOR PAYMENT. containing Conlnlctor's signed Cer:tification, is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Conttacts when: variable retainage for line items may apply.

A B ,..,

C D ~ F. ,

WORK COMPLETED ., ITEM

.::>,.

DESCRIPTION O~ORK SCHEDULED FROM PREViOUS NO. co VALUE ..,., AI'PllCA TION THISPliRlOD -e.

(D+E) = 03402 Precast Concrete Ho~ Core $81,867.00 $0.00 SO.OO 04050 OMsion4 $33.199.00 SO.OO SO.OO SO.OO 04100 Mortar $1,383.00 SO.OO 51,383.00 04101 SaI1d $335.00 SO.OO SO.OO 04102 RII $5,018.00 SO.OO SO.OO 04150 Mason<y Rein10rcement $1,517.00 SO.OO $1,517.00 04151 MasoOlyAccess.ories $1,115.00 SO.OO $1.115.00 04200 4"CMU $4,628.00 SO.OO 51,157.00 04201 6'" CMU $1.896.00 SO.OO $474.00 04202 8'"CMU $16,727.00 SO.OO $4,181.75 04203 Block Cleaning $580.00 SO.OO SO.OO 05050 Oivision 5 $10,594.00 SO.OO SO.OO SO.OO 05100 Mise. Steel $8,921.00 SO.OO $5,352.60 05800 Anchor Bolts $1.673.00 SO.OO $1.673.00 06050 Division IS $2,565.00 SO.OO SO.OO $0.00 06100 Rough Carperrt'Y $2.565.00 SO.OO SO.OO 07050 OMs",n 7 $90,509.00 SO.OO SO.OO SO.OO 07110 VlSqueen $1.296.00 SO.OO SO.OO 07213 Rigid Insulation 4"@ Root .. $18.958.00 SO.OO SO.OO 07500 Membrane Roofing $61,334.00 SO.OO SO.OO ()7900 Caull<ing & Sealants $6.921.00 SO.OO $(1.00 08050 OMsion 8 $8$,192.00 SO.OO SO.OO SO.OO 08110 Metal 000"" F",mes & Hdwr 535,635.00 $0.00 SO.OO 08111 Frame Jnstalrtion $1,740.00 SO.OO SO.OO 08112 Ooor lnst:lllalion $4,349.00 SO.OO SO.OO 06S00 Metal Window $23,418.00 $0.00 SO.OO 06050 OMsion 9 $8$,535.00 SO.OO SO.OO SO.OO 092S0 Gypsum Wallboard Syslems $1.115.00 SO.OO $0.00 09500 Ac;oustical Ceilings 51,784.00 SO.OO $0.00 0S501 Metal Soffit $12,366.00 $(I.()() SO.OO 09650 ResiT_ Roaring $14,403.00 SO.OO SO.OO 09S00 Sealed Concrete $17,564,00 SO.OO SO.OO moo Painting $22,303.00 SO.OO SO.OO 00990 OMsion 10 $28.237.00 SO.OO SO.OO SO.OO

----

APPLICA nON NO.: 00005 APPLICATION DATE:

PERIOD TO: 711712012 ARCHITECTS PROJECT NO.: FEMA #0179

F G H I

MATERIALS TOTAL BAlANCE R.ET AJNAGF. PRFSENTI.Y COMPLETED % TO IF V AR.IABl.E) STOR.ED ANCSTOREO F1NISH RATE (NOT IN TOCATE (G7C)

(C·G) OORE) (D+E+F)

SO.oo $0.00 a $81,867.00 SO.OO SO.OO SO.OO 0 SO.oo SO.OO SO.OO 51,383.00 100.000 SO.OO SO.OO SO.OO SO.OO a $335.00 SO,OO SO.OO SO.OO 0 $5,018.00 $0.00 SO.OO $1,517.00 100.000 SO.OO SO.OO $(1.00 $1.115.00 100.000 SO.OO SO.OO SO.OO $1.157.00 25.000 $3,471.00 SO.OO SO.OO $474.00 25.000 51,422.00 SO.OO SO.OO $4,181.75 25.000 $12,545.25 SO.OO $0.00 SO.OO 0 $58Il.OO SO.OO SO.OO SO.OO 0 SO.OO SO.OO SO.OO $5.352.60 60.000 $3.568.40 SO.OO SO.OO $1,673.00 100.000 $0.00 SO.OO SO.OO SO.OO 0 SO.OO 50.00 SO.OO SO.OO () $2.565.00 SO.OO SO.OO SO.OO 0 SO.OO SO.OO $0.00 SO.OO a $1.295.00 SO.OO, $0.00 SO.OO 0 $18,958.00 SO.OO SO.OO SO.OO a $61.334.00 SO.OO $0.00 SO.OO 0 $6.921.00 SO.OO SO.OO SO.OO a SO.OO $0.00 SO.OO SO.OO 0 535.635.00 SO.OO $0.00 $0.00 0 $1,740.00 SO.OO SO.OO SO.OO a $4,349.00 SO.OO SO.OO SO.OO a $23,418.00 SO.OO SO.OO $0.00 0 SO.OO SO.OO SO.OO SO.OO a $1,115.00 SO.OO SO.OO SO.OO () 51.784.00 SO.OO SO.OO SO.OO a $12,366.00 SO.OO SO.OO $0.00 0 $14,403.00 SO.OO SO.OO SO.OO 0 $17,584.00 SO.OO SO.OO SO.OO 0 $22.303.00 $0.00 SO.OO SO.OO 0 SO.OO SO.OO

ili.l!ii AlA OOCtJMENT G703· APPUCATION AND CERTIHCATE FOR PA YMEN'l' • 1m EDmON • AJJ\'" 01992 • TIlE AMERICAN INSTITUT£ OF ARClilTECTS. 1735 ,.'F:W YORK G703-1992 ~ AVlZ.NU£.N.W.> WA.SRINm'ON, D.C. 2Q006..sm .. WAAHlNG: Unlicensed phOtocopying YioIatt:s U.s. copyrigh:t taws and IN:in$Ubject:theYiolatortolegal~. 10 ........ :... .. ~~-t......~~wtb~P-n"-"tITTho!o~1II:i:ttIftOIJ\ref!~!.II'Ideo'u.:em..r.1OOl! .. ~$~!~ ~ctl.to':ldocu:mod~~~~"'_~ ~TheAmmt!::Mn I~Qt~

- l»"""""'tl'!oo~~'lf1NS~iIf'II:I~~_~

,...

; .CONTINUATION SHEET AIA DOCUMENT G703 PAGE 3 OF 4 PAGES

AlA Document G702, APPLlCA TfON AND CERTfFICATE FOR PAYMENT, containing Cootractors signed CertifiC3!:iOD, is attacbed. In tabulations below, amounts are stated to the nearest dollar. Use CollI!llll I on Contracts where variable retainage for line items may apply.

A B .... C D E

'" WORK COMPLErED mM OESCR.Il"l1ON OF WORK SCHEDULED FROM PREvtOus NO, VAWE

"" IIPPLICATION THlSPERlOO ~ .", (0+1»

"'" 10000 Specialties Inslallaijon 0 $7249.00 $0.00 $0.00 " "" 10150 Compartments & Cubicles $11,732.00 SO.OO SO.OO 10440 Signage S2,7ll8.oo SO.OO $0.00 10$20 Fire Extinguishers & Cabinets $892.00 SO.OO 50.00 10800 Toilet Accessories $5,576.00 SO.OO SO.OO 11050 O;';';;on 11 $7.BOZ.OO SO.OO SO.OO SO.OO 11400 FOOd Sollli"" Equipment $7.SOZ.00 SO.OO S7.SOZ.00 12050 DNision 12 515,500.00 SO.OO $0.00 SO.OO 12345 WOOdC_rk $7.694.00 SO.OO SO.OO 12480 Floor Grilles $7,806.00 SO.OO SO.OO 15050 Division 22 $91.788.00 SO.OO SO.OO SO.OO 15400 Plumbing Rough In 541.606.00 511,406.78 $8,500.00 15401 Plumbing SIad< Out $27,879.00 SO.OO SO.OO 1540Z Plumbing Trim Out $22.303.00 $0.00 SO.OO 15445 Division 33 $172,849.00 SO.OO 50.00 SO.OO 15450 Site U~llties $122.667.00 569,000.00 $26,000.00 15451 WaterWeU $50.182;00 SO.OO SO.OO 15490 Division 21 $74,116.00 SO.OO $0.00 SO.OO 15500 Fine Sprinkler Piping 541,261.00 $0.00 $0.00 15$01 Fire Sprinkler Fire Pump $33.455.00 $29,000.00 SO.OO 15700 Division 23 $334,547.00 SO.OO SO.OO SO.OO 15800 HVAC Ductwork $78,061.00 $0.00 $0.00 1ii801 HVAC Equipment $223.031.00 SO.OO SO.OO 1580Z HVAC Controls $33.455.00 $0,00 SO.OO 15900 O;';';;on 26 $265,011.00 $0.00 SO.OO SO.OO 15000 Efodrieal Below Slab $27,879.00 $4,181.85 $2,700.00 18001 Efodrieal Generator $111,515.00 $22,000.00 SO.OO 16002 E1_1 Rough In $44,606.00 $3,400.00 SO.OO 16003 Electrical Trim Out $53,138.00 SO.OO SO.OO 16004 Electrical SIte Work $21,879.00 $0.00 $5,220.00 17100 NOTE: Change O<der#1 has been SO.OO SO.oo SO.OO 17101 Incorporated into this schedule $0.00 SO.OO $0.00 17102 of values SO.OO SO.OO SO.OO

APPLlCA TION NO.: 00005 APPLICATION DATE:

PERIOD TO: 7/1712012 ARCHITECTS pR.OmCT NO.: FEMA #0179

F G H I ---------

MATERIALS TOTAl. BAlANCE RETAlNAGE PRESENTLY COMPLErED % TO [IF VARIABl.e) STORl:D ANDSTOltED fiNISH

(NOT IN TO DATE (G.;.C) RAm (C-G)

OORE) (Dl-E+F)

SO,OO 50,00 0 $7249.00 SO.OO SO.OO SO,OO 0 $11,732,00 SO.OO SO.OO SO.OO a $2.7ll8.OO $0.00 SO.OO $0.00 0 $892.00 SO.OO SO.OO so.oo 0 $5,575.00 SO.OO so.oo SO.OO a $0.00 $0.00 SO.OO $7,802.00 100.000 50.00 SO.OO SO.OO SO,OO 0 SO,OO SO.OO SO.OO SO.OO 0 $7.594.00 SO.OO SO.OO SO.OO a $7.806.00 SO.OO SO.OO SO.OO a SO.OO SO.OO SO.OO 519,908.78 47.851 $21,697.22 50.00 $0.00 SO.OO a $27,879.00 50.00 $0.00 SO.OO a $22,303.00 SO,OO SO,OO SO.OO a SO.OO $0.00 $0.00 $95.000.00 77.445 $21,667.00 SO.OO SO.OO SO,OO 0 $50,182;00 $0.00 $0.00 SO.OO 0 $0.00 SO.OO SO.OO SO.OO 0 541261.00 SO.OO SO.OO 529.000.00 86.594 $4,455.00 $0.00 SO.OO SO.OO 0 SO.OO $0.00 SO.OO SO.OO 0 $78.061.00 SO.OO $0.00 SO.OO 0 $223,031,00 SO.OO SO.OO SO.OO 0 $33,455.00 SO.OO SO.OO SO.OO 0 SO.OO SO.OO SO.OO $6,881.85 24.685 $20,997.15 SO.OO $0,00 $22,000.00 19.728 $89.515,00 SO.OO $0.00 $3,400.00 7.622 $41,206.00 $0.00 SO.OO $0.00 0 $53.138.00 SO.OO $0,00 $5,220.00 18.724 $22.559.00 SO.OO SO.OO SO.OO 0 SO.OO SO.OO $0.00 $0.00 0 SO.OO SO.OO SO.OO SO.OO a $0.00 SO.OO

III AlA DOCUMENT G7'03- APPUCA-no(lol AND CERTmCATE FOR PA YMl::."NT • 1m mmON .. AlA®''' cum .. THE AMllRICAN tNSITI1..ITE Of ARCHITECTS. I13S NEW YORK G703-1992 .. .. AV£N'tJ'E..N,W,. WA.~INCTON. D,C. 200()6..S1:92 " WARNlNG; Un1icemsed photocopying 'VioJates. U.s. <»pyright laws and will subjed:the 'IriofatDr1Q. Legal P~OI'1. -;. ..... ~ '"Thi$~f't#<:I;~~~_II'III~ol''I''tIoAmm'k:;;lnIIl3lllufl!~~~\.JQItII::io!:97000\I.I~~lnC. ~oI""'~~PiQj4<:lomtQrk:~~IlO1~1IIed ~The~lo1nIlI\MrtJ_ - '\I) __ ~~~oIlIli5 ____ ~-

C? .cONTINUATION SHEET AIA DOCUMENT G703 PAGE 4 OF 4 PAGES

) AlA Document 0102, APPLICATION AND CERTIFICATE FOR PA ¥MENT, cOmainfng Contl:actOl:'s signed Certification, is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column I on Contracts where variable retainage for Ijne items may apply.

A B "" C D ...., R F

APPLICA TlON NO.; 00005 APPLICATION DATE:

PERIOD TO: 7/1112012 ARCHITECTS PROJECT NO.: FEMA #0179

G H I

MA:r£lUALS roTA!. WORK COMPLETED BA.lJ>.NCE RETAINAGE .,. PRESEN1LY COMPLETED ITEM DESCRlI'nON OF WORKE" SCHEDULED FROM PREVlOUS % 10 f1F V ARlABLE)

NO. STORED AND STORED FINISH

'" VALUE AFPUCATlON TIllS PERIOD (Nor IN TO DATE (G~q RATE

'" (e,G) - (D+E) "" DORE) (D+E+F)

17200 ! Chan<le Order #002 Q

($6.300.00) SO.OO ($6,:)0<),00) $0.00 ($6.300.00) 100,000 SO.OO SO.OO " $2,575,629.00 $771.681,44 $102,735.29 SO.OO $874.416.73 33.95% , $1,701,212.27 SO.OO

1\ AlA OoctlMaIT (;703- AP!'UCATION AND CERTIFICATE FOR PA ""'F.NT -!m EDmON - AlA~ - elm - TIlEAMF,RrCA}/ rNsmur:E Of ARCIiI1ECTS. 113, l/'EW YORK G703-1992 ':<; • AVENUE. N.W .• W~'(jTON.D.C. 20006-5292 .. WARNING: ljnJie9n$ed photocopying violates u.s. copyright Jaws and will $utUecttheW>latorto legal prosecution . .... w;o. .. ~~ha_~~-tI'I~~o1~~~<>I~vl1do:!rl.i_91oo:.1'!>~~1nC.. ~ottt%S~~~~~bJ'l'O\Pft'ITIIIl'toI1. ~~~!=Ibdt:""~ - I&.....m.o,._~oth~....,,~~·

Corporation • Oeneral Contractors P.O. Box '1678 NaNII.burg, Mlabil,jll30404

• A Hanbenry & Hudson Company Pltone 601·583.6500

Fax 601.513·6103

July 17, 2012

Pearl River County - Board of Supervisors Attn: Mr. J. Patrlck Lee P. O. Box 569 Poplarville, MS 39470

Re: Rain 1 Inclement Weather Days Poplarville Community Safe Room (FEMA #0179)

Mr. Lee:

Book 015B Pa9" 576

As a matter of record, we were delayed due to wet 1 muddy 1 inclement conditions on the above referenced project from the period of June 11, 2012 to July 16, 2012 on the following dates:

06/11/12 07/08/12 07/13/12

07/03/12 07/09/12 07/14112

07/06/12 07/10/12 07/15/12

The Poplarville site was delayed (9) days during this pay period due to excessive rainfall at the jobslte. There are typically (7) precipitation days on average for the month of June. We are requesting a (2) day extension to this contract for the Poplarville site.

Steven W. Bridges Estimator 1 Project Manager

c:eIf)

~(F-l

,-t-- .-

-\"0_--- .~~:;,;~~

.. -, i , ...

~"""""----""----r-"--"""----"""-----------------------r--~' 17~1~~ ..<>eN _ _ SeIe:t F,lll'BuIlding,?ad

'" ~(Ji(rR~ .~UJG~n

_F~~ _ PlmP~&W3brtfTri

p......"UIG _ ifMh)

~·_UlG""'''''(F_l __ I

_ PrecntWIlI P:anoIs & Oou:lte TctS

I CUU~W"(1stCoulw~ I Pow Wet;t Sl::tIb 011 GBc»

........... """". CoIomiO J &.II tW Ftwnuin ~

• CULlI3fodt WaIb(ToMen.) . ...". ......... -• ttIeir:%. HoIcw C<d SIOb5 .•• PiUMCi::'To~jin~l"SLab

_ CMJ BIQct YhIb (TO' Roo/J _ Pmr~StatIs

I $et~~Unib • Sot_ ............. ~ ......... " ... _ ... "'.''''' .... _'' --• Root HoIik>w eor.

I Roet HoIcw Cote Topplog Sbb ''''R\>d 10,'''' •• ''0 _. ..

_ RooIT_ .... _ MM. 8.ib.rrninous Roof &~

.. --------------~--------------------~:::::::::::::::::::.::~~~.~ '"NO ."' __ ' 4 21..Jan.13.~

"'it"~"~'i

-(<l __ .1n<.

rJ) r- -If)

0> r-

~' I-,E""_::: .. := ... "'._.~~I . -.J..:. -X-

I·· ) .... ~-. _._ ..

.~~JUj:i2 ._.l.!:'~_~~.~_(f~t .&! -

: Pr.castWaD Pat.b & I

~.1~:;t;;~~J -";0 .... -·.*f~ . l=-tfM~~ii&~' I .,]~~~ ~:.l~1[~~bi(fo~~f~:J~.~··_ . i~~~-~!!.- __ .. -'-. __ 4: 13-"!!2: ~~H~~.~.~_ '. t ._, . ~ •. ~~I!H2 , Pour Me:2Z. T epping Slab . .

~.~-~~_&.~~.- ..... ~--. I . f~'.!''!!!!:'-~-~·- .... _.;. ...... !1~

.~-.--- o..r.--I..--':'_ •• ,-'>.. ! 2107..sep.l

-.":.'" -~~n~~-· I-'~~'::

t.,. 3OiO :; __ .;- __

- , ; -..u ......... , ... ~ROOii. 'AitSiiini"i"TFi"nbh~a~" .,' ",

~·~l·~~

1.."'" : .. 7:'" ~,~

-: :.;::=!I~: M-.'."- ~

~_. ___ ,_ .... ". ..... _._ .. ~~1~::'_~ _".tCIe8rSit~tCI.!!. ____ ... _._ .. : ..... _.~I~~ .. i~l-:: --l~.~~~,ad," ..... --.. ; .. _!·~_~ ..... _V~() .. MaY-~ _ ,~~~~ ... ). .. ___ tOl~~~-::...li .-+.--icoI'-"G~~_i ___ ..!.~~=---+ -.. ! Footings (Partial) ,10: 31-Mayo.... : J.~--f.Y?-JI&~.T~~~ .. ~·~!--·-~: ...... ~~.1~.~E~11. "~~biGl :FOOiIiiQs(1

El~

- "'""'----

\':~}. ..~~~~~!2._i~~.~~,~. (FrI1&h) 101 11-JuJ.12 t24-Ju1..12 ... . .. ··:.-... T;';~~;:f·! ~--:-'

.

.. ~ --

1

I

I

_~ F"""'(F-:' Piociit __ &OoUoIeT.., I CMUBkdWab(1stCourM) I Pew VIa S!IIb on Grade: I lnsbI Fire Pump & Column • Set tiM Frames. kI Maaonfy "il CMl)"BIOC:t W3Rii (To"Mea,) . • MEf' MMonry Rough-In

I Ma:z. HoIow' ear. Slabs I Pew U!rzL Topping S!IIb _ CMU EIIock. Wd!I {To ~

1IIIiII' POur RmiAining"S1iJ.b5 • Sat Mcz. Mec:banicaI Units.

I Sot """"""" M6chanical Rough-In

_ f'kImmgAough-1n . . ...••. 00.·. "EIOdiiCiJ R~1n

• RtIof HoIow" Core • Roar HoIaw ear. Topping Slab _ Rigid InauIWon C: Root

_ Roof Topping S1sb

foO _ __ 1

'iIiiaiiI Moi:L BituTrinOus" ROOf & FIashIDg

,~ ____________ J. ________________________ ~=====================:·====~Fo:~:·:~~&~ 05-Feb-13. CanieI1l ..Claar~

I UJG RoI.agh-Jn (P3rtIa/) _ .. ~ ....... Pad

:.. ~"'.~;:::~~"(F-) _ EIedrIc:aI UIG Rough-In (Fni5h) _ FootInrp(FIndh)

P~2of3

_ PnK:;;qfWaKPaneb

I CUU BIodcWab(1I11:CcunI&} . i" 'POUr We:Sr S!8b on GitIde: .

I lnstaI Fn P'Ia'np & CoUnn I Ser: tiM FIOImCI'S in Ibsonry

• CMU 9Ioc:k. Walls

[I"ASK filter. ByWBS.

(e) Pnrna--. Syst.m.1nc..

III

i f .. I

-

DUNGAN

Englneerlng, PA

July 24. 2012


Re: Carriere Community Safe Room FEMA Project NO.1604 -#0180 Pay Application No.5 Pearl River County, MS

Dear Mr. Lee:

925 Goodyear Boulevard Picayune, Mississippi 39466

Phone 1601) 799·1037 Fax (601) 799"()480

www.dunganeng.com

Book 0156 P~9~ SBO

Enclosed please find Pay Application No. 5 from Hanco Corporation and approved by Basco Associates. PC for work completed through July 17. 2012 on the above referenced project Basco Associates recommends payment be made to Hanco Corporation in the amount of $57,449.68 as indicated on the attached payment application. This amount reflects the total work completed to date.


Sincerely,

Stephen L. Sowell, P. E. Resident Project Representative

SLSldg

Enclosure(s)

l\de·fil •• · .... dskproj\1715C367IDocum.n\slFin.nci.I\Contr.clor t"voi~\P.Le. - Pay Request NO.5


_ APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT 0702 PAGE ONE OF PAGES

iJ TO OWNER; Pearl River County - Board of Sup. PROJECT: FEMA #0180, Carriere Comm. Safe APPUCATION NO: 00005 DistnDution to: ) P. O. Box 569

Poplarville, MS 39470 PERlODTO: 7/1712012

PROJECT NOS.: FEMA#Ol80

DoWl'i'"ER o

FROM CONTRACroR: Hanco Corporation P. O. Box 17678

VIA ARCHITECr: BASCO Associates, P.C. o o

ARCHITECT

CONTRACTOR

Hattiesburg, MS 39404f1'!678

CONTRACT FOR: C.O~~viW ij! ~

CONTRACTOR'S APPLICATIQN FOR PAYMENT Application is made for payment, as shown below, in Oiinnection wi!h !he contract.

c Continuation Sheet, AlA Document G103, isanachctf"

The RllsseU E. Horn B'liJding York,PA 17401 .-.~ . CONTRACT DATE:

Ul'l1~Vlu..g:t·:N\EL ." - '$nftirL--N~::".

o

The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief the W orIc covered by this application for Payment bas been completed

Contractor for Work wh' b previous' for Payment were issue(!, and p in accordance with the Docwn~~ amounts beve been paid by the

ments received ryrnr .. an. ~ t payment shown herein it: now . $2.799,000.00 CONTRACTOR: ancoCon

......... ".................................. ($89.678.00) B ~._

1, ORIGINAl. CONTRACT SUM ................................................... ..

2. Netehange by Change Orders

3. CONTRACT SUM 10 OAT!: (Unc I :!:2) .................................. $2,709.322.00

'" TOTAL COMPl.ETED & STORED TO OAT!: ......................... $924,065.60 (Column G OR (103)

5. RETAlNAG'E:

a. 10.OOO%ofCO<1lpI_ Work (Columns 0+ EOn 0703)

b . .!2,...OOO %ofStorod Matmal (Columns f on 0703)

S92.406.56

$0.00

y: V~ -'tf' } )

State of: AS County of: Fcr<.t.-.;-ISubscribed and sworn to before

mothis 1'11!:1 day of O~ J;lOI~

Notary Public: ~~ d:f\i.k. My Commission expires: ~\ at,.:Io1+

Total~(Uu.5.+5boc

To<aJ in Columns I OR G7(3) ...................................... _...... $92.406.56 ARCHITECTS CERTIFICATE FOR PAYMENT

6.lOTAL EARNED LESS RETAINAGE.......................................... $831 659 04 In accordance with the Contract Docwnents, based on on-site obsetvatioos and the da!a (Line4 I"", Line S Total) comprising this application, the Architect certifies to the Owner thal to the best of the

7. LESS PREVIOUS CER11ACATl:S FOR PAYMENT Architect's knowledge, information and belief the Work bas progressed as indicated, the (Line 6 Ji:om prior Certifi_) .......................... "......................... $774 2Q9.16 quality of the WoO<: is in accordance with the Contract Docwnents, and the Contractor

8. CURRENT PAYMENT DUE ............................ " ........................... 1 $57,449.681 is entitled to payment of the AMOUNT CERTIFIED.

9. BALANCE TO FINISH, lNCWOING RETAlN.AGE

(Line 3 1= Lin. 6) $ I ,877,662,96

AMOUNT CERTlFIEO __ ... ___ ....................... ____ .__ $57,449.68

(AttJJcn uplanation if amoun.( cerlij'red differs from tire amoont applied for. Initial all figwes on this Application and on tire ContilrULltiOn Sheet thol are changed to co'ljorm to lire amount certified)

~talchGF.ORDERS~Y ADDI'I10NS DEDUCTIONS ARCHITEc:r.: : .. f'#,·1:.':n.AI,"fNN~ A Ih . . .. 7/2() /tz._-i 0 aogcs approvt;;U m B _ =.J..v..vvr ~~_~~ Dal:~ meviousmonlhsbvOwncr $0.00 $89,678.00 Y'.. '(2.A~ 1ii~M.~h ?oZ;. .. ... --. ---ITo'.' this Month $0.00 $0.00 This CertiKcate is not i1{gOlliul'Te:"Tiie AMOUNT CERTIFIED is payable only to the

TOTALS. $0.00 $89678.00 Contractor named berein. Issuance, payment and acceptance of payment are without iNET CHA"Gf's by Chan!!. Cirdc< I ($89,6Is.()O) prejudice to any riJZ.hts of the Owner or Contractor under this Contract.

•

= AlA DoctJMEN1'G702· APP1.lCATlON AND CERTlFICATE FOR PAYMENT' 1m ElJITION • AlA"" "'992 • TIffi AMERICAN INSTITUTE OF ARCHITECTS. ms NEW YORK G702-1992 "" .. AVl::."NUE..N,W .• WASJ:{[NQ'TON. D,C. 20006-5292 .. WARNING! Un~ ptlotocopyingviol.a::tes us. CbJ1,fright lavtts and wid $ubject.the vio1atorto legal prose:eutlon. _. ;.., -rhII~_~~~~'ll'ldhh'~oITht~lm:tlIuln .. l~_~S_7OO:I\<I~s.~1JIe. ~1IQ1thbOOOJrnOl'l't~~~~"o;Mf~ ~"I'I'IoeAmt1'b!ljn:a.det)fNdl~

- 16-.1y_a.omtoIll~~e!I:J;~;Md~~·

~ ··CONTINUATION SHEET AlA DOCUMENT G703 PAGE I OF4PAGES

') AlA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing Conlractor's signed Certification, is anaclled. In tabula!:ions below, amowlts are sfated to the nearest dollar. Use Column I on Contracts where variable tetainage for line items may apply.

A B ~ C D E

'" WORK COMP{,E'rm

." ITEM DESCRIPTION OF WORK • .on SCHEDULED FROM PREVIOUS ~

NO, "'- VALUE "" APP'LlCA nON THlSPERIOD ~ .=. (D+E)

"" 00999 Division 1 $296.9:3.5.00 " $0.00 $0.00 $0.00 '" ~ 01000 TalreS $97,965.00 $31,103,89 $2.302.18 01001 Bonds $30.231.00 $30.231,00 $0.00 01002 Insu,?nce $29.112.00 $29.112.00 $0,00 01SOO Site Fac:ilities $104.998,00 $41,999,20 $10.499.80 01501 Testing Laboratory $1,039.00 $0,00 $0.00 01502 Layout I Engineering 99,598,00 $2.799,00 $0,00 01600 Electrical Below Sial> $27.992.00 $0,00 $0,00 02010 DiVision 31 $117,847.00 SO,OO $0,00 $0.00 020S0 Demolition 99.115,00 99,115,00 $0,00 02200 Earthworlt $60,1&4.00 $4.5,123.00 $0.00 02201 Silt Fence $2,329.00 $2.329.00 $0.00 02240 Concrete Foundation ExcJBackfill $3.359,00 51.007.70 $0,00 02250 Termile Control Sl.283,00 $192,45 $0.00 02400 Aspllalt Patching $8,398,00 $0.00 $0,00 02401 Striping 51,680,00 $0.00 $0,00 02SOO Storm Drainage $21,274,00 $0.00 $21.274,00 02600 Sidewalk I.3b<lr 99,770.00 $0.00 $0,00 02601 Curb Labor $2,167,00 $0,00 $0.00 02600 Grassing $4.143.00 $0.00 $0.00 02801 Fine Grading $2,165,00 $0.00 $0,00 03050 DiVision 3 $1,031.482.00 $0.00 $0,00 $0,00 03100 Concrete FOImWQrl< $4.479.00 $0.00 $0,00 03200 Concrete Reinforoement $32,471,00 $32,471,00 $0,00

=1 Rod Busting $10,749,00 51,612.35 $0,00 03202 Stands & A<:Gessories $2.799,00 $0.00 $0.00 03300 Concrete Material $60,7$9,00 $9,119,$8 SO.OO 03310 . Post Footing I.3b<lr $1,601.00 $0.00 $0,00 03311 Spot Footing Labor $2,475.00 51,237,50 $0.00 03312 Continuous Footing labor $9,298.00 $4,IS4a,oo SO,oo

=0 Slab on Grade Labor $24,633.00 $0,00 SO.oo

= Topping Sial> Labor 59,517,00 SO,OO $0,00 03370 Elevated Beam Labor $2.002.00 $0,00 $0.00 03371 Pumping $3,057.00 $0,00 $0,00

APPLICATION NO.: 00005 APPLICA TION DATE:

PERIOD TO: 7/1712012 ARClllTEITS PROJECT NO.: FEMA #0 180

F G H I

MATERIALS TOTAl. BALANCE f~~ PRESENTLY COMP1.ETED % TO [f VARIABLe)

STORED ANOSTORED FlNlSH (NOT IN TODATE (<r.C) RATE

(C-G) DORE) (D+Il"'~)

$0,00 $0.00 a $0.00 $0,00 $0,00 $33.406.07 34.100 $64.558,$3 $0.00 $O.Oc) $33,231,00 100.000 $0.00 $0.00 $0.00 $29.112.00 100.000 S(lOO $0.00 $0.00 $52,499.00 50,000 $52.499,00 $0.00

$0.00 $0,00 0 $1,039.00 $0,00 $0.00 $2.799.00 50.000 $2.799.00 $0,00 SO,OO $0.00 a $27,992,00 $0,00 $0,00 $0,00 a $0.00 $0.00 $0.00 99.115.00 100.000 $0,00 $0,00 $0,00 $45,123.00 75.000 $15.041,00 $0.00 $0.00 $2.329,00 100.000 $0,00 $0.00 $0,00 $1,007,70 30.000 $2.:3.51.30 $0.00 $0.00 $192.45 15,000 $1,090.55 $0.00 $0,00 $0,00 ° $8.398,00 $0.00 $0.00 $0.00 ° $1.660.00 $0.00 $0.00 $21,274,00 100,000 $0,00 $0.00

$0.00 SO,OO a $5,770.00 $0,00 $0,00 $0.00 0 $2,167,00 SO.OO $0,00 $0,00 a $4.143,00 $0.00 $0.00 $0.00 ° S2, 165,00 $0.00, $0.00 $0.00 ° $0.00 $0001 SO.OO $0.00 0 $4,479.00 $0,00

$0.00 m,471.0a 100.000 SO.OO 50.00 $0,00 $1.612.35 15.000 $9,136.65 $0.00 $0,00 $0,00 0 $2.799,00 $0.00 $0.00 59,119.85 15.000 991,679.15 SO.OO SO,OO $0.00 ° $1,601.00 $0.00 $0,00 Sl,237.50 50.000 51,237,50 $0.00 SO,OO $4.1S4a.00 50.000 $4,648.00 $0,00

$0.00 SO.OO a $24.633,00 $0,00

$0.00 $0.00 0 $9.517,00 $0.00 $0.00 $0.00 0 $2.002.00 $0.00

$0.00 $0,00 ° $3,057,00 $0.00

_ A1AOOCUMEHTG703-Al'PLlCATIONANDCER11FlCATEFOItPAYMENT - I992EOITlON - AlA<IIl' 01991' nlEAMERlCAN n<srnvrF. Or ARC!IITECfS, 1735 NEW YORK G703-1992 ~ AVENlJE. N.W.~ WASHiNCiTON.D,C. 200Q6..$292 • WARNJNG: Uokensod phOtOcopyingviol.a:tes lJ_S_ coP)'rigbttaws and will subjecttneviclatorto legal prosecution. '!.,;. ..... .:- ~~M3.bftII~~~tm~otThstM~~of~~~1I1OCO.1O~S~lnoe. ~tJftf!b~I~PO. ::IspIQf("'~enot~ ~Tl1c~~tofAt!:lllted;s. - tD~lfIer.:r.m'lltll"II.'!t!IIODoIM~ __ 1Iitm\4·

I) D 'CONTINUATION SHEET AlA DOCUMENT G703 :1 PAGE 2 Of 4 PAGES

AlA OQcument G702, APPUCA TlON AND CERTIFICA TE FOR PAYMENT. contl>ining Contractor's signed Certification. is attached. ll:t tabulations below. amoWlts are stated to the nearest dollar. Use Column I on Coo:traets where variable retainage for line items may apply.

A B M C D E

'" WORK COMPL£TEl) ." ITEM DESCRlP'I10N OF WORK Ii!' SCHEDUl.EO fROM PREVIOUS

NO. "- VAWI:: co APPUCATION TIllS PE.RlOD

'" - (D+E) = "" 03372 Finishing '" $16.814,00 $0,00 $0,00 '" 03400 Precast Concrete Walls '" $641,212,00 $502,245,11 $0,00

03401 Precast Concrete Double Tees $127.362.00 $0,00 SO.OO 03402 Pre<:as! Conaete Hollow Co", $82.216,00 SO,OO SO.OO 040$0 Division 4 $30.70200 $0,00 SO,oo $0.00 04100 Mortar SI.:254,oo $0.00 $0.00 04101 Sand $236,00 $0.00 $0.00 04102 FoIl $5,OOS.oo $0.00 $0.00 041SO Mason!), Reinforcement 51.388.00 $0.00 $0.00 04151 Masonry Accessories $1.120,00 $0.00 50.00 04200 4"CMlJ 53.247,00 $0.00 50.00 04201 O"CMU $3..247,00 SO,OO 50.00 04Z02 O"CMU $14,$56,00 $0,00 $0,00 04203 Block Cleaning $515,00 $0,00 SO.OO 05050 Division 5 518,475,00 $0,00 $0,00 $0.00 05100 Mise. Steel $16.795,00 $0,00 510.m.00 05800 Anchor Bolts $1.680,00 $0.00 $1.680.00 06050 Division 6 $2,575,00 $0,00 $0.00 $0.00 06100 Rough Carpen!Jy $'2.$75,00 $0.00 $0.00 07060 Division 7 $89.740.00 $0,00 $0.00 $0.00 07110 Visqueen $1.284.00 $0.00 $0.00 07213 Rigid Insulation 4' @ Roof $19.0$5.00 $0.00 $0.00 07500 Membrane Roofing $61,583.00 SO.OO $0,00 07900 Caull<ing & Sealants 57.838.00, $0.00 SO,OO oaoao Division 8 $60.979.00 $0,00, $0.00 $0,00 08110 Metal DooIs. Frames & Hdwr $35,830.00 i SO,OO $0,00 08111 Frame Instanation 51.747,00 S(),OO SO,OO 08112 Door Installation 84.357,00 $0,00 5(tOO 06$00 Metal WindOW' $19,0$5.00 $0,00 $0.00 09050 Division 9 567.22$.00 SO.OO $0,00 $0.00 09250 Gypsum Wallboao:! S'ystems $1,120.00 SO,OO $0,00 09501 Metal Soffit $14,271,00 $0.00 $0.00 09660 Resa~nt Flooring 513,951,00 $0,00 $0.00 09800 Sealed Concrete $15.493,001 $0.00 $0.00

_ ...

APPLICATION NO.: 00005 APPLlCATION DATE:

PERIOD TO: 7/17/2012 ARCfflTECT'S PROJECT NO.: FEMA #0 180

F 0 II I

MA~ TOTiIL OALAN'CE RETAlNAOE PRESEN'lLY COMPl.E.11lD % TO (IF VARIABLE) STORED AND STORED FINISH

(NOTlN TO DATE (O,:-C) RATE (C -0)

o ORE) (D+E+l')

$0,00 SO.OO 0 $16.814.00 $0.00 $0,00 $502.245.11 78.3;17 $138.966.89 $0,00 SO.OO $0.00 0 S127.382.OO $0,00 $0.00 $0.00 0 $82,216,00 $0,00 $0.00 $0.00 0 $0,00 $0,00 $0.00 $0.00 0 $1,250\,00 $0,00 $0.00 $0.00 0 $236,00 $0,00 SO.OO $0,00 0 $5,03$,00 SO,OO $0.00 $0.00 (} 51.388,00 $0,00 $0,00 $0.00 0 51.120,00 $0,00 $0,00 $0.00 0 $3,247,00 $0,00 $0,00 $0,00 0 $3.,247,00 $0,00 $0,00 $0,00 0 $14.$56,00 $0.00 $0,00 SO,(}O 0 $515,00 $0,00 $0.00 50.00 0 $0.00 $0,00 SO.OO SI0.m.00 60.000 $6.718,00 $0,00 $0.00 51.680.00 100.000 $0.00 $0,00 $0,00 $0.00 0 $0,00 $0,00 $0.00 SO.OO 0 $2,575,00 $0,00 $0.00 SO.oo 0 $0,00 $0,00 $0.00 SO.OO 0 $1.284,00 $0,00 $0.00 SO,OO a $19.035.00 $0.00: SO.OO SO,OO 0 $61.583.00 $0.00' $0.00 so,oo a $7.838.00 $0.00 $0.00 $0,00 0 $0.00 $0.00 $0.00 $0,00 0 $35.830.00 $0.00 SO.OO SO,OO 0, 51.747.00 $0,00 $0.00 $0,00, 0 $4,357,00 SO.OO $0.00 $0,00 0 519.0$5,00 $0.00 $0.00 $0,00 0 SO.OO SO.OO $0,00 $0,00 0 51,120.00 SO.OO $0.00 $0,00 0 $14.271.00 SO.OO $0,00 $0,00 0 513,951,00 $0.00 SO,OO $0,00 0 $15,493.00 $0,00

&I AIA="'ENTG103- APPLlCATlON ANDCI'lm>lCi1.lEFQR PAYMENT • 1!l92 EDmON - NA®' 01992 • THEAMERlCAN lNS'ITr1JI'EOF ARCHITECts. 173H''SW YORK G703-1992 .. .. AVENUE.. N.W .• W ASHINV"TON, D.C. 2O('l(I6..S2:92 • WARNlHG~ Unlicensed photocopying violates U.s. eopyl1ght law:$ and will subject the Ylolator to legal prosecution. ~.. ...: "'fII;:J~lIa$tIcC'I't~~~ltoi!r~ .. "I'lloo&~ _ .... r~tloI'Itd9r~9JtlO:liIO~:s~ Inc.. FI~«IOI'lm.~MlI'oo..dptO~IIc~Ion/il.l\ClpwI'I'I'lIn«4, ~'T'M~lfts&IotWtolAlU'l«ds - 1O~fl>cQl __ ofmill~IIIId~~·

b'CONTINUATION SHEET AlA DOCUMENT G703 PAve 3 OF 4 PAGES ')

AlA Document 0102. APPLICATION AND CERTlFICA TE FOR PAYMENT, containing Contractor's signed Certification, is attached. In tabulations belGw, am<>Wlts are stated tG the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply.

A B ~ C D

'" E

WORK COMPLETED ~ ITEM DESCRIPTION OF WORK E SCHEDULED FROM PREVIOUS

NO. co VALUE APPIJCATIQN 'rHlS PERIOD ~ Co (0+ E)

, 09900 -:5 Painting 0 $22.394.00 $0.00 $0.00

'" 100$0 DNision 10 $28,303.00 SO.OO $0.00 $0.00 10100 Spedalties Installation 57,278.00 $0.00 $0.00 10150 Compartmeots 8. Cublicles S11.736.oo $0.00 $0.00 1~ Signage $2,795.00 $0.00 SO.OO 10520 F;", ElcIi"guis~rs 8. cabinets $896.00 $0.00 $0.00 10800 Toilet Al:c:esso<ies SS.598.00 SO.OO $0.00

t11050 DNisian 11 57.838.00 $0.00 $0.00 SO.OO 11400 Food SeM'" Equipment 57.838.00 SO.OO $0.00 12050 Division 12 $16,354.00 SO.OO $0.00 $0.00 12345 Wood~ 57.397.00 SO.OO $0.00 12480 Floor Grilles $8.957.00 $0.00 $0.00 15050 Division 22 $91.173.00 SO.OO $0.00 SO.OO 15400 Plumbing Rough In 540.787.00 $9,486.57 $0.00 19401 Plumbing Stack Out $27.992.00 SO.OO SO.OO 15402 Plumbing Trim Out $22,394.00 $0.00 SO.OO 15440 Division 33 $207,142.00 $0.00 $0.00 SO.OO 19450 Site Utilities $156.756.00 $56,000.00 $18.000.00 15451 Water Wen $50,386.00 SO.OO SO.OO 15460 Division 21 575.019.00 SO.OO SO.OO so.oo 15500 Fire Sprinkler Piping $41.428.00 $0.00 SO.OO 15601 Fire Sprinkler Fire Pump $33,591.00 $29,000.00 $0.00 15700 Division 23 $335.906.00 SO.OO SO.OO SO.OO 15800 HVACDudwotk 578.378.00 SO.OO SO.OO 15801 HVAC Equipment $223,937.00 $0.00 $0.00 15802 HVAC Controls $33.591.00 SO.OO SO.OO 16000 Division 26 $237,971.00 SO.OO SO.OO SO.OO 16001 Electrical Generator $111,866,00 $22,000.00 SO.OO 16002 Electrical Rough In $44,787.00 $3,400,00 SO.OO 16003 Electrical Trim Out $53,224.00 SO.OO $0.00 16004 E1edrical Site Won.. $27.992.00 SO.OO $0.00 17100 NOTE: Change Orde, #1 has been SO.OO SO.OO SO.OO 17101 Incorporated into this schedu.1e $0.00 SO.OO $0.00 11\02 0I.3IuO$. $0.00 50.00 $0.00

APPLICATlONNO.: 00005 APPLICATION DATE:

PERIOD TO: 711712012 ARCHITECT'S PROJECT NO.: FEMA #0180

F G H I

MAT~1UiI.LS TOTAL BAlANCE RETAINAGE PRESENlLY COMPLETED % TO f:n'VARIABLb) STORED AND STORED WISH

(NOTlN TO DATE (G+C) RATE (C-G)

DORIO). (O+E+F)

$0.00 SO.OO 0 $22.394.00 $0.00 SO.OO $0.00 0 $0.00 $0.00 $0.00 $0.00 0 $7,278.00 $0.00 $0.00 $0.00 a $11,736.00 SO.OO 50.00 50.00 0 $2,795.00 $0.00 $0.00 $0.00 0 $895.00 $0.00 $0.00 SO.OO 0 $5.598.00 $0.00 $0.00 $0.00 0 $0.00 $0.00 $0.00 SO.OO a S7,838.00 $0.00 $0.00 $0.00 0 SO.OO SO.OO $0.00 $0.00 0 57,397.00 $0.00 $0.00 $0.00 0 $8.957.00 $0.00 $0.00 $0.00 0 SO.OO SO.OO SO.OO $9,486.57 23.259 $31.:lOO.43 SO.OO SO.OO $0.00 0 $27,99:2.00 SO.OO SO.oo SO.OO 0 =,394.00 SO.OO $0.00 SO.OO 0 SO.OO $0.00 SO.OO $74,000.00 47.207 $82,756.00 SO.OO $0.00 $0.00 0 $60.386.00 $0.00 SO.OO $0.00 0 $0.00 $0.00 $0.00 $0.00 0 $41.428.00 SO.OO $0.00 529,000.00 86.333 $4.591.00 SO.OO SO.OO SO.oo 0 so.oo SO.OO 50.00 SO.OO 0 $78,378.00 SO.OO SO.OO $0.00 0 $223,937.00 SO.OO SO.OO $0.00 0 $33,591.00 $0.00 $0.00 $0.00 0 SO.OO SO.OO SO.OO $22.000,00 19.648 $89,968.00 $0.00 SO.OO $3.400.00 7.591 541,387,00 SO.OO $0.00 SO.OO 0 $53,224.00 $0.00 $0.00 SO.OO 0 $27,992.00 SO.OO SO.OO SO.OO 0 SO.OO $0.00 SO,OO SO.OO a $0.00 $0.00

SO.OO SO.OO a SO.OO so.oo ~ ~DOCUMENTG703"APPUCAT10NANDCERTmCATEFORPI\YMENT .. 1992EDmON" AlA.<£I .. 01992 "l1JF..AMERICJ\,"IlNSTlTUTEOFARCHITECTS,I73SNHWYORK G103-1992 ~ AVENUE.N.W ... WASHrNG"rON, D.C. 20006-5292 A WAAMNG: Unlicensed photoeopylttgviolates U.s. copyright laws and"Mllsubjed:t:hcvlotatorlofegaJ pro:seeution. "..,,,.,; .... 111 '1"II<l~PlEftbftn~~~lM~Of1'he~!~otAItM!l'd::r...no:I"'~\..1CIcroeWtloJto~~.lN:. ~(I!_~wAtIouIpmiecI.:specdIC~i$,,*,,~ ConuaThot-.....~_(>f~

- !Q<-""'!l'>ecum:nt~Q/!Ns~.wrod~~~

j ·.CONTINUATION SHEET AlA DOCUMENT G703 PAGE 4 OF' PAGES )

AlA Document G702, APPLICATION AND CERTIFICATE FOR PAYMENT, containing C()lItractor's signed Certification, is attached. In tabulations below, amOlllllS are stated to the nearest dollar. Use Column r on ConlraCtS where variable retamage for line items lDl!Y apply.

A B U> C D ,,., E

WORK COMl'LETED

ITEM •.

DESCRlPTlON OF WORK "" SCHEDULEO FROM PREVIOUS NO.

.;:. VALUE ." APPLICATION THlS PliRiOD

co - (l)+ E) "" 17200 Change OIde, 11002 "l5 ($6,348.00) SO.OO SO.OO "

$2,709,322.00 $860,232.62 $63,832.98


PERIOD TO: 711712012 ARCHITEcrs PROJECT NO.: FEMA #OJ80

F 0 H I

MATERIALS TOTAL BIlLA.NCE PRESliN1LY COMPU,rED RErAlNAGE

% TO IF v ARlA8LE) STORED AND STORED FTNlSH (NOT IN TO DATE (OH., RATE

(C-G) DORe) (D+E+F)

SO.OO $0.00 0 ($6,348.00) so.ool I

SO.OO $624,065.60 34.11% $1,7$5,256.40 SO.OOI

l6l!iIi AlA DOCUMENT' Gi7Ol .. APPUCATION ANJ)CERTIFtCATE .FOR f*A ¥MEN" .. 1992 EI)tTtON .. AlA®" 01992 .. ntH AMERICAN INSTI'f1.J'tF, Ott ARCI"II1'F.crs, I13S NEW YORK G703-1992 ~~ AVENUE. N.W., WASJnNGTON. D.C 20006-5292 • WARNlNG; UolieenHd photoc.opying~ u.s.. copyrig.ht laws and will SlIbj&Ct the v;olator to legal p~. ~ ......... ~ "1'l'\G~rltinlnll"!~~..Il:h!l'lOl~ctTlle~ll'\lIIj, ..... or~~~\I'1'(Io03U)~~lrIC. ~..aioI'I!){!l'II$~....tI'tout~~ ... ~<Srootpill'111otl..:l CMIio!::I'l'MArne ...... ni"""ituI"ot~

- towrih_CImJIIi"!I'_4I'1hi:c$~iII\IIJ~~.-

Corporation • General Contractors P.O. lox 17678 HaHI •• burt, MI .. lmppl 39404

• A Hanbel'l'Y & Hudson Company PhOll1 601·583.61100

Fax 601·583.6503

July 17,2012

Pearl River County - Board of Supervisors Attn: Mr. J. Patrick Lee P. O. Box 569 Poplarville, MS 39470

Re: Rain 1 Inclement Weather Days Carriere Community Safe Room (FEMA #0180)

Mr. Lee:

As a matter of record, we were delayed due to wet 1 muddy 1 inclement conditions on the above referenced project from the period of June 11, 2012 to July 16. 2012 on the following dates:

06/11/12 07/06/12 07/10/12 07/15/12

06/14/12 07/08/12 07/11/12

07/04/12 07/09/12 07/14/12

The Carriere site was delayed (10) days during this pay period due to excessive rainfall at the jobslte. There are typically (7) precipitation days on average for the month of June. We are requesting a (3) day extension to this contract for the Carriere site.

Sincerely,

~1' Steven W. Bridges Estimator 1 Project Manager

-::0' D

------- ........ -.......,

... -----------11----------------------.... -... , 11...Jm..1:3.P'it..ayune ..aear~ _ UectFIIIBuI~ Pad

.:P~::=1?E= _ FootirIgs ,

_ VauII& Wat«Tw. _UlG_ (FNIlI)

_(UG~,"'_).

F_~) _ Prec:astWdPaneb&~Ted

l CMUBbc:kwale{1!1t~' • Pow 'We:tIt SJab 00 Gntde '·f~·Fn·fSUMP·&·CoUM

I Set tU F'nfII'lloCa in Mai»oNy

• CMUBbd(Wab(To~) .NEP __

• Mez:z.. K:IIow Cot1t Stabs "'t" 'POt,iu.:r£ i~-St:ib

_ CtrAO BloO. Walls (To Root) -"""'_ ..... I $04: Mt!zz. ~ IJni!s

I So< """""'" ............... _----------I Roof Hollow Core J Root ....... eore Topping SIM> ·iiI· ..... ~·I!iROOl ..

_ Rodiopping Slab _ MI:d. SiIummua Roof 0& ~

,.-------~~----------.:::::::::~~~~~~:.~~~~~&~ 2'J:...Ial'P13. PoplarliiJJo . ' •. u:ttttt;r' ;.

ICIoat_

-~~;; V_&W;it;OrT_

{C) PrIrNwera ~ Inc.

~.

cP U)

.'

IPRCFEf,tA. = '" I" I ,_VlG .......

.:F~~C l~~~~~

I 1O:03-J "",._:.=.;..::::-

.. -.!~~ .-~~~

... _ .. :. ". ~l~~., .

., ;,~.'-: : Jnsta: """"" . . . r .... ~i~·~l~~·

I ......

"'~~. •. __ ~1;..._

.._ 4

[-~~=: :~l.CMU. ,,~,~~-~~( i3-A&9-12 !

"!o'!!,._ ... ___ .. _. . Pulr~T~ .. ~ ~ .-

l· ~~~--:-'::7-;--:;-,"~--'--' " :

.. ~~_ ~~... )i~ji~~ __ ,' I h~bing"""'" .. .'~l~j

-.----.~..." . 3<!1"~!' WCont 2,11..sep..t

-r rIrl~:

-_ ..... _...... •. 1'-"-" J- ·I~ '"""" ~.l!'~.Sto> ... :.~!~1, ,.""""'.

·,·t~.~~~~·~:~·~·.-='~~-·_,1~~fJ~-d.. Bib.mIt!cus Red .& Fla$hlng

I t ,Rniih·.-.....,;: .. ~ 'r

i .... ,- .. _ ,_._.~I_ .. ._.l.9!!!!:.~_. .. ,...~rQ2~,,,

~~

''''~~~1!~~-'~~ .... ~~t'!~~~ ~.~~l:':'".' :==.:,~.

4Rj31..way.

Cmi~ .. :-~

afik-~.~ .... ) i.JUi

. ___ ~ ·,1

:.JW..<\~

~.". ~,~:I!:'I:c!t~~!~~~,\~.·-!l. ~ r .iF~ !f"··'L .. _- ........ :-.

Lw

~'."'-...l!!!!.~) ... :. PoarWestSlMmCmdo '

!'~~.-:~~~~~-.. _~~.~. __ ... jJ.31~i:(}=!.1.4 . __ ~.~,~~i~_~~_ _) _~,.,.~~+31*12 3~

. ~ l.·t~!~.l"'~

Fr"""!'!.'t!<"~- --- ..... L.

, ............... ....,..::;;;:::: _ ....... ---I-.. ---

I

I I

..F -"'":" ___ ,"'--T'" I CMU BlOCk Wds ('J'lltCol.inwt}

I: Pout WMt Stab 01\ ~

I lnItaII Fn Pl.np & CcNnn J s.t .... Frames in Ua:I.arvy

. '·jjj'tllI.r __ «.·_l .MEP __

I Uezz.. HolowCom ~ I Pout IiIe:l%.. 'Topp.Ing Stab _ c.:wu Block Wah (fo RtlQf) . ___ ~SIOi>O ..

• SoI:Mft.7::z.. ~t.mb I$«_

Doc

--" _~~In iOiiiiiiioii' 'iii' .... ' __

• Roof t'ttoIIiM ~ • Roo! HoI:!W ConI TcwIng Slab ___ @R"",

_ RcorTCipPing sao ,

1o..Ju.t.12 09::3&

.J

.... __ Root.~

.. ------------~----------.... --------.:::::::::::::::::::::~.::::~~=~~~~&~~ • 0$-Fd)..\3, ~ .-I 'U;;;_~ I . _~

I """''':::::=~' . "'"

- .. =~w:~,,~) __ UlG_Ifrish) __ {Floi<k)

-. ~'WoJIIfPaMl$ I CMU EIoek W_ (1At CcI.inI&) 'Ii POOl'Neil'saibon'GmJ.' ,

• lRStiII Fit1a Pump & CoII,imn

I Sd MY Fr.lII'nD in U:asonty • CMu BkIck ~ (fa Moz:t.,

I ,ByWBS.

(CJ~.~.k\c.

.

III

I-

,

•

DUNGAN

Engineering. PA

July 24,2012


Re: Picayune Community Safe Room FEMA Project NO.1604 - #0178 Pay Application No.5 Pearl River County, MS

Dear Mr. Lee:

925 Goodyear Boulevard Picayune, MIssissippi 39466

Phone (601\799.1037 Fax (601) 799·0460

www.dunganeng.com

Boof; 0158 P'9~ 590

Enclosed please find Pay Application No. 5 from Hanco Corporation and approved by Basco Associates, PC for work completed through July 17, 2012 for the above referenced project. Basco Associates recommends payment be made to Hanco Corporation in the amount of $268,643.64 as indicated on the attached payment application. This amount reflects that total work completed to dale.


Sincerely,

Stephen L. Sowell, P.E. Resident Project Representative

SLS/dg

Enclosure(s)

lIde-fileHlsdskproj\1715C36BIDocomentsIFlnanclaIIContfHctof InvoicelP.L •• - Pay Request No.5


;::; APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF PAGFS

O'ro OWNER: Pearl River County - Board of Sup. PROJECl': FEMA #0178, Picayune COmIn. Sat'< APPLICA nON NO: 00005 Distribution to:

P. O. Box 569 PERJODTO: 711712012 DOWNER PoplarVIlle, MS 39470 PROJECfNOS.: FEMA#0178 o ARCHITECT

FROM CONTRACTOR: Haeco Corporation P. O. Box 17678

VIA ARCHITI:X .. l; BASCO Associates, P.C. o o o

CONfRACfOR

Hattiesburg, MS 39404-7678 ~ The Russell E. Hom Building

.-:C:I»ll!2~~

York, PA 17401 --J(.' Cq!'frRACfOATE:

·t51i~-0.¥l~~~_._ .. .3/11 J12. NTf CONTRACT FOR: ~.

.!1. =

CONTRACTOR'S APPLICATION ~R PAYMENT ApI'IiJ::31ioo is made ror payment, as shown below, in connecfilln with the contract.

'" Continuation Sheet, AlA Document G703, is anached. ""

1. ORIGINAL CONTRACT SUM ..................................................... $2.547.000.00

2. Net change by Change Orders ............................................. ($82.455.00)

3. CONTRACT SUM TO DATE (Line I ±2) .................................. $2.464.545.00

4. TOTAL COMPI.ETEO & STORED TO DATE ......................... $1 141.613.84 (Culwnn G on G703)

5. RETAlNAGE:

a. .J..Q..QOO % ofComplcte.d Work (CoIUIMS D + F. on G703)

b . .lQ.OOO % ofSlOred Material (CoIuIMS f on G703)

$114.161.3&

so.oo

The undersigned Contractor certifies that to the best of the Cootractors knowledge, infor-mation and belief the Wort< covered by this . 'on for Payment has been completed in accordance with the Contract Documen , all amounts have been paid by the Contractor for Wo1irlOr'WlUcll pre'jo ertifi for Payment were issued and pay-.-,"""" "'" .. "'-'. '" , ~ ,.,... -. -;::;. ,~ By: • 1 I Date: 7 17 Z

Smre of: t-A. '7 County of; j;;1(~~t Subscribed and sworn to before

me this J1-!!! day of ;:r ¥.J 't .;lOI 1;1.

Notlllj' Public: ~~ ~J..... My Commission expires: ktri l ~,j;lO 1+

Total R.<:taInage (Line: Sa + Sb or Tolal in Columns I 00 G703)

................................................ $114.161.38 ARCHITECrS CERTIFICATE FOR PAYMENT

6. TOTAL EARNED lESS RETAlNAGE.......................................... $1 02745246 In accordance with the Contract Documents, based on on-site observations and the data (Line 4i<ss LiI1e S ToW) comprising this application, the Architect certifies to the Owner that to the best of the

7. lESS PREVIOUS CERTIFICATES FOR PAYMENT Architect's knowledge, information and belief the Work has prognossed as indicated, the (LiI1e 6 from prior CcrtiliC3le) ..................................................... $758 8Q8 82 quality of the Work is in accordance with the Contract Documents, and the Contractor

8. CURRENT PAYMENT OUE ......................................................... 1 $268,643.641 is entitled to payment of the AMOUNT CERTIFIED.

9. BALANCE TO FINISH, INCLUDING RETAlNAGE

(l.loe 31ess LiI1e 6) :£1,437,092.54

AMOUNT CER11FIEO • ___ • ____ • ___ ............. mm._m .... _... $268,643.64

(Atk:V:h expiaNJljem if anww:J c£rtffled differsfrom Il-.e amow:t applied/or. initial al/figures on lhis Application a:nd on lhe Contimumon Sheellhal are changed 10

conform /0 the amounJ. certified.) • /

CHANGE ORllER S~RY ADDITIONS OF:DUcnONS ARCHITEcr:. ..._. -::::'f'~~~It-,. ¥A..t.ft. Alh. 7. tl/lz. Total changes approved III B . ~ --I- Dare' ____ -'--fPtCViousmonthsbyOwncr $0.00 $82,455.00 y. .. ~j}A.A.rlA-1-:AJ;~~- -rio .... iTnto' .nnrnv<'rl .hi. Mnnlh $0.00 $0.00 This Certificate is nor,:"g~tiaJ;'te. "The"i&t~Jtr(FlED' is payable only to the

TOTALS $0.00 $&2,455.00 Contractor named herein. Issuance, payment and acceptance of payment are without I'NET CHANGES bv Change Order ($82.455.00) pr~indice to any rights of the Owner or Contractor under this Contract.

• AlA OOCUMENT G702· APPUCAnON AND CERTlF1CATE FOR PA YMF..N'T .. 1992 EDmON" AJA®" (am" 'THE AMERl~ tNSTITUTE OF AROUIECTS. 113S NEW YORK G702~1992 '" .. AVENUE.N.W .• WASHINOTORO,C. 20006-5m .. wARNlJtG: Urtlieensod photoeopyingYiol3tes. u,.s,.copyrlghttaws an4WiIJ$ubjedthe Yiolatortotegal p~utiorL ~"" .... ~ "'l"tMCIOCUI'neIIII!II5~~~"'""'u.~.,rThe~"'-I.u04~!6IdorIJctlmoa!l:1tll)jko~~hoi:.. ~«'!I'lh~'OOlIboot~~<:r._~ ChDaTh.~~ot~

- ltI"etllYtt1oE:Umll'll~o:rf1ll>j.~.M~~·

i . ,":CONTINUATION SHEET AIA DOCUMENT G703 PAGE 1 Of 4 PAGES )

AlA DocumentG702, APPLICATION AND CERTIFICATE FOR PAYMENT, comaining ContractoJ:'s signed Certification, is attached. In tabulations below, amounts are stated 10 the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply.

A B '"

C D E u;

1--- WORK COMl'lzrED I1'EM ~. SCHEDULED DESCRll'TlON OF WORK .,. FROM PREVIOUS

~

NO. 0.. VAl.UE

'" APPUCAl1QN THlSPERlOD

In ;;;; (D+E)

00999 OMsion 1 $260.866.00 -'" " $0,00 $0.00 $0,00 " 01000 Taxes "" $89,145.00 =,496,51 $10,777.53

01001 Bonds $31,=,00 $31,032..00 $0,00 01002 Insurance $29,370,00 I $29,370,00 $0,00 01500 Site Facilities $104,453,00 $41,781,20 510,445.30 01501 Testing t.aboratoty $1,325,00 $0,00 $1,325,00 01502 Layout I Engineering $5,541,00 $2,770,50 $1,386,25 02040 Division 31 $57.195 $0,00 $0,00 $0.00 02050 Oemolition $2,972.00 $2.972.00 50,00 02200 Earthwork $42.610.00 $31,957.50 $0,00 02201 sat Fence $2.394,00 $2,394,00 $0,00 02240 Concrete Foundation ExcJSad<fi1i $2,771,00 $531,30 $831,30 02250 Termite Control $1,244,00 $186,60 $186,60 02500 HOPE 15" $2,660,00 $0,00 SO,OO 02501 00nw$pQvt 60ct $1,413,00 $0,00 $0,00 02600 Sid""""'k - Lal>or $5.506.00 $0,00 $0,00 02600 Grassing 53,746,00 $0,00 $0,00 02801 Fine Grading $1,879,00 $0,00 $0,00 03050 DMsioo 3 $865,245,00 $0,00 $0,00 $0,00 03100 Concrete Formwol'k $3,325,00 $0,00 $997,50 03200 Concrete Reinforcement $29,370,00 $29.370,00 $0,00 0$201 Rod austing $9,645.00 $1,446.75 $3.375,75 03202 Slands&~ $2,217,00 $0.00 $2,217,00 03300 Concrete Material 554,392.00 $8,1$8,80 $8.1$8,80 03310 Post Footing Labor $1.729,00 $0,00 $1,729,00 03311 Spot Footing Labor $2.449,00 51,224,50 $1,224,50 03312 COntinuous Footing labor 87,982.00 $2,394,60 $5.587.40 03320 Slab on Grade labor $20,206,00 $0,00 $2.020,50 03330 Topping Slab Labor $12,169,00 $0,00 $0,00 03370 Elevated Beam Labor $1.982,00 $0,00 $0,00 03371 Pumping $2,793,00 $0,00 $279.30 03372 Finishing $15,751,00 $0,00 $1,575,10 03400 Precast Concrete Walls $493,900.00 $363,550,00 5130.350,00 03401 Precast Concrete Double Tees $125,996,00 $83.84$,60 $42.146.40

APPLICA nON NO.: 00005 APPLlCA nON DATE:

PERIOD TO: 7117/2012 ARCHITECTS PROJECT NO.: FEMA1I(l17&

F G H I

MATElUALS TOTAL BALANCE RETAINAGE PRESENTLY CQMI"UITED TO frF v A.RIASLE) % STORED AND STORED fINISH (NOT IN TO DATE (G-!-C) RATE

(C·O) DORE) (D+E+F)

$0,00 $0,00 0 $0,00 $0,00 $0,00 $41,274.14 46,300 $47,870,86 $0.00 $1l.00 $31,=,00 100,000 $0.00 $0,00 $0,00, $29,370,00 loo,DOQ $0.00 $0.00 $0,00 652,226,50 50,000 $52,226,50 $0,00 $0,00 51,325,00 100,000 $0,00 $0,00 $0.00 $4,155,75 75,000 $1,386,25 $0.00 $0,00 $0,00 a $0,00 $0,00 $0.00 $2,97:2,00 100,000 $0,00 $0,00 $0,00 531,957.50 75.000 $10.652,50 $0,00 $0,00 $2,394,00 100,000 $0,00 $0,00 $0,00 $1,662,60 60,000 $1,108.40 $0,00 $0,00 $373,20 30.0001 $870,80 $0,00 $0,00 $0.00 0 $2,660,00 $0,00 $0,00 $0.00 0 51,413,00 $0,00 $0,00 $0.00 a $5,506,00 $0.00 $0,00 $0,00 0 $3,746,00 $0,00 $0,00 $0,00 0 Sl,879,00 SO,oo $0,00 $0,00 0 $0,00 $0,00 $0,00 $997,50 $0,000 52.327,60 $0,00 $0,00 $29,370,00 100,000 $0,00 $0,00 $0,00 $4,822,60 50,000 $4,822.50 $0.00 $0,00 $2,217,00 100,000 $0,00 $0,00 $0,00 $16,317.60 30,000 $38,074,40 $0,00 $0,00 $1,729,00 100.000 $0,00 $0,00 $0,00 $2,449,00 100,000 $0,00 $0,00 $0,00 87,$82,00 100,000 SO,OO $0,00 $0,00 $2,020,50 10,000 $18,185,40 $0,00 $0.00 SO,OO 0 $12,169,00 $0,00 $0,00 $0,00 0 $1.982.00 $0,00 $0,00 5279,30 10,000 $2,513,70 $0,00 SO,OO $1,575,10 10,000 $14,175,50 $0,00 $0,00 $493,900,00 100,000 $0,00 $0,00 $0,00 $125.996,00 100,000 $0,00 $0,00

•

AlAOOCUMENTG'/03- Al'!'UCATION JlNO (.'ERTlFICATE FOR PAYMENT - 1992EO,TION • AlAJI)' (lIm - lHEAMERJCAN [NS1'!TUTRO" ARCHITECTS, 173S NEW YORK. . G703-1992 .. • AVENlJ£, N.W., WASllTNVlON, D.C. 20006-5292 .. WARNlHG: Unlicensed: pho:toeopying: vimates U.s~COP'lrl9htlaw$an<twi]lsubjedttJemt..rtorto legal~. -,;;;.,i,$ ~~'*IIlftII~~WI!l111'!aperm~«'ThoI'Afnc:IIc:lrI!rt:1/IutoIIoI~~~~700J)O~~,1/II:'.. Rt'I)fO(I~«_~~l)I'I)j~~lI!not~. ~'fM~l\LrGiI...tf"ot~

- '!(!!_tIW'a.-.....sian"'~~..-.!~!Il.3lIA.

f) . "':' .CONTINUATION SHEET AlA DOCUMENT G703 PAGE20F 4 PAGFS

") AlA Document G702. APPLlCA TION AND CERTIFlCA TE FOR PAYMENT, APPLICATION NO.: 00005 containing Contractors signed Certification, is attllChed. APPLICATION DATE: In tttbularions below, amounts are stated to the nearest dollar. PERIOD TO: 7/1712012 Use Column 1 on Contracts where variable retainage for line items may apply. ARCIDTECTS PROJECT NO.: FEMA #0178

A B ~ C D E F G H r 0-

WORK COMPLETED MATERIALS TOTAl.. BALANCE RETAINAGE .,

ITEM ",. SCHEDULED FROM PRF.VlOUS PRFSENTI..Y COMPLETED % TO ~ V ARlABLE) DESCRlI'l1ON OF WORK 0:. NO. VAl..UE STORED AND STORED FlN1SH ." APPUCATION TIllS PllRlOD (NOT IN TO DATE (G';'C) RATE :0: (C -G)

"" (D+E) o ORE) (D+E+F) 0

$0.00 03402 Precast Con<:rete Hollow Core c $81,339.00 $8,133.90 $32.53.5.60 SO.OO $40.669.50 SO.COO $40,669.50 "" 04050 Oillision 4 $41,002.00 $0.00 SO.OO SO.OO $0.00 SO.OO 0 SO.OO SO.OO 04100 Mortar 51,685.00 SO.OO 51,685.00 $0.00 $1,685.00 l00.COO SO.OO SO.oo 04101 Sand $443,00 SO.OO S2Z1.SO SO.oo S2Z1.SO SO.COO $221.SO $0,00 04102 Fifl SO,650.00 SO.OO $0,00 SO.OO $0.00 a SO,650.00 $0.00 041SO Masonry Reinforcement 51,862.00 SO.OO 51,862.00 SO.OO $1,862.00 loo,COO $0.00 $0,00 04151 Masonry A=ries 51,IOS.00 so.OO 51,IOS,00 SO.OO 51,108.00 l00.COO $0,00 $0.00 04200 4"CMU $2,760.00 SO.OO $1.380.00 SO.OO $1,380.00 5O.COO $1,380.00 SO.OO 04201 S"CMU $1,413.00 SO,OO $705.50 SO.OO $700.50 5O.COO S706.SO SO,OO 04202 S"CMU $24.383.00 SO.OO $12,191.SO SO.OO 512.191.50 SO.COO $12.191.50 SO,OO 04203 Siock Cleaning $8$8.00 so.OO S209.4O SO.OO $2OS.4O 3O.COO 5488.60 SO.OO 05050 Division 5 $10,528.00 SO.OO SO.OO SO.OO SO.OO SO.OO 0 SO.OO SO.OO 05100 Misc.Steel sa,866.00 SO.OO sa.319,60 SO.OO $5.319.60 6O.COO $8,546.40 SO.OO 05800 Anellor Solis 51,862.00 SO.OO 51.562.00 SO.OO $1,862.00 l00.COO $0.00 SO.OO 000$0 Division S $2,549.00 SO.OO SO.OO SO.OO SO.OO SO.OO a SO.OO SO.OO 00100 Rough Carpemry $2,549.00 SO.OO $0.00 SO.OO SO.OO 0 $2,549.00 $0.00 07000 Division 7 $89.907.00 SO.OO SO.OO SO.OO SO.OO SO.OO 0 SO.OO SO.OO 07110 V'lSqueen $1.244.00 SO.OO SO,OO SO.OO SO.OO a $1,244.00 SO.OO 07213 Rigid Insulation 4" @l Roof $19,949.00 SO.OO SO.OO SO.OO SO.OO 0 $19,949.00 SO.OO 01500 Membmne Roofing SSO.956.00 SO.OO SO.OO SO.OO SO.OO 0 SSO.956.00 SO.OO 07900 C.aul!cing & Sealants $7.758.00 SO.OO SO.OO SO.OO SO.OO 0 $7,758.00 SO.OO 08050 Division 8 $80,307.00 SO.OO SO.OO $0.00 SO.oo SO.OO 0 SO.OO SO.OO 08110 Metal 000Is, Frames & HdWr $35.466.00 SO.OO $5.319.90 SO.OO $5,319.90 15,COO S30.146.10 SO.OO OS111 Frame Installation $1.729.00 SO.OO $864.50 SO.OO $864.50 5O.COO $864.50 SO.OO 08112 Door Instarlalion 54,322.00 SO.OO SO.OO SO.OO SO.OO 0 94,322.00 SO.OO 08S00 MetalWmdaw $38,790.00 SO.OO SO.OO SO.OO SO.OO 0 $38,790.00 SO.OO 0S050 Division 9 $63.745.00 SO.OO SO.OO SO.OO SO.OO SO.OO () SO.OO SO.OO 09250 Gypsum Wallboard S)lSten1S $1,1OS.00 SO.OO SO.OO SO.OO SO.OO 0 51,108.00 SO.OO 09800 Acoustical Cellings $1,330.00 SO.OO SO.OO SO.OO SO.OO 0 51.330-00 SO.OO 09501 Metal Soffit $11,554,00 $0.00 so.OO SO.OO SO.OO 0 S11.654.00 SO.OO 09650 Resilient Flooring $14,455.00 SO.OO SO.OO SO.OO SO.OO 0 514.450.00 SO.OO 09800 Sealed Con"",te $18,032.00 SO.OO SO.OO SO.OO SO.OO 0 $18.032.00 SO,OO 09900 Painting $22,155.00 SO.OO SO.OO SO.OO SO.oo I) $22.166.00 SO.OO 10000 Division 10 $28.050.00 SO.OO SO.OO $0.00 SO.OO SO.OO 0 SO.OO SO.OO

,. AlA DOCUMENT Gl'03- APPUCATIOl< A.."Il>CElmflCATEFOR PAYMENT • '992 wrnON " AlA<!> - ,,'992 • THF. AMERICAN 'l<STI'rtrrE OF AACHlTECl'S. 1735 NEW YORl: G703-1992 _ • AVE:N\IE, N,W .. WASHlNcrroN,l>.C. 20006-S2?2 • WARNING: Un' __ g_ U,S,""PYriia ......... ndwiU.ulljeettl>O_tolegal_uti<>n. "'!o ......... ,: "7lrI!I~~_~~ __ ~_OI'l'hor~l~ot~ __ l_f11«I)w~~1I!oc. ~O'I'\tIIS~~"'; r ~~fII:iI:~ CcdiiOTIIi:~~oI~

- Ul-""th.!~~tifthl:l\1I1QJ1'1'lC'lll,'ml¢~~~

SCONTINUATION SHEET AIA DOCUMENT G703 PAGE30F4PAGES

") AlA Document G702, APPUCA nON AND CERTIFICATE FOR PAYMENT, <:cntaining Contractor's signed Certification, is attached. In tabulations below, amounts are stated to the nearest dollar. Use Column Ion Contracts where variable retainage for line items may apply.

-A B ~

.~ C 0

'" E

WORK COMl'I.ETEll 01-

fiU\ll I)FSCRIPTION OY WORK "". SCHEDULED FROM PREVIOUS ro "'-

VALUE NO. <0 APPLICATION TlDSPERIOD en - (I)+E) .:.

10100 Speeialties 1nst3llation ~ $7,201.00 SO.OO so.oo " = 10150 Compartments & CublicJes $11,650.00 SO.OO SO.OO 10440 Signage $2,771.00 so.OO SO.OO 10520 Fire Extinguishers & Cabinets $887.00 SO.OO SO.OO 10800 Toilet Accessories $5,541.00 SO.OO SO.OO 11050 D"Msion 11 $7,758.00 SO.OO SO.OO SO.OO 11400 Food Service Equip $7,758.00 SO'OO $7,758.00 12050 OMsion 12 $15,589.00 SO.OO SO.OO $0.00 12345 Wood casework $7,841.00 SO.OO $0.00 12480 AoorGrtlies $7.758.00 $0.00 SO.OO 15:lO0 DMsion 22 $91,205.00 $0.00 $0.00 so.oo 15400 Plumbing Rough In 541.332.00 $20,333.00 $2.000.00 15401 Plumbing Stack Out $27,707.00 SO.OO SO.OO 15402 Plumbing Trim 0u1 S22. 166.00 SO.OO SO.OO 15440 DMsioo 33 $171,75S.oo SO'OO SO.oo SO.oo 15450 Site U~lities $121.913.00 $84.000.00 SO.OO 15451 Water We!I 549,873.00 SO.OO SO.OO 15400 Division 21 $74,256.00 SO.OO SO.OO SO.OO 15S00 F"" Sprinkler Piping 541,007.00 SO.OO $0.00 1$501 F"" Sprinkler F"" Pump $33.249.00 $29.000.00 SO.OO 15750 Division 23 $332,489.00 SO.OO SO.OO SO.OO 15800 HVAC Duc:!work $77,581.00 SO.OO SO.OO 15801 HVAC Equipment $221.659.00 SO.OO SO.OO 15802 HVAC Controls 533,249.00 SO.OO SO.OO 15900 Division 26 $283,371.00 SO.OO SO.OO SO.OO 16000 Eled:!ieal Below Slab $27.707.00 $8.926.75 $1,130.00 16001 EIed:!ieaI Generator $110,650.00 $22.000.00 SO.OO 16002 Sedrical Rough-In .$44.332.00 $3,400.00 SO.OO 16003 eee!rieal Trim 0u1 $52,79$.00 $0.00 SO.OO 16004 Sedrical Site Work $27,701.00 $5,541.40 $4,240.00 17100 NOTE: Change OrDer #1 has been SO,OO SO.OO SO.OO 17101 Incorporated into this scIIedule of SO.OO $0.00 SO.OO 17102 vallJes SO.OO SO.OO $0.00

APPUCA TION NO.; 00005 APPLICATION DATE;

PERIOD TO; 7/1712012 ARCHITECTS PROJECT NO.; FEMA #0178

F G H I

MATERIAl.S TOTAL llALANCE Rlz.TAlNAGE PRESENTI.Y COMl'l.ETED % TO IF V AlliABLE) STORED ANDSTORJ:D FlNlSH (NOTJN TO DATE (G~C) RATE

(C ·0) DORE) i

$0.00 SO.OO 0 $7.201.00 SO.OO SO.OO SO.OO 0 $11,ESO.00 SO.OO $0.00 SO.OO 0 $2.771.00 SO.OO SO.OO SO.OO 0 $8Ir1.oo SO.OO SO.OO SO.OO a $5,541.00 SO'OOI SO.OO SO.OO a $0.00 $0.00, SO.OO $7,758.00 100,000 $0.00 so.ooi SO.OO SO'oo 0 SO.OO so.oo SO.OO SO.OO 0 $7,841.00 SO.OO SO.OO SO.OO O. $7,758.00 so.oo SO.OO SO.OO 0 $0.00 SO.OO SO.OO $22,333.00 54.033 $18.99$1,00 SO.OO' SO.OO SO.OO 0 $27.707.00 SOOO! so.oo SO.oo 0 $22,166.00 so.oo; SO,oo SO.OO 0 SO.OO SO.OOj SO.OO $84,000.00 68.= $37,913.00 so.ooi SO.OO SO.OO 0 $49.873.00 so.001 SO.OO SO.OO 0 $0.00 SO.OO SO.OO SO,OO 0 $41.007.00 SO.oo SO.O!) $29,000.00 87.221 $4.249.00 $0.00 SO.OO SO.OO 0 SO.OO SO.OO SO.OO SO.OO 0 $77.581.00 SO.oo SO.OO SO.OO 0 $221,659.00 SO.OO SO.oo SO.OO 0 $33,249.00 SO.OO SO.OO SO.OO 0 SO.OO SO.OO SO.OO $8,058.75 29.078 $19,650.25 SO.OO SO.OO $22,000.00 19.850 saa.650.00 SO.OO SO.OO $3,400.00 7.589 $40,932.00 SO.OO SO.OO SO.OO 0 $$2.795.00 SO.OO SO.OO $9.781.40 35.303 $17,925.60 SO.OO SO.OO SO.OO 0 SO.oo SO.OO SO.OO SO'oo 0 SO.OO $0.00 SO.OO SO.OO 0 SO.OO SO'oo

II AlA DOCUMENT G71J3. Ae.,.fCAT!QN ANOCERTIFlCA11(>1)R PAYMF.,,"T • 1992 EDmON' AlAi'" 01992 • nm~CAN INSTIruTEOF ARCIllTF.Cl'S.173S NEW YORK G703-1992 • AVENU£.N.W .• WAS«JNGTON.D.C. 200<X>-S292 • WAR!ilHG: unr_ p/IoIl:>c<Ipy!ng_u.s.copyrlght __ will.ubjeet""'_tolegal~.

-... ..... .;.'"" ~~_.I>l!en~~"""'I'I\;IIq~Q4'tbe~~<!I~..-~'»t:lntl>~~I~ ~OIIhG~~~iIj'lOl:dill:~~$It~ ~""t!!cAma'lc::ltllm.UlJttor~ - W"""lmowmwft~e(u..:.~8I'IIt1ioo;:;.l._~-

) .. - .CONTINUATION SHEET AIA DOCUMENT 0703 )

AlA Document G702, APPLICA nON AND CERTIFICATE FOR PAYMENT, containing Contractnr's signed Certification, is attached. In tabulations below, amounts are staled to the nearest dollar. Use Column I on Contracts where variable retainage for line items may apply.

A B '"

C D E '-" WORK COMPLETED

ITEM DIlSCRJPTlON OF WORK SCHEDULED FROM PREVIOUS NO. ..... VALUE APPUCATION THlSPERIOD

In - (D+E) c ---------

~

17200 Chall!!" Order #002 g ($6,313.00) $0.00 ($6,313.00)

$2,464.545.00 5843,120.91 =.4ll2.93


PAGE 4 OF 4 PAGES

PERIOD TO: 711712012 ARCHITECTS PRomer NO.: FEMA #0178

F 0 H J

MATERlALS TOTAL BALA.'lCE RETAlNAGE PRESENTLY COMPLETED % TO n' v ARlABI..h") STORED AND STORED

(G-i-C) FINlSlI RATE (NOT IN TOOAT8 (C-G)

DORE) (D+E+F)

SO.OO ($6.313.00) 100.000 $0.00 SO.OO

SO.OO 51,141,613.84 46.32% $1.322,931,16 SO,OO

II AlA DOCUMEHT G7Q3- APPUCATION ANDCERnFlCATE FOR PAYMEl<T • 1m EDmON' AlA<1il- "'991 • TIlE AMERICAN 1NSTI1V!E Of ARCI<ITECTS. l13S NEWYORK G703-1992 • w A\I'El:ft.1E., N,W .• WASHINGTON, D.C. 20006-sm .. WARNING: Unliec~ pholOCopying ~ u.s. copyright laws and will subjKt tM'IIioJatorto legal pros.ee.u:tior). ~.-..:~ "1'b.~_I)ro:o\~~...mthe~bf1'llotcAmelknroI!tl2JlVll!~~l.!I'ode:rl..lctrl5oeg7('Jl;O",,~~lIIc ~QfM ___ ~itI~l$lI4t~ C<lt!IlIoCITlM~_af~

- tIIY!I:J'IIVthe~VCI"'.JoIIorlhi5~,;r,r.,:tIkemo!::wwU$o.·

Corpora.lon • General Contractors • A Hanberry & Hucbon Company P.O. lox 17678 Phone 601.583.6500 lIaHl •• lturt, MIIII .. lppl 39404 " . . . 'ax 601 .583.6503

July 17, 2012

Pearl River County - Board of Supervisors Attn: Mr. J. Patrick Lee P. O. Box 569 Poplarville, MS 39470

Re: Rain 1 Inclement Weather Days Picayune Community Safe Room (FEMA #0178)

Mr. Lee:

Bonk 0158 P~l~ 596

As a matter of record, we were delayed due to wet 1 muddy 1 inclement conditions on the above referenced project from the period of June 11, 2012 to July 16, 2012 on the following dates:

06/11/12 07106/12 07/10/12 07/15/12

06/14/12 07108/12 07/11/12

07104/12 07109/12 07/14/12

The Picayune site was delayed (10) days during this pay perIod due to excessive rainfall at the Jobslte. There are typically (7) precipitation days on average for the month of June. We are requestfng a (3) day extension to this contract for the Picayune site.

~, St."", w .• 1 Estimator I Project Manager

rcr:t[)

--~ ...

------ .. ---

.-...................... ~r-.............................................. ----"" 17~t3,~ .-.c:Irnf~ _ SoIoc:t~Pad

ii·~i.JIG ROOoi ,_llIG_ • _F_W. -

_(l'lnioh' _ Pntc:ia:I Will PanelS & Ooobts T era I CMU Bb:I\ WaJb (1$C CQ.I~) I Pour Wed $lab en Gt'.lcte

,_""" ..... &c.om; I s.t HN Ftwne$ in M;ascnry

• CUJBb::kWds(foUr!tt.} . ...,.---• Mft.r.l:. HoII!:I« Ccm S1ab5

.. ·.·'PtU~ T~'Sbb' _ CMU Sb:k Wd& (fo Roof) _ Pt)!.Ir RMmIining StooD!t

• Sat Mazz.~ UM$ ,s.._ -----____ """"",,,_1Hn

I Root~CortI • Root HaIow Core T cppttIg Slob 'iiii'~~O'fIOoI"' ..

_ RocIT~StIb

_ UOod.~aocr&~

................. +-...................... -!======================~==~:F~ln~&~ 'fI '21~13,~

. '". ·~·il·j' ... iii .""""-------"-'~" (cl:~~tne.

r::fJ (7'"

\D

i"""" .-~ , EIodri<iOi UI(

-1'-'---• +F,!:!!~I!!'..~

. ··1~~ 1:Mu

.~&

I-j~~~~~ If~~~~"~

g:;

1---1-' r:-,~ , .. ~!~~~~b~1~

1ri!~2A~~~~._ JW.!?_~~~~~~

;;" __ ' ••• , ... t~~~~

.-.~~-.+ .. --.-.¥~t::~~~~_ ... .:;.. . ;j;O::~~~~i·l~t

-,.~~ !n~!~·-:·~'-~.-.---,.-~

!'!!2:

.~:~-T~_. ··:'I~~. __ ,L~~H!~W.(T~~ __ ._".p_,. 71~~.

~¥,~_", •• _._~ __ <_ • ...!~1~~01~1!.

I· ! ~~1_

~,~ .. __ :, __ .... _~~12~ 12 _ "-_ .. _ ._l_.:!..~g-L!..~.~,.

. _~t!~~1~_~~~:,!~,. ,;.;.:-;~"_ .~._. .._,.~~..l~ !~~~

~~ .. _ •. ". ,~~~_1.~_~'~1.~ """":~ .. 21"~--'-~~t~U.

~~'.1~ ....... ~"toppilJ9Si:ab. ~t.'~t2..j~)l. I-'~'_!L~ ... __ -l _.!L2!~12.i.2lI~!!':~~. .t~-~~- -~-.~-.~ ","~§eP-lli~J~". jl\lcd..~,~,~ ___ .:~.OI~1:2;J.~!~12 .AnlehInktOOr&~ \ 04-()Ct..12 '21..Jan..13

_~!'!tt_.~.~,~_,_~ _.hi .. _.513Q.Apt-1.::l02.u.y.l_ tn.... .. ~Io.Jt~d -1 __ $J~~::-. lG3abt1_

;. .:mt!~.",-l."-" .. ·.l:b_

I _·~;;;~_\~J._ ~ .. l:t~;¥J=-4~~j~· '-r.-~ ~-~-,-.. ~ r_ ...... _ ""'--".... _ .... ' ... ~ .. , :

ti~~U£~T~)-:T-:-~~:~!:':~B;.:::H·· _U!~Y!c;_~~;'i&ji~ t~Jii.~-,.-u--'r-· '-~f~ 12 t1~~""

1

::1 .. - -.-..... -------=-~ 'u CM<I-W!!~ .... ~) ... ;., , ... )~~~12 ,; _' IPoor~~ilt!~.. i _ .. ~~1~ !~j

-.~~~.~, '.-~ , i~.~i?~z1t~1 ~r~ ~, ... _"._. ____ .. __ ,J~.~~J!!..~:). __ . .;. ____ ~9!:§

r i;JOEMA. T ""'2

~--) '" F '"- iiiiiii- 'Pi..cutWlil PI!noM a' 00ubiIl' Tees I CloItJ ""'" ..... (11<0..-) I PtM'w..t StIIb en GoraSa J IiMtaIFftPump & CobM 1 Set ... ~ ... Muonty

.... , .. iii '1:IOlu1!liiCtWOb (To"""',) . • NEP Masonry RocgMn

I MI.z:L JioIow Cool Slabs I PIourIlN::t. 1'~ Slab _ OIU SioI:'.t. Wd:t (To RooI)

. .... ·PcitJr~·SI8bS • s.t Mcz. ~ lH\It:$ , ... ",,-

Mtlcha;1ic:aI R.ough-tn _ .... _-.. , ··· .. -" .. ·"~R .........

I 1b>oI HoIIoIPt Coq

• Roof HQIIQw (loq T oppit!g Sial> • RIgid tnlt.!.dal)on @ RtK:lf

_ Roof Topping; $iIb ,

.....-·Mad..8~RooU:F~

-------------~----------------------~~~~~~~~~~~~~~~:.:~.~ ., OS-Fab-t3.C$tJ'I$re ..a..w~ ...... • - -~,~=::;~"~ _ ......... IJiC_"'_ __ (finish)

_ Pnlc::ntW;l~

I CMU Bbc:tWah <1stCouDe) "iI ~wat·$QboaGtad."

, 1MbIII FIm P\I'Qp" CoUnn J Set: ... F)':Ime&.In ua.orvy

• CMU BIodt u._ ..... -_ .. .--r.:ByWBS.

..1

+ __ "'"-..... ·1 1 ('I"""""""S_1nc.

_ ....... ---- .. ---

~ ~ li; ii !!

f I ~

" f f ~ f ~

§ if

STATE OF MISSISSIPPI PHll.llRYANT, GOVERNOR

MISSISSIPPI EMERGENCY MANAGEMENT AGENCY

Jul)' 17,2012

Mr. Adrian Lumpkin County Administrator PEAHL RIVER COUNTY DOS POBox 569 Poplarville, MS 39470

RE: PEARL RIVER COUNTY BOS FEMA·1604·DR·MS 11109·99109·00 HUlTicanc Katrina

ROBERT R. LATHfu'>1, JR. EXECUrrVE DIRECTOR

Federal Share plus Administrative Costs Payment for Reimbursement # J 00

Dear Mr. Lumpkin:

We have been recently informed that the MS Depanment of Finance and Administration electronically made a financial deposit into the Pearl River County BOS's bank account. According to the attached documents a deposit in Warrant HC001293549£ln the amount of $48.&.~which represented payment of the Federal Share plus Administrative Costs as ~hown on the enclosed MEMA PA·4 form was deposited. Tq assist us to complete our records, please contact the department/section, which has the knowledge and documents to verify that this amount was deposited, so that you can sign and return this acknowledgement receipt letter.

If you have any questions, please contact Mr. Larry Bowman, Siale Public Assistance Officer, at the Mississippi Recovery Office (MSRO), Mailing Address: 220 Popps FelTY Rd., Bldg. A, Biloxi, MS 3953 J at telephone number 228-594·3197.

Sincerely,

o crt R. Latham, Jr. 1\ -Governor's Authorized Representative

V Enclosure This acknowledges receipt of Warrant IICOOl2935496 in the amounl of $4&,Q2451 under FEMA-1604·DR-MS, Hurricane Katrina which was deposited into the BOS 's banls: account. ..' >;--"

" ", ,t' ,/ , R/' ,I (' - ._~~" .. >.l:/ /,,' ··-t,,-~ } .,' r...,; .... _ .. ~ •• l- ....... ,'-!' ,~~" ... __ c~;.. ~,

Dale Mr. Adrian Llulipkln, CQimty Administrator Pearl River County BOS

POST OFFICE BOX 5644 • PEARL, lv1lSSISSIPPI 392&8-5644 • PHOl\'E: 601·933·MEMA EMBRGENCY 1·800-222·6362 (24 HOUR)

TDD 1-&00-445-6362

Goo

FORf~ 1l.aO.10 RI'V. 7-1-89 STATE OF NISSISSI?PI PAYME~ VOUCBER

TO: DEPARTf'.llNl· OF FINANCE" ADMINISTRl\UON Jl\CKSON, MISSISSIPPI

Q7/10/12

TO SE:TTLE: CLA1M AS SHOlm BY INVOICE OR EVIDENCE O~' CLAIM ATTACHED, ALL ~'OR GOODS RECEIVED OR SERVICES RENDERED FOR THE use MID BENEFIT OF TaE STATE, cHl\RGEIIBLIl AS FOLLO~lS:

BATCH NUM: PV 721- EM3266 PV Ntll'lBER: I.'V 721 16040011392

PV DATE: ACCTG PRD: llODGET FYI 13 ACTION: E PV TYPE, 1 SCB PAY DATE: OFF LIIIB ACCT: FA IND, DOCUMENT TOTAL: 48,1;24.53

EFT FLAG, C . VENDOR CODE: V000012002 0 BIPAA FLAG: N BINGJ,Jij CHECK FLAG, IlQot 0lS8 Pa9~ 601 VENDOR NAME: PEAR~ RIVER CTY BOS VEND PAYMENT TYPE:

ADDRl: BOARD OF SUpERVISORS PRIVACY FLAG: Y ADDR2: POBOX 569 ADDR31 POPLARVI~LE MS 39470

LN -----REFERENCE----- COM NO CD DEPT NUMBER LN LN

VENDOR INVOICE

SUB APPR ACTI FUND Dgp'r ORG ORG UNIT VITY

SUB REV SUB PROJ/GEN REPT Bls OBJ OIlJ SRC REV Nut1BER CATG I\CCT.

ACCOUNT NUNBER

01 64260

DESCRIPTION

CONTRACT n

109-99109-00 RQ100liN6SS9

W.OUNT REC DATE

16040011399 3729 721 2400 KATR

49,624,53

~. ____________ ~ __ Y ____ M _________________________ _

NAME OF DEPAATME);'T: EMERGENCY HANAGEMENT

CERTIFICATION

I/D P/F LaC

2725 SUBG i

I HEREBY CERTIFY THAT THE ABOVE CLAIM IS JUST, DUE, CORRECT AND UNPAID, THAT TilE GOODS SOLD OR SERVICES RENDERED HAVE BEEN DELIVERED OR PERFORMED IN GOOD ORDER ~~ THAT ALL STATUTORY REQUIREI4ENTS COVgRING T~. PAYMENT F TillS CLAIM HAVE BeEN COMPLIED ~l1TH, AND I NOI1 REQUEST ISSUANCE DEI.' Til DISBURSEMENT WARRAN'f IN PAYMENT TaRREOF.

COUNTERSIGNED BY: SIGNED BY: ~~~~~~\!-4~--~-----(IF RllQUIRED) - ......... - -TITLE, TITLE:

DISTRIBUTIO;)l, DEPART!>lBNT OF FINANCE & ILlHINISTAATION, VENDOR, DEPARTMlll\T

Gol

State of Mississippi Application for

Request for Reimbursement For Public Assistance Funds

Request Number:

Declaration:

Type of Request:

FederallD Number:

Vendor No.:

100

1604

Partial

109·99109-00

VOO00120020

AITN: Adrian lumpkin, Counly Admlnstrator

Pearl River (County) 80S

Period Covered By The Request:

Name:

Address: PO 80x 569

Poplarville, MS 39470

Phone: 6014032302

Inc u e nt I d d I hi r--"

pW Fed Share Paid Admin Paid

18559 $46.382,62 $241.91

I Tolal $48,382,62 $241.91

--~-"---

Governor's Authorized Representative:

From: Aug 29, 2005

To: Ju/2,2012

PreparodBy:

Package(sllncluded:

Ivy Lacy

269 Sook 'liSe P.39~ 602

s Payment Federal Tolal Paid Slate Share Paid

$48,624,53 $0,00

$48,624,53 $0,00

I certIfY thai the amount claimed on Ihis voucher is correct and payment has not been received,

Amount Approved: $48,624.53

.. -~.~.---~~

i ,

1

PA relmbursemenlepptOved based on review and verlficaUon of all required documenlatkln

h!1ounl$ 441;:2 *.;?~ J SPAOApPrOVedft /~~7L.-_

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 603 MEMA REIMBURSEMENT #3 ON SAFE ROOMS Date 8/ 6/2012 MEMA REIMBURSEMENT ON HAZARD MITIGATION

ORDER TO ACCEPT MEMA REIMBURSEMENT #3 ON SAFE ROOMS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of MEMA reimbursements.

Upon motion made by Sandy Kane Smith and seconded by Dennis Dedeaux, the following order was adopted, to-wit,

Be It Ordered by the Pearl River County Board of Supervisors to accept attached MEMA reimbursements #3 on Safe Rooms as follows:

REIMBURSEMENTS Carriere Safe Room Poplarville Safe Room Picayune Safe Room

$ 67,641.00 $ 35,071.00 $ 345,814.00


Voting AYE,

Voting NAY: Absent,


ORDER TO ACCEPT MEMA REIMBURSEMENT ON HAZARD MITIGATION PLAN UPDATE REVISED ADMIN PAYMENT

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of MEMA reimbursement.


Be It Ordered by the Pearl River County Board of Supervisors to accept attached MEMA reimbursement on Pearl River Hazard Mitigation Plan Update Revised Admin 1604-0299 in the amount of $272.00.


Voting AYE,

Voting NAY: Absent:


PAGE 30

STATE 01<' MISSISSIPPI PHIL BRYANT. GOVERNOR


July 16,2012

Mr. Danny Manley Emergency Management Director 207 West Pearl Poplarville, MS 39470

ROBERT R. LATIlAM, JR.. EXEC1JTIVB DIRECTOR

RE: 1604·0180 - Pearl River Co Stand Alone Shelter-Carriere, Payment 113

Dear Mr. Manley:

Find enclosed documentation of the electronic transfer of funds via State Warrant # C0012935500

in the amount of$67 ,641.00 for the above referenced project. Upon verification of receipt of the,

attached payment, please sign and retum the certifieation at the bottom of this letter.

Sincerely, I'

1J}JJ' .

dJ.f1J, Z I. fl' { ..:,..", c. .. \} ('~ I Jana N. Henderson ·-..Office Director

Office ofMitigatioll

Attachment as stated

This acknowledges receipt of electronic transfer of State Warrant # C0012935500 in the amount of$67.641.00 for reimbursement of 1604-0180 - Pearl River Co Stand Alone Shelter-Carriere.

POST OFFICE BOX 5644 • PEARL. MISSISSIPPI 39288-5644 • PHONE: 601-933-MEMA EMERGENCY 1-800-222-6362 (24 HOUR)

TDD 1-800-445-6362

GOy

FORN 11.20,10 REV, 7-1-89 STATE OF MISSISSI?PI

PAYMENT VOUCI1ER

TO: DEPARTMENT OF FINANCE &. ADMINISTRATION JACKSON, ~IISSISSIPl'I . { / f "' _. ______ ~ ______ ~ _______ ff _____ ~. ______________ ••• _ ••• «_~ __ ~ ___________ ~~_~_~ __ _

TO SETTLE CLAIM AS SHOlm BY INVOICE OR EVIDENCE OF CLAIl1 ATTACHED, ALL FOR GOODS RECEIVED OR SERVICES RENDERED FOR THE USE ~ND BENEFIT OF THE STATE, CHl'.RGEARL~ AS FOLLOWS,

BATCH NOM: l'V 721 EM3284 l'V NUMBER: PV 721 16040011437

PV DATE: ACCTG PRD: ACTION: E PV TYPE: 1 Ol?F LIM ACCT: FA IND:

EFT FLAG: C VENDOR CODE: V000012002 0 HIPAA VENDOR NAME: PEARL RIVER CTY BOS

ADDR1: BOARD OF SUPERVISORS ADDR2: POBOX 569 ADDR3: POPLARVILLE MS 39470

BUDGET F!.': 13 SCH PAY DATE: DOCOHENT TOTAL:

SINGLE CHECK VEND PAYJ>1ENT

PRIVI'.CY

H8,7~8.00

FLAG: Y 1YPE: FLAG: Y Book 0156 P~'l~ 6Q6

LN -----REFERENCE----- COM NO CD !)EPT NUMBER LN LN

VENDOR lI"NOICE

SU!l APl?R ACTI FUND PEPT ORG ORG UNIT VITY

SU!l REV SUB PROJ IGEN REPT Bls OBJ OBJ SRC REV NUMBER CA1G ACCT.

ACCOUNT NOMBER

DllSCRUTION AMOUNT REC DATE

CONTRJ\CT "

01 16"0400114.36 372U 721 2600 64260 16"04 IiY.GP16040406 RQ12 PW 67,641.00

02 16040011436 372lJ 721 2600 64260 1604 RMGP16040407 RQ13 PW 35,071.00

03 16040011436" 372U 721 2600 64260 1604 IIM(lP1604040S RQ14 PI"! 345,814.00

• O~ 16040011436 372U 721 2600 64260 1604 HMGP16040S39 RQ15 E'vI 272.00

lID pIF LOC

2725 SUBG

2725 SlJBG

2725 SU!lG

2725 SU!lG

___ w __ ~~_~ ________________________ ~ ___________________ --~-------~--------------

NAMll OF DEpARTMENT: ENERGENCY l-lANAGEr.mNT

CERTIFICATION

I HEREBY CERTIF¥ THAT THE ABOVE CLAIM IS JUST, DUE, CORREC'r AND UNPAID, THAT THE GOO!)S SOLD OR SERVICES RENDERED HAVE BEEN DELlVER(J. OR PERFORMED IN GOOD ORDER ANP THAT ALL STATUTORY REQUIREMEN1S COVERING TH. JPAYMEN!~~~~ CLAIM HAVE BEEN COI·lPI.II!D WITa, AND I NOW REQUES';' ISSUANCE 0,1J.lE,PW,;1';""1i"-'!".y , DISBURSE:MENT WARRANT IN PAYMENT THEREOF, , (J(?,lf9)vr.I'oV Jt>'" COUNTSRSIG1IED BY: SIGNE!) BY, ______ ':..' -"-____ _ (IF RllQlJIRED)

TITLE: TITI.E:: __ _

DISTRIBUTION: DllPART14ENT OF FINP.NCE " ADI1INIS'I'RATION, VENDOR, DEPARTI-lE"l'l'l'

STATE OF MISSISSIPPI PHIL BRYANT, GOVERNOR


July 16,2012


ROBERT R, LATHA.\1, JR. EXECUTIVE DIRECTOR

RE: 1604-0179 - Pearl River County Shelter - Poplarville, Payment #3

Dear MI', Manley:

Find enclosed documentation of tile electronic transfer of funds via State Warrant # C0012935500

in the amount of $3 5,071.00 for fue above referenced project. Upon verification of receipt of the

attached payment, please sign and return the certification at the bottom ofthis letter.

Sincerely, ! ~j4~~

lJJuia N. Henderson Office Director Office of Mitigation


This acknowledges receipt of electronic transfer of State Warrant # COO 12935500 in the amount of $35,071.00 for reimbursement of 1604-0179 - Pearl River County Shelter - Poplarville.

~ {~t,~,i:=--' .-_ Mr. Danny Mat cy, Emergency ~anagement Director Date

POST OFFICE BOX 5644 • PEARL, MISSISSIPPI 39288·5644 • PHONE: 601·933-ME~1A EMERGENCY 1·800·222·6362 (24 HOUR)

TDD 1·800·445·6362

Go'7

FORlt, 11.20.10 REV. 7 -:-89 07/1G/12 STATE: or mSSISSI!?PI

P~.Yl.jENT VOUCHER

TO: DEPARTMEl<r OF FIlvANCE " AD~1INISTRl'.Trol' JACKSON, ~!ISSISSIPPI

, - .. :

--------.----------------------------------.- .. ---------.-.-.-------------~!---TO SETTLE CLAII~ AS SHOWN BY INVOICE: OR EVIDENCE OF CLAIM P.TTACHED, />.LL FOR GOODS RECEIVED O~ SERVICES RENDERED FOR THE USE AND BENEFIT OF THE STATE:, C!i!>.RGEABLE AS FOLL01W:

BATCH Nm1: PV 721 EM32B4

PV DATE: ACCTG PRD:

?V NUMBER: PV 721 16040011437

BUDGET FY: 13 ACTION: E PV TYPE: 1 OFF LIl>.B ACCT: FA IIID:

EFT FLAG: C VENDOR CODE: \'000012002 0 HIPAA VENDOR NAME: PEARL RIVER CTY BOS

AODR1: BOARD OF SUPERVISORS

SCH PAY DATE: DOCUNENT TOT/>.L:

FLAG: N SINGLE CHECK VEND PAYMENT

PRIVACY ADDR2: POBOX 569 ADDR3: POPLARVILLE MS 39470

~48,798.00

FLAG: TYPE: Bodk 0158 Pag~ 609 FLAG: Y

LN •• "-. RIlFEREllCE - - - -. cor~

NO CD DEPT NUMBER LN LN VENDOR

INVOICE SUB APPR ACTI

FUND DEPT ORG ORG UNIT vI'l'Y

SUB REV SUB PROJ/GEN REPT B/S OBJ OBJ SRC REV NUI~ER CATG ACCl'.

ACCOUNT NUMBER

DESCRIPTION AMOUNT REC DATE I/O P/F LOC

CONTRACT « -----~---.--------------------01 16040011436 372U 721 2600 2725 SUBG 64260 1604 HMG1?160~0406 RQ12 PW 67,641. 00

02 16040011436 372U 721 2600 2725 SUBG 64260 1604 F.MGP16040~07 RQ13 PN 35,071.00

03 16040011436 372U 721 2600 2725 SUBG 64260 1604 HHGP1604040S RQ14 PW 3~5,814.00

• 04 1604001lf36 372U 721 2600 2725 SUBG 64260 1604 HMGP16040839 RQ15 PN 272.00

-------------------------------------------------~--------------~--------------N!\J~ OF DEPARTI1ENT: EMERGENCY t1ANAGEMENT --------~--~------------------------------------------ -------------------------

CERTIFIC1\TION

I HEREBY CERTIFY THAT THE ABOVE CLAIM IS JUST, DUE, CORRECT AND UKPAID, THAT THE GOODS SOLD OR SERVICES RENDERED HAVE BEEN DELlVER~' OR PERFO~!E. D IN GOOD ORDER AND THAT ALL STATUTORY REQUIREt1ENTS COVERING TH ~AYHEN.r, <l!l, :£f!l;S C. LAIM HAVE BEEN COMPLIED WITH, AND I NON REQUEST ISSUANCE 0 . EP{I;-"-I'1ENTil!, (\ DISBURSEMENT NARRANT IN PAYMENl' THERJWF. .' 'l' If I!II'~'J ,W,),(ffil IiI' f

. .'.h ... \I\d )' v, ),/'<:' COUN'l'E~SIGNED BY: SIGNED BY: { • ., . \ (IF REQUIRED)

TITLE: TI1'LE : ___________ _

DISTRIBUTION: DEPARTMENl' OF FIN~.NCE '" ADMINISTRATION, VENDOR, DEPARTMEIIT

STATE OF M[SS[SSIPPI PHIL BRYANT. GOVERNOR


July 16,2012


ROBERT R. LATHAM. JR. EXECUTIVE DlR&.'TOR

M: 1604·0178 • Pearl River Co Stand Alone Shelter-Picayune, Paywent #3

Dear Mr. Manley:

Find enclosed documentation of the electronic transfer of funds via State WalTant # COO 12935500

in the amount of$345,814.00 for the above referenced project. Upon verification of receipt of the

attached payment, please sign and return the certification at the bottom of this Jetter.

Sincerely.

CfitJJri/t JUL L.Jan8 N. Henderson

Office Director Office ofMitigatiol1


This acknowledges receipt of electronic transfer of State Warrant # COO 12935500 in the amount of$345,814.00 for reimbursement of 1604-0178 - Pearl River Co Stand Alone Shelter-Picayune.

5.ddd< L.. Date

POST OFFICE BOX 5644 • PEARL. MISSISSIPPI 39288·5644' PHONE: 601-933·MEMA EMERGENCY 1-800-222-6362 (24 HOUR)

IOD 1-800-445-6362

GIl

?'ORE 11,20.10 REV, 7-),-89 07/lC'/12 STATE OF ~!ISS!SSI?U

PA\1>IE!;T VOUCF,ER

TO: DEPARTHENT OF FIl'IlINCE I< AD_lXNISTRATION JACKSON, MISSISSIPPI

. ,

TO SETTLE CLAIH AS SHOWN BY INVOICE OR EVIDENCE OF CLA!11 ATTACHED, GOODS RECEIVED OR SERVICES RENDERED FOR THE USE AND BENEFIT OF THE CHARGEAllLE AS FOLLOI~S:

A.LL FOR STATE,

BATCH NUl<: PI' 721 EM3284

PV DATE: ACCTG PRO: ACTION: E PI' TYPE: 1 OFF LIAS ACCT: FA IND:

EFT FLAG: C VENDOR CODE: V000012002 0 HIPAA VENDOR NAME: PEARt. RIVER CTY BOS

ADDR1: BOARD OF SUPERVISORS

~V NUMBER: PI' 721 16040011437

BUOOET FY: 13 SCH PAY DATE, DOCUl>IENT TOTAL:

FLAG: 1'1 SINGLE CHECK VEND PAYMEUT

PRIVACY

~48,'/98.00

FLAG: Y TYPE: FLAG: Y

- :.

ADDR2: 'Ii' 0 BOX 569 ADDR3: POPLARVILLE

LN -----REFERENCE----- COH NO CD DEPT NUl-IBER LN LN

MS 39470

VENDOR INVOICE:

Book 0158 ra9"- 612

SUB APPR ACTI FUND DEPT ORG ORO UNIT VITY

SOB REV SUB PRoo/oEN REPT Bls OBJ OSJ SRC REV NU!<lBER CATG ACCT.

ACCOUNT NUMBER

DESCRIPTION AMOUNT REC DATE 110 pip LOC

CONTRACT ff -

________ ~w __________ ~~_._~ __

01 16040011436 372U 721 2600 2725 SiJBG 64260 1604 HMGP16040406 RQ12 PW 67,641. 00

O. 16040011436 372U 721 2600 27.25 SOBG 64260 1604 HMGPH040407 RQD PW 35,071.00

03 1604001.1436 372U 721 2600 2725 SUBO 64260 1604 HMGP16040408 RQ14 PI'! 345,614.00

04 • 1604001.1436 372U 721 2600 2725 SUBG 64260 1604 HMOP16040639 RQ1S PI'! 272 .00

M _____________ ~ __________ -------~~---------------~--------- -~------~---------

NAME OF DSl?ARTI>lElIT: EMERGENCY f~AGEMENT -------------------------~~-------------------.-------------~-----~---~--------

CERTIFICATION

I HEREBY CERTIFY THAT THg ABOVE CLAIt1 IS JUST, DUE, CORRECT AND UNPAID, THAT THE GOODS SOLD OR SERVICES RENDERED HAVE BEBN DELIVERED OR PERFORMED IN GOOD ORDER lIND THAT ALL STATUTORY REQUIREMElITS COVERING TH~)PAYMEN. '1', ~ ~IS CLJIoIM HAVE BEEN COMPLIED WITH, AND I 1'101'1 REQUEST :rSSUANCE 0 P)El'n1f>IEwt' (1 DISBURSEMENT W.7IRl(Mll' XII PAYMENT THEREOF" '" rf IJ fi('f'fJ 7I1"'}')}. 1//",

I 1\' "\ Vi )1' 1\ '.,,·0', COUNTERSIGNED BY: SIGNBD BY: ' ," "", (Il" REQITIREDl -" .---..... -~ -

TITLE: TITLE!: _______ , _____ _

DISTRIBUTION: DEPARTMENT OF FINI'.NCE £< l\DMIIHSTHATION, VENDOR, DEPARTHE1IT

STATE OF MISSISSIPPI PHIL BRYANT, GOVERNOR


July 16,2012

Mr. Dalmy Manley Emergency Management Director 207 West Peru'l Poplarville, MS 39470

ROBERT R. LATHAM. JR. EXECUTIVE DlRECTOR

Book 0158 Pa~~ 61J

RE: 1604·0299· Pearl River Hazard Mitigation Plan Update, Revised Admin Payment

Dear Mr, Man.ley:

Find enclosed documentation of the electronic transfer of funds via State Warrant # COO 12935500

in the amount of $272.00 for the above referenced project. Upon verification ofreceipl of the

attached payment, please sign and retum tile celtificalion at the bottom of this letter.

Sincerell' (1 0 /1!J>..!IU tY l{~ ~(~" ~ ..

~alla N. ~enderson '-Dffice DIrector

Office of Mitigation

Attachment as slated

This';Cknowledges receipt of electronic transfer of State Warrant # C0012935500 fll tbe amount of $272.00 for reimbursement of 1604·0299 . Pearl River Hazard Mitigation Plan Update.

( 'l..--

Mr. 1mny !Vfanley, Emergency M llagemcnt Director '-J '

Date

POST OPFIC!! BOX 5644. PEARL. MISSISSlPPI39288·5644· PHONE: 601·933·MEMA EMERGENCY 1·800·222-6362 (24 HOUR)

TDD 1·800-445-6362

<.." I 'i

?OR!'l 11.20.10 REV. 7-1-89 STATE OF IHSSISSJ;PH

P~.Yl"ENT VOUCHER

07/10/12

TO: DEPAATl1ENT OF FIl,A1;CE I< ADHniTSTRATION JACKSON, MISSJ;SSIPPI

, ' . , \ t !.

-------~-----~--------------------~-----------------.----- _____________ .·_~~!_~R TO SETTLE CLAnl AS SHOWl{ BY !NVOICE OR EVIDllNCE OF CLAIM ATTACHED, ALL FOR GOODS RECEIVED OR SERVICES RENDERED FOR THE USE AND BENEFIT OF THE STATE CHARGEABLE AS FOLLOWS, '

BATCH NOM, PV 721 E!~32a4 PV NUMBER: PV 721 1604001~437

py DATlJi: ACCTG PAD, BIJDGET F~: 13 ACTION: E PY TYPE, 1 SCH PAY DATE: OFF LIAS ACCT: FA It>.'D: DOCtJl1ENT TOTAL: ~4a.79g.00

EFT FLAG: C W!iDOR CODE, V000012002 0 HIPAA FLAG: N SINGLE CHECK FLAG: BOp: 0158 ~a,). 615 VENDOR NANE: PEAAL RIVER CTY BOS VEND I'AYMENT TYPE:

ADDR1: BOARD OF SUPERVISORS PRIVACY FLAG: Y ADOR2: POBOX 569 AODR3: POI'LARVILLE MS 39470

LN -----REFEaENCE----- CO!4 NO CO DEPT NUMBER Ll~ LN

VENDOR Il\'VOICE

SITe APPR ACTI FUND DEpT ORG ORG UNI? VIT'{

SITe REV SITe PROJ/GElJ REPT Bls OBJ OBJ SRC REV t>.~ER CATG ACCT.

ACCOUNT NUMBER

DESCRIPTION !tEC DATE r/D plF LOC

CONTRACT #

01 l6040011436 372U 721 2GOO 2725 SOBG 64:?60 1604 HMGP16040406 RQl2 PW 67,641.00

02 16040011436 3nu 721 2600 2725 SITeG 64:260 1604 HMG1'16040~07 RQ13 PI! 35,071.00

03 16040011436 312U 721 2600 n25 SITeG 64260 1604 fI!~Gp1604040a RQ14 PW 345,814.00

• 04 16040011436 372U 721 2600 2ns SITeG 64260 1604 HMGP16040839 RQ15 P.I 272.00

NANE OF DEPARTMENT: EMERGEL-ICY MANAGEMENT

CE?TIFICATION

I HEREBY CERTIFY THI<T THE ABOVE CLAIM IS JUST, DUE, CORRECT AND UNP)UD, THAT THE GOODS SOLO OR SERVICES RENDERED HAVE BEEN DELlVERi2 OR PERFORMED IN GOOD ORDER AND THAT ALL STATUTO;ay REQUIREMEIITS COVERING Til .. JIl?AYMENT, QIl~flU CLl\I.>.M HAVE BEEN COMPLIED WITH, AND r 1~0\'I REQUEST ISSUANCE O'J~.EPARlME~rt' j' DISBURSEMENT 11l\RRA.lIT IN PAYHENT THEREOF. tl') fll/iQ) rl ') f~iJ !i f _.

, r' I. ""\' \ I' 'nl\l ""' .. COUN'TERSIGlIED BY, SIGNED BY: ' . ' > »

(IF REQUIRED) ~ ... TITLE: TITLE:

DISTRIIlUTION: DEPARTI1ENT OF FINANCE ., ADI~INISTMTION, VlllIDOR, DEPART£>!EtIT

CJL MBMMAS03 08/15/2012 10,06 Board Minutes Minute Book Text Detail Book 0158 Page 616 DESTRUCTION AND DISPOSAL OF RECORDS Date 8/ 6/2012 PICAYUNE AND PRC SCHOOL LEASES

ORDER TO APPROVE DESTRUCTION AND DISPOSAL OF RECORDS

There came on this day to be cos ide red by the Board of Supervisors of Pearl River County, Mississippi, the matter of destruction and disposal of records.

Upon motion made by Sandy Kane Smith and seconded by Dennis Dedeaux, the following order was adopted, to-wit,

Be It Ordered by the Pearl River County Board of Supervisors to approve attached request of destruction and disposal of records in accordance with MS Code Section 9-5-171.


Voting AYE,

Voting NAY, Absent:


ORDER TO APPROVE PICAYUNE SCHOOL AND PEARL RIVER COUNTY SCHOOL DISTRICT LEASES

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of school leases.


Be It Ordered by the Pearl River County Board of Supervisors to approve attached school leases from picayune School District and Pearl River County School District.


Voting AYE:

Voting NAY, Absent:


PAGE 32

J. PATRICK LEE President, District Four SANDY KANE SMITH Vice-President, District Five ANTHONY HALES District One

August 6, 2012

Honorable Board of Supervisors:

.. . . , • > . . -.. ---~ . . .

BOARD OF SUPERVISORS PEARL RIVER COUNTY

P.O. BOX 569 POPLARVILLE, MS 39470

(601) 403·2300 (601) 403-2309 Fax

ADRAIN LUMPKIN, JR. County Administrator

JOYCE CULPEPPER District Two

DENNIS DEDEAUX District Three

DAVID EARL JOHNSON Clerk of Board

Please authorize the destruction and disposal of the listed records in accordance with MS Code Section 9-5-\71.

2005 Bank Statements for depository account 2006 Time Sheets 2006 Duplicate Warrants 2006 First Net Register, Payroll Disbursement Journal, State Monthly Earnings 2006 Cafeteria Plan Enrollment 2006 Deferred Compensation Billings 2006 941 Quarterly Billings 2006 Account Billings

Health Insurance and Supplemental policies 2006 Unemployment Quarterly Billings 2006 Retirement Account Billings 2006 W-2's 2007 Leave Records 2007 Agendas for Board of Supervisors 2007 Purchase Orders - pink copies 2007 Voided Purchase Orders 2007 Office Supply Quotes 2006 Bids 2006 Requisition Books

Thank you for your assistance.

Admin Lumpki County Administrator

CIt)

PICAYUNE SCHOOL DISTRICT OEANSHAW Supuinltll&nl

BRENillARRELL AMUtanI SupMntMdMt

July 25. 2012

Mr. David Earl JolUlson Chancery Clerk P.O. Box 431 Poplarville, MS 39470

706 Goody_lloulevard Pi"'yune, Mississippi 39466

(601)798.3230 Fa:< (60 II 79&·1142

VERABIlECH f«lend Plowamlll

Cun'iru)um Dirtdor

WALT ESSUNQER Suwort Strvictl DUf(!(Q(

Book 0158 P"9~ 61S

LtSAPENTON Pinanoe lJ~cfOf

SUBJECT; Recording J 6'11 Section Lease (l) I Cancellations (2) I Amendments (2)

Dear Mr. Johnson:

Enclosed are (5) documents to be recorded by the County Board of Supervisors. I have enclosed a check for $ n.oo for the recording fee (2 cancellations@$13.00 each II lease @$12.00f2 amendments @ $17.00 each).

Document #

PLS# 132

PLS# 162

PLS# 124

PLS# 130

PLS#47

Lessee

Ir"in Templet

Susan Stockstill and Xayiel' Dedeaux

First NBC Bank

Christopher Myers

Alene Goff

Type of Document

Commercial I Residental Lease

Amendment

Amendment

Cancellation

Cancellntion

Please return the original copies to the Picayune School District. Thank you for your assistance in this matter.

Sincerely,

j~ckie Lumpkin Bookkeeper

Enclosure (5)

I'lCA YUNE SCHOOL DISTRICT CLAIM VOUCHER

" , . ~'t

PAY TO: , 1/1.;.,:' ,: '.\ t.' ',( " TOTAL: _' ___ _

. ,,;-, ' •. " !. f,' '\ f :', 1,1. _ /,::! ~ ,~~ ,', ". i,' ',I ,i .. ·.'.·. ',' ".1.'1'" ""'~; ,}.~,~-, •• , • •• ,1, '.', PURPOSE: 1,(':.,:(1<-.: ""·.w!,, ;~i " ..... "". "L··

f. -" " 0

GL# 1.' -ii' ';:., ". '

,i !..'

SUPPLIES: ____ ~GLH ___________ --0-:-_ $~-.~--

L; ~~.C~.~~~.i!!l'~c'9IWt~9~·619 . ,."' -,,' . -- I "~"': ,( . . . .... I . ;.!"', .--' r'

rRA VEL ROUTE (FromrrolReturn):

MILEAGE: ----c--------------' " .. '

Odometer Start: ________ Odometer End: -----------c7". i i' "-, I" J ~. ,-~, u.

Total Miles: _____ @ .SllMile GL#

Lodgillg(Name/#Nights): _____ GLH ... .I} ;

______ ..,.....;,. .• ::...;.-~c~ . ..:.-'. _. __ ',f ~J:",,: . ..

Airfare: (Airline) ______ _ GL#

Olher: __________ _ GL# --------------$_------Maximum In-Btate: $31/day (except high cost areas: S36/day) (out of stale $411day)

Date Per Diem

Total Meals: GIL # ------------$_---Signatures for Approval:

.~ / f. Payee: ,.----;,.; .. ! "-j_~'~.{, ',-'----

I Supervisor: ~ .~ Finance Director: : " ~)(IztX/t; .. ~

oz:::::;;:;: •

Date: -: . /' ";,

{ C .. ~,' c..

Ilollld Approved 02ll2f201l

Indexing Instructions: 0.17 acre(s) 1 Lot, 50' x 150' in SE v.. of the SE v.. Section 16, Township 6S, Range 17W City of Picayune Parcel# 6175160040200500

After Recording Mail To I Prepared By: Picayune School District 706 Goodyear Blvd. Picayune, MS 39466 601.798·3230 I Fax·60 1-798·1742

STATE OF MISSISSIPPI COUNTY OF PEARL RIVEH

SIXTEENTH SECTION

Lessee Irvin Templet

PLS# 132

38 Minnie Penton Road Carriere, MS 39426 601-916-7253/601-916-7251

PUBLIC SCHOOL TRUST LANDS COMMERCIAL 1 RESIDENTIAL LEASE AGREEMENT

THIS AGREEMENT, made and entered into this, the 22nd day of JyI.J!V012, by and between the Board of Education of the Picayune School District, (hereinafter

called "LESSOR"), 'A'HOSE ADDRESS IS 706 Goodyear Boulevard. Picayune, Mississippi 39466, telephone (601 )798-3230,and IRVIN TEMPLET (hereinafter called "LESSEE"), whose address is 38 Minnie Penton Road, Carriere, Mississippi. 39426, telephone (601-916· 7253/601-916-7251).

WITNESSETH:

That, for the term and in consideration of the rentals hereinafter set forth, and the covenants, conditions, and by the authority and under the direction of the BOARD OF EDUCATION OF THE PICA YlfNE SCHOOL DISTRICT, as recorded in Minute Book. :,,' , Page l_'.',: " ,does hereby lease and rent unto LESSEE the following described land, to-wft--

Section 16, Township 6 South, Range 17 West

Commence at the point where the East l'ight-of-way of West Street intersects the South right-of-way of Rosa Street; thence run East along the South right-of-way of Rosa Street a distance of 125.00 feet more or less, this being the Point of Beginning. From said Point of Beginning, thence run South a distance of 150.00 feet more or less; thence run East a distance of 5.0.00 feet morc or less; thence lUll North a distance of 150.00 ~eet m~GM;qlhi\H~Q~o !~ South right-of-way of Rosa Street; thence nm West along the South nght-of-way of Rosa 'Street, a distance of 50.00 feet marc or less, to the Poim of Beginnillg, [containing 0.17 acre(s) morc or less, 1627 Rosa Street].

I. The term of this lease shall be for twenty-five (25) years, beginning 011 the 22nd day of Mav 2012, and terminating 011 the 21st day of May 2037, at which time the Lessee shall have a prior right. exclusive of all other persons, to re-lease said property at an anllual rental based on the then appraised fair market value of the land excluding buildings and improvements not then owned by LESSOR.

2. LESSEE covenants and agrees to pay as rent to LESSOR the sum of ONE HUNDRED NINETY FOUR DOLLARS AND N0l100 ($194.00) per annum, in advance, 011 or before the anniversal), of this lease each year. subject to any rent adjustment clause as herein included, LESSEE may use an escrow account at a local bank for this annual disbursement. Before rent will be accepted each year, however, LESSEE must provide proof of payment of ad valorem taxes for the City of Picayune and Pearl River County.

3. (a) The lOll>, 2011., and 30,10 anniversary dates of the commencement of tbis Lease Agreement shall be the effective dates of rental adjustments, and on SUcil dates the amount of anllual rental due and payable hereunder shall be adjusted in the manner hereafter described to reflect thc current fair market rental value of the subject property. LESSOR shall use its best efforts to cause the subject property to be reappraised and a redetermination made of the arumal fair market rental amount within six months before any readjustment date. In the event the LESSOR shall fail to instigate reappraisal within the six months preceding any rent adjustment date LESSOR shall not be deemed to have waived this provision requiring rent adjustment, and in such event (at any time after a rent adjustment date) LESSOR may proceed to have the lease premises reappraised and an adjusted rent determined for an)' such readjustment period. The adjusted rent shall be effective on the required adjustment date and LESSEE shall pay any deficiency to LESSOR within fifteen (15) days of the determination of the adjusted rent. The reappraisal shall be made pursuant to the Mississippi Code of 1972, § 29-3~69, or pursuant to the statute then in effect governing such leases and procedures for

2

determining fair market rental value. The reappraisal shall establish the fail' market valuc of the property unencumbered by this lease and shall reflect the market rate of return at the time but shall be no less tllan the minimulll acceptable percentage provided by the statute in effect. Unless altered by the procedures described below, the amount of rent so determined as of each rental adjustment date shall be paid until the next rental adjustment date or for the balance of the lease as tile case may be. The appraisal process described in this subparagraph

(a) may be referred to hereafter as the Statutory Procedure. The cost of the reappraisal shall be borne by the LESSEE, using an appraiser selected by LESSOR.

(b) Should the Statutory Procedure result in an increase in~rflliln ~ver tlll2 amount previously due, LESSEE, by notice ill writing given to ffi6 t;t!SS'l5R \vithin 15 days after receiving notice of the increase, shall have the right to elect an altemate method of detennining the cnrrent fair market rental value of the subject property (the "Alternate Procedure") as follows:

(1) LESSEE Illay provide an appraisal by an appraiser having the qualifications hereafter described giving an opinion of current fair market annual rental value based on the (I) the fair market value of the land unencumbered by this Jease and (II) a reasonable percentage of return on comparable land investments as of the rental adjustment date. The written repmi of LESSEE'S appraiser shall be delivered to LESSOR within 45 days after the date on which LESSOR gave notice of all increase in rent under the Statutory Procedure. UPON FAILURE TO PROVIDE AN ALTERNATE APPRAISAL WITHfN THE TIME ALLOWED, LESSEE SHALL FORFEIT TIlE RIGHT TO PURSUE THE ALTERNATE PROCEDURE, AND ANNUAL RENT DETER.\1INED UNDER THE STATUTORY PROCEDURE SHALL BECOME DUE AND PAY .A,.BLE,

(2) The two appraisers shall make a good faith effOli to reconcile their differences. If tbey have been unable to do so within 10 days after delivery of the repOl1 of LESSEE'S appraiser, the two appraisers within such IO day period shall each submit the names of three appraisers having the qualifications hereafter described who practice in Mississippi to serve as a review appraiser, and they shall select the review appraiser from names in common 011 the two lists. If there is no name ill common on the two lists, or if the persoll selected shall decline to serve, then each appraiser shall submit another list of three names of persons meeting the same criteria.

(3) The review appraiser shall review and analyze the two appraisal repOlts, and if needed, inspect the land, consult with the two appraisers, review their assumptions and source information and request corrections, revisions, and additions 10 the appraisal reports. The review appraiser

3

may also consider relevant information from his own files, conduct such independent investigation as he deems appropriate and Illay consider comparable transactions which occurred aftcr the rental adjustment date.

(4) The review appraiser shall report his opinion of annual fair market rent and such amount shall be accepted by LESSOR and LESSEE as the current fair market rental value ofthe subject propc11y.

©) If LESSEE requests the Alternate Procedure, LESSEE shall pay all fees and expenses of the LESSEE'S appraiser, the review appraiser and any additional charges of LESSOR'S appraiser. The review appraiser, however, shall perform his duties in an independent and impartial mlllmer irrespective of the source of payment of his fees and expenses.

Book 01SB P~9. 623

(d) The annual rentals on any adjustment date shall not be reduced below the amount established upon the initial date of this lease except upon determination by the Statutory Procedure.

(e) The amount of rent determined in the above manner shall be remitted on or before the rental adjustment date or, if the rental adjustment procedures are concluded after such date, then promptly upon conclusion of such procedures effective as of the rental adjustment date.

(I) The rent adjustment procedures will not delay the due date of rent at the existing annual rate and will not affect LESSOR'S right to declare a default if such fent is not timely paid.

(g) LESSEE'S appraiser and the review appraiser must be members of the same organization of appraisers as LESSOR'S appraiser, or an organization having higher requirements for admission, and must have the same or higher designation (sllch as, for example, Member, Appraisal Institute). If LESSOR'S appraiser belongs to more than one organization, the other appraisers must belong to the organization having the highest standards and qualifications for membership. If the organization has multiple designations for appraisers, the review appraiser and LESSEE'S appraiser must hold the same or a higher designation as held by LESSOR'S appraiser.

4. LESSEE covenants and agrees to pay allY and all general taxes, including City of Picayune and Pearl River County ad valorem taxes, and special assessments, if ever any thereby, applicable to the above described property and LESSEE'S interest therein. Special Assessments must be imposed by specific authority and not by the Board of Education of the Picayune School District.

5. Lessee ma)' assign this lease in its entirety whereupon the LESSEE shall be relieved of all obligations accming subsequent to the assignment. However this lease may only be assigned upon the prior written approval of the LESSOR. LESSOR reserves the right to refuse any assignment wherein the proposed LESSEE does not have the financial ability or creditworthiness to comply with the lease. Furthermore, before said lease may be

4

assigned, it must be current in the payment of all rental amounts and all taxes described in Paragraph 4. If these requirements are not timely met, LESSOR, upon discovery of the assignment, may declare a forfeiture of this lease and any assignments 01' transfers terminate or cancel said lease. Not withstanding anything to the contral), herein above contained LESSEE shall have the right to cancel this lease at any time by filing a "NOTICE OF CANCELLATION" with the Superintendent of Education who shall record the cancellation in the Office of the Chancel), Clerk of Pearl River County, Mississippi.

6. The parties herein expressly agree that if DEFAULT shall be made in the payment of any tax assessment or rent due, made pursuant to this lease, then and in such event of DEFAULT it shall be unlawful for the LESSOR to enter upon said premises, or any pal1 thereof unless it is preceding at law which cannot be initiated until at least sixty (60) days have elapsed from the date of default. LESSEE shall have sixt~C(IIiO)1~~to fi9t'rect any such default before any type proceeding at law may be initiated by LESSOR. If LESSEE is adjudicated to be in default of this lease, LESSEE agrees to pay reasonable cOUl1 costs and reasonable attorney fees.

7. In the event of any FORFEITURE, DEFAULT, OR CANCELLATION of tlus lease 01'

tennination of the term therefore as aforesaid, said LESSEE shall quit, deliver up and surrender possession of the leased propelty, and all LESSOR owned structures and improvements thereon to the said LESSOR, and thereupon this lease and all agreements and covenants on the LESSOR'S behalf to be performed and kept, shall cease, terminate and be utterly void, the same as if the lease had not been made. In addition thereto, the LESSOR shall be entitled to whatever remedies it may have at law, or equity for the collection of any unpaid rental hereunder, or for any other sums for damages or other wise, that it may have sustained on account of the LESSEE'S nonfulfillment or nonperfonnance of the terms and conditions of this lease.

Upon expiration or termination of this lease, all improvements made by the LESSEE during the tenn of ,the lease then and on that date situated on the land shall become the property of the LESSOR, except that the LESSEE shall have sixty (60) days after expiration or termination to remove any improvements made by LESSEE. However, LESSEE shall during said time of removal pay the pro-rata rent in effect at the time of said expiration or termination. If the improvements are removed, LESSOR shall have the right to require the LESSEE to remove all foundations and paved areas, fill any excavations witll soil material suitable as a foundation sUpp0l1 for further construction and generally restore the premises to a condition suitable for construction, use, and occupancy by others.

8. The LESSEE shall be responsible for any damages that may be caused to LESSOR'S propel1y by the activities of the LESSEE under this lease, and shall exercise due diligence in the protection of all improvements, timber and other property of LESSOR, which may be located on the lease propelty or in the vicinity thereof, against fire, damage, or waste from any and all other cause.

9. LESSEE agrees to hold and save harmless, protect and indemnifY LESSOR and the State of Mississippi from and against any and all loss, damages, claims, suits or actions at law,

5

judgments and costs, including attorney's fees, which may arise or grow out of any injury or death of persons, Ol' cOlmected with the LESSEE'S exercise of any right granted or confen'cd hereby, or the LESSEE'S lise, maintenunce, operation or condition of the property herein leased or the activities thereon conducted by LESSEE, whether sustained by LESSEE, their respective agents or employees, or by any other persons, or corporations which seek to hold LESSOR liable.

10. Notwithstanding any provisions of this lease containing a DEFAULT provision, auy present or future holder of a mOligage 01' deed of trust representing money loaned on these facilities, shall have the right of a sixty (60) day notice of default within which to cure auy DEFAULT which may be cured by the payment of money. In addilion, for any other DEFAULT for which a forfeiture of said lease may be invoked, such holder of such mortgage or deed of trust shall be entitled to a notice in writing of the claimed DEFAULT and shall have a reasonable time, which shall not be less than ~iil:%'~n, ga)6~5to either require the correction of such DEFAULT or in lieu thereof to pro'tect itse:~f through the exercise of a power of sale and thereby acquire a leasehold in said property and COlTect such DEFAULT. LESSEE hereby covenants and agrees 10 notify the LESSOR of the existence of all such mOligages, deeds oftl'Ust or other seclIred encumbrances and that, in the absence of such notice, LESSOR has no obligation whatever to notify allY such holder of said encumbrance.

11. LESSEE shall have quiet and peaceful possession of said property as long as compliance is made by LESSEE with the terms of this agreement.

12. It is expressly agreed by and between the parties that the LESSEE will not made any alterations upon the said property without the express written consent of LESSOR and that the LESSEE will not occupy or use, not permit to be occupied or used, the said property, for any business deemed extra-hazardous on account of fire or otherwise; nor will the LESSEE permit the same to be used for any immoral or unlawful purpose. LESSEE also covenants and agrees to maintain the said premises in a neat and orderly manner and to refrain from,creating or maintaining any eyesores, utlllttractive nuis~nces, or other nuisances.

13. TIle LESSEE hereby covenants and agrees thnt if an execution or process is levied upon the said premises 01' if a petition of bankruptcy be filed by or against the LESSEE in any conti of competent jurisdiction, the LESSOR shall have the right, at its option, to cancel this lease. The LESSEE further covenants and agrees that this lease and the interest of the LESSEE hereunder sball not, without the writteu consent of the LESSOR first be obtained, be subject to garnishment or sale under execution or otherwise in any suit 0)'

proceeding which may be brought by or against LESSEE.

14. LESSOR reserves title to all oil or gas, coal, lignite or other minerals in, on, or under said lease pl'opeliy, together with the right to enter and remove the same.

15. LESSOR reserves and excepts from said lease an timber now and during the term, being situated on said property with the right to ingress and agree to remove same, and with the right to sell all or any pari of said timber without any breach of any right of LESSEE

6

hereunder.

16. This lease shall be binding upon the heirs, executors, administrators, devisees, legatees and assigns of both patiies.

17. LESSOR reserves the right to grant or selJ right-of-ways across any of said lands for roads, Ilighways, railroads or any public utility Jine, provided only that LESSEE be paid a reasonable rental for the unexpired term of this lease, and fol' any damages done to LESSEE'S propcliy or improvements located on said lands, by the GRANTEE of such right-of-way.

18. LESSEE understands, covenants and agrees that this is a Residential Lease as described in Section 29-3-33, Mississippi Code of 1972 Annotated, and as such this must be the residential home of the LESSEE. Should this IJroperty no longer constitute the residence of the LESSEE, then this lease is subject to reclassification and a different remal rate and/or termination. LESSEE fmiher understands that he or she has an oblisation to inform LESSOR in writing within 30 days if the IJfOperty cea~~o~ PdSMaffic ~.g>sidential home of LESSEE. Failure of the LESSEE to comply with this paragraph would constinlte grounds for DEFAULT 011 this lease and grounds for immediate termination of this lease.

19. LESSEE understands, covenants, and nlrther agrees that he or she must maintain and keep said lease property clean so as to not beCOlne a public nuisance or menace to the public health and safety of the community. Examples of conditions constituting such a nuisance or menace could be high grass or weeds, rubbish, dilapidated fences, dilapidated buildings, dilapidated or old broken down vehicles, and other debris as described in Section 21-19-11, Mississippi Code of 1972 Annotated. Should the LESSOR decide that sllch conditions exist, LESSEE shall be given written notice to clean said propeliy and correct the conditions by United States regular mail to the property address as contained in this Jease. Failure of the LESSEE to coneet said conditions within sixty (60) days of the date of said notice shaH constit,ute grounds for DEFAULT on this lease and grounds , for termination of this lease.

20. LESSEE understands and agrees that the following actions, or inactions, on the pali of the LESSEE shall constitute a DEFAULT fol' which this lease may be terminated by the LESSOR. The following list is not intended to be all-inclusive, but is intended to be a quick reference for the LESSEE. Said list is as follows:

a. Failure of the LESSEE to pay the anllual rent within sixty (60) days of the due date;

b. Failurc of the LESSEE to pay the City of Picayune and Pearl Rivcl' CO\lnty 3d valorem taxes, and any other general taxes and assessments pursuant to Paragraph 4 of this lease;

c. Impl'Oper assignment ofthis lease ill violation of Paragraph 5 of this lease;

7

d. Failure of the LESSEE to maintain the lease property herein as his or her residential home and/or failure to notify LESSOR in writing once the prope!1y is no longer his or her residential home pursuant to Paragraph 18 of this lease; and

e, Failure of the LESSEE to maintain and keep the lease property clean pursuant to Paragraph 19 of this lease.

21. SECRETARY of STATE. By virtue of the signature below, tbe Secretary of Stale of the State of Mississippi has approved tbis Lease Agreement in accordance with the Secretary's authority for general supervision of 16'h Section Public School Trust Land. Approval of this Lease Agreement by the Secretary of State indicates that the Picayune Board of Education has exercised the care and skill of an ordinary prudent person to protect the beneficiaries of the 16,h Section Public School Tmst Land.

22. SUPER VISOR Y RIGHT. Tbe Secretal)' of State, as supervisory trustee, shall have the right to institute any action to enforce the terms of this Lease Agreement in the event LESSOR fails to do so in a timely manner. In the event the Secretary institutes legal action to enforce the terms of this Lease Agreement, he shall have all rights as are conferred to LESSOR. BOOK 0158 P"9~ 627

IN WITNESS WHEREOF, this lease is executed by LESSOR and pursuant to order entered upon its minutes and is executed by LESSEE, this the 22nd day of May 2012.,

LESSOR: BOARD OF EDUCATION OF THE PICA YlII\'E SCHOOL DISTRICT

BY:_~~ ~, Superint dent of Education

t V ,

!

Sup 0isors

AND LESSEE

By: " ". ,'c \. _,,-" IRVIN TE~1PLET

8

APPROVED SECRETARY OF STATE

(: . QJhti,-,-,-(j~-,-,---_\. __ _ C. Delbc11 Hosemann, Jr.

Secretary of State (Seal)

8T A TE OF MISSISSIPPI COUNTY OF PEARL R[VER

This day personally appeared before me, the undersigned authority at law in and for the above llamed county and state, the within named Superintendent of 'Education and Chalrpers()n of the Board of Education of the Picayune School District, who acknowledged that they signed and delivered the above and foregoing instrument of writing on the day and date therein stated, inlhe capacity therein set forth, and after having been authorized so \0 do.

,!--" .'\. ' Given under my hand and official seal on this, the day of ._"" ," ._".- 2012.

,I J "~Htf ....

-', J.,;.. ..... * STAr. .. ······:. J ~ '''~''

" '~.·l ,./ J' . ;; ..... "1, ;y..~9., .. , i-~. ___ .:. '\.'-.~. , 'L" ".... '.~ ..,.--- _~~.~ •

NOTARY rUBL 'i\\~' ~ ~ , ~1 H1;~ gi7

My Commission Expires: \\~ "~ ~:"', ;: • C! ,/ .

;. ~ (I " , 1. ~ I ••••• 00/{'rv --!~ ". r 1 , 1 """ '


This day personally appeared before me, tbe undersigned authority at law ill and for the above named county and state, the within named IRVIN TEMPLET who acknowledged that they executed the above and foregoing instrument of writing, on the day and year therein mentioned and for the purposes therein mentioned,

NOTARY PUBLIC .J

"

9

My Commission Expires: STATE OF MISSISSIPPI COtJNTY OF PEARL RIVER

This day personally appeared before me, the authority at law in and for the above named county and state, the witbinllamed President of tbe Pearl River Coullty Board of Supcnisors, who acknowledged that he executed the above and foregoing instrument of "'Titing on the day and year therein mcntioned and for the purpose therein mentioned.

Given under my hand and official seal on this, the __ day of _______ 2012.

NOTARY PUBLIC

My Commission Expires:

10

16th Section Lands Amendment of Lease

Parcel# 617-516-001-01-022-01

Prepared By: Picayune School District 706 GOODYEAR BLVD. PICAYUNE, MS 39466 601-798-3230

16th SECTION LANDS AMENDMENT OF LEASE

Page 1

PLS# 162

Return To: Picayune School District 706 GOODYEAR BLVD PICA YUNE, MS 39466 601-798-3230

WHEREAS that certain Commercial/Residential Lease Contract (hereinafter "base

lease") dated October 13,2002 for a term of forty (40) years ending 011 October 13, 2M2, was • •

executed by and between the Picayune School District Board of Education, as Lessor and

Susan Stockstill, as Lessee, and;

WHEREAS said base lease was filed for of record in the Office of the ChancelY Clerk of

Pearl RiverCounly, Mississippi, in Book 889 at Page 401- 409, and;

WHEREAS said base lease covers the following described land in Pearl River County,

Mississippi:

50S fORM AMENDMENT

16'h Section Lands Amendment of Lease

Scction 16, Township 6 South, Range 17 West Page 2

Commence at the NE comer of NE \I; of NE \1;, thence run Soulh 250 feet to

the point ofbeginlling, thence rUll West 150 feet, thence nm South 50 feet, tbence

run East ISO feet, thence runl\'Olth 50 feet to the point of beginning, being Parcel

1102 of Block #1, on Tax Map #617-516-2 of the Tax AssessodCoJlector of Pearl

River County, Mississippi more particularly described as: Book 0158 Pa~~ 631

Commence at the Northwest corner of NW \I; of NE V. of Section 16,

Township 6 South, Range 17 West, Picayune, Mississippi. From said point thence

nUl due South along the West right-of-way of Neal Road a distance of250.00 feet

more or less this being the Point of Beginning of the following described land.

From said Point of Beginning, thence lun West a distance of 150 feet more or less;

thence run South a distance of 50.00 feet more or less; thence run East a distance of

150.00 feet more or less to the West right-of-way Neal Road; thence run due North • •

along said right-of-way of Neal Road a distance of 50.00 feet more or less to the

Point of Beginning. containing 0.17 aere(s) more or less. Said land being part of the

NW \I; of NW \I; of NE \1;, Section 16 Township 6 South, Range 17 West,

Picayune, Pearl River County, Mississippi [201 Neal Road].

sos FORM AMENDMENT

161h Section Lands Amendment of Lease Pllge3

WHEREAS the legal Name of Lessee of said base lease slales Susan Stocl\stlll as being

said lessee; and

WHEREAS, Lessee desires to change the namc oflhe Lessee, of Slate Lease Number

14021, filed of Record in the Office oflhe Chancery Clerk of Pearl River County, Mississippi,

in Book 889 at Page 401 - 409, and; 300k 0158 F"9~ 632

WITNESSETH:

The Name of Lessee of base lease, State Lease Number 1402J, is amended as follows:

SUSAN STOCKSTILL AND XAVIER DEDEAUX

Said base lease shall remain in force and effect as to all other provisions,

EXECUTED on this the 12th day of June,2Cl,12.

LESSEE

prCA YUNE SCHOOL DISTRICT

By: ~--7~ SUPERINTENDENT

~~ ,.I J

By: ~/Ae~~ . __ PRESIDENT, BO OF EDUCATION

50S FORM AMENDMENT

16'" Section Lands Alllendment ofLeRsc Page /.j

This amendment was approved by the __________ Board of Supervisors on the ____ day of ,2012.


By: -:-=-:-=-:-=-:-=_-:-=-:-=-:-=-:-= __ PRESIDENT, BOARD OF SUPERVISORS

ACKNOWLEDGMENT

PERSONALLY APPEARED before me, the undersigned authority in and for the said count)' and state, on this the ..':" " day .. ,.' 2012, within my jurisdiction, the within named SUSAN STOCKSTILL who acknowledged that she executed the above and foregoing instrument.

STATE OF MISSISSIPPI COUNTY OF PEARL RlVER

sos FORM AMENDMENT

NOTARY PUBLIC

...... ~l'.,~.o :: ~ ' .. ',., ';.' __ -'-(~_'_" '.::: • ....: ... _ •• '_-"--'-__ _ .J

N,oT ARY PUBLIC

] 6th Section Lands Amendment of Lease

STATE OF MISSISSIPPI COUNTY OF PEARL ruVER

Pagel)

Boof; 0158 f'."!O 63~

Personally appeared before me, the undersigned authority in and for said county and state,

011 this the 12110 day of June, 2012, within my jurisdictioll, the within named, DEAN SHAW,

Superintendent of Schools, and EDWARD STUBBS, School Board President, oftlle Picayune

School District Board of Education, who acknowledged that in said representative capacity as

Superintendent of Schools and President of the Board of Education of Picayune School District,

Mississippi, they executed the above and foregoing instrument for and on behalf of said Board of

Education, after first having been duly authorized so to do.

ADDRESS OF LESSOR;

PICA l'UNE SCHOOL DISTruCT 706 GOODYEAR BLVD.

• PlCA YUNE. MS 39466 Telephone: 601-79&-3230

INDEXING L'IISTRUCTION

SECTION: 16 TOWNSHIP: 06S RANGE: 17W

Parcel # 6175160020100200

ADDRESS OF LESSEE:

SUSAN STOCSTTLL AND XAVIER DEDEAUX 705 CHARLOTTE DRlVE PICA YlJNE. MS 39466

Telephone: 601-799-1835

QUARTER SECTIONS: NW v.. OF THE NE 1/4

THIS INSTRUMENT WAS PREPARED BY; JACKIE LUMPKIN 50S FORM AMENDMENT

] 6'" Section Lands AI11cndmcnl of Lease

Prepared hy: PICAYUNE SCHOOL DISTRlCT 706 GOODYEAR BLVD. PICAYUNE, MS 39466 601-798-3230

Page 1

Soak 0158 P~9~ 635

PLS# 124

Retnm to: PICA YUNE SCHOOL DISTRICT 706 GOODYEAR BLVD PICA YUNE, MS 39466 601-798-3230

16th SECTION LANDS AMENDMENT OF LEASE

WHEREAS that ccl1ain Commercial Lease Contract (hereinafter "base lease") dated July •

22,d, 1991 for a term offOliy (40) years ending on Jllly nnd 1-(t~L was execuled hv ~lld

INVESTMENT CORPORATION Lessee, and;

WHPREAS said base lease was filed for ofrorol'd in the Office of the Chancery Clerk of

Pearl River County, Mississippi, in Book 558 at Page 343 - 350, and;

WHERl~AS said base lease covers the following described land io Pead River County.

Mississippi:

50S fORM AMENPMENT

16 th Section Lauds Amelldmellt of Lease

Section 16, Township 6 South, Range 17 West Page2

Commencing at the Northwest corner ofthe Northeast Quarter of Section 16, Township 6 South, Range 17 West; thence South 845.82 feet to the North right of way of Palestine Road; thence South 66 degrees 31 minutes East 2211.49 feet to the Point of Beginning; thencc North 355.17 feet; thence East 3 J 4.52 feet to a point on the west right-of-way of the Pearl River Valley Railroad; thence South 3 degrees 46 minutcs East along said right-of-way 211.41 feet; thence West 200 feet; thence South 68.54 feet; thence South 21 degrees 31 minutes West 120.64 feet to a point on the North margin of Palestine Road; thence North 66 degrees 31 minutes West along the said margin 91.75 fl::et [0 the place of b~ginning; containing 2.0 acres, more or less, in the Northeast Quarter of Section 16, Township 6 South, Range 17 West, Pearl River County, Mississippi. Book 0158 P.~~ b3b

WHEREAS the legal Name of Lessee of said base lease states BAYOU IRON

INVESTMENT COlU>ORATION as being said lessee; and

WHEREAS, Lessor desires to change the name oCthe Lessee, of State Lease Number 18377

due to FIRST NBC BANK paying back due rent and taxes to keep lease on tax rolls, filed of Record

ill the Office of the Chancery Clerk of Pearl River County, Mississippi, in Book 1588 at Page 354,

and;

WITNESSETH:

The Name of Lessee of base lease, State Lease Number 18377. is amended as 101l0w8:

FmST NBC BANK

Said base lease shall remain ill force and effect as to all other provisions.

EXECUTED on this the lih day of I\!!l~, 2012.

SOS FORM AMENDMENT

16'" Section Lands Amendment of Lease

PICA YUNE SCHOOL DlSTRlCT

/) ~J9~ 637

By:~~ ~~.-SUPERINTENDENT

This amendment was approved by the /l'r< / I t:'t'.I'~ ~ Board of Supervisors on

the ___ $ ;.t- dayof_ilv7l/,sf 7012.

,-""c.:, :<,~", S TATE OF Mi5S1£rf.TfP.J2:I.-CBL-'NT"N,}F PEARL Rt)'E-R 0v'?4 vL= <;p~k~/

ACKNOWLEDGMENT

PERSONALLY APPEARED before me, the undersigned authority in and for the said

)

county and state, on this the /Il day of 1<',/-4 ,2012, within my jurisdiction, the within named JlAVlB C06K who acknowledged tImt he/she executed the above and foregoing instrument. i;.."LLI/lI;\ ':;-. r::;.): n;-LL . ,,--, . ,-"" .. ~;'.

"" ~~.--- ... ,

SOS FORM AMENDMENT

16,1. Scction Lands Amcmlmcnt of Lease

STA TE OF MISSISSIPPI COUNTY OF PEARL RIVER

Personally appeared before me, the undersigned authority in and for said county and state, on this the

J 2'" day of June, 20 I 2, within my jurisdiction, the wilhinnamed, DEAN SRA W, Superintendent of

Schools, and EDWARD STUBBS, School Board President, of the Picayune School District Board

of Education, who acknowledged that in said representative capacity as Superintendel1l of Schools

and Presid",1t ofthe Board ofEducatioll ofPicayulle School Disu !ct, Mississippi, they e:~ccuted the

above and foregoing instrument for and on behalf of said Board of Education, after first having been

duly authorized so to do. .. ............... ~ . ,..-; ,,'\SSfS'.$'r;-'\

ADDRESS OF LESSOR:

PICA YUNE SCHOOL DISTRICT 706 GOODYEAR BLVD. PICAYUNE, MS 39466 Telephone: 601-798·3230

INDEXING INSTRUCTION

SECTION; 16 TOWNSHIP: 06S RANGE: 17W

QUARTER SECTIONS: NE V.

50S FORM AMENDMENT

. /..~~ '!.~ \.U<liR...,.~ \. . . . , - ~ '8 \\It;i, 1- {: \ I r-~ "," v ,

-' -~"cN~ta~y-Pu61i~)' -_ .. _- 1;;- ~"()'~~~! t:! \ it: C?:;':", •• zo\' (C,.' "..0 ~,~ A-J .: \~ (;v.,

•• ••• ~1T1. R 1'1\''' ........ ~'··'h ....... ····

ADDRESS OF LESSEE:

FIRST NBC BANK, DA VlD COOK 210 BAR Ol\TNE STREET NEW ORLEANS, LA 70130 Telephone: 504-671-3463

Indexing Instructions: 0.17 8cre(s), Block A, Lot #08 SE 114 of SE 1/4~ Section 16, Township 6S, Range 17W City of Picayune Parcel # 617-516-004-02-003-00 Pearl River County, MS

After Recording Mail To 1 Prepared By: Picayune School District 706 Goodyear Blvd. Picayune, MS 39466 60J-798-3230/Fax-60 1-798-1742

800K 0158 PJ9~ 639

PLS# 130

CANCELLATION SIXTEENTH SECTION LEASE CONTRACT


WITNESSETH

WHEREAS, THE Board of Trustees of the Picayune School District, by order entered upon its minutes on the 24th day of July_~~_20l2, does hereby declare CANCELLED AND TERMINATED, a certain Residential Lease Contract executed to CHRISTOPHER MYERS issued by the Picayune School District on the 9th day of November 2010, and recorded in Deed Book 1027 at Page 976 - 986 in the office of the Chancery Clerk of Pearl River Counly;


Commence at a point where the Wesl right-of-way of Beech Road intersects the South right-of-way of Rosa Street; thence run West along said South right-of-way of Rosa Street a

distance of 350,00 feet more or less this being the Point of Beginning of the followiug described land, From said Point of Beginning; thence run due South a distance of 150,00 feet more or less; thence run West a distance of 50.00 feet more or less; thence run due North a distance of 150.00 feet more or less to the South right-of-way of Rosa Street; thence run East along said right-of-way of Rosa Street a distance of 50.00 feet more or less to the Point of.Beginning, containing [0.17] acre(s) more or less; 1618 Rosa Street. The property described is part of the SE 1/4 of SE 1/4 of Section 16, TownShip 6 South, Range 17 West, City of Picayune, Pearl River County, Mississippi

800v. 1)158 Pa~~ 640 IN WITNESS WHEREOF, this Residential Lease Contract is hereby CANCELLED and TERMINATED by the Board of Trustees of the Picayune School District in accordance with terms of original lcasc issued on the 9th day of November 20 I 0, The cause for said cancellation by Lessor is request of Lessee.

NOW THEREFORE BE IT RESOLVED AND ORDERED, the Board of Trustees of the Picayune School District in its official capacity as Trustee of SiJ. . .-teenth Section Land does hcreby terminate the aforesaid Sixteenth Section Residential Lease Contract on this the 24th of July 2012.

Board of Trustees of Picayune School District: Lessor

By:itk~~ ( President of the Board of Educati~

BY:~~~=c",,,,,-,,,-::,",,.!=---:--__ r Superintendent of Education

STATE OF MISSISSIPPI COUl\TY OF PEARL RIVER

This day personally appeared before me, the undersigned authority at law in and for the above named county and state, respectively the President of the Board of Trustees and Supel'intendent of Education for the Board of Trustees of the Picayune School District, who acknowledged that they signed, executed and delivered the above and foregoing Cancellation of Sixteenth Section Lease Contract on the day and year therein set forth, being first duly authorized so to do,

Given under my hand and seal, this the 24th ........... <I. ",\SSi:,'~> ..

,,~ 7<1 ....... :' ),,;:r .... '"' ~~tY';'';j:'"''''

~.... . ,",,, '. C .. E . ~ ir ,~"., :"\ .I, \ My orrumsslOn xp 1f.:l ."'·' .. ,\.r, .,.!

~ ..... ~,,"'.,r-,~" 1["" : '~', ': I

•. '.' . l \c ... '. "

day of July

Indexing Instructions: 0.29acrc(s), Unit #3, Lot #1 Greenview Subdivision Section 16, Township 06S, Range 17W City of Picayune Parceln-617-516-001-Q3-Q43-00

After Recording Mail To I Prepared By: Picayune School District 706 Goodyear Blvd. Picayune, MS 39466 601-798-3230IFax-60 1-798-1742

CANCELLATION SIXTEENTH SECTION LEASE CONTRACT

STATE OF MISSISSIPPI <:mUNTY OF PEARL RIVER

WITNESSETH

PLS# 47

WHEREAS, THE Board of Trustees of the Picayune School District, by order entered upon its minutes on the 261h day of June 2012, does hereby declare CANCELLED Arm TERMINATED, a certain Residential Lease Contract executed to ALENE GOFF issued by the Picayune~chool District on the 31st day of May 2005, and recorded in Deed Book 882 at Page 420 - 428 in the office of the Chancery Clerk of Pearl River County;


Greenview Subdivision, Part 3, Lol i/O 1. of the City of Picayune, Peal'! River COllllty, Mississippi, as per Map or Plat thcreof Oil "file in the Office of the Chancery Clerk of Pearl River County, Mississippi, (0.29 acre(s) more or less. 100 Carver Drive]; more particularly described ns:

Commence at a point where the South right-of-way of Palestine Road intersects the West right-of-way of Carver Drive this being the Point of Beginning. From said point thence !'Un South a distance of 66.2 feet more or Jess; thence run West It distance of 122,09 teelmore or less; thence run North It dislance of 123.6 feel more or less 10 the South right-of-way of Palestine Road; thence run East along said righl-of-way of Palestine Road a distance of 151.9 feet more 01' Jess to the Point of Beginning; containing 0.29 acre(s) more or less,

IN WITNESS WHEREOF, this Residential Lease Contract is hereby CANCELLED and TERMINATED by the Board of Trustees of the Picayune Schoo'°r.>i~tfM"(j·h &t"cOl'dance with terms of original lease issued on the 13th day of October 2002, The cause for said cancellation by Lessor is death of lessee,

NOW THEREFORE BE IT RESOLVED AND ORDERED, the Board of Trustees of the Picayune School District in its official capacity as Trustee of Sixteenth Section Land does hereby terminate the aforesaid Sixteenth Section Residential Lease on this the 26th of June 2012,


Board of Trustecs of Picayune School District: Lessor

By: t~lCatiOn By: ~// ~~_...-' ___ _

Superintendent of Education

This day personally appeared before me, the undersigned authority a\ law in and for the above named county and state, respectively the I'resident of tbe Board of Trustees aud Superintendent of Education foJ' the Board of Trustees of the l'icayune School District, who acknowledged that they signed, executed and delivered the above and foregoing Cancellation of Sixteenth Section Lease Contract on the day and year therein set f0l1h, being first duly authorized so to do.

Given under my hand and seal, this the 261h day of JUll~_ 2012. ..' ,

2

dated

Prepared by: Return to: Ter(!sa Quave Teresa Quave Pearl River COllnty Sehool.J)islricl 7441 Hwy. II

Pearl River Couj)ly School District 7441 Hwy. II

Can-iere, MS 39426 6()1-798-7744 ext. 25

Can-iere. MS 39426 601-798-7744 ext. 25

16'h SECTION LAl\'DS AMENDMENT OF LEASE

800k 0158 Pa9~ 643

WHEREAS that certain Hunting and Fishing Lease Contract (hereinafier "base lease")

__ ~ .. OCiober4.2010 ___________ for a lenn of_-,t",hr",ee,,-~years ending all

_____ _.",O"'c"lo"'b"'er'--__ -', __ 3rd ... _ 20 13 ~ was executed by and between the

Pear) Ri ver County Board of Education, as Lessor and Virgil Dwayne Lewis, as Lessee, alld;

WHEREAS said base lease was filed for of record in (he Office of the Chancery Clerk of

_____ --'-P-"e"'m.!.·1 ",Rl",'v",e,-r _____ .County, Mississippi, in Book 1041 ___ "1 Page 401·419 , and;

WHEREAS said base Jease covers Ihe following described land in _--,-P-"e",ar.!.1 ",Rl",'v",eLr_ County, Mississippi:

Section 16, Township __ 5South. ______ • Range _ .. !7WgSt

WHEREAS the legal description of said base lease stales _64=2",,~,",7,-___ acres more or Jess

WITNESSETfu

The Legal Description of base lease is alllended as follo\\'s:

Section 16, To\\'nship 4 South, Range 11 West

Containing (642.47), mOre or less.

Said base lease shall remain ill force and effect as to all other provisions.


EXECUTED on (his the ____ 7utl!.!..t _

Page2

day of....M~ ",,20~1,",2_~ __ .

\

Book 01sa ra9~ 644 LPc",awrluR"jv",c1Lr-,"C",ou",o"'!Y1-__ SCHOOL D1STRlCT

This amendment was approved by the #I'(//;§) V,. /' ~Board of Supervisors on

the __ --C.~_r--__ day of_..!.d.L:..,/J-f-""-"'$:..L!_-__ ~

BY·~b~:l':~~~~::t':-!-::l-~-:'::::::' VENT, ACKNOWLEDGMENT

STATE OF MI~SISSIPPJ

COUNTY OF~Q,"'! f; cer PERSON ALLY APPEARED before me, the undersigned authority in and for the said county and state, on (his

the ~3 day of 0.) I=] ~~ ____ , 2/L}).. ,within my jurisdiction, (he within named

Virgil Dwayne Lewis _--=-___ ..... __ who acknowledged that he

,Lo-Q~ itoTARY PUBLIC

executed the above and foregoing instrument.

«SEAL»

MY COMMISSION EXPIRES:

~ ,S?.3, ;;).3~j l ~:r (A!flx o!fleial seal. ifappJicable)

SOS FORM AMENDMENT 04i29105



COUNTY OF :jJuuJ., Fvf~

Page 3

8oot. OlSe P.9~ MS Personally appeared before me. the undersigned authority in and for said county and state. on this

the 1-{)1 day of '111 ¥ __ ~ 20 I ')..., • within my jurisdiction.

the within named Alan Lumpkin, Pearl River County ,_,_~~ Scnool District. Superintendent of Schools.

and _--"Je"ff"'J"o"'n,eis'-________________ ~. Seuool Board President. oflhe Pear;

River Counly ____________ School District Board of Education, who acknowledged that in said

representative capacity as Superintendent of Schools and President of the

Board of Education of Pearl River County ________ School District. Mississippi. they

executed the above and foregoing instrument for and on behalf of said Board of Education, after first having been

duly authorized so to do,

ADDRESS OF LESSOR:

7441 lilY)', II Carriere, MS 39426

Telephone: 601-798-7744

INDEXING INSTRUCTION

SECTION: 16 TOWNSHIP: 4 South RANGE: 16 West

QUARTER SECTIONS:

50S FORM AMENDMENT 04J2~JOS

"\/ ' ;} )/1,/ A IV ,,~ -If /un/;=iv V (Nolary Public)

ADDRESS OF LESSEE:

;)34 Harry Sones Rd. ____ _ Cnniere. MS 39426

Telephone: 601-798-7111


THIS INSTRUMENT WAS PREPARED BY: Teresa Quave Pearl River COUllty School District 7441 Hwy. 11 Carriere, MS 39426 601·798·7744 ext. 25

50S FORM AMENDMENT 04129105

Page 4

CJL MBMMAS03 08/15/2012 10:06 Board Minutes Minute Book Text Detail Book 0158 Page 647 CENTRAL LANDFILL QTR CHECK & REPORTS Date 8/ 6/2012 CHARTER COMM QTR. CHECK & REPORTS

ORDER TO ACCEPT CENTRAL LANDFILL 2ND QUARTER 2012 HOST FEE CHECK AND REPORTS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of Central Landfill host fee check and reports.


Be It Ordered by the Pearl River County Board of Supervisors to accept attached Central Landfill 2nd Quarter 2012 host fee check in the amount of $9,220.15 and reports.


Voting AYE:

Voting NAY: Absent:


ORDER TO ACCEPT CHARTER COMMUNICATIONS 2ND QUARTER 2012 FRANCHISE FEE CHECK AND REPORTS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of Charter Communications franchise fee check.


Be It Ordered by the Pearl River County Board of Supervisors to accept attached Charter Communications franchise fee for 2nd quarter 2012 in the amount of $17,495.33 and reports.


Voting AYE:

Voting NAY: Absent:


PAGE 34

July 15.2012

Pearl River County Board of Supervisors AUention: Board President 207 West Pearl St. Poplarville, Mississippi 39470

Dear Board Members:

TRANSAMER'CAN WAST~ CElNTRAt.. t..ANOFILL. INC. A WASrE MANAO£MfN, t:OMrAl\IY

86:1,) Hi~:hw;I't 11 N!lf!I'I

P.O.)',,1<I9 ~kNdli. M" 1~417 «("l I ) ]9q it'll (601) 1')1.onQ F",

Per the Solid Waste Disposal agreement between Central Landfill and the Pearl River County Board of Supervisors, Central Landfill has imposed and collected a tonnage host fee on all tons generated outside of Pearl River County. The ClIIl'ent rate applied to the outside PRC tonnage is 0.7117 per ton. The host fce is to be paid on a quarterly basis. Below is the calculation for the 2nd Quarrel' 2012:

Total Tonnage Inside Pearl River Co.

Outside Pearl RivcrCo.

24.413.77 tons 11.458.66 tons

12,955.11 Ions

Enclosed is a check in the amount of $9,220.15 for the 2nd Quarter host fee. Please feel free to contact me should YOli have any questions or concerns.

SiOC"dY/~ Justin Page Central Landfill- Operations Mallager

'tS/ 'iJs.J r'.U. tiOx JULt '.'IAS'''' t.lAMAI3:';!.\J;;"H' HO~lston. TX 77253

866-834.2080C;;Y'1

Chock No 0010574422 '" Doc Dale I

I Invoice Number I Des~~tion Original Amount Discount Amount Amount Paid

, 0612012012 1140·06302012 9,220.15 0.00 9,220.15

'INO' 2ND QrR HOST FEES

, i

Dook 0158 Pl'~~ 649

.

Vend(i( Number Nilm~

0000073854 Pearl River Counly General Fund ~~~~_~k ;,\fumlJer 0It: I Tot;'t Amount OHcoII(lt$ Taken i Toto! £la!d AIl)(Jllnt 1

0010514422 0111812012 $9,220.15 $0.00 $9,220.15 -" THIS OOCVMf1NTHASACOLOReO 3ACKOROUNO MID MICROPRINTING IH THE ENDORSEMENT SIGNATVRE LINE. THE REVERSE SIDIl OF THiS DOCUMENT HAS All ARTIFICIAL WATERMAR,<

W ' BANK OF AME.RICA CHECK ,10 0010.574422

"!", Waste Management ED COMMERC1At OISBUR$'EM'ENf ACCOUNT

_ - . PH·O.8,OX3

TOx2'7·7253 -: \- _",,' ~Oln-H8ROOl(,I~, 1.~O~2l2.8/719

. WASTa !,'ANA<l~M~:\l'f ous on, " _ ,_

DATE: 01Jl812012 PAY EXACTlY

PAY EXA¢T~Y . ..... " ,. , ;,_. t )

.... NfNET(fOUSAND TWOHUNDREPTWENTV ANt 15/100 DOLi,;i\R····.

S9,220.15*'· . J VOiD AFTER 90 DAYS

r----~-~--'--------~. c"".t~--t._lJ~~~- .. V

PEARL RIVER COUNTY GENERAL FUND ". , AUTHORIZED SIGNATURE lOTHE ORDER OF

PO Box 249 ,. Mcneill, MS 39457

AUTHORIZED SIGNATURE

w

August 1.2012

Pearl River County Board of Supervisors Attention: Board President p,O, Box 569 Poplarville, Mississippi 39470

Dear Board Members:

TRANSAMER.CAN WASTE CENTRAL LANDFILL, INC. 1\ WASTC MAt-lALlf,MFNT COMPANY

8()H{~ I H~hW,!\" I f "onh P.O, RI)l( 14\} "'''N'',Ii, /.-1;; 1'!41) (nl)!) -N~,r}O~ (oOI) (9),012\) Fax

Per the Solid Waste Disposal agreement between Central Landfill and the Pearl River County Board of Supervisors. Below is the calculation for total tons accepted at Central Landfill for the month of July 2012 .

Outside Pearl River Co. Inside Pearl River Co.

Total Tons

4212.57 tons 3913.59 tons

8126.16ton8

Please feel free to contact me should you have any questions or concerns.

Sincerely, ~~ 11 7J'dL-L::;'j ~.5---

Justin Page Central Landfill - Operations Manager

f!JCharter

Pearl River County, MS Carriere, MS 39426

RE: Quarterly Franchise Fee Payment

Dear Sir or Madam:

July 20, 2012

Enclosed please find our franchise fee remittance covering the period from April 1, 2012, to June 30, 2012, for Charter Comml;nicatlons ("Charter"). This franchise fee computation has been prep"red in accordance with the terms and conditions found In your cable television Franchise Agreement ("Agreement") with Charter. This payment specifically complies with the language found In the Franchise Agreement, whether the Agreement is based on a percentage, flat rate, or per sub payment, and Includes all appropriate revenue sources required by the Agreement.

This payment was calculated as follows:

Franchise Fee Base

Franchise Fee (as defined In Agreement):

Fee Ad)ustment

Fee Due

Please contact your Government Relations representative or send an email directly to [email protected] for any address updates or corrections.

$583,177.58

3%

$0.00

$17,495.33

We would also like to remind you of an alternative to US mall·dellvered paper checks for franchise fee payments. You now have the option of signing up for an electronic direct payment process for franchise fees, assuring a more efficient and timely manner of receiving your funds. If you would like to pursue the electronic payment process, please contact your Government Relations representative for instructions. We believe this convenient method will be of significant value to you.

ChartN Communications Is proud to serve your community and our customers INlth cable television service. Please feel free to contact our office [email protected] If any additional Information is required.

SincerelYI

Jj;t~' ~, Steve Lottmann Divisional Controller

3365·00166963·32201

Enclosure

,I1TAcml~;NT CO:-lTAINS TRADE SECREr INFORMATIO:'/ AND IS CO:'/FIOENTIAL & PIIOPRIETARY • NOT FOIlI'VOLIC DlSCLOSl'RE

1

(3141288,310)

www.charter.com 1

'2405 Powerscourt Drive 5t Louis, MO 63131

{.,51

c\ 3gCharter Summary of Revenues2

Subject to Franchise Fee

32201 North Shore

'" ':2 3365130 Pearl River County, MS

.. Source FTA Code(s): 8381/2600/0020,0030.0040.0050.6800.82041400011350, 1360.13~.1380.6840

Fee Factor: 3%

u.~u i , .n-----; ;:.;

." "'" c .g

TRADE SECRET J CONFIDENTIAL & PROPRIETARY - NOT FOR PUBLIC DISCLOSURE

Prim l)are 712012012

Run l)are 712012012 1O:41:35AM

Vendor Code: 00166963 FCC 10:

Frequency: Quarterly Base Period: 1

21311 ! 2405 Powfncouil OJ 5t: levis, MO &3131 !314,SES·OS55

04/JO/12 Q201204 05/31/12 Q201205 06/30/12 0201206

Franchise Fee Franchise Fee Franchise Fee:

166963 COUNTY OF PEARL RIVER

f/Charter 12405 Pow.rBeour! Drive

St. Louis. MO 63131·3674 ~""'_~_"""'''''''''''1'"'' ..... L __ , ... ,g

166903

STUB 1 OF 1

CIIECKIlATE, 07/20/12 NO. 04821260

5 1 8S5.33 5,95iL09 5.687.91

5,855.>3 5,952.09 I

Sf 687 .91:

I

8 uk ')J5B r39~ 653

60- 1 159:0815

us RAN1< M£MI'HIS, M(l

DATE

07/20/12

NO. 04821260

AMOUNT

$*******17 1495.33'

PAY SEVENTEEN THOUSAND FOUR HUNDRED NINETY FIVE AND 33/100**************:;****4***,******'/dl

TO TIlE

ORDER OF

COUNTY OF PEARL RIVER President P.O. Box 569 Poplarville MS 39470 -

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 654 UNITEDHEALTHCARE INSURANCE 2011 REBATE Date 8/ 6/2012 COUNTY ADMIN JULY 2012 MONTHLY REPORTS

ORDER TO ACKNOWl,EDGE RECEIPT OF UNITEDHEALTHCARE 2011 PREMIUM REBATE CHECK ON POLICY #0715117

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of health insurance premium rebate for year 2011.

Upon motion made by Dennis Dedeaux and seconded by Sandy Kane smith, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of supervisors to acknowledge receipt of attached Unitedhealthcare health insurance premium rebate for year 2011 policy #0715117 in the amount of $74,467.78.


voting AYE:

voting NAY: Absent:


ORDER TO ACKNOWLEDGE RECEIPT OF COUNTY ADMINISTATOR'S JULY 2012 MONTHLY REPORTS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of July 2012 monthly reports.

upon motion made by Sandy Kane smith and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River county Board of Supervisors to acknowledge receipt of County Administrator's July 2012 monthly reports.


Voting AYE:

Voting NAY: Absent:

Anthony Hales, Dennis Dedeaux, Patrick Lee, and Sandy Kane smith None Joyce Culpepper

PAGE 2

Unitedl-laalUlCare Insurance Company MLR OPERATIONS POBOX 30519 SALT LAKE CITY, VT 84130

I)'/; UnitedHeal'thcare' "

Group Information =

= = 2Q~LREM1AOOO2001

Group Name: Pear! River County Board of Supervisors ;:;;

Group No; 0715117 Pearl River County Board of SupelVisors Pearl River County BOS

Check No: 00113201 5!i!

PO Box 569 Check Amounl: $74,467,78 ::::!

PoplalVille, MS 39470

Quesllons? Learn more aboUI MLR rerunds, Visit wl;WI,uho,com{re(orm Call: 1·866·802·8602

Please keep this document for your records,

Re: Health Insurance Premiuln Rebate for Year 2011; Policy #0715117 ~QOK 0156 Pa9~ 655 Dear Pearl River County Board of Supervisors:

Your 2011 medical loss ratio (MLR) premium rebate check is attached below. Enclosed you will find a leiter that the federal government required be sent to you explaining why you have received this rebate. We've drafted and included a set of Frequently Asked Questions 10 provide you more inform alion,

= =

UnhodHoallbcDfe ImHJfanee Company MLR OPERATiONS po aox 305'9 SAL HAKE CITY, UT 64130 PHONE: 1.868.802.86OZ

~ MLRE 00113201

JP Morgan Cha.e Sank NA Syracuse, NY 13206

DATE: 0712012012

PLEASE PRESENT PROMPTLY fOR PAYMENT

PAY: $ ...... ··74,467.78 ..

*"'Sevenl~f four Thousand Four Hundred Slxt)t Seven Dollars and seventy EIght Cenls'HHh~hHh''''''''Hd'HHH''''''.Hn ..

PAY TOTHE

ORDER OF

Pearl River County Board of Supervisors Pearl River County BOS PO 80x SE9 Popla",llle, MS 39470

AUTHORIZED SIGI'ATURE

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 656 ACKNOWLEDGE FURLOUGH REPORT Date 8/ 6/2012 APPROVE TRAVEL

ORDER TO ACKNOWLEDGE FURLOUGH REPORT

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of furlough report.


Be It Ordered by the Pearl River County Board of Supervisors to acknowledge attached furlough report for 7/5/12 to 7/18/12.


Voting AYE:

Voting NAY, Absent:


ORDER TO APPROVE TRAVEL

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of travel for county employees and officials.


Be It Ordered by the Pearl River County Board of Supervisors to approve travel for the following listed officials and county employees to attend various workshops, seminars and meetings listed below and that reimbursement for any expenses incurred be and is hereby approved, including, but not limited to, travel, meals, lodging registration fees and other expenses incidental to said workshops, seminars, and meetings.

Election Commissioners Margaret Woodson, Tommy Breland, and Harold Blappert to training in Biloxi, MS, on August 30, 2012.

Tax Assessor/Collector Gary Beech and Office Manager, Jo Lynn Houston to Certification Program in Hattiesburg, MS on August 13 - 17, 2012.



PAGE 4

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 656 ACKNOWLEDGE FURLOUGH REPORT Date 8/ 6/2012 APPROVE TRAVEL

Voting AYE: Anthony Hales, Dennis Dedeaux, Patrick Lee, and Sandy Kane Smith

voting NAY: None

PAGE 5

Pearl River County Furlough

07/05/2012 thru 07/18/2012

General Fund Administration $1,027.76 BOS $101.43 Buildings & Grounds $565.08 Chancery $1,121.41 Circuit $859.91 County Courl $654.32 Sheriff· Investiga!ion $526.27 Sheriff· Jail $1,388,89 District Ally $815,63 Data Processing $289,86 Emergency Mgt $454,19 Justice Court $606.04 Planning $358,03 Salety $221.10 Sanitation $355.20 Tax Assessor $1,328.13 Velerans $131.86

Total

Building Code Fund

E911 Fund

Reappraisal Fund

Road & Bridge Fund

Dook 0158 P~9~

$10,825.11

$502.37

$1,330.68

$917.94

$6,274.63

Total $19.850.73

657

DATE: July 26, 2012

Pearl River County Election Commissioners Poplarville, MS

MEMO TO: Board of Supervisors

We hereby request permission to travel to a "Train The Trainer" TSX voting Device training session scheduled for August 30, 012, at the St. Martin Community Center in Biloxi, MS.

Commissioners Margaret Woodson, Tommy Breland and Harold BJapper! will be attending.

('..55

Pearl River County Tax AssessorlColiector

July 30, 2012

Soard of Supervisors Poplarville. MS

P.O.l3<>xS59 PopI.rvllle, MS 601 .. 03·2300

flool: 0158 Page 659

Please make the following a part of your official minutes. Authori~e alllravel cost and registration tees for Tax AssessorlColiector and Office Manager 10 Hat1lesburg AuguSI13 through 17 for Collector Certificallon Program. This Program is mandated by Mississippi Code Section 27-1-51(b).

/:?J~foA-Gary BeeC~a:AssessOrICOl!ector Pean River Counly

Search - j l{esult - § n-I-5J. Mississippi Tax Collectors Education and Certitication Program; levels of ... Page 1 of2

Geo

FOCU5'M Terms Search Within Original Results (1 - 1) . III Advanced... View Tutorial

View Full 10fl Book Browse

Miss. Code Ann. § 27-1-51 (Copy wi Cite) Miss. Code Ann. § 27-1-51

MISSISSIPPI CODE of 1972

*** Current through the 2011 Regular Session and 1st Extraordinary Session ***

TITLE 27. TAXATION AND FINANCE Book 0158 PaQo 660 CHAPTER 1. ASSESSORS AND COUNTY TAX COLLECTORS .

MISSISSIPPI TAX COLLECTORS EDUCATION AND CERTIFICATION PROGRAM

Miss. Code Ann. § 27-1-51 (2011)

§ 27-1-51. Mississippi Tax Collectors Education and Certification Program; levels of certification; reimbursement of certain expenses for attending certified collection school

Pages: 2

(1) (a) The Office of the State Auditor shall establish and Implement a Mississippi Tax Collectors Education and Certification Program under which county tax collectors and assessor-tax collectors and their deputies may attain certification as a tax collector or assessor-tax collector of state, county or municipal revenue. The Education and Certification Board, created under Section 27-1-53, In cooperation with the Center for Governmental Training and Technology within the Mississippi State University Extension Service, shall administer and conduct the education and training programs and examinations as may be appropriate for those persons to attain the certification, as directed by the Office of the State Auditor through Its rules and regulations for the efficient administration of the programs and examinations authorized under Sections 27-1-51 through 27-1-69. There shall be three (3) levels of certification: Collector of Revenue I (CR 1). Collector of Revenue II (CR 2), and the Mississippi Collector of Revenue (MCR).

(b) Counties having not more than fifteen thousand (15,000) parcels of real property shall have a minimum of two (2) Collectors of Revenue I (CR 1), and counties having more than fifteen thousand (15,000) parcels of real property shall have a minimum of three (3) Collectors of Revenue I (CR 1).

(2) (a) In any year in which a county tax collector or assessor-tax collector takes office for th" first time, the Office of the State Auditor shall require training sessions to be conducted In accordance with rules and regulations adopted by the office for these new officials. These sessions shall be held at sufficiently convenient locations throughout the state and at times that are sufficient to provide each county tax collector and assessor-tax collector with an opportunity to attend the training.

(b) To ensure that all newly elected or appointed tax collectors and assessor-tax collectors have an opportunity to attend the training sessions required by this section, the Office of the State Auditor shall require the training sessions to be conducted In each congressional district within the state.

(3) When any tax collector, assessor-tax collector, or the deputy thereof, travels outside of his county to attend a certified collection school approved by the Office of the State Auditor, that person shall receive a reimbursement of expenses for the travel at the same rate for mileage, food and lodging as allowed under Section 25-3-41. However, mileage shall not be authorized when the travel occurs by use of a motor vehicle owned by the county. All expenses reimbursed for a'tendlng a certified collection school shall be charged against the approved budget of the county tax collector or assessor-tax collector.

(4) The Office of the State Auditor shall have plenary authority to prescribe forms and to promulgate rules and regulations necessary to implement the provisions of Sections 27-1-51 through 27-1-69.

(5) The county tax collector or assessor-tax collector shall select a candidate from among his deputies to

http://web.lexisnexis.coll1/researchlretrieve? _ll1=d912be80fed3fdb9f811 02648eaad I ed&csvc=toc2doc&cL. 7/30/20 j 2

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 661 VOCA GRANT CLOSE OUT CORRESPONDENCE Date 8/ 6/2012 ELECTION SUPPORT FUNDS DISTRIBUTION

ORDER TO APPROVE EXECUTION OF VOCA GRANT CLOSE OUT DOCUMENT

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of VOCA Grant document.

Upon motion made by Sandy Kane smith and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to approve execution of attached VOCA Subgrantee No. 10VA1552.


Voting AYE:

voting NAY: Absent:


ORDER TO ACKNOWLEDGE RECEIPT OF DISTRIBUTION OF HELP MISSISSIPPI VOTE AND ELECTION SUPPORT FUNDS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of election support funds received.


Be It Ordered by the Pearl River County Board of Supervisors to acknowledge receipt of attached check from Secretary of State Distribution of Help Mississippi Vote and Election Support Funds in the amount of $6097.56.


Voting AYE:

Voting NAY: Absent:


PAGE 7

Division of Public Safety Planning CERTIFICATION OF SUB GRANT COMPLIANCE

SUBGRANTEEPearl River COlloty .Board of SlIpervisoS$JBGRANTEE NO, 1OVA1552. ___ _

A. RELEASE

Pursuant to the terms of said subgrant and ill consideration of the sum of

$ 47,899.72 Tot,1 ,\mount P,id & P'l'oble by Division of Public Safet), PlaMing

which has been or is to be repaid to the Subgrantee or to its assignees, if any, the Subgrantee upon payment of the said sum does remise, release, and discharge DPSP, its officers, agents, and employees, of and from all liabilities, obligations, claims and demands whatsoever under arising from the said subcontract, except:

1, Specified claims in stated amounts or in estim.ted amounts where the amounts are llot susceptible to exact statement by the Subgrantee, as follows:

2. Claims together with reasonable expenses incidental thereto, based upon the liabilities of the Subgrantee to third parties arising out of the perfonnance of the said subgrant, which are not know to the Subgrantee on the date of execution of this release and of which the Subgrantee given notice in writing to the DPSP Depanment Director v;oithin the period specified in the said contract.

3. Claims, after closeout, for costs which result from the liability to pay Unemployment Insurance costs under a reimbtttsement system or to settle Workers' Compensation claims,

B, ASSIGNMENT OF REFUNDS, REBATES AND CREDITS

Pursuant to the terms of said subgrant and in consideration of the reimbursement of costs and payment of fees as provided in the said subgrant any assignment thereunder, the Subgrantee does hereby:

1. Assign, transfer, set over and release to DPSP all rights, titles and interest to all refunds, rebates, credits or other amounts (including any interest thereon) arising or which may hereafter aCcrue thereunder.

2. Agree to take whatever action may be necessary to effect prompt collection of all such refunds, rebates, credits or otheramounts (including interest thereon due or which may become due, and to fo+ward promptly to DPSP) for an)' proceeds so collected.

3. Agree to cooperate fully with DPSP as to any claim or suit in connection with such refunds, rebates, credits or other amounts due (including any interest tllereon); to execute aoy protest, pleading, applicatioll, power of attome), or other papers in connection tberewith; and to permit DPSP, tl,e State Attorney General's Office or the Federal Grantor Agency to represent it at any heating, tJ:ial or otller proceeding arising out such claim or suit.

C. INVENTORY CERTIFICATION (Select one)

D.

TheSubgrantee hereby certifies that all items of materials and equipment purchased, furnished or transferred of 'or to said Subgrantee were done so in accordance with the terms and conditions of ,aid sub gram.

2 .. ___ "X ____ Tl,e Subg<an,ee hereby certifies that no equipment was furnished or acquired under the terms and conditions of said subgrant.

CERTIFICATION OF CASH BALANCE

The Subgrantee hereby certifies that the cash balance applicable to said subgrant as of the date of the execution of this documenf is 1\5 follows::

1.

2.

3.

4.

5.

Total DPSP funds received: 1)

Less final DPSP cumulative cost reported; 2)

Equals (=) unexpe~ded balance: 3)

(a) Plus(+)blllance=unexpended IilOds: (Refund due to DPSP) 4.)

(b) l\:!inus(-)balance=funds dues Subgrantee: 4b) (Subgrantee submits request)

Balance must equal zero

*Refund check must include the following:

(a) (b)

-Unexpended funds amount; Outstandiug claimants amount

(as applicable)

(e) Total amount refunded

5)

. 4.)

Enter Check Number _______ _

44,166.30

47,899.72

-3,733.42

3,733.42

-0-

E. GENERAL STATE OF COMPLIANCE

Ti,e subg"otee further certifies that all other terms a~d conditions of said subgrant have been met.

IN WITNESS THEREOF, this Certification of Subgrant Compuance Ius been executed this day of

~.-!A~usg\lst 6 ,20.1:2 __ .

TITLE

BDOk 0158 Page 664

WITNESSED BY:

1. _______ ._~~_

DELBl-:RT HOSEMANl>I

Sacrdal')' oj State

TO: President, Pearl River County Board of Supervisors

FROM: Delbert Hosemann

DATE: August 1,2012

SUBJECT: Distribution from Help Mississippi Vote and Election Support Fund

Please frod enclosed herewith your county's check in the amount of $6097.56, representing the July 2012 distribution from the Help Mississippi Vote Fund.

Statute places certain restrictions on the use of the monies from these funds. The distribution from the Help Mississippi Vote Fund " ... shall be used to support the state's efforts under the federal mandates of the Help America Vote Act."

Your Circuit Clerks have been thoroughly trained on the appropriate use of this fund. With funding from the Help Ameriea Vote Act (HAVA) diminishing, the Mississippi Legislature created this fund to assist as well as the Election Support Fund, to assist counties ill meeting their eltctiolls-related budgetary needs. These monies are intended to offset revenue shortfalls created through the windiog down ofHA VA funds, and provide counties with a cushion within which to contioue the important work of conducting elections.

Thank you for all that you do for your county, and for the State of Mississippi. Should you have any questions, please contact me at 601.359.6342, or Delbert.Hosemann@~os.ms.gov.

cc: Circuit Clerk Chancery Clerk

401 l>'fi;;t-is~lppi $trett

?OS~ Offic(: Bn~: T3G JIiC)aOJJ. hHul>:dppi 39~05

rl.'tf:phcnt (fior) 359-i350 !rHlI"'llilt (601) 359"1499

WWw.$os.ms.g<lv

aUld$:. vr ""aal;)::.-Jl'l'l

DEPARTMENT OF FINANCE AND ADMINISTRATION NO. 012955412

VENDOR V000079398A PAY DATn 07-27-12

AG.£NC'l' NAME

ADDRESS SECRETARY OF STATE P. O. /lOX 136

CITY JACKSON, MS 39205 FOR E-PAY INFO, GO TO WWW.8ANKOFAMERICA.COM/PAYMODE/MS AGY PHONE (601) 359-1350

, • JNV. DATE· JNVOICn NUMBER. P.O.NUMBER. ' DESCRIPTION ACCOUNT NUMBER' , NUT )NVOl"!! AMOUN): , PEARL RIVER4 , , I

ELECTION HELP liS VOTE 7/13 SEC. OF STATE

, ,

$ 6,097.56

Book (lISa ~a9~ 666

, . ,

, WARRANT TOTAL $ ,

, 6,097.56

I .-l''1>E.,. '" ".'. . . NO .. ,012955412 . - ~~~.~~'~~-•. !" .. 'I<>

" ! THE 'sTATE' OF MISSISSIPPI _ ~ I. ~_~:':::"'~"c.:-,-,-,c:::.-_::::-:: ~~~----,-,~

"~ ....;.;,,'~,~ . DEPARTMENT or. FINANCE AND'ADM.INISTRATION, . ll,.' . P. 0, BOX 1060 JACKSON. MS. 39215-1060 .

PAY TO THE ORDER OF: PEARL RIVER CTY

P 0 IlOX569 POPLARVILLE

-31i-ttMW"

MS 39470

PAY TBIS' AMOUNT

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 667 CIRCUIT CLERK PERSONNEL Date 8/ 6/2012 STOP FURLOUGH ORDER FOR EMPLOYEES

ORDER TO ACCEPT CIRCUIT CLERK'S PERSONNEL

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of personnel changes in the Circuit Clerk's Office.

upon motion made by Sandy Kane smith and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to approve the following and attached personnel changes in the Circuit Clerk's Office:

Melinda Lumpkin Resign


Voting AYE:

Voting NAY: Absent:


ORDER TO STOP BOARD ORDER ON EMPLOYEE FURLOUGH

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of order to furlough.

Upon motion made by Anthony Hales and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to stop Board Order on Employee Furlough.



Anthony Hales, Dennis Dedeaux, Patrick Lee, and Sandy Kane Smith Joyce Culpepper

PAGE 9

Vickie Hariel

From: Sent: To: Subject:

Melinda a. Lumpkin Tuesday, May 29, 2012 12:11 PM Vickie Hariel resignation

I wanted to give my notice of resignation. I thank you for this opportunity to try this position but I don't think I am suited for this

Job.

Thank You, Melinda

600k 0158 Pa~,~ 66S

l

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 669 CORONER REQUEST TO CONSIDER PAUPER Date 8/ 6/2012 CLOSE SESSION

ORDER TO APPROVE REQUEST FROM CORONER TO CONSIDER PAUPER

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of coroner's request on burial or cremation.


Be It Ordered by the Pearl River County Board of Supervisors to approve attached request from Coroner to consider Merrill Roy Shipman, III as a Pauper and assist with his cremation.

Order and adopted, this the 6th day of August, 2012.

Voting AYE:

Voting NAY: Absent:


ORDER TO CLOSE SESSION

There came on this day to be considered by the Board of supervisors of Pearl River County, Mississippi, the matter to close session.


Be It Ordered by the Pearl River County Board of Supervisors to close the session to determine the need for executive session.


Voting AYE:

voting NAY: Absent:


PAGE 11

August 06,2012 Office of the Coroner

Pearl River Counly, Mississippi 917 Goodyear Blvd., Picayune Ms. 39466

P.O. Box 703, Picayune, MS. 39466 (601) 749-7750 -(601) 749-7751 facsimile

Board of Supervisor

Pearl River County

P.O.8ox569

Poplarville, MS. 39470

RE: Merrill Roy Shipman, III

Date of Death 07/25/12

Date of Birth 10/21/53

To The Honorable Board of Supervisors:

We are currently holding the body of Merrill Roy Shipman, Ill, 58 who died 07/25/12. I have made

an attempt to contact the family but have been unsuccessful at this time.

I am requesting the Board of Supervisors to consider Mr. Shipman as a Pauper and assist with his burial or cremation.

Derek Turnage, C.M.E.!.

Pearl River County Coroner

CC: Adrian lumpkin, County Administrator

David Earl Johnson, Chancery Clerk

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 671 EXECUTIVE SESSION Date 8/ 6/2012 RETURN TO REGULAR SESSION

ORDER TO GO INTO EXECUTIVE SESSION


Be It Ordered by the Pearl River County Board of Supervisors to retire into executive session at 12:08 p.m. to discuss pending litigation.


Voting AYE:

Voting NAY: Absent:

Anthony Hales, Dennis Dedeaux, patrick Lee, and Sandy Kane Smith None Joyce Culpepper

ORDER TO RETURN TO REGULAR SESSION


Be It Ordered by the Pearl River County Board of Supervisors that this Board does now return to regular session at 1:00 p.m. after taking no action in executive session.


Voting AYE:

Voting NAY: Absent:


PAGE 13

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 672 FUND AREA AGENCY ON AGING & LIBRARY Date 8/ 6/2012 LIFT HIRING FREEZE AT ROAD DEPARTMENT

ORDER TO RESTORE FUNDING TO AREA AGENCY ON AGING AND LIBRARY SYSTEM FOR THE REST OF 2012 FISCAL YEAR

There came on this day to be considered by the Board of supervisors of Pearl River County, Mississippi, the matter of funding for last quarter of 2012 fiscal year.

upon motion made by Anthony Hales and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to restore funding to Area Agency on Aging for feeding program and the Library System for the rest of 2012 fiscal year in the amount of $25,000.00 each.



Anthony Hales, Dennis Dedeaux, and Patrick Lee None Joyce Culpepper and Sandy Kane smith

ORDER TO LIFT HIRING FREEZE AT ROAD DEPARTMENT

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of hiring freeze.

upon motion made by Anthony Hales and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to lift hiring freeze at Road Department.



Anthony Hales, Dennis Dedeaux, and Patrick Lee None Joyce Culpepper and Sandy Kane Smith

PAGE 14

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 673 POP-PRC AIRPORT GRANT AGREEMENT Date 8/ 6/2012 CIRCUIT CLERK TO HIRE ONE EMPLOYEE

ORDER TO SIGN POPLARVILLE/PEARL RIVER COUNTY AIRPORT GRANT AGREEMENT

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of grant agreement with Poplarville-Pearl River County Airport.


Be It Ordered by the Pearl River County Board of Supervisors to sign attached Grant Agreement for Poplarville-Pearl River County Airport.




ORDER TO AUTHORIZE CIRCUIT CLERK TO HIRE ONE EMPLOYEE

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of personnel in the Circuit Clerk's Office.

Upon motion made Anthony Hales and seconded by Dennis Dedeaux, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to authorize Circuit Clerk to hire one employee.


Voting AYE: voting NAY: Absent:


PAGE 15

Bennie Sellers

From: Sent: To: ee:

Subject: Attachments:

Importance:

Barbara.Slmmons@faa,gov Wednesday, July 25. 2012 1 :51 PM [email protected] [email protected]; Bennie Sellers; [email protected]; Rans.Black@faa,gov; [email protected] Grant for AlP Project No. 3-28-0096-008-2012 m13008 grant.pdf; T&C Airport Sponsors_April 2012.pdf

High

We are electronically transmitting a Grant Offer for Project No.

..... 1'1

3-28-0096-008-2012, for the Poplarville-Pearl River County Airport, in response to the Project Application dated July 11, 2012. Acceptance of this Offer will constitute a Grant Agreement by which the Government will participate in the allowable costs of the project with a maximum Federal obligation not to exceed $316,801.00.

(See attached file: m1300S grant.pdf)

Also attached are Terms and Conditions of Accepting Airport Improvement Program Grants dated April 13, 2012. They will be incorporated by reference into this and all future grant offers for the above airport until the date of their next revision.

(See attached file: T&C Airport sponsors_April 2012.pdf)

Review the Grant and Terms and Conditions carefully. If you have questions, please call Mr. William J. Schuller at 601-664-9883; and he will be glad to discuss them with you.

Please refer to items listed below in executing this grant:

Q The Grant Offer must be accepted on or before August 15, 2012.

Q Five fuily executed copies of Grant Agreement should 6e returned to this office by overnight mail. (Copies of signatures are not acceptable.) Upon receipt, I will sign the first pages of the Grant Offer and return three executed copies for your files.

Q Each sponsor involved must execute each grant copy.

Q Do not send the state aeronautics division a copy of the executed grant. We will provide them with an executed copy.

Q Fax a copy of grant to us at 601-664-9901 as soon as it is executed or email a pdf copy to [email protected].

Instructions for Sponsor's Attorney: Date of certification must be on or after date of sponsor's acceptance.

Please let us know if you have any questions or if we can be of further assistance.

Sincerely,

lsI Rans D. Black

1

Rans D. Black Managel' FAA/Airports District Office

2

U. S. V8par1menl Of Transportation Federal Aviation Administration

Date of Offer! July 25, 2012

Project Number 3-28-0095-008-2012

GRANT AGREEMENT

RECIPIENT! CITY OF POPLARVILLE AND PEARL RIVER COUNTY, MISSISSIPPI, AND THE POPLARVILlE·PEARL RNER COUNTY AIRPORT BOARD (Herein Called Cosponsors)

POPLARVlllE·PEARL RIVER COUNTY AIRPORT

OFFER

THE fEDERAL AVIATION ADMINISTRATION, FOR AND ON BEHALF OF THE UNITED STATES, HEREBY OFFERS AND AGREES 10 pay, as the United Slates' share, 90 percent of the allowable costs Incurred In accomplishing the project oonsisGng of the following:

Conslrucl terminal building; Insfall pelimeler fence (2, 125± tf.); rehabiRate aocass road (3701' x 18')

as more particularly described In the Ptoject Application dated July 11, 2012.

The maximum obligation of the United States payable under this Offer shall be $316,801.00 for all)lO~ development.

This offer Is made in accordance I'Iflh and for the purpose of carrying oUllhe applicable provisions of the Federal Aviation Act of 1958, as amended, codified at Tille 49 of the United Stetes Code. Acceptance and execution of this offer shall comprise a Grant Agr •• men~ as provlded by Title 49 of the Uniled Slales Code, constituUng the conkaclual obligations and rights of the United States and the Cosponsors. •

UNITED STATES OF AMERICA FEDERAL AVIATION ADMINISTRATION

Manager, Airp0l1s District Office, JacKson, MS

Projeci 3-26-0096-006-2012 Page 2

ACCEPTANCE

Tha Cosponsor agrees 10 accomplish Ihe projecl in compliance .~Ih Ihe (erms and condilions contained heroin and In Ihe documenl'Terms and Conditions of Accepung Airport Impcovemanl Program Granls" daled April 13, 2012,

Execuled Ihis ._ day of ____ _ .... __ ,20 __ ,

CITY OF POPLARVILLE, MISSISSIPPt

(Seal)

Attes! Signature of Cospensor's Designated Official Representative

Tiffe Bnnk flfES pave 671

CERTIFICATE OF COSPONSOR'S ATTORNEY

I, _______________ , acting as AUorney for the Cospensor do hereby certify:

Thai in my opinion Ihe Cosponsor Is empowered to enler inlo Ihe foregoing Granl Agreement under Ihe lel'ls of Ihe Stale of Mississippi. Funher, I have eXamined Ihe foregoing GranlAgreemenl, and Ille acuons taken by said Cosponsor reiatingthereto, and find fhalthe acceptanco thereof by said Cosponsor and Cosponsor's offidal representative has been duly authorizad and Ihalthe execution !here(Jlls In all respecls due and proper and in a:cordance wilh Ihe laws of Ihe said State and the applicable provisions of the Federal Aviation Act of 1956, as amended, codifted at Title 49 of Iha UnUed Siaies Code_ In addilion, for grants involving projects to be earned oul on property not ovmed by Ihe Cosponsor, there are no legal impedimenls thai will prevenl lull performance by the Cospensor. Further, it is my opinion thallhe said Grant Agreemenl constitules a legal and binding obftgalion of the Cosponsor in accordance v~lh t~e tenms !hereof.

Signa lura of Cosponsors AHomey Dale {Dale must be on or laler than execution dale above)

ProjecI3·2(1.0096.()oa·2012 Pagel

ACCEPTANCE

The Cospom.or agrees 10 accomplish Ihe project in compliance wllh Ihe lenns and conditions conlalned herein and in the documenl "Terms and Conditions of Accepting Airport Improvement Program Granls' daled April 13. 2012.

Iv (; II $ t __ .20.Lb f

~ CERTIFICATE OF COSPONSOR'S ATTORNEY

/ ~ I. ".:u"'11 t.¢ (f,v..c-~ . acting as Atlomey for Ihe Cosponsor do hereby cerufy:

That in my opinion the Cosponsor Vempowered 10 enter inlo Ihe foregoing Grant Agreement under the laws 01 the State of Mississippi. Further. I have examined the foregoing Grant Agreement, and the acllons taken by said Cosponsor relating therelo. and find thai the acceptance thereof by said Cosponsor and Cosponsors official representative has been duly authorized and Ihallhe exacullon thereof is in all respects due and proper and in accordance with the Jaws of the said State and Ihe applicable provisions of the Federal Aviation Act of 1956, as amended, codifiad atTille 49 of the Unlled Siates Code. In addition. for grants involving projects to be carried out on property not owned by the Cosponsor, there are no legal impediments thai wltl prevent full performance by the Cosponsor. Funher, It is my opinion thai the said Grant Agreement constitutes a legal and binding o~ligaHon at the Cosponsor in accordance with the tenms Ihereol.

// ,/' ,~v

ProjecI3·28·0096.o08·2012 Page 4

ACCEPTANCE

The Cosponsor agl66S to accomplish the project in compliance with the terms and condilions contained herein and in Ihe documenl'Terms and Conditions 01 AccepUng Airporllmprovement Program Grants' daled April 13, 2012.

, ' r" - r'?" ,~.

Execuled Ihis;' / ... ~ day of _"""'~"----''--___ , 20/·,- . Boop. HiSS Pa~~ 679

POPlARVllLE·PEARL RIVER COUNTY AIRPORT BOARD

~£ ' :-- / ,/' ./

!~J~ ~ Signature of Cosponsor's Designaled Official Represenlalive ,1'/> D a '/

,fr'/5 Tcf' .5..c:rJ?1r 1IUe

CERTifiCATE OF COSPONSOR'S ATTORNEY

I, _______________ , acling as Atiomey lor the Cosponsor do hereb,' certily:

ThaI In my opInion lI1e Cosponsor is empowered to enter inlo Ihe foregoing Granl Agreemenl under the laws of Ihe Slate 01 MissIssIppi, Further, I have examined Ihe foregoing Granl Agreement, and lI1e acllons laken by said Cosponsor relating thereto, end find Ihallhe acceplance thereof by said Cosponsor and Cosponsor's official represenlative has been duly authOrized and that Ihe executionlhereof is In all respecls due and proper and in accordance wllh the laws ollho said state and Ihe applicable provisions olthe Federal Aviation Acl of 1958,,5 amended, Cildified at Title 49 oflhe United States Code. tn addition. for granls InvoMng projects to be carried out on property not oMled by the Cosponsor. there are no legallmpedimenls thai will prevent full performance by Ihe Cosponsor. Furtller, il is my opinion that Ihe said Grant Agreement constitutes a legal and binding obligation 01 the Cosponsor in accordance with the terms Ihereol.

Signalure of Cosponsor's Attorney Dale (Dale must be on or later than execution dale abovel

U. S. Department ofTransportation Fedoral Aviation Administration

Terms and Conditions

April 13, 2012

of Accepting Airport Improvement Program Grants This document was compUed from multiple government source documents.

ThIs document contains the terms and conditions of accepting Airport Improvement Program (AlP) grants from the Federal Aviation Administration (FAA) for the purpose of carrying out the provisions of Title 49, United States Code. These terms and oondltlons become applicable when the Sponsor accepts a Grant Offer from the FAA that referenoes this document. The FAA may unilaterally amend the terms and conditions by notification in wrlUng, and such amendmenl will only apply to grants accepted after notlfloallon.

I. DEFINITIONS

A. Sponsor-An agency that Is legally, financially, and otherwise able to assume and carry out the certifications, representations, warranties, assurances, covenants and other obligations required In this document and 'In the accepted Grant Agreement.

B. Project-Work as identified In this grant AgreemElnt.

C. Primary Alrport-A commercial service airport the SElcretary of Transportation determines to have more than 10,000 passengElrs boarding Elach year.

D. "this granr -In this document the term "this granl" refers to the applicable grant agreement or grant agreements that Incorporate(s) these Terms and Condlttons as part of the grant agreement.

II. CERTIFICATIONS

Title 49, United States Code, section 47105(d), authorizes the Secretary to require certification from the Sponsor that It will comply wllh statutory and administrative requirements In carrying out a project under the AtP. The following list of certlfled ItemsJncludes major requlremElnts for this aspect of project Implementation. However, Ihe list Is not comprehensive, nor does It relieve sponsors from fully complying with all applicable statutory and admlnlstraUve standards. In accepting this grant, the Sponsor certifies thai each of the following lIems was or will be complied with In the performance of grant agreements. If a certification cannot be mElt for a specific project, the Sponsor must fully explain In an attachment to the project application.

A. Sponsor Certification for SelElctfon of Consultants. General standards for selection of consultant services within FEldElrat grant programs are described in Title 49, Code of Federal RElgulations (CFR), and Part 18.36. Sponsors may use other qualifications-based procedures provided they are equivalent to specific standards in 49 CFR 18 and Advisory Circular 150/5100-14, Architectural, Engineering, and Planning Consultant Services for Airport Grant Projects.

1. Solicitations were (will be) made to ensure fair and open competition from a wide area of intElres\.

2. Consultants WElrEl (will be) selected using compeliUve procedures based on qualifications, experience, and disadvantaged enterprise requirements with the fees determined through negotiations.

3. A record of negotiations has been (will be) prepared reflecllng considerations InvolvEld in the establishment of fees, which are not significantly above the Sponsor's Independent cost estimate.

1

Terms and Conditions of Accepting Airport Improvement Program Granls April 13, 2012

4. If engineering or olher services are 10 be performed by Sponsor f&~ a'd511~"er4lhhnel, prior approval WaS (will be) oblalned from the FAA

5. The consultant sorvices contracts clearly establish (will establish) the scope of work and delineate the division of responsibilities belween all parties engaged in carrying out elemenls of the project.

6. Costs associated with work Ineligible lor AlP funding are (wid be) clearly identified and separated from eligible Items tn solicitations, contracts, and related project documents.

7. Mandalory contact provisions for grant-assisted contracts have been (will be) Included in consultant services contracts.

8. The cost-plus-percentage-of-cost methods of contracting prohibited under Feaeral slandards were not (will not be) used.

9. If the services being procured cover more than the single grant project referenced In this certification, the scope of work was (will be) specifically described In the advertisement; and future work will nol be initiated beyond five years.

S. Sponsor Certfflcafion for Project Plans and SpecifIcations. AlP standards are generally described In Advisory Circulars 150/5100·6, Labor Requirements for the Airport Improvement Program; 150/5100-15. Civil Rights Requirements for the Airport Improvement Program; and 15015100-16. Airport Grant Assurance One-General Federal Requirements. A list of current advisory circulars with speclflc standards for design or construction of airports. as well as procurement/Installation of equipment and facilities, is referenced In standard airport sponsor Grant Assurance 34 In this document.

1. The plans and specifications were (will be) prepared In accordance with applicable Federal standards and requirements; sO nO deviation or modification to standards set forth In the advisory circulars, or State standard, is necessary other than those previously approved by the FAA,

2. Specifications for the procurement of equipment are not (will nol be) proprietary or written so as to restrict competition. At least two manufacturers can meet the specifications.

3. The development included (to be Included) in the plans is de~lcted on the airport layout plan approved by tile FAA.

4. Development that Is Ineligible for AlP funding hal' bean (will be) omitted from the plans and specifications or olherwise Identified 10 assure that nO reimbursement wm be made for the cost of the Ineligible item( s).

5. The process control and acceptance tests required for the project by standards contained in Advisory Circular 150/5370·10 are (will be) included in the project specifications.

6. If a value engineering clause Is Incorporated into the contract. concurrence was (will be) obtained from the FAA.

7. The plans and specifications incorporate (will incorporate) applicable requirements and recommendations set forth in the Federally approved environmental finding.

B. For conslnuction acUvlties within or near aircraft operational areas, the requirements contained In AdviSOry Circular 150/5370-2 have been (will be) discussed with the FAA, as well as incorporated into the specifications; and a safety/phasing plan has FAA's concurrence, 11 required.

- -. '- ,_. . .....

9. The prolecl was (will be) physically completed without Federal participation in costs due to errors and omissions in the plans and specifications Ihat were loreseeable at the time of project design.

C. Sponsor Certification for EqulpmenUConstructfon Contracts. General standards for equipment and construction contracts within Federal grant programs are described In Title 49,

2

Terms and Condilions of Accepling Alrpartlmprovemenl Program Granls April 13, 2012

CFR, Pari 18.36. AlP standards are generally described In FAA Advls!ll;yluIMiiIa'ilv-.cf&2 100/5100-6, Labor Requirements for the Alrporllmprovement Program; 150/5100-15, Clvn RIghts Requirements far the Alrporllmpravement Program; and 150/5100-16, Alrporl Grant Assurance One-General Federal Requirements. Sponsors may use Slate and local procedures provided procurements conform to these Federal standards.

1. A code or standard of conduct Is (will be) In effect governing the performance oflhe Sponsor's officers, employees. or agents In soliCiting and awarding procurement contracts.

2. Quallned personnel are (will be) engaged to perform conlract admlnlstrailon, engineering supervision, construction inspection, and testing.

3. Unless the FAA approved (has approved) otherwise. the procurement was (will be) publicly advertised using the competitive sealed bid method of procurement.

4. The bid soliCitation clearly and accurately describes (will describe):

a. The current Federal wage rate determination for all construction projects; and b. All other requirements of the equipment andlor services to be provided.

5. Concurrence was (will be) obtained from FAA prior to contract award under any of the following circumstances:

a. Only one qualified personlflrm submits a responsive bid; b. The contract Is to be awarded to other than the lowest responsible bidder; c. Ufe cycle costing Is a factor In selecting the lowest responsive bidder; or a. Proposed contract prices are more than 10 percent over the Sponsor's cost estimate.

6. All contracts exceeding $100,000 require (will require) the following provisions:

a. A bid guarantee of 5 percent, a performance bond of 100 percent, and a payment bond of 100 percent;

b. Conditions specifying admlnlslratlve. contractual, and legal remedles,lncludlng cJ)ntract termination. for those instances In which contractors violate or breach contact terms; and

c. Compliance with applicable standards and requirements Issued under SecUon 306 of the Clean Air Act (42 USC 1857(h», Section 508 of the Clean Water Act (33 USC 1368), and Executive Order 11738.

7. All construction contracts contain (will contain) provisions for: • a. Compliance with the Copeland' Anti-Kick Back" Act: and b. Preference given In the employment of labor (except in executive, administrative, and

supervisory positions) to honorably discharged Vielnam-era veterans and disabled veterans.

8. All conslructlon contracts exceeding $2,000 conlaln (will contain) the following provisions:

a, Compliance with the Davis-Bacon Act based on the current Federal wage rate determination; and

b. Compliance with the Contract Work Hours and Safety Standards Act (40 USC 327-330), Sec lions 103 and 107.

9. All construction contracts exceeding $10,000 contain (will contain) appropriate ctauses from 41 CFR Part 60 tor complial1ce with Executive Orders 11246 and 11375 on Equal Employment Opportunity.

10. All contracts and subcontracts contain (will contain) clauses required from Title VI of the Civil Rights Act and 49 CFR 23 and 49 CFR 26 for Disadvantaged Business Enterprises.

11. Appropriate checks have been (will be) made to assure thai COl1tracts or subcontracls are not awarded 10 those individuals or firms suspended, debarred, or voluntarily excluded from doing bUSiness with any U.S. Department of Transportation (DOT) element and appearing on the DOT Unified List.

3

Ternls and Conditions of Accepting P,irport Improvement PlOgram Grants April 13. 2012

8001: 0158 Pa9~ 683

D. Sponsor Certification to!' Real Property AcquiSition. General requirements on real property acqulsU;on and relocation assistance are In Tille 49, CFR, Part 24 and the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (Uniform Acl).

1. The Sponsor's attorney or other official has (will have) good and sufficient tiUe and title evidence on property in the project.

2. If defects andlor encumbrances exist in the title that adversely Impact the Sponsor's intended use of property in the project, they have been (will be) extinguished, modified, or subordinated.

3, II property for airport development is (will be) leased, the 101l0v.1ng conditions have been (will be) met:

a. The term is for 20 years or the useful life of the project: b. The lessor Is a public agency; and c. The lease contains no provisions that prevent full compliance with Ihls grant agreement.

4. Property In the project Is (will be) in conformance wllh the current Exhibit "A' property map, which is based on deeds, title opinions, land SU/veys. the approved airport layout plan, and project documentaUon.

5. For any acqUisition of property inlerest in noise sensitive approach zones and related areas, properly interest was (will be) oblalned to ensure land Is used for purposes compatible wllh noise levels associated with opera lion of the airport.

6. For any acquisition of property Interest In runway protection zones and areas related to 14 CFR 77 surfaces, property inlerest Was (will be) obtained for the following:

a. The right of Hight: b, The right of Ingress and egress to remove obstructions; and c. The rigntto restrict the establishment of future obstructions.

7. Appraisals prepared by qualified real estate appraisers hired by the Sponsor Include (will include) the following:

a. Valuation data to estimate the current market vaiue for the property Interest acquired on each parcel; and I

b, Verification that an opportunity has been provided the property owner or repres'entative to accompany appraisers during inspections.

8. Each appraisal has been (will be) reviewed by a qualified review appraiser to recommend an amount for the offer of jus! compensation, and the written appraisals and review appraisal are (wilt be) available to FAA for review.

9. A written offer to acquire each parcel was (,,;11 be) presented to the property owner for not iess than the approved amount of just compensation.

10. Effort was (will be) made to acquire each property through the following negotiation procedures:

a. No coercive action was (will be) taken to induce agreement; and b. Supporting documents for settlements are (will be) Included in Ihe project files. . -

11. If a negotiated settlement is not reached. the following procedures ware (will be) used:

a. Condemnation was (will be) initialed and a court deposit not less than the just compensation was (will be) made prior to possession of the property; and

b. Supporting documents for awards were (will be) Included in the project files.

4

Terms and Condllions of Accepting Alrpol1lmprovemenl Program Grants April 13, 2012

12. If displacement of persons, businesses, falll1 operations, or non·pl\'l~~dlllilhf.il!lflorMlls Involved, a relocation assistance program was (will be) established, with displaced parties receiving generallnfolll1atlon on the program In wrillng, including relocation eligibility, and a gO-day notice to vacate.

13. Relocation assistance services, comparable replacement housing, and payment of necessary relocation expenses were (wm be) provided within a reasonable I1me period for each displaced occupant in accordance with the Uniform Act.

E. Sponsor Certification for Construction Project Final Acceptance. General requirements for final acceptance and closeout of Federally funded construction projects are in Title 49, CFR, Part 18.50. The Sponsor shall determine that project costs are accurate and proper In accordance with specific requirements of this grant Agreement and contract documents.

1. The personnel engaged In proJect adminlstralion, engineering supervision, construction Inspection, and lesting were (will be) determined to be qualified as well as competent to perform the work.

2. Dally construction records were (will be) kept by the resident engineer/construction inspector as follows:

B. Work in progress b. Quality and quantity of materials delivered c. Test localions and results d. Instructions provided the contractor e. Weather condilions f. g. h. i.

Equipment use Labor requirements Safety problems Changes required.

3. Weekly payroll records and statements 01 compliance were (will be) submitted by the prime contractor and reviewed by the Sponsor lor Federal labor and civil rights requirements (Advisory CirCUlars 150/5100·6 and 150/5100·15).

4, Complaints regerding the mandated Federal provisions set forth In the conlract documents have been (will ba) submitted to the FAA.

5. All tests specified In the plans and speciflcatrons were (will be) performed and the test results documented as well as made available to the FAA.

6. For any test results outside of allowable tolerances, appropriate corrective actions were (will be) laken.

7. Payments to the conlractor were (will be) made in compliance with contract provisions as follows:

a. Payments are verified by lhe Sponsor's Internal audit of contract records kept by the resident engineer; and

b. If appropriate, pay reduction factors required by the specifications are applied in computing final payments; and a summary of pay reductions are made available to the FAA.

8. The project was (will be) accomplished without significant deviations, changes, or modifications from the approved plans and specifications, except where approval Is obtained from the FAA.

9. A final project Inspection was (will be) conducted with representatives of tho Sponsor and the contractor, and project files contain (will contain) documentation of the final inspection.

5

Terms and Omdmons of AccepUng Airport Improvement Program Grants April 13, 2012

10, Work In this grant agreement was (will be) physically completed, .llAIf:CBfl'acftwacllffi'1s required as a resull of the final inspecllon are completed to the sallsfactlon of the Sponsor,

11, If applicable, the as-built plans, an equipmenl inventory, and a revised airport layout plan have been (will be) submiUed to the FAA.

12. Applicable close out financial reports have been (will be) submitted 10 the FAA.

F. Sponsor CertWcatlon for Seismic Design and Construction. 49 CFR Part 41 sets forth the requirements In the design and construction of the bulldlng(s) to be financed with the assistance of the FAA, Compliance will be mel by adhering 10 at leasl one of Ihe following accepled standards:

1, Model codes found to provide a level of seismic safely substantially equlvalenllo that provided by use of the 1988 National Earthquake Hazards Reduction Program (NEHRP) Including:

a. The 1991 International Conference of Building Officials (ISCO) Uniform Building Code, published by Ihe International Conference 01 Building OffiCials, 5360 South Workman Mill Road, WhiUier, California 90601;

b. The 1992 Supplement to the Builoing Officials and Code Administral!on International (BOCA) National Building Code, published by the Building Officials and Code Administrators, 4051 West Flossmoor Road, Country Club Hills, Illinois 60478·5795; and

c. The 1992 Amendments to the Southern Building Code Congress (SBCC) Standard Building Code, published by Ihe Southern Building Code Congress Intemallonal, gOO Montclair Road, Birmingham, Alabama 35213-1206.

2. Revisions 10 the model codes listed above that are substantlally equivalent or exceed the then current or Immediately preceding edition of the NEHRP recommended prOVisions, as It Is updated, may be approved by the DOT Operating Administration to meet the requirements of 49 CPR Part 41.

3. Slale, county,locat, or other jurisdiclional building ordinances adopting and enforcing the model codes, listed above, in their entirety, without significant revisions or changes in the direction of less seismic safety, meet the requirement of 49 CFR Part 41,

G. Sponsor Certification for Drug-Free Workplace. General requirements on the drug-free workplace within Federal grant programs are described In Title 49, CFR, Part 29 and the Drug- • Free Workplace Act of 1988. Sponsors are required to cerufy they will provide, or will continue to provide, a drug-free workplace In accordance with the re9ulatlon.

1. A statement has been (will be) published notifying emplol'ees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance Is prohibited In the Sponsor's workplace, and specifying the actions to be taken against employees for violation of such prohibition.

2. An ongoing drug-free awareness program has been (will be) established to inform employees about:

a, The dangers of drug abuse In Ihe workplace;

b. The Sponsor's policy of maintaining a drug-free workplace;

c. Any available drug counseling, rehabililation, and employee assistance programs: and

d. The ifenaltles thartnay be imposed upon employees for drug abuse violations occurring In the workplace.

3. Each employee to be engaged In the performance of the work has been (will be) given a copl' of the statement required within item 1 above.

6

Terms and Conditions of Accepting Airport Improvement Program Grants April 13, 2012

4. Employees have been (will be) notified In the statement required by Item 1 above that, as a condition of employment under this grant, the employee will;

a, AbIde by the terms of the statement; and

b. Notffy the employer In wrillng of his or her convlcUon for a vlolalinli dllti!tIl"linaKl!tug statute occurring' In the workplace no later than five calendar days after such convIction.

5. The FAA will be notified In wrtUng within ten calendar days after receiving notice under ilem 4b above from an employee or otherwise receIving actual notice of such conviction. Employers of convIcted employees must provide notice, Including position tIlie of the employee, to the FAA. Nollces shall Include the project number of each affected grant.

6, One of the following actions will be taken withIn 30 calender days of receivIng a notice under Ilem 4b above with respect to any employee who Is so convicted;

a, Take appropriate personnel action against such an employee, up (0 and IncludIng termination, consistent with the requirements of the RehabIlitation Act of 1973, as amended; or

b, Require such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local heallh, law enforcement, or other appropriate agency,

7. A good faith effort will be made to continue to malnlaln a drug-free workplace through Implementation of Items 1 through 6 above,

III, GENERAL CONDITIONS

A, The allowable costs of the project shall not Include any costs determined by the FAA to be Ineligible for consideration under Title 49 U,S,C.

B. Payment of the United States' share of Ihe allowable project costs will be made pursuant to and In accordance wIth the provisions of such regula lions and procedures as the Secretary shall prescribe, Final determlnalion of the United States' share will be based upon the final audit of the total amount of allowable project costs, and settlement will be made for any upward or downward 'adjustments to the Federal share of cosls.

C, The Sponsor shall carry out and complete the ProJecl(s) without undue delays and In accordance with the terms hereof, and such regulations and procedures as the Secretary shall prescribe. • •

D, The FAA reserves the right to unilaterally terminate Ihls grant if the Sponsor does not make at least one draw down of funds under their Letter of Credit or submll at least one written Request for Reimbursement, as applicable, in each twelve month period after grant acceptance.

E, The Sponsor agrees to monitor progress on the work to be accomplished by this grant. For engineering services, the Sponsor agrees to make payment only for work that has been satisfactorily completed and thai len percent (10%) of the tota! value of the engineerIng services contract will not be paid 10 !he Engineer until acceptable final projecl documentation is provided.

F. The Sponsor agrees to submit final grant closeout documents to the FAA withIn 60 days after physical completion of the projecl(s), but no greater than four (4) years from the date of the grant, unless otharwlse agreed to by the FAA,

G. The FAA reserves the right to amend or withdraw Ihls grant offer at any lime prior to lis acceptance by the Sponsor.

H. this grant offer will expire, and the United Slates shall not be obligated to pay any part of the costs of Ihe project unless this grant offer has been accepted by Ihe Sponsor on or before 30 days aller Ihls grant offer but no laler than September 30 of the federal fiscal year this grant offer was made, or such subsequent date as may be prescribed In wriling by the FAA.

L The Sponsor shall take all steps, Includlngli!lgatlon tf necessary, to recover Federal funds spent fraudulently. wastefully, or in violation of Federal antitrust stalutes, or misused in any manner In

7

Terms and Conditions of Accepting P,lrpMlmprcl'emen! Program Grants April 13, 2012

any project upon which Federal funds have been expended. For the PI!l/WoQ6'illdli\tlls ~Jnt agreement. the term "Federal funds" means funds however used or disbursed by the Sponsor Ihat were originally paid pursuant 10 Ihis or any other Federal grant agreement. !t shall obtain the approval of the Secretary as to any delermination of Ihe amount of the Federal share of such funds. It shall relurn the recovered Federal share, including funds recovered by se«lement, order or judgment, to Ihe Secretary. II shall furnish to Ihe Secretary, upon requesl, all documents and records pertaining 10 Ihe delermlnation of the amount of the Federal share or to any settlement, JUigation, negotiation, or other efforts taken to recover such funds. All seHlemenls or other final posillons of th" Sponsor, In court or otherwise, Involving the recovery of such Federal share shall be approved In advance by lIhe Secretary.

J. The United States shall not be responsible or liable for damage to property or injury to persons that may arise from, or be incident to, compliance with this grant agreement.

K. If, during the Ille of the project, the FAA determines that this grant amount exceeds the expected needs of the Sponsor by $5.000 or five percent (5%), whichever Is greater, this grant amount can be unilaterally reduced by leiter from FAA advising of the budget change. Conversely, with the excepllon of planning projects, if there Is an overrun In the eligible project costs, FAA may Increase this grant to cover the amount of the overrun not to exceed Ihe statutory fifteen (15%) percent limitation for prfmary airports or either by not more Ihan fifteen percent (16%) of the original grant amount or by an amount not to exceed twenty-five percent (25%) of the total Increase In allowable project costs attributable to the acquisition of land or inleresls In land, whIchever Is greater, based on current credible appraisals or a court award in a condemnation proceeding for non-primary alrpon". FAA will advise Ihe Sponsor by leiter of the increase. Planning projects will not be increased above the planning portion of Ihe maximum obligation of the United States shown In this grant agreement Upon issuance of either of the aforementioned letters, the maximum obligation of the United Stales Is adjusted to the amount specified. In addition, the Sponsor's offiCially designated representative, Is authorized to request FAA concurrence In reviSing the project descrlpllon and grant amount within statutory limitations. A letter from the FAA concurring In the said requested revision to the project work description and grant amount shall constitute an amendment to this Granl Agreement.

L If requested by Ihe Sponsor and authorized by the FAA, the leHer of credit melhod of payment may be used. It ts understood and agreed thaI the Sponsor agrees 10 request cash withdrawals on the tetter of credit only when actually needed for lis disbursements and to timely reporting of such dlsbursemenls as required. It is understood that lallure to adhere to this provisIon may cause Ihe letter 01 credit to be revoked.

M. Unless otherwise approved by the FAA, It will not acquire or permit any contractor or subcontractor to acquIre any sleei or manufactured products produced outside the United States t ..... ho ".,(;\,.( f ........ ,.. ................. loC'I .... f .... " "'1 .......... .-+ ....l<t>., .... I ...... P'TI ....... I ...... n .... ~o:oc. " .................... lIhaa" r"" ..... hl ... h f., ..... ....1 ... ~ .. n , ... "" ............ "" .. • v • ...... , ""VJ'"'V~'V' ...... I"' ... ,.""'''''~ .... '''t''''' .... , ....... ....... ,.., ..... "' ...... ,... ........ ,,"J ,...." ••• ,,""., ................. ...... provided under thIs grant. The Sponsor will Include In every contract a provision Implementing this condition.

N. Central Contractor Registra!/on and Universal Identifier Requirements

1. Requirement for Central Contractor Registration (CCR)

Unless you are exempled from II1ls requirement under 2 CFR 25.110, you as the reclpienl must maintain the currency of your Information in the CCR unm you submit the final financial report required under this award or receive the fmat payment, whichever is iater. This requires that you review and update the information ai least annually after the Initial regislrallon, and more frequently If required by changes In i'olir Information oranather award term,

2. Requirement for Data Universal Numbering System (DUNS) Numbers

If you are authorized to make subawards under this award. you:

8

Terms and Conditions of Accepllng Airport Improvement Program Granls Aprt113,2012

a. Must notify potential subreclplenls that no entlly (see deflnitlor!lIl<lIpIl,lli§rl!~C~thls award term) may receive a subaward from you unless the snllly has provided Its DUNS number to you.

b. May not make a subaward to an enllly unless the entity has provided Its DUNS number to you.

3. Defini(ioos

For purposes of this award term:

a. Central Contractor Reglstrat/on (CCR) means the Federal repository Into which an entity must provide information required for the conduct of business as a recipient. Additional Information about registration procedures may be found at the CCR Internet site (currently at flttp://www.ccr.gollj.

b. Date Universal Numbering System (DUNS) number means the nine-digit number established and assigned by Dun and Bradstreet, Inc. (D&B) to uniquely Identify business entities. A DUNS number may be obtained from D&B by telephone (currently 866--705-5711) or the Internet (currently at htlp:llfedgov.dnb.comr.vebform).

c. Entity, as It Is used In this award term, means ali of the following, as defined at 2 CFR part 25, subpart C:

1) A Governmental organization, which Is a State, local government, or Indian Tribe;

2) A foreign public entity;

3) A domestic or foreign nonprofit organization;

4) A domestic or foreign for-profit organization; and

5) A Federal agency, but only as a subrecipient under an award or subawerd toa nonFederal entity.

d. Subaward:

1) This term means a legal Instrument to provide support for the performance of any portion of the substantive project or program for which you received this award and that you as the recipient award to an eligible subreclplent.

2) The term does not include your procurement of property and services needed to carry out the project or program (for further explanation, s(le Sec. 210 of the attachment to OMS Circular A-133, "Audits of Stales, Local Governments, and NonProfit Organizations") .. A subaward may be provided through any legal agreement, Including an agreement that you consider a contract.

e. SUbreclplcmt means an enllty thal:

1) Receives a subaward frorn you under this award; and

2) Is accountable to you for the use of the Federal funds provided by the subaward.

3) A subaward may be provided through any legal agreement, including an agreement that you consider a contract.

O. If this grant agreement Includes pavement work thai equals or exceeds $250,000, the Sponsor will perform the following:

1. Furnish a construction management program to FAA prior to the start of construction which shall detail the measures and procedures to be used to comply with the quality controt provisions of the construction contract, Including, but not limited to, all quality control provisions and tests required by the Federal specifications, The program shall Include as a minimum:

9

Terms and Conditions of Accepling Airport Improvement Program Gran;s April 13, 2012

a, The name of the person representing the Sponsor who h.s oJ\ilP!It'f~gi\'1:ibIlR~gfor contract administration for the project and the authority to tat(s necessary actions to compty with the contract.

b. Names of testing laboratories and consulling engineer firms with quality control responsibilities on the project, together with a descrlpllon of lIle services to be provided,

c. Procedures for determining that testing laboratories meet the requirements of the American SOCiety of Testing Materials standards on laboratory evaluation, referenced in the contract specifications (03666, C10n).

d. Qualifications of engineering supeEVislon and construction inspecllon personnel.

e. A listing of all tests required by the contract specifications, Inc[ud[ng the type and frequency of tests to be taken, the method of sampling, the applicable test standard, and the acceptance criteria or tolerances permitted for each type of test.

f. Procedures for ensunng that the tests are taken [n accordance with the program, that they are documented dally, that the proper corrective actions, where necessary, are undertaken.

2, Submit at completion of Ihe project, a final lest and quality control report documenting the results of all tests performed, high[lghting those tests that failed or did not meet the appllcab[e test standard. The report shalllnc[ude the pay reductions applied and reasonS for accepting any out-<Jf-tolerance mater[al. An interim test and quality controt report shall be submiHed, if requested by the FAA.

3. Failure to provIde a complete report as described [n paragraph 2, or failure to perform such tests, shalf, absent any compelling justification, result In a reduction in Federa[ participation for costs Incurred In connection with construction of the applicable pavement. Such reduction shal[ be at the discretion of the FAA and will be based on the type or types of required tests not performed or not documented and will be commensurate with the proportion of applicable pavement with respect to the total pavement constructed under this grant agreement.

4. The FAA, at its discretion, reserves the right to conduct Independent tests and to reduce grant payments accordingly [t such [ndependenttests determine that Sponsor tests results are inaccurate.

P. For a project to replace or reconstruct pavement at the airport, the Sponsor shall implement an effective airport pavemenl maintenance management program as iSJequ[r<:ld by Airport Sponsor Assurance Number 11. The Sponsor shal[ use such program for the useful life of any pavement constructed, reconstructed, or repaired wllh Federa[ tinancial assistance at the airport. As a minimum, Ihe program must conform with the fotlowlng provisions:

Pavement Maintenance Management Program

An effecUve pavement maintenance management program is one lIlat details the procedures to be followed to assure that proper pavement maintenance, bath preventive and repair, [s performed. An airport sponsor may use any form of inspection program [t deems appropriate, The program must, as a minimum, Include the following:

1. Pavement Inventory. The follow[ng must be depicted in an appropriate form and leve[ of detail: a. Location of all runways, taxiways, and aprons;

-b. Dimensions; c. Type of pavement, and; d. Year of construclion or most recent major r"habilitation.

For compliance with the Airport Improvement Program (AlP) assurances, pavements that have been constructed, reconstructed, or repaired with federal financla! assistance shalt be so depicted,

10

Terms and COnditions of Accepllng Airponlmprovement Program Granls April 13, 2012

2, Inspection Schedule. a. Detailed Inspection. A detailed Inspeclion must be performed at least once a year. If a

history of recorded pavement deterioration is available; I.e., Pa~EIIlIIsiII$~jtio()9!.ndex (PCI) survey as sel forth In Advisory CIrcular 150/5380·6, "Guidelines and Procedures for Maintenance of AIrport Pavements: the frequency of Inspections may be extended to three years.

b, DrIve-By Inspect/on, A drive-by Inspection must be performed a mInImum of once per month to detect unexpected changes in the pavement condItion.

3. Record Keeping. Complete Information on the findings of all detailed Inspections and on the maintenance performed must be recorded and kept on file for a minimum of five years. The types of distress. their locations. and remedial action. scheduled or performed, must be documented. The minimum Information to be recorded Is listed below: a. Inspection date; b. Location; c. Distress types; and d. Maintenance scheduled or performed. For drive·by Inspections, the date of inspection and any maintenance performed must be recorded.

4. Information Retrieval, An airport Sponsor may use any form of record keeping it deems appropriate, so long as the Information and records produced by the pavement survey can be retrieved to provide a report to the FAA as may be required.

5. Reference, Refer to Advisory Circular 150/5380-6, "Guidelines and Procedures for Matntenance of Airport Pavements; for specific guidelines and procedures for maintaining airport pavements and establishing an affective maintenance program. Specific types of distress, their probable causes. Inspection guidelines, and recommended methods of repair are presented.

Q. Takeover of Instrument Landing System and Associated Equipment In Project, If this grant Includes an Instrument landing system and associated equipment and the FAA has agreed to takeover the system and equipment, the Sponsor must check the facility prior to Ks commissioning to assure It meets the operational standards. The Sponsor must also remove, retocate, or lower each obstruction on the approach, or provide for the adequate lighting or marking of the obstruction If any aeronaullcal study conducted under FAR part 77 determines thai 10 be acceptable, and mark and light the runway, as appropriate.

R. Airport-Owned Visual or Electronic NAVAIOS In Project. If this grant Includes a visual or electronic navigational aid, the Sponsor must provide for the conUnuous operation and maintenance of any navigational aid funded under the AtP during the useful life of the equipment and check the facility prior to lis commissioning to assure II meets the operational standards. The Sponsor must also remove. relocate, or lower each obstruction on the approach or provide for the adequate lighllng or marking of the obstruction if any aeronautical study conducted under FAR Part 77 determines that to be acceptabte, and mark and light the runway, as appropriato. The FAA will not take over the ownership, operation, or maintenance of any sponsor-acquired equipment other than an AIP·funded Instrument landing system and associated oqulpment where FAA agrees to take over the system and equipment.

S. Non-AI P Work in Application. Ills understood and agreed by and between the parties hereto that notwithstandIng the facl thai a Project Application may include therein the construction of work not Included In this grant agreement project description. said work shall nol be a part of this project and, If or to the extent accomplished by the Sponsor, such accomplishment shall be wilhout any participation In the costs thereof by the Unlled States under this project. It is further understood and agreed that. In the event the work which is excluded from the project Is accomplished by the Sponsor, the Sponsor shall maintain as a portion of the cost records covering this project, separable cost records pertaining to the above-identified work excluded from Federal participation under this project. which records shall be made available for Inspection and audit by the FAA to the end that the cost of the excluded work may be definitely determined.

11

Terms and Condilions of Accepting Airponlmprovemenl Program Grants Apr!l13,2012

It Is further understood and agreed that the Sponsor will submit 8BQ~lIJbllaf;f9~tar3Inenvcosl estlmale depicting Ihe exclUded cosls or a cosl eslimale depicting only those costs eligible for Federal partiCipation In this project.

T. Utility Relocation In Proiae!. it is understood and agreed by and between the parties hereto that the United States shall not parliclpate In the cost of any utility relocation unless and unW the Sponsor has submitted evidence satisfactory to the FAA that the Sponsor is legally responsible for payment of such costs. FAA participation will be limited 10 those utilities located on private right·of-way or utilities that exclusively serl'e the Airport.

U. Revenue from Real Propert)t - Land In Project. Tha Sponsor agrees that all net revenues produced from real property purchased in part with Federal funds in this grant shall be used on the airport for airport planning, development or operating expenses, except that all income from real property purchased for noise compatibility purposes or for future aeronautical use be used only to fund projects which would be eligible for grants under the Act. Income frpm noise or fulure use property may nol be used for ths Sponsor's matching share of any airport grant. Airport fiscal and accounting records shall clearly identify actual sources and useS of these funds.

V. Future Development land. If this grant Includes acquisition of land for fulUre development, the Sponsor agrees to implement within five years of such grant the airport development that requires this land acqUisition, unless the FAA agrees to a different duration. Furthermore, the Sponsor agrees not to dispose of the land by sale or lease without prior consent and approval of Ihe FAA. In Ihe event the land Is not used within ten years for the purpose for which II was acquired, the Sponsor will refund the Federal share of acqulsiHon cost or Ihe current fair market value of the land, whichever Is greater, unless the FAA agrees to a different duration.

W. Runway Protection Zones. The Sponsor agrees to take the following actions 10 maintain andlor acquire a property Interest, satisfactory 10 the FAA, In the Runway Protection Zones:

1. Existing Fee Tille Interest In the Runway Protection Zone; The Sponsor agrees to prevent the erection or creation of any structure or place of public assembly In the Runway Protection Zone, except for NAVAIDS thai are fixed by their functional purposes or any other structure approved by the FAA. Any existing slructures or uses within the Runway Protection Zone will be cleared or discontinued unless approved by the FAA.

2, EXisting Easemenllnterest in Ihe Runway Protection Zone: The Sponsor agrees to take any and all steps necessary to ensure that the owner of the land within the designated Runway Protection Zone will not build any structure in Ihe Runway Protection Zone that is a ha.ard to air navigation or which might create glare or misleading lig,hts or lead to the construction of residences, fuel handling and stor~ge facilities, smoke generating activities, or places of public assembly. such as churches. schoals, office buildings, shopping centers, and stadiums.

3. Future ifliere~i. in lhe Runway Proieciiofl Zune: Till~ Sponsor (fgrees {ilai it wiii acquire fee tille or less-than-fee Interest In the Runway Protection Zones that presently are not under Us control under an agreed schedule with the FAA. Said interest shall provide the protection noted In above Subparagraphs 1 and 2.

X. Noise Projects on Privately Owned Property. No payment shall be made under the terms of this grant agreement for work accomplished on privately owned land until the Sponsor submits the agreement with the owner of the property required by Assurance 5d of the ASSURANCES Airport Sponsors. and such agreement is determined to be satisfactory. As a minimum. the agreement with the private Owner must contain the following provisions:

1, The property owner shall subject the construction work on the project to such inspection and approv,Wdllring the-construction or installallon of the noise compatibility measures and after· completion of the measures as they may reasonably be requested by the Secretary or the Sponsor.

2, The property owner shail assume the responsibility for maintenance and operation of Ihe Items installed, purchased, or constructed under this grant agreement. NeHher Ihe FAA nor the Sponsor bears any responsibility for Ihe maintenance and operation of these items.

12


3. If Federal funds for the noise compatibility measures are transfa!lletJ \t#iaHl!l¢lpoWgor to the owner of the private property, or the owner's agenl, the property owner shall agree to maintain and make available 10 the Secretary or the Sponsor, upon reasonable request, records disclosing the amount of funds received and Ihe dlsposfllon of those funds.

4. The property owner's right to sue the owner of Ihe nolse-Impactrng Airport for adverse noise Impacts will be abrogated If Ihe property owner dellberalely or willfully acts to reduce or destroy the effecllveness of the noise compatibility measures during the useful life of such measures. This obllgalion shall remain In effacI throughout the useful life of Ihe noise compallbliity measures, but not to exceed 20 years from the date of the Sponsor's acceptance of federal aid for the project.

Y. Update Approved Exhibit "A" For Land In Project. It Is underslood and agreed by and between Ihe parties hereto that notwithstanding the fact that this grant offer Is made and accepted upon the basis of the current Exhlbft "A" Property Map, the Sponsor hereby covenants and agrees that upon completion of an AlP funded land acqulsUlon proJect, It wilt update saId Exhibit' A" Property Map to standards satisfactory to the FAA and submit said documentallon in Hnal form to the FAA. It Is further mutually agreed that the reasonable cost of developing said Exhibll "A" Property Map Is an eligible administrative cost for participation within the scope of this project.

Z. Friction Measuring Devices. If this granllnctudes acquisition of friction measurIng devIces, the Sponsor assures that it wI!! properly callbrale, operate, and malnlaln the friction measuring equIpment In accordance with the manUfacturer's guidelines and Instructions and Advisory Circular 150/5320-12. The friction measuring equipment and tow vehicle (If applicable) shall not be used for any other purpose other than for conducting friction measuring tests on airport pavement surfaces and directly related activities, such as training and calibration.

AA. Low Emission Systems. If this grant Includes low emission systems work, the Sponsor agrees to the following conditions under the Voluntary Airport Low Emission (VALE) program;

1. Vehicles and equipment purchased with assistance from this grant shall be maintained and used for their useful life at the airport for which they were purchased. Moreover, any vehicles or equipment replaced under this program shall not be transferred to another airport or location within the same or any olher nonattalnmenl or maintenance area. No airport-owned vehicles or equipment may be transferred to, taken to, or used al another airport without the consent of the FAA In consultallon with the United States Environmental Protection Agency and,State air quality agency.

2. All vehicles and equipment purchased with assistance from this grant shall be clearly labeled using Ihe VALE program emblem designed by the FAA.

3. The Sponsor shalt maintain annual reporting records of all vehicles and equipment purchased with assistance from this grant. These public records shall contain detailed Information involving Individuat vehicles and eqUipment, proJecl expenditures, cost effectiveness, and emission reductions,

The Sponsor certifies that It shall replace any disabled or seriously damaged vehicle or eqUipment purchased wilh assistance from this grant, at any lime during Its useful life, with an equivalent vehicle Or unit that produces an equal or lower level of emissions. The Sponsor assumes all Hnanclal responsibility for reptacement costs. The Sponsor also certifies that it shall fulfill this reptacement obligation, beyond the useful life of the affected vehicle or equipment, for Ihe possible longer life of Airport Emission Reduction Credits that were granted to the Sponsor for this vehicle or equipment.

IV. ASSURANCES The following FAA document tilled ASSURANCES Airport Sponsors, dated April 2012, Is Incorporated as part of these Terms and Conditions;

13

T arms and Conditions of Acceptlr.g Airport Improvement Program Grants

A. General.

Assurances Airport Sponsors

April 2012

April 13. 2012

Boot; 0156 P3'j~ 693 1. These assurances shall bi; complied with In the performance of granl agraaments for airpurt

development, airport planning, and noise compatibility program granls for airport sponsors.

2. These assurances are required to be submitted as part of the project application by sponsors requesUng funds under the provisions of TWe 49, U.S.C., subUUe VII, as amended. As used herein, the term "public agency sponsor" means a public agency with control of a public-use airport; the term nprivale sponsor" means a private owner of a public-use airport; and the term "Sponsor"lncludes both public agency sponsors and prlvale sponsors.

3. Upon acceptance of this grant offer by the Sponsor. these assurances are incorporated In and become part of this grant agreement

B. Duration and Applicability.

1. Airport development or Noise Compatibility Program Projects Undertaken by a Public Agenc)' Sponsor. The terms, conditions and assurances of this grant agreement shall remain In full force and effect throughout the useful life of the facililies developed or eqUipment acquired for an airport development or noise compatibility program project, or throughout the useful life of the project items Installed within a facility under a noise compatibility program project, but In any event not 10 exceed twenty (20) years Irom the date of acceptance of a grant offer of Federal funds for the project However, there shall be no limit on the duration of the assurances regarding Exclusive Rights and Airport Revenue so long as the airport Is used as an airport. There shall be no limit on the duration of the terms, conditions, and assurances with respect to real property acquired with federal funds. Furthermore, the duration of Ihe Civil Rights assurance shall be specified In the assurances.

2. Airport Development or Noise Compatibility Projects Undertaken by a Private Sponsor. The preceding paragraph 1 also applies to a private sponsor except that the u-,eivllifs of project Items insialled within a facflnyor the useful life of the facilities developed or eqUipment acquired under an airRort development or noise compatibility plOgram project shall be po less than ten (10) years from the dale of acceptance of Federal aid for l/1e project.

3, Airport Planning Undertaken by a Sponsor. Unless otherwise specified in this grant ........... "' ___ ~ ..... 1 •• " ........ ~_ ............... " .., ") I: a >t? <to ':In ,,1") ?? ... ~,J ,)A I ... ...... _j~ ...... r- .. __ I •• ,1._ C11;11"::01l10In, ""'Hll n.:r';:>\.,OIQllvC" 11 ~, .... , ......... , 1""1 IV, .... V, ",41 ...... , au ........ .,. III .::> ....... ~IV" v apply IV

planning projects. The terms, conditions, and assurances of this grant agreement shall remain in full force and effect during the life of the proJecl.

C. Sponsor Certification. The Sponsor hereby assures and certifies, with respect 10 this grant that:

1, General Federal Requirements, It will comply with all applicable Federal laws, regulations, executive orders, policies, guidelines. and requirements as they relate to lhe application, acceptance and use of Federal funds for this project Including but not lim lied 10 the following:

Federal Legislation

a. Tille 49, U.S.C., subtitle VII, as amended.

b. Davis-Bacon Act - 40 U:S.C. 276(a). et seg,'

c. Federal Fair Labor Standards Acl- 29 U,S.C. 201. et seq,

d, Hatch Act - 5 U.S ,C. 1501.l'.lseo!

e. Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 Title 42 U.S.C.4601, alseg."

14

(0'13

T anns and Conditions of Accepting Alrpon Improvemenl Program Grants April 13, 2012

f. National Historic Preservation Act of 1966· SecUon 106·16 U.S.C. 470(0.'

g. Archeological and Historic Preservation Act of 1974·16 U.S.C. 469 through 469c.'

h. Native Americans Grave Repatriation Act· 25 U.S.C. Seclion 3001, et seq.

I.

J. Clean Air Act, P.L. 90·148, as amended.

Coastal Zone Management Act, P.L. 93-205, as amended.

k. Flood Disaster Protection Act of 1973 • Section 102(a)· 42 U.S.C. 4012a.'

I. Title 49, U.S. C., Seclion 303, (fonmerly known as Secllon 4(1)

m. Rehabilitation Act of 1973·29 U.S.C. 794.

n. Civil Rights Act 011964 - Title VI· 42 U.S.C. 2000d through d·4.

o. Age Discrimination Act of 1975·42 U.S.C. 6101, et seg.

p. American Indian Religious Freedom Act, P.L. 95-341, as amended.

Q. Architectural Barriers Act of 1966 -42 U.S.C. 4151, at seq.'

r. Power plant and Industrial Fuel Use Act of 1978 - Section 403- 2 U.S.C. 8373.'

s. Contract Work Hours and Safely Standards Act- 40 U.S.C. 327, et seg.'

I. Copeland Anti kickback Act -18 U.S.C. 874.1

u. National Environmental Policy Act of 1969·42 U.S.C. 4321, at seg.'

v. Wild and Scenic Rivers Act, P.L. 90-542, as amended.

w. Singte Audit Act of 1984 - 31 U.S.C. 7501, et S9q.2

x. Drug-Free Workplace Act of 1988 - 41 U.S.C. 702 through 706.

Executive Orders

Executive Order 11246 - Equal Employment Opportunity'

Executive Order 11990 - Protection 01 Wetlands

Executive Order 11996 - Ftood Plain Management •

Executive Order 12372 • Intergovernmental Review of Federal Programs

Executive Order 12699 - Seismic Safety of Federal and Federally Assisted New Building Construction'

Executive Order 12898 - Environmental Justice

Federal Regula/ions

a. 14 CFR Part 13 • Investigative and Enforcement Procedures.

b. 14 CFR Part 16 • Rules of Practice For Federally Assisted Airport Enforcement Proceedings.

c. 14 CFR Part 150 - Airport noise compatibility planning.

d. 29 CFR Part 1 • Procedures for predetermination of wage rates.'

e. 29 CFR Part 3 • Contractors and subcontractors on public building or public work financed In whole or part by loans or grants from the United States,'

f. 29 CFR Part 5 - Labor standards provisions applicable to contracts covering federally financed and assisted construction (also labor standards proVisions applicable to nonconstruction contracts subject to the Contract Work Hours and Safety Standards Act).'

g. 41 CFR Part 60 • Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor (Federal and federally assisted contracting requirements).'

15

Terms and Conditions of Accepting Airport Improvement Program Granls April 13, 2012

h. 49 CFR Part 18 - Uniform administrative requirements for grants and cooperative agreements to state and tocat governments.'

I. 49 CFR Part 20 - New restrictions on lobbying,

J. 49 CFR Part 21 • Nondiscrimination In federally-assisted programs of the Department of Transportation· effectualion of Title VI of Ihe Civil Rights Act of 1964, 0 690

Boo,: 0156 I.~~ 0

1(. 49 CFR Part 23 - Participation by Disadvantage Business Enterprise In Airport Concessions.

L 49 CFR Part 24 - Uniform relocation assistance and real property acquisition for Federal and federally assisted programs.' 2 .

m. 49 CFR Part 26 - Participation 8y Disadvantaged 8uslness Enterprises In Department of Transportation Programs.

n. 49 CFR Part 27 • Nondiscrimination on the basis of handicap In programs and activities receiving or benefiting from Federal financia I assistance.'

o. 49 CFR Part 29 - Government wide debarment and suspension (nonprocurement) and government wide requirements for drug-free workplace (granls).

p. 49 CFR Part 30 • Denial of public works conlracls to suppliers of goods and services of countries that deny procurement market access to U.S. contraelors.

q. 49 CFR Part 41 • Seismic safety of Federal and federalli' assisted or regulated new building construction. '

Offica af Management and Budgel Circulars

a. fl,·S? - Cost Principles Applicable to Grants and Contracts with State and Local Governments.

b. A·133 - Audits of States, Local Governments, and Non·Profit Organizations

1. These laws do not apply to airport planning sponsors.

, These laws do not apply to private sponsors.

, 49 CFR Part 18 and OMB Circular A-S? contain requirements for State and Local Governments receiving Federal assistance. Any requirement levted upon State and local GOVernments by this regulation and circular shall .also be applicable to private sponsors receiving Federal assistance under Title 49, United Slates Code.

SpeCific assurances required to be included in grant agreements by any of the above laws, regulations or circulars are incorporated by reference in this grant agreement.

16

G'15

Terms and Conditions of Accepting Airpo~ Improvement Program Grants April 13, 2012

2. Responsibility and Authority of the Sponsor. Book (r159 P<l9~ 696

a. Public Agency Sponsor: It has legal authority to apply for this grant, and to finance and carry out the proposed project; that a resolution, motion or similar action has been duly adopted or passed as an official act of the applicant's govemlng body authorizing the filing of the application, Including all understandings and assurances contained therein, and d/rectlng and authorizing the person Identified as the official representative of tha applicant to act in connection with the application and to provide such additional Information as may be required.

b. Private Sponsor: It has legal authority to apply for this grant and to finance and carry out the proposed project and comply with all terms, conditions, and assurances of this grant agreement. It shall designate an official representative and shall In writing direct and authorize that person to file this application, Including all understandings and assurances contained therein; to act In connection with this application; and to provide such additional Information as may be required.

3. Sponsor Fund Allellablllty, It has sufficient funds available for Ihat portion of the project costs which are not to be paid by the United States. It has sufficient funds available to assure operation and maintenance of nems funded under this grant agreement which it will own or control.

4. Good Title.

a. it, a public agency or the Federal government. holds good litle, satisfactory to the Secretary. to the landing area of the airport or site thereof. or will give assurance salisfactory to the Secretary that good title will be acquired.

b. For noise compatibility program projects to be carried out on the property of the Sponsor, it holds good title satisfactory to the Secretary 10 that portion of Iha property upon which Federal funds will be expended or will give assurance to the Sacretary that good title will be obtained.

5. Preserving Rights and Powers.

e, It will not take or permit any action which would operate to deprive it of any of the rights and powers necessary to perform any or all of the terms, conditions, and assurances In this grant agreement without the written approval of the Secretary, and will act promptly to acquire, extinguish or modify any outstanding rights or claims of right of others which would Interfere with such peoormence by the Sponsor. This shall be done In e manner acceptable to the Secretary.

b. It will not sell, lease, encumber, or olherwise transfer or dispose of any part of lis tille or other interests In the property shown on Exhibit A to this application or, for a noise compatibility program project, that portion of the property upon which Federal funds have been expended, for the duration of the terms, condilions, and assurances In this grant agreement without approval by the Secretary. If the transferee Is found by the Secretary 10 be eligible under Title 49, United States Code, to assume the obligations of this grant agreement and to have the power, authority, and Hnanclal resources to carry out all such obligations, the Sponsor shall Insert In Ihe contract or document transferring or disposing of the Sponsor's interest, and make binding upon Ihe transferee all of Ihe terms, conditions. and assurances contained in this grant agreemen\.

c. For all noise compatibility program proJecls which are to be carried out by another unit of local government or are on property owned by a unit of local government other than the Sponsor, it will enler Into an agreement with that government. Except as otherwise speciHed by the Secretary, that agreement shall obligate that government to the same terms, conditions, and assurances that would be applicable to it If it applied direclly to the FAA for a granl to undertake the noise compatibility program project. That agreement and changes thereto must be sallsfactory to the Secretary. 11 will take steps to enforce this agreement against the local government If there is substantial non-compliance with the terms of the agreement.

17

Terms and Conditions of Accepting Airport Improvement Progrsr:1 Grants April 13. 2012

d. For noise compatibility program projects to be carried out on privately owned property. il will enter into an agreement with the owner of that property which Includes provisions specified by tho Secretary. It will take steps to enforce Ihis agreement against the property owner whenever there is substantial non·compllance wilh lhe terms of Ihe agreement.

e. If the Sponsor Is a private sponsor, It will lake steps sa!isfactolYlll!3I,tItllSiEf:f~ar)!\tP ensure that the airport will continue to function as a public-use airport In accordance wilh Ihesli' assurances for the durallon of these assurances.

f. If an arrangement is made for management and operation of Ihe airport by any agency or person olher than the Sponsor or an employee of the Sponsor, the Sponsor will reserve sufficient rights and authority to Insure that the airport will be oparated and maintained In accordance TItle 49, United Stales Code, the ragulations and the terms, conditions and assurances In this grant agreement and shall insure that such arrangement also requires compliance therewilh.

g. Sponsors of commercial service airports will not permit or enter into any arrangemenllhat results In permission for the owner or tenant of a property used as a reSidence, or zoned for residential use, to taxi an alreraft between that property and any location on airport. Sponsors of general avialion airports entering inlo any arrangement that results In permission for the owner of residenilal real property adjacenllo or near the airport must comply with the requiremenls of Sec. 136 of Public Law 112·95 and the sponsor assurances.

6. Consistency with Local Plans. The project Is reasonably consistent with plans (existing at the lime of submission of Ihis applicalion) of public agencies that are aulhorlzed by Ihe State in which the project is located to plan for the development of the area surrounding the airport.

7. Consideration of Local Interest. It has given fair consideration to the interest of communities in or near where the project may be located.

6. Consultation with iJsers. In making a decision 10 undertake any airport development project under Titie 49, United Slates Code, it has undertaken reasonable consultations with affected parties using tho air par! at which project is proposed.

g. Public Hearings. In projects involving tho location of an airport. an airport runway, or a major runway extension. it has afforded Ihe opportunity for public hearings for the purpose of considering the economic, social, and environmental effects of the airport or runway location and Its consistency with goals and obJecUves of such planning as has been carried out by th~ community and it shall, When requested by the Secretary, submit a copy of the transcript of such hearings to the Secretary. Further. for such projects, it has on Its management board either voting representation from the communitIes where the project Is localed or has advised the communities :h~t the,' ho.':c the rIght ~c p~Utkm !hc Sccrct~i)' conCG::o;ng D: p"G.~::;s3d p;~j$c!.

10. Air and Water Quality Standards. In projects involving airport locaUon, a major runway extension. or runway location II will provide for Ihe Governor of the slate In which the project is located to certify in wrillng to the Secretary that the project will be tocated, designed, conslructed, and operated so as to comply wl1h applicable air and water quality standards. In any case where such standards have not been approved and where applicable air and water quality standards have been promulgated by the Administrator of the Environmental Protection Agency, certification shall be obtained from such Administrator. Nolice of certificaVon or refusal to certify shall be provided vAthin sixty days after Ihe project application has been received by the Secretary.

16

Terms and Conditions of Accepting Airport Improvement Program Grants Aprt113,2012

11. Pavement Preventive Maintenance. With respect to a project apprdlq~ 'lIMr ?~~ua\'i}l1, 1995, for the replacement or reconstruction of pavement at the airport, It assures or certifies that it has Implemented an effective airport pavement maintenance-management program and It aSSures that 1\ will use such program for the useful life of any pavement constructed, reconstructed or repaired with Federal financial assistance at the airport. It will provide such reports on pavement condition and pavement management programs as the Secretary determines may be useful.

12. Terminal Development Prerequlslles. For projects which include terminal development at a public use airport. as defined In Tille 49, It has, on the date of submiUal of the project grant appllcalion, all the safety equipment required for certlflcallon of such airport under section 44706 of Title 49, United States Code, and all the security equipment required by rule or regulation, and has provided for access to Ihe passenger enplaning and deplaning area of such airport to passengers enplaning and deplaning from aircraft other than air carrier aircraft.

13. Accounting System, Audit, and Record Keeping Requirements.

a. It shall keep all project accounts and records which fully disclose the amount and disposWon by the recipienl of the proceeds of this grant, the tolal cost of the project In conneclion with which this grant Is given or used. and the amount or nature of Ihat portion of the cost of the project supplied by other sources, and such other financial records pertinent to the project. The accounts and records shall be kept in accordance' wllh an accounting system that will facilitate an effective audit In accordance with the Single Audll Act of 1984.

b. It shall make available to the Secretary and the Comptroller General of the United States, or any of their duly authorized representatives. for the purpose of audit and examination, any books, documents, papers, and records of the recipient that are pertinent to this grant. The Secretary may require that an appropriate audit be conducted by a recipient. In any case In which an Independent audit Is made of Ihe accounts of a sponsor relating to the disposition of the proceeds of a grant or relating to the proJect In connection with which this grant was given or used, It shall file a certified copy of such audit with the Comptroller General of the United States not later than six (6) months following the close of the fiscal year for which the audit was made.

14. Minimum Wage Rates. It shall include. In all contracts In excess of $2,000 for work on any proJects funded under this grant agreement which Involve labor, provisions establishing minimum rates of wages. to be predetermined by the Secretary of Labor. In accordance with the DavisBacon Act, as amended (40 U.S.C. 276a-276a-5), which contraclors shall pay to skilled and unskilled labor, and such minimum rates shall be stated in the Invllatlon for bids and shall be Included In proposals or bids for the work.

15. Veleran'" Preference. It shallinciude In all contracts for work on any project funded under this grant agreement which Involve labor, such provisions as are necessary to Insure that, In the employment of labor (except In executive, administrative, and supervisory positions), preference shall be given to Vietnam era veterans, Persian Gulf veterans. Afghanistan-Iraq war veterans, disabled veterans, and small business concerns owned and controlled by disabled veterans as defined In Secllon 47112 of Title 49, United States Code. However. this preference shall apply only where the Individuals are available and qualified to perform the work to which the employment relates.

16. Conformity to Plans and Specifications, II will oxecute the project subject to plans. speCifications, and schedules approved by the Secretary. Such plans, speclOcations, and schedules shall be submitted to the Secretary prior to commencement of slle preparation, construction, or other performance under this grant agreement, and, upon approval of the Secretary, shall be incorporated into this grant agreement. Any modification to the approved plans, speCifications, and schedules shall also be subject to approval of the Secretary. and Incorporated Into this grant agreement.

19

Terms and Conditions of P,ccepting Airport Improvemenl Program Granls April 13, 2012

17. Construction Inspect/on and Approval. It will provide and m<ilnllliirll1GlbrfljAAerWliechnical supervision at the construction site throughout Ihe project to assure Ihat the work conforms to the plans, specifications, and schedules approved by the Secretary for the project. It shall subject the construction work on any project contained in an approved project application to inspection and approval by the Secretary and such work shall be in accordance with regulations and procedures prescribed by the Secretary. Such regulations and procedures shall require such cost and progress reporting by the sponsor or sponsors of such project as the Secretar)' shall deem necessary.

18. Planning Projects. In carrying out planning projects:

a. It will execute the project in accordance with the approved program narrative contained In the project application or with the modifications similarly approved.

b. Il will furnish the Secretary with such periodic reports as required pertaining to the planning project and planning work activities.

c. It will include In all published material prepared In connection with the planning project a notice that Ihe material was prepared \lnder a grant provided by the United States.

d. It will make such material available for exam Ina lion by the public, and agrees that no material prepared with funds under this project shall be subject to copyright In the United States or any other country.

e. It will give the Secretary unresiricted authority to publish, disclose, distribute, and otherwise use any of the material prepared In connection with this grant.

f. It will grant Ihe Secretary the right to disapprove the Sponsor's employment of specific consultants and their subcontractors to do all or any part of this project as well as the right to disapprove the proposed scope and cost of professlonat services.

g. It will grant the Secretary the right to disapprove the use of Ihe Sponsor's employees to do all or any part of the project.

h. It understands and agrees thaI the Secretary's approval of this project grant or the Secretary's approval of any planning material developed as part of this grant does not constitute or imply any assurance or commllment on the part of the Secretary to approve any pending or future application for a Federal airport grant.

19 .. Operation and Malnlenance.

a. The airport and all facll/tles which are necessary 10 serve Ihe aeronautical users of the airport, olher than facilities owned or controlled by the United Slales, shall be operated at all times In a safe and serviceable condilion and In accordance with the' minimum standards as may be required or prescribed by applicable Federal, state and local agencies for maintenance and operation. It will not cause or permit any activity or action thereon which would Interfere with its use for airport purposes. It will suitably operate and maintain the airport and all facilities thereon or connected therewilh, wilh due regard to climatic and flood conditions. Any proposal to lemporarily close the airport for non-aeronautical purposes musl first be approved by the Secretary. In furtherance of this assurance, Ihe Sponsor will have in effect arrangements for-

1) Operating Ihe airport's aeronautical facilities whenever required;

2) Promptly marking and lighting hazards resuiting from airport conditions, including _ temporary conditions; and

3) Promptly notifying airmen of an)' condition affecting aeronautical use of the airport.

Nolhing contained herein shall be construed to require that the airport be operated for aeronautical use during temporary periods when snow. flood or other climatic conditions interfere with such operation and maintenance. Further, nOlhing herein shall be construed as requiring the maintenance, repair, resloration, or replacement of any structure or facility

20

Tenns and Conditions of Accepting Airport Improvement Program Granls April 13, 2012

which Is substantially damaged or destroyed due to an act ofa~cPlJiSJ\ffifr dBKdition or circumstance beyond the control of the Sponsor,

b, II will suitably operate and maintain noise compallbllity program Items thai It owns or conlrols upon which Federal funds have been expended,

20, Hazard Removal and Mitigation, It will take appropriate acllon to aSsure that such terminal airspace as Is required to protect Instrument and visual operations to the airport (Including eslabllshed minimum flight altitudes) will be adequately cleared and protected by removing, lowering, relocating, marking, or lighting or otherwise mitigating eXisting airport hazards and by preventing Ihe establishment or crsallon of future airport hazards,

21, Compatible Land Use. It will take appropriate acllon, 10 Ihe extent reasonable, Including Ihe adoption of zoning laws, to restrict Ihe uSe of land adjacent to or In Ihe Immediale vicinity of the airport to activities and purposes compatible wllh normal airport operations, Including landing and takeoff of aircraft. In additlon, If the project is for noise compatibility program implementation, It will not cause or permit any change in land use, within its Jurlsdlcllon, that will reduce ils compatibility, with respect to the airport, of the noise compatlbllily program measures upon which Federal funds have been expended.

22. Economic Nondiscrimination.

a. It wlll make the airport available as an airport for public use on reasonable terms and without unjust discrimination to all types, kinds and classes of aeronautical activities, Including commercial aeronautical activities offering services to the public at the airport,

b. In any agreement, conlract, lease, or other arrangement under which a right or privilege at the airport Is granted to any person, firm, or corpora lion to conduct or to engage In any aeronautical acllvlly for furnishing seNicas to the public at the airport, the Sponsor will insert and enforce provisions requiring the contractor to-

1) furnish said services on a reasonable, and not unjustly discriminatory, basis to all users thereof, and

2) charge reasonable, and nol unjustly discriminatory, prices for each unit or service, provided that the contractor may be allowed to make reasonable and nondiscriminatory discounts, rebates, or other similar types of price reductions 10 volume purchasers,

c. Each fixed-based operator aJ the airport sha1l be subject to the same rates, fees, rentals, anp other charges as are uniformly applicable to all other fixed-based operators making the same or similar uses of such airport and utilizing the same or similar facilities.

d, Each air carrier using such airport shall have the right 10 service itself or 10 use any fixedbased operator thaI is authorized or permitted by the airport to serve any air carrier at such airport,

e, Each air carrier using such airport (whether as a tenant, non lenant, or subtenant of another air carrier tenant) shall be subject to such nondiscriminatory and substantially comparable rules, regulations, conditions, rates, fees, rentals, and other charges with respecl to facilities directly and substantially related 10 providing air transportation as are applicable to all such air carriers which make similar use of such airport and utilize similar facilities, subject to reasonable classifications such as tenants or non tenants and signatory carriers and non signa lory carriers. ClassificaUon or status as tenant or Signatory shall not be unreasonably wllhheld by any airport provided an air carrier assumes obligations substantially similar 10 those already imposed on air carriers In such classification or status.

f. It will nol axerclse or grant any right or privilege which operates to prevent any person, firm, or corporation operating aircraft on the airport from performing any services on lis own aircraft wllh its own employees [Including, but not limited to maintenance, repair, and fueling] that it may choose to perform,

21


g. In Ihe event the Sponsor itself exercises any of the rights and 9A~M~~~ fJMrre"(f'\o In this assurance, the services Involved will be provided On the same conditions as would apply to the furnishing of such services by commercial aeronautical service providers authorized by the Sponsor under these provisions.

h. The Sponsor may establish such reasonabte, and not unjustly discriminatory. conditions to be met by all users of the airport as may be necessary for the safe and efficient operation of the airport

I. The Sponsor may prohibit or limit any given type, kind or class of aeronautical use of the airport If such acllon Is necessary for Ihe safe operation of the airport or necessary 10 serve the civil avlallon needs of Ihe public.

23. exclusive Rights. It will permll no exclusive righl for tho use o( the airport bl' any person providing, or intending to provide, aeronautical services 10 Ihe public. For purposes of this paragraph. the providing of the services al an airport by a slnglo fixed·based operator shall nol be conslrued as an exclusive right if bolh of lhe (ollowlng appty:

a. It would be unreasonably cosily, burdensome, or Impractical for more than one fixed·based operator to provide such services, and

b. If allOWing moro than ona fixed·basad operator to provide such services would require the reduction of space leased pursuant to an existing agreement between such single fixed· based operator and such airport. It further agrees Ihat It will not, either direcliy or Indlrecliy, grant or permit any person, firm, or corporation, the excluslva rlghl at tha airport to conducl any aeronautical acllvltlas, Including, but not limited 10 charter flights, pilot training, aircraft rental and sightseeing, aerial pholography, crop dusting, aarlal advertiSing and surveying, air carrier operations, alrcrall sales and services, sale of avlalion petroleum producls whether or not conducted In conjunction with olher aeronautical acllvlty, repair and maintenance of aircrafl, sala of alrcraH parts, and any other activities which because of Iheir direct relationship to the operation of aircraft can be regarded as an aeronautical activity, and Ihallt will terminate any exclusive right 10 conduct an aeronautical activity nOw existing at such an airport before the grant of any assistance under Tille 49, United States Code.

24, Fea and Rental Structure, It will maintain a fee and rental structure for the facilities and services at the airport which will make the airport as self-sustaining as possible under too circumstances existing at the panicular airport, laking inlo accounl such faclors as Ihe volume of traffic and economy of collection. No part of the Fede;al share of an airport developmfnt, airport planning or noise compatibility projecl for which a' grant is made under Title 49, United Slates Code, the Airport and Airway Improvement Act of 1982, the Federal Airport Act or the Airport and Allway Devetopment Act of 1970 shall be included In the rate basis in establishing fees, rales, and

25. Airport Revenues.

a, All revenues generated by the airport and any local taxes on aviation fuel eslablished after December 30, 19S7, will be expended by it for Ihe capital or operating costs of Ihe airport; the local alrpon system; or other local facilities which are owned or operated by the owner or operator of Ihe airport and which are dlreclly and substantially relaled 10 the actual air transportation of passengers or property; or for noise miligation purposes on or off the airport. The following excepllons apply to this paragraph:

1) If covenants or assurances in debl obligations issued before Septamber 3, 1982, by the owner or operator of the airport, or provisions enacted before September 3, 1982, in governing stalules controlling the owner or opera lor's financing, provide (or the use of the revenues from any of the airport owner or operator's facilities, including Ihe airport, to support nol only the airport but also the airport owner or operator's general debt obligations or other facilities, then Ihls IImllatian on the use of all revenues generated by the airport (and, In the case of a public airport, local taxes on aviation fuel) shall not apply.

22

'tv I

Terms and Conditions of Accepting Airpo~ Improvement Program Grants April 13, 2012

2) If the Secretary approves the sale of a privately owned airport to a public sponsor and provides funding for any portion of the public sponsor's acquisition of land, this limitation on the use of ali revenues generated by the sale shall not apply to certain proceeds from the sale, This Is conditioned on repayment to the Secretary by the private owner of an amount equal to the remaining unamortized portion (amortized over a 20-year period) of any aIrport Improvement grant made to the private owner for ali'J p4fms~ Q\heli,tI;lan land acquisition on or after October 1, 1996, plus an amount equal f811'''l'ft!l:lerll1<shM~ of the current fair market value of any land acquired with an airport Improvement grant made 10 Ihat airport on or after October 1, 1996.

3) Certain revenue derived from or generated by minerai extraction, production, lease, or other meanS at a general avlat/on airport (as defined at Sect/on 47102 of title 49 United States Code), If the FAA determines the airport sponsor meels Ihe requirements set forth in Sec. 813 of Public Law 112-95,

b, As part of the annual audit required under the Single Audit Act of 1984, the Sponsor will direct that the audit will review, and the resulting audit report will provide an opinion concerning, the use of airport revenue and taxes In paragraph (a), and Indicating whether funds paid or transferred 10 the owner or operalor are paid or transferred in a manner consistent with Tille 49, United Stales Code and any other applicable provision of law, Including any regulation promulgated by the Secretary or Admlnlstralor.

c. Any civil penalties or olher sancllons wllf be Imposed for violation of this assurance In accordance with the provisions of Section 47107 of Tille 49, United States Code,

26. Reports and Inspections. It will:

a, submit to the Secretary such annual or special financial and operations reports as the Secrelary may reasonably request and make such reports available to Ihe public; make available to the public at reasonable limes and places a report of the airport budget In a fonnat prescribed by the Secretary;

b, for airport development projects, make the airport and all airport records and documents affecting the airport, including deeds, leases, operation and use agreements, regulations and other instruments, available for Inspecllon by any duly authorized agent of the Secretary upon reasonable request;

• • c. for noise compallbility program projects, make records and documents relating to the proJecl and continued compliance with the terms, conditions, and assurances of this grant agreement including deeds, leases, agreements, regulations, and other instrumenls, available for Inspection by any duly authorized agent of the Secretary upon reasonable request; and

d, In a format and time prescribed by the Secretary, provide to the Secretary and make available to the public following each of its fiscal years, an annual report listing In detail;

1) ali amounts paid by the airport to any other unit of government and the purposes for which each such payment was made; and

2) all services and property provided by the airport to other units of government and the amount of compensallon received for provision of each such seNlce and property.

27. Use by Government Aircraft, It will make available ali of the facilities of the airport developed wllh Federal financial assistance and all those usable for landing and takeoff of aircraft to the United States for use by Government alrcrart in common with other aircraft at ali limes without charge, except, If the use by Government aircraft is SUbstantial, charge may be made for a reasonable share, proportional to such use. for the cost of operaling and maintaining the facilities used. Unless olherwlse determined by the Secretary, Or otherwise agreed to by the Sponsor and the using agency, substantial use of an airport by Government aircraft will be considered to exist when operations of such aircraft are in excess of those which, In the opinion of Ihe Secretary,

23

, 10:;1

Terms and Conditions of Accepting Airport Improvemenl Program Grants f<pri113,2012

would unduly interfere with use of the landing areas by other aUihodl21!1d I);jjf(lrii'ft~'l8r (!(lrlng any calendar monlh that -

a. Five (5) or more Government aircraft are regularly based attha airport or on land adjacent thereto; or

b. The total number of movements (counllng each landing as a movement) 01 Government aircraft is 300 or more, or the gross accumulative weight 01 Government aircraft using Ihe airport (the total movement 01 Government aircraft mulllpiled by gross weights 01 such aircraft) is In excess of five million pounds.

28. Land for Feclersl Facilities, It will furnish without cost to the Federal Government for use in connection with any air traffic control or air navigation Bcllvilles, or weather·reporting and communication activities related to air traffic control. any areas of land or water, or estate therein. or rights in buildings of the Sponsor as the Secretary considers necessary or desirable lor construction, operation, and maintenance at Federal expense of space or facilities lor such purposes. Such areas or any portion (hereof \\111 be made available as provided herein within four months alter recelp( of a wrillen request Irom Ihe Secretary.

29. AIrport Layout Plan.

a. II will keep up (0 date at all Umes an airport layout plan 01 the airport showing (1) boundaries 01 the airport and all proposed additions Ihereto, (ogether with Ihe boundaries of all offsile areas owned or controlled by the Sponsor lor airport purposes and proposed additions thereto; (2) the loea"on and nature of all existing and proposed airport facilities and structures (such as runways, taxiways, aprons, terminal buildings, hangars and roads), Including all proposed extensions and reducUons of existing airport facilities; (3) the location of all existing and proposed non·aviation areas and of all existing Improvements thereon; and (4) all proposed and existing access points used 10 taxi aircraft across the airport's property boundary. Such airport layout plans and each amendment, revision, or modlflca!ion thereol, shall be subject to lhe approval of the Secretary which approval shall be evidenced by the Signature 01 a duly authorized representative 01 the Secretary on the lace 01 the airport layout plan. The Sponsor will not make or permit any changes or alterations in the airport or any of tts lacillties which are not in conformity with the airport layout plan as approved by the Secretary and which might, In the opinion of the Secretary, adversely affect the saiety, utility or efficiency of the airport.

,b. II a change or alteration In the airport or the facilities is mad~ which the Secretary determines adversely aflects the salety, utility, or efficiency 01 any federally owned, le'ased, or funded property on or off the airport and which is not In conformity with the airport layout plan as approved by the Secretary, the owner or operator will, If requested, by the Secretary (1) :a::mfiiata such adv~i'se et:'.;ct lii a i'iit'inner ovpi"ov-ad by ;ha S6cretaty~ Cii {2, baar an costb of relocating such property (or replacement thereof) to a sile acceptable to the Secretary and all costs of restoring such property (or replacement thereof) to the level of safety, utilily, efficIency, and cost of operation existing befort;! the unapproved change In the airport or lIs factlities, exceplln the case of a relocation or replacement of an exlsfing airport lacllity due to a change In the Secretary's design standards beyond the control of the airport sponsor.

30. Civil Rlghls. It will comply with such rules as are promulgated to assure thaI no person shall, On the grounds of race, creed, color, national origin. sex, age, or handicap be excluded Irom participating in any activity conducted with Or beneFiting from lunds received from this grant. This assurance obligates the Sponsor for Ihe period during which Federal financial assistance Is extended to Ihe program, except where Federal financial assistance is to provide,.or is In the form of personal property or real property or Interest therein or structures or Improvements thereon in which case the assurance obligates the Sponsor or any transferee for the longer of the following periodS: (a) the period during which the property Is used lor a purpose for which Federal financial assistance Is extended. or for another purpose involving the provision of similar services or benefits, or (b) the period during which the Sponsor retains ownership or possession of the property.

24

1103

T arms .nd Conditions of Accepting Airport Improvement Program Grants April 13. 2012

31. Disposal of land.

a. For land purchased under a granl for airport noise compatibility purposes. It will dispose of Ihe land. when the land Is no longer needed for such purposes, at fair market value, at the earliest praclicable time. That portion of the proceeds of such disposition which is proportionate to Ihe United States' share of acqulsillon of such land will be, at the discretion of Ihe Secretary, (1) reinvested In another project at Ihe airport, oV0(2) l\daIl&fe9I'ed~lhnother eligible airport as prescribed by the Secretary. The Secretary shall give preference 10 the following, In descending order. (1) reinvestment In an approved noise compatibility project. (2) reinvestment In an approved project that Is eligible for grant funding under Section 47117(e) of Utle 49 United States Code. (3) reinvestment In an approved airport development proJect that Is eligible for grant funding under Sections 47114. 47115. or 47117 of title 49 United Slates Code, (4) transferred to an eligible sponsor of another public airport to be reinvested In an approved noise compatibility project at that airport, and (5) paid to the Secretary for deposit In the Airport and Airway Trust Fund. If land acquired under a grant for noise compatibility purposes Is leased at fair market value and consistent with noise buffering purposes, the lease will not be considered a disposal of the land. Revenues derived from such a lease may be used for an approved airport development project that would otherwise be eligible for grant funding or any permitted use of airport revenue. .

b. For land purchased under a grant for airport development purposes (other than noise compatibility). It will, when the land Is no longer needed for airport purposes, dispose of such land at fair market value or make available to the Secretary an amount equal to the United Slates' proportionate share of the fair market value of the land. That portion of the proceeds of such dlsposillon which Is proportionate to the United States' share of the cost of acqulsillon of such land will, upon application to the Secretary. be reinvested or transferred to another eligible airport as prescribed by the Secretary. The Secretary shall give preference to the following. In descending order: (1) reinvestment in an approved noise compatibility project. (2) reinvestment In an approved project that Is eligible for grant lundlng under Section 47117(e) of title 49 United States Code. (3) reinvestment In an approved airport development project thai Is eligible for grant funding under Sections 47114. 47115. or 47117 of tille 49 Untted States Code. (4) transferred to an eligible sponsor of another public airport to be reinvested In an approved nolsa compatibility project at that airport, and (5) paid to the Secretary for deposit In the Airport and Airway Trust Fund.

c. Land shall be considered to be needed for airport purposes under this assurance if (1) it may be needed for aeronautical purposes (including runway protection +ones) or serve as noise buffer land, and (2) the revenue from Interim uses of such land contributes to the financial setf-sufficlency of the airport. Further, land purchased with a grant received by an airport operator or owner before December 31, 1987, will be considered to be needed for airport purposes If the Secretary or Federal agency making such grant before December 31. 1987. was notified by the operator or owner of the uses of such land. did not object to such use, and the land continues to be used for that purpose, such use having commenced flO later than December 15, 1989.

d. Disposition of such land under (a) (b) or (c) will be subject to the retention or reservation of any loteresl or right therein necessary to ensure that such land will only be used for purposes which are compatible wilh noise levels associated with operation of the airport.

32. Engineering and DeSign Services. It will award each contract, or sub-contract for program management, construction management. planning studies. feasibility studies. archllectural services. preliminary engineering. design. engineering, surveying, mapping or retated services with respect to the project In the same manner as a contract for architectural and engineering services Is negotiated under Tille IX of the Federal Property and Administrative Services Act of 1949 or an equivalent qualifications-based requirement prescribed for or by the Sponsor of the airport.

33. Foreign Market Restrictions. It will nol allow funds provided under this grant to be used to fund any project which uses any product or service of a foreign country during the period in which such

25

Tern" and Conditions of p,ccopling p.irport Improvement Program G;anls Apo113.2012

foreign country is listed by the United State, Trade Representative a!oB~rM~~ ~~Wanl:ll~quitable market opportunities for products and suppliers of Ihe United States in procurement and construction.

34, Pollclas, Standards, and Specifications. It will carry out the projecl In accordance with policies, slandards, and specifications approved by the Secretary including but not limited to the advisory circulars listed In the "Current FAA Advisory Circulars Required for Use In AlP Funded and PFC Approved Projects', dated (the latest approved version as of Ihis grant offer) and Included In this grant, and In accordance with applicable state policies, standards, and specifications approved by the Secretary,

35, Relocation and Real Property Acquisition. (1) It will be guided in acquiring real property, to the greatest extent practicable under State law, by the land acquisition policies in Subpart S of 49 CFR Part 24 and will payor reimburse property owners for necessary expenses as specified In Subpart S, (2) It will provide a relocation asslslance program offering the services described in Subpart C and fair and reasonable relocation payments and assistance to displaced persons as required In Subpart 0 and E of 49 CFR Part 24. (3) It will make available within a reasonable period of time prior 10 displacement, comparable replacement dwellings to displaced persons in accordance with Subpart E of 49 CFR Part 24.

36. Access By Intercity Buses. The airport owner or operator will permit, to the maximum extent practicable, intercity buses or other modes of transportation 10 have access to the airport; however, II has no obligation to fund special facilities for intercity buses or for other modes of transportation.

37, Disadvantaged Suslness Enterprises, The recipient shall not discriminate on the basis of race, color, national origin or sex In the award and performance of any DOT·assisted contract or in the administration of Its DBE program or the requirements of 49 CFR Part 26, The Recipient shall take all necessary and reasonable steps under 49 CFR Part 26 to ensure non discrimination In the award and administration of DOT-assisted contracts. The recipient's aBE program, as required by 49 CFR Part 26, and as approved by DOT, is incorporated by reference In this agreement. Implementation of this program Is a legal obi/gaUon and failure 10 carry out Its terms shall be treated as a violation of Ihis agreement. Upon' notification to the recipient of its failure to carry out Its approved program, the Department may Impose sanctions as provided for under Part 26 and may, in appropriate cases, refer the matter lor enforcement under 18 U,S,C, 1001 andlor the Program Fraud Civil Remedies Act of 1986 (31 U.S.C. 3801),

, 38, Hangar Construction. If Ihe airport owner or operator anp a person who owns an aircraft agree that a hangar is 10 be constructed at the airport for the aircraft at Ihe aircraft owner's expense, the airport owner or operator will grant to the aircraft owner for the hangar a long lerm lease that is subject to such terms and conditions on the hangar as the airport owner or operator may Impose,

39. Competitive Access.

a. If the airport owner or operator of a medium or large hub airport (as defined In section 47102 of title 49, U.S.C.) has been unable to accommodate one or more requests by an air carrier for acceSs to gates or other facilities at that airport in order to allow the air carrier to provide service to the airport or to expand service at the airport, the airport owner or operalor shall transmit a report to the Secretary that·

1) Describes Ihe requests;

2) Provides an explanation as to why the requesls could not be accommodated; and

3)" Provides a time frame within which, if any, the airport will be able to accommodate the requests,

b. Such report shall be due on either February i Or August 1 ot each year if the airport has been unable to accommodate the requesl(s) in the six month period prior to the applicable due date,

26

'lQ

Terms and conditions of Accepling Airport Improvement Program Grants April 13. 2012

You can find FAA Advisory Circulars for AlP projects at the web site below under "Advisory Circulars (ACs)"

http://www'(aa,gov/airports/southern/alp/

Boof; (1l5B Pago. 7<)0

27

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 707 BUDGET WORKSHOP SCHEDULE Date 8/ 6/2012 CLOSE SESSION

ORDER TO SET BUDGET WORKSHOP MEETINGS

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of budget workshops.

Upon motion made by Dennis Dedeaux and seconded by Anthony Hales, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of supervisors to set Budget Workshops to meet on August 13, August 16, and August 20, 2012.




ORDER TO CLOSE SESSION

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter to close session.

Upon motion made by Dennis Dedeaux and seconded by Anthony Hales, the following order was adopted, to-wit:

Be It Ordered by the Pearl River County Board of Supervisors to close the session to determine the need for executive session.




PAGE 17

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 708 EXECUTIVE SESSION Date 8/ 6/2012 RETURN TO REGULAR SESSION

ORDER TO GO INTO EXECUTIVE SESSION


Be It Ordered by the Pearl River County Board of Supervisors to retire into executive session at 1:25 p.m. to discuss pending litigation.




ORDER TO RETURN TO REGULAR SESSION


Be It Ordered by the Pearl River County Board of Supervisors that this Board does now return to regular session at 1:40 p.m. after taking no action in executive session.


voting AYE: Voting NAY: Absent:


PAGE 18

CJL MBMMAS03 OS/16/2012 15:30 Board Minutes Minute Book Text Detail Book 015S Page 709 NUNC PRO TUNC ORDER ON TWIN ROAD Date S/ 6/2012

ORDER NUNC PRO TUNC CORRECTING BOARD ORDER AND COUNTY ROAD LIST TO INCLUDE TWIN ROAD AS A PUBLIC ROAD

Whereas, as a part of the settlement in Cause No. OO-OOSO-GN-D in the Chancery Court of Pearl River County, Mississippi, styled "Estate of William C. Garrett v. Pearl River County" Agreed Judgment was entered May 10, 2001, by and between the Estate of William C. Garrett, by and through CO-Executrixes Billy Lynn Garrett Simms and Deborah Kay Garrett Lewis and Pearl River County, Mississippi whereby Billy Lynn Garrett Simms and Deborah Kay Garrett Lewis as Co-Executrixes of the Estate of William C. Garrett, deceased, and individually, in conformity with the order authorizing quitclaim, conveyed Pearl River County numerous rights-of-way to roads in Pearl River County, Mississippi, situated in Sections 2, 3 and 24, Township 2 South, Range 14 West, and Section 34, Township 4 South, Range 14 West, Pearl River County, Mississippi, dated August 31, 2004, involving thirty-two separate lengthy legal descriptions, and recorded with various other dedications in Book 859 at Pages 488-517 of the Land Deed Records on file in the Office of the Chancery Clerk of Pearl River County, Missiasippi; and

Whereas, subsequently on October 26, 2004, and November 29, 2004, by Board order aome of these roads were incorporated in and made a part of the county road list, but through inadvertence and scrivener's error, Twin Road was not included, but was intended to and should have been included on the official county road list; and

Whereas, upon motion made by Dennis Dedeaux and seconded by Anthony Hales, the following order was adopted, to-wit:

BE AND IT IS HEREBY ORDERED NUNC PRO TUNC to axxept the dedication of and include Twin Road as a county road as originally intended since it was inadvertently omitted and not included in the original order as a county road when it should have been, and IT IS ALSO HEREBY ORDERED NUNC PRO TUNC to place Twin Road on the county road list as a county public road.





PAGE 19

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 709 NUNC PRO TUNC ORDER ON TWIN ROAD Date 8/ 6/2012

A true copy of the survey describing Twin Road is attached to this order and made a part herof, the same as it was originally recorded as a part of said easement

PAGE 20

:, '

. f8 ~ 39Vd {) S 8 }I008 ,

Book; 0158 P.3g~ 710

z o -i

-i o (j) () ):> r fT1

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 711 FACILITATORS CONTRACT ON A&D PROGRAM Date 8/ 6/2012 AUGUST 6, 2012 DOCKET

ORDER TO RATIFY CONTRACT FOR PROFESSIONAL SERVICES ON DRUG AND ALCOHOL EDUCATION PROGRAM AT JAIL

There came on this day to be considered by the Board of supervisors of Pearl River County, Mississippi, the matter of professional services contract.


Be It Ordered by the Pearl River County Board of Supervisors to ratify attached contract between Pearl River County Correctional Facility and Carl Elton Heberg and Teddy L. Lewis as Independent Contractors as personal instructors for Alcohol and Drug Program at Jail.




ORDER TO APPROVE CLAIMS DOCKET FOR AUGUST 6, 2012

There came on this day to be considered by the Board of Supervisors of Pearl River County, Mississippi, the matter of claims docket.


Be It Ordered by the Pearl River County Board of Supervisors to approve claims docket for August 6, 2012.




PAGE 22

PEARL RIVER COUNTY CORRECTIONAL FACILITY AND INDEPENDENT CONTRACTOR

CONTRACT FOR PROFESSIONAL SERVICE~ook 0156 Pl9~ 712

1. Parties. This Contract is made and entered into by and between PEARL RIVER COUNTY CORRECTIONAL FACILITY, hereinafter referred to as "PRCCF," and CARL ELTON HEBERG, hereinafter referred to as "Independent Contractor."

2. Purpose. PRCCF hereby engages Independent Contractor and Independent Contractor hereby agrees to render all professional instructional services necessary to implement and teach an MDOC approved drug and alcohol education program under MDOC standards at PRCCF and to provide at least twenty hours minimum per week.!n personal instruction of inmates at PRCCF.

3. Scope of Services. Independent Contractor shall provide all necessary profeSSional instructional services to implement and operate at PRCCF an MOOC approved drug and alcohol education program to comply with all requirements of MOOC in order for PRCCF to meet all MOOC mandates in the operation of state drug and alcohol related education programs. PRCCF shall provide an MOOC approved curriculum of drug and alcohol education for use by Independent Contractor at PRCCF and Independent Contractor shall provide a minimum of at least twenty hours per week in actually personally instructing inmates at PRCCF in drug and alcohol education per the MOOC approved curriculum.

4. Period of Performance. The period of performance of services under this Contract shall begin on July 16,2012, and end on July 15, 2013. PRCCF shall have the option to renew annually hereafter upon the same terms and conditions by notifying Independent Contractor.

5. Consideration and Method of Payment.

A. As consideration for the performance of this Contract, the Independent Contractor shall be paid a fee of Twelve Hundred ($1,200.00) Oollars per month for all products, services, salaries, travel, performances, costs, and expenses of whatever kind and nature for services rendered under this Contract. Payment shall be made monthly. It Is expressly understood and agreed that in no event shall the total compensation paid hereunder exceed the specified amount of Fourteen Thousand Four Hundred ($14,400.00) Dollars per year. No additional cost Is authorized to be incurred by Independent Contractor.

B. The Independent Contractor will be paid monthly following the month the work is performed. Independent Contractor understands and agrees that the PRCCF, Inc. is not responsible for providing any benefits for I ndependent Contractor, nor payment of any taxes or insurance on behalf of the Independent Contractor. No additional cost is authorized to be incurred by Independent Contractor.

C. It is further understood that the consideratio¥t"1e5l:lJf'e'Slsi9cf1l~erein constitutes full and complete compensation for all services and performances hereunder, and that any sum due and payable to Independent Contractor shall be paid as a gross sum with no with holdings or deductions being made by PRCCF for any purpose from said Contract sum.

D. Independent Contractor will not be entitled to any further compensation or benefits under this contract. Independent Contractor shall be solely responsible for payment of any and all taxes due any governmental entity for his services rendered under this contract. PRCCF shall provide no benefits Whatsoever, including holidays, for Independent Contractor.

6. Rel!,-t1onshlp of Parties. It is expressly understood and agreed that PRCCF enters into this Contract with Independent Contractor on a purchase of service basis and not on an employer-employee relationship basis. Nothing contained herein shall be deemed or construed byPRCCF, the Independent Contractor, or any third party as creating the relationship of principal and agent, partners, joint ventures, or any similar such relationship between PRCCF and the Independent Contractor. Neither the method of computation of fees or other charges, nor any other provision contained herein, nor any acts of PRCCF, or the Independent Contractor hereunder, creates or shall be deemed to create a relationship other than the independent contractor relationship of PRCCF and the Independent Contractor.

7. Termination for Cause. If, through any cause, Independent Contractor shall fail to fulfill in a timely and proper manner, as determined by PRCCF, its obligations under this Contract, or if Independent Contractor shall violate any of the covenants, agreements, or stipulations of this Contract, PRCCF shall thereupon have the right to terminate the Contract by giving written notice to Independent Contractor of such termination and specifying the effeclive date thereof. If this contract is terminated,lndependent Contractor shall be compensated for all services actually rendered prior to date of termination on a pro rata basis for the number of hours actually worked at PRCCF since the last pay period at the monthly rate herein provided.

Page;;: of 5

Notwithstanding the above, Independent Contractor shall not be relieved of liability to PRCCF for damages sustained by PRCCF by virtue of any breach of this Contract by Independent Contractor, and PRC®PkrflM~~li'tMd any payments to Independent Contractor for the purpose of set off until such time as the exact damages due to PRCCF from Independent Contractor are determined.

8. Termination for Convenience. PRCCF may terminate this Contract at any time by giving written notice to Independent Contractor of such termination and specifying the effective date thereof. If this contract is terminated, Independent Contractor shall be compensated for all services actually rendered prior to date of termination on a pro rata basis for the number of hours actually worked at PRCCF since the last pay period at the monthly rate herein provided.

9. Ownership of Documents and Work Products. All data collected by Independent Contractor and all documents; notes, programs, data bases(and all applications thereof), flies, reports, studies, and/or other material collected and prepared by Independent Contractor in connection with this Contract shall be the property of PRCCF upon completion of this Contract or upon termination of this Contract. PRCCF hereby reserves all rights to the data base and all applications thereof and to any and all information and/or materials prepared under this Contract

I ndependent Contractor is prohibited from use of the above described information and/or materials without the express written approval of PRCCF

10. Modification or Amendment. Modifications, changes, or amendments to this Contract may be made upon mutual agreement of the parties hereto. However, any change, supplement, modification, or amendment of any term, provision, or condition of this Contract must be in writing and signed by both parties hereto.

11. Assignments and SubcQntracts. Independent Contractor shall not assign, sublet, or otherwise transfer the obligations incurred on its part pursuant to the terms of this Contract without the prior written consent of PRCCF Any attempted assignment or transfer of its obligation without such consent shall be wholly void.

12. Waiver. Failure of either party hereto to insist upon strict compliance with any of the terms, covenants, and conditions hereof shall not be deemed a waiver or relinquishment of any similar right or power hereunder at any subsequent time or of any other provision hereof, nor shall it be construed to be a modification of the terms of this Contract.

Page 3 0(5

'lll

13. Availflbilltyof Funds. It is expressly understood and agreed that the obligation of PRCCF to proceed under this Contract is conditioned upon the availability of funds, the appropriation of funds by the Mississippi Legislature, the Mississippi Department of Corrections and the receipt of state and/or federal funds. If, at any time, the funds anticipated for the fulfillment of this Contract are not forthcoming or insufficient, either through the failure of the federal government to provide funds or of the State of Mississippi to appropriate funds orthe discontinuance or material alteration ofthe program under which funds were provided, or if funds are not otherwise available to PRCCF for the performance of this Contract. PRCCF shall have the right. upon written notice to Independent Contractor, to immediately terminate this Contract without damage, penalty, cost, or expense to PRCCF of any kind whatsoever. The effective date of termination shall bllo&.sof\l8%We~lin the notice of termination. .

14. Indemnification. PRCCF shall, at no time, be legally responsible for any negligence or wrongdoing by the Independent Contractor and/or its employees, servants, agents, contractors, and/or subcontractors. Independent Contractor agrees to indemnify, defend, save and hold harmless PRCCF and Pearl River County, Mississippi from and against all claims, demands, liabilities, suits, damages, and costs of every kind and nature Whatsoever, including court costs and attorney's fees, arising out of or caused by Independent Contractor and its employees, agents, contractors, and/or subcontractors.

15. Applicable Law. The contract shall be governed by and construed in accordance with the laws of the State of Mississippi, excluding its conflicts of laws provisions, and any litigation with respect thereto shall be brought in the courts of the state. The Independent Contractor shall comply with applicable federal, state and local laws and regulations.

16. Severability. If any term or proVision of this Contract is prohibited by the laws of the State of Mississippi or declared invalid or void by a court of competent jurisdiction, the remainder of this Contract shall not be affected thereby and each term and provision of this Contract shall be valid and enforceable to the fullest extent permitted by law.

17. Entire Agreement. This Contract constitutes the entire agreement·of the parties with respect to the subject matter contained herein and supersedes and replaces any and all prior negotiations, understanding and agreements. written or oral, between the parties relating thereto.

Page 40(5

'115

is, t-/otice. Any notice required or permitted to be given under this Contract shall be In writing and sent by United States Certified Mail, Returned Receipt Requested to the party to whom the notice should be given at the address set forth below:

PEARL RIVER COUNTY CORRECTIONAL FACILITY:

INDEPENDENT CONTRACTOR:

Sheriff David Allison 200 South Main Street Poplarville, MS 39470 '.16

Bouy. OlS8 ~.9~

Carl Elton Heberg Ie 1 !.};c:.i Lee

.. IN WITNESS WHEREOF, this Contract has been made and interchangeably

executed by the parties hereto in duplicate originals.

WITNESS OUR SIGNATURES, on this, the il day of 4~1<-v"fT 2012. > '7

. /

PEARL RIVER COUNTY CORRECTIONAL FACILITY

By: CC::: (~,~~~ (1....(:( .J~ ;.. David Allison

Its: Sheriff

CARL ELTON HEBERG

~'.- 5? //.1,' , ./ /'. /'. i/.,. " ./ .~. /...,2'1,..-."",-' u/ /.'T<~_ .~--.~ __ 'V ~i

Independent Contractor .;:.-/

Page 5 of 5

'lIb

PEARL RIVER COUNTY CORRECTIONAL FACILITY AND INDEPENDENT CONTRACTOR

CONTRACT FOR PROFESSIONAL SERVICE$l0k 015B Pa9~ 717

1. Parties. This Contract is made and entered into by and between PEARL RIVER COUNTY CORRECTIONAL FACILITY, hereinafter referred to as "PRCCF," and TEDDY L. LEWIS, hereinafter referred to as "Independent Contractor. "

2. Purpose. PRCCF hereby engages Independent Contractor and Independent Contractor hereby agrees to render all professional instructional services necessary to implement and teach an MDOC approved drug and alcohol education program underMDOC standards at PRCCF and to provide at least twenty hours minimum per week in personal instruction of inmates at PRCCF.

3. Scope of Services. Independent Contractor shall provide all necessary professional instructional services to implement and operate at PRCCF an MDOC approved drug and alcohol education program to comply with all requirements of MDOC in order for PRCCF to meet all MDOC mandates in the operation of state drug and alcohol related education programs. PRCC F shall provide an MDOC approved curriculum of drug and alcohol education for use by Independent Contractor at PRCCF and Independent Contractor shall provide a minimum of at least twenty hours per week in actually personally Instructing inmates at PRCCF in drug and alcohol education per the MDOC approved curriculum.

4. Period of Performance. The period of performance of services under this Contract shall begin on July 16, 2012, and end on July 15, 2013. PRCCF shall have the option to renew annually hereafter upon the same terms and conditions by notifying Independent Contractor.

5. Consideration and Method of Payment.

A. As consideration for the performance of this Contract, the Independent Contractor shall be paid a fee of Twelve Hundred ($1,200.00) Dollars per month for all products, services, salaries, travel, performances, costs, and expenses of whatever kind and nature for services rendered under this Contract. Payment shall be made monthly. It is expressly understood and agreed that in no event shall the total compensation paid hereunder exceed the specified amount of Fourteen Thousand Four Hundred ($14,400.00) Dollars per year. No additional cost is authorized to be incurred by Independent Contractor.

B.

C.

D.

The Independent Contractor will be paid monthly following the month the work is performed. Independent Contractor understands and agrees that the PRCCF, Inc. is not responsible for providing any benefits for Independent Contractor, nor payment of any taxes or insurance on behalf of the Independent Contractor. No additional cost is authorized to be incurred by Independent Contractor.

Book Q158 P~'l. 718 It is further understood that the consideration expressed herein constitutes full and complete compensation for all services and performances hereunder, and that any sum due and payable to Independent Contractor shall be paid as a gross sum with no with holdings or deductions being made by PRCCF for any purpose from said Contract sum.

Independent Contractor wilt not be entitled to any further compensation or benefits under this contract. Independent Contractor shall be solely responsible for payment of any and all taxes due any governmental entity for his services rendered under this contract. PRCCF shall provide no benefits whatsoever, including holidays, for Independent Contractor.

6. Relationship of Pilrtie§. It is expressly understood and agreed that PRCCF enters into this Contract with Independent Contractor on a purchase of service basis and not on an employer-employee relationship basis. Nothing contained herein shall be deemed or construed by PRCCF, the Independent Contractor, or any third party as creating the relationship of principal and agent, partners, joint ventures, or any similar such relationship between PRCCF and the I ndependent Contractor. Neither the method of computation of fees or other charges, nor any other provision contained herein, nor any acts of PRCCF, or the Independent Contractor hereunder, creates or shall be deemed to create a relationship other than the independent contractor relationship of PRCCF and the Independent Contractor.

7. Termination for Cause. If, through any cause, Independent Contractor shall fail to fulfill in a timely and proper manner, as determined by PRCCF, its obligations under this Contract, or If Independent Contractor shall violate any of the covenants, agreements, or stipulations of this Contract, PRCCF shall thereupon have the right to terminate the Contract by giving written notice to Independent Contractor of such termination and specifying the effective date thereof. If this contract is terminated, Independent Contractor shall be compensated for all services actually rendered prior to date of termination on a pro rata basis for the number of hours actually worked at PRCCF since the last pay period at the monthly rate herein provided.

Page 20r5

Notwithstanding the above, Independent Contractor shall not be relieved of liability to PRCCF for damages sustained by PRCCF b~xlrtM~ of anyJlreach of this Contract by Independent Contractor, and PRCCf! 'rfll:\'~ ~fthtldrd any payments to Independent Contractor forthe purpose of set off until such time as the exact damages due to PRCCF from Independent Contractor are determined,

8. TermInation for Convenience. PRCCF may terminate this Contract at any time by giving written notice to Independent Contractor of such termination and specifying the effective date thereof. If this contract is terminated, Independent Contractor shall be compensated for all services actually rendered prior to date of termination on a pro rata basis for the number of hours actually worked at PRCCF since the last pay period at the monthly rate herein provided,

9. Ownership of Documents and Work Products, All data collected by Independent Contractor and a/l documents; notes, programs, data bases(and all applications thereof), files, reports, studies, andlor other material collected and prepared by Independent Contractor in connection with this Contract shall be the property of PRCCF upon completion of this Contract or upon termination of this Contract. PRCCF hereby reserves all rights to the data base and all applications thereof and to any and all information andlor materials prepared under this Contract

Independent Contractor is prohibited from use of the above described information andlor materials without the express written approval of PRCCF

10, Modification or Amendment. Modifications, changes, or amendments to this Contract may be made upon mutual agreement of the parties hereto. However, any change, supplement, modification, or amendment of any term, provision, or condition of this Contract must be in writing and signed by both parties hereto.

11. Assignments and Subcontracts. Independent Contractor shall not assign, sublet, or otherwise transfer the obligations incurred on its part pursuant to the terms of this Contract without the prior written consent of PRCCF Any attempted assignment or transfer of its obligation without such consent shall be wholly void.

12. Waiver. Failure of either party hereto to Insist upon strict compliance with any of the terms, covenants, and conditions hereof shall not be deemed a waiver or relinquishment of any similar right or power hereunder at any subsequent time or of any other provision hereof, nor shall it be construed to be a modification of the terms of this Contract.

Page 3 0(5

13. Availability of Funds. It is expressly understood and agreed that the obligation of PRCCF to proceed under this Contract is conditioned upon the availability of funds, the appropriation offunds by the Mississippi Legislature, the Mississippi Department of Corrections and the receipt of state and/or federal funds. If, at any time, the funds anticipated for the fulfillment of this Contract are not forthcoming or insufficient, either through the failure of the federal government to provide funds or of the State of Mississippi to appropriate funds or the discontinuance or material alteration of the program under which funds were provided, or if funds are not othefWise available to PRCCF for the performance of this Contract. PRCCF @blfYl;!a9>'l~. ttw(tight, upon written notice to Independent Contractor, to immedIately terminate this Contract without damage, penalty, cost, or expense to PRCCF of any kind Whatsoever. The effective date of termination shall be as specified in the notice of termination.

14. Indemnification. PRCCF shall, at no time, be legally responsible for any negligence or wrongdoing by the Independent Contractor and/or its employees, servants, agents, contractors, and/or subcontractors. Independent Contractor agrees to indemnify, defend, save and hold harmless PRCCF and Pearl River County, Mississippi from and against all claims, demands, liabilities, suits, damages, and costs of every kind and nature whatsoever, including court costs and attorney's fees, arising ot/t of or caused by Independent Contractor and its employees, agents, contractors, and/or subcontractors.

15. Applicable Law. The contract shall be governed by and construed in accordance with the laws of the State of Mississippi, excluding its conflicts of laws provisions, and any litigation with respect thereto shall be brought in the courts of the state. The Independent Contractor shall comply with applicable federal, state and local laws and regulations.

16. Severability. If any term or prOVision of this Contract is prohibited by the laws of the State of Mississippi or declared invalid or void by a court of competent jurisdiction, the remainder of this Contract shall not be affected thereby and each term and provision of this Contract shall be valid and enforceable to the fullest extent permitted by law.

17. Entire Agreement. This Contract constitutes the entire agreement of the parties with respect to the subject matter contained herein and supersedes and replaces any and all prior negotiations, understanding and agreements, written or oral, between the parties relating thereto.

Page 4 of 5

1:;;l..O

18. Notice. Any notice required or permitted to be given under this Contract shall be in writing and sent by United States Certified Mail, Returned Receipt Requested to the party to whom the notice should be given at the address set forth below:

PEARL RIVER COUNTY CORRECTIONAL FACILITY:

INDEPENDENT CONTRACTOR:

Sheriff David Allison 200 South Mll&b\~IW'f~ge 721 Poplarville, MS 39470

Teddy L. Lewis I <J S; b; (.k. i;

- -;

IN WITNESS WHEREOF, this Contract has been made and interchangeably executed by the parties hereto in duplicate originals.

WITNESS OUR SIGNATURES, on this, the /3 day of r(Z! //,1-I ' 2012. 0/

./

PEARL RIVER COUNTY CORRECTIONAL FACILITY

c> .. -. \ - / .., By: _.~.) t-.{., ~./

David Allison

Its: Sheriff

Independent Co tractor

Page 50' 5

'.

CJL MBMMAS03 08/16/2012 15:30 Board Minutes Minute Book Text Detail Book 0158 Page 722 ORDER TO RECESS Date 8/ 6/2012

ORDER TO RECESS

Upon motion made by Anthony Hales and seconded by Dennis Dedeaux, the following orders were adopted, to-wit:

Be It Ordered to direct County Administrator to post a notice of this recess meeting within one hour after such meeting is called in a prominent place available to examination and inspections by the general public in the Chancery Court Facilities Building at the Pearl River County Courthouse and make attached notice as part of minutes.

Be It Further Ordered that this Board does now take a recess until the next scheduled meeting to be held at 9:00 a.m., Monday, the 13th day of August, 2012, at the Board of Supervisors meeting room in the Chancery Court Facilities Building at the Pearl River County Courthouse in Poplarville.



Anthony Hales, Dennis Dedeaux, and Patrick Lee None Joyce Culpepper

PRESIDENT CLERK OF THE BOARD

PAGE 24

NOTICE OF SUPERVISOR'S MEETING

You are hereby notified

pursuant to

THE MISSISSIPPI OPEN MEETINGS LAW

that the next meeting of the

Board of Supervisors of Pearl River County, Mississippi,

will be held on ~ /3, ?gL at 2, {Va o'clock a,m.

in the Board of Supervisors Meeting Room

in the Court Facilities Building

at the Courthouse in Poplarville, Pearl River County, Mississippi.

BOARD OF SUPERVISORS PEARL RIVER C NTY