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HomeMy WebLinkAboutContract 54684CSC No. 54684 INTERLOCAL AGREEMENT TO PROVIDE TRANSPORTATION SERVICES This Agreement to Provide Disaster Relief Services ("Agreement") is made and entered into effective the Effective Date (see Section II.A below) by and between the City of Fort Worth ("City"), a Texas home rule municipality, and the Metropolitan Area EMS Authority doing business as MedStar Mobile Healthcare ("MedStar"), a governmental agency created through an Interlocal Cooperative Agreement between municipalities under the provisions of section 773.051 of the Texas Health and Safety Code and the provisions of Chapter 791 of the Texas Government Code. RECITALS 1. WHEREAS, as a result of referral through the State of Texas, the City of Fort Worth received a request to shelter evacuees from cities and counties in south Texas in which there existed a declared state of disaster resulting from the anticipated widespread damage, injury, loss of life and property and the after effects caused by Hurricane Laura in August 2020 2. WHEREAS, on August 25, 2020, the Mayor of the City of Fort Worth determined that extraordinary measures must be taken to alleviate the suffering of people and therefore, the Mayor declared a state of disaster for the City of Fort Worth as allowed under section 418.108 of the Texas Local Government Code; 3. WHEREAS, on August 25, 2020, the City Council of the City of Fort Worth continued the state of disaster declaration for up to sixty days; 4. WHEREAS, the situation in the Hurricane -ravaged areas and the large number of evacuees led the City Council to determine that the evacuees would need sheltering, emergency services, and recovery services; 5. WHEREAS, MedStar is an interlocal governmental authority formed by the City of Fort Worth and other member jurisdictions to further their governmental functions and has the expertise, personnel and equipment to provide disaster response and support services; 6. WHEREAS, Chapter 791 of the Texas Government Code allows for local governments to enter into Interlocal Agreements for the provision of governmental functions and both City and MedStar meet the definition of local government and wish to enter into this agreement to facilitate the provision of sheltering, emergency services, and recovery services for evacuees of Hurricane Laura; NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX I. PURPOSE. The purpose of this Agreement is to memorialize MedStar's agreement to provide disaster response and support service to assist the City in providing sheltering, emergency services, and recovery services to evacuees of Hurricane Laura. II. SERVICES TO BE PERFORMED. A. CITY's Services: Notify MedStar's command staff of any medical or transportation needs between the shelters. B. MEDSTAR's Services: • Provide non -medical transportation between shelter and dialysis facilities. • Provide command staff to collaborate with both onscene and EOC incident command. • Provide medical assessments and referral for non -urgent needs such as dialysis scheduling, prescription refill services, etc. • Provide medical transportation as needed. • Provide all equipment, supplies and equipment needed to fulfill the above services. • All MEDSTAR Services provided under this Agreement are documented on the form attached hereto as Exhibit A - Texas Standard Incident Reimbursement Form III. MISCELLANEOUS A. Term and Termination Term. Services under this Agreement began on March 18, 2020 ("Effective Date") and the Agreement shall expire immediately at the time all emergency overflow shelters are closed by the City or immediately upon written notice by the City, whichever is earlier. Execution of this Agreement shall be deemed to be effective as of the Effective Date and execution after the Effective Date shall have no bearing on the enforceability of the Agreement. 2. Termination. City may terminate this Agreement at any time and for any reason by providing MedStar with written notice of termination. The termination shall be immediate upon notice or on a date certain, if the City includes a specific date of termination in its written notice. MedStar may terminate this Agreement at any time and for any reason by providing City 30 days' written notice of termination. B. Records. Each party shall maintain their own service records in accordance with their records policies and any applicable laws or regulations. Any records that must be shared to effectuate the purpose of this Agreement shall be done only as allowed by law and in compliance with any applicable regulations. C. Equipment. Each party shall provide any equipment needed to perform their duties and obligation under this Agreement. D. Immunity. It is expressly understood and agreed that in the execution of this Agreement, no party waives nor shall be deemed hereby to waive any immunity or defense that would otherwise be available to it against claims arising in the exercise of governmental powers and functions. E. Remedies. No right or remedy granted herein or reserved to the parties is exclusive of any other right or remedy herein by law or equity provided or permitted; but each shall be cumulative of every other right or remedy given hereunder. No covenant or condition of this Agreement may be waived without written consent of the parties. Forbearance or indulgence by either party shall not constitute a waiver of any covenant or condition to be performed pursuant to this Agreement. F. Amendment. No supplement, modification or amendment of any term, provision, or condition of this Agreement shall be binding or enforceable on either party hereto unless in writing signed by both parties. G. Consideration and Compensation. The Parties acknowledge that as a condition precedent to signing this Agreement, that there was good and valuable consideration exchanged between the Parties. The Parties further acknowledge that there is a shared public mission to fulfill the State of Texas' request to facilitate the provision of sheltering, emergency and recovery services. No payment shall be made from City funds to MedStar for any services provided in connection with or pursuant to this Agreement and the parties stipulate that MedStar's services under this Agreement are in furtherance of the governmental functions delegated to it by the City and its other member jurisdictions. However, as further consideration to MedStar, the parties agree that MedStar will track all expenses incurred in providing services and supplies under this Agreement on the form attached hereto as Exhibit A - Texas Standard Incident Reimbursement Form and may submit requests for reimbursement to the State of Texas and United States Government through the City of Fort Worth. City will use its best to efforts to assist MedStar in obtaining such reimbursement. H. Assignment. No party to this Agreement may assign its rights under this Agreement without the prior written consent of the other party. I. Governing Law; Jurisdiction. The agreement between the parties regarding the subject matter hereof shall be governed by and interpreted in accordance with the laws of the state of Texas, without reference to its laws relating to conflicts of law. Any legal action arising out of or relating to the subject matter hereof shall be brought only in the state or federal courts located in Tarrant County, Texas, and the parties irrevocably consent to the jurisdiction and venue of such courts. J. Relationship of the Parties. None of the provisions of this Agreement are intended to create, and none shall be deemed or construed to create, any relationship between the parties, other than that of independent contractors. This Agreement shall not create the relationship of employer -employee, agency, partnership, or joint venture. Neither party shall have the right or power in any manner to unilaterally obligate the other to any third party, whether or not related to the purpose of this Agreement. K. Notices. Notices pursuant to this Agreement must be in writing to be effective. Notices shall be delivered as follows: For MEDSTAR: Metropolitan Area EMS Authority dba MedStar 2900 Alta Mere Drive Fort Worth, Texas 76116 Attn: General Counsel With copy to Compliance rymedstar9l Lorg For City: City of Fort Worth Attn: Valerie Washington - Assistant City Manager 200 Texas Street Fort Worth, TX 76102-6314 Facsimile: (817) 392-8654 With copy to Fort Worth City Attorney's Office at same address L. Severability. Should any part, term, or provision of this Agreement be declared to be invalid, void, or unenforceable, all remaining parts, terms, and provisions hereof shall remain in full force and effect, and shall in no way be invalidated, impaired, or affected thereby. M. Entire Agreement. This Agreement contains the entire agreement between the parties relating to the rights herein granted and the obligations herein assumed, and supersedes all prior written or oral agreements or communications between the parties. J. Electronic Signatures; Facsimile and Scanned Copies; Duplicate Originals; Counterparts; Admissibility of Copies. Each Party agrees that: (i) any electronic signature (if any), whether digital or encrypted, to this Agreement made by any Party is intended to authenticate this Agreement and shall have the same force and effect as an original manual signature; and (ii) any signature to this Agreement by any Party transmitted by facsimile or by electronic mail shall be valid and effective to bind that Party so signing with the same force and effect as an original manual signature. Delivery of a copy of this Agreement or any other document contemplated hereby bearing an original or electronic signature by facsimile transmission (whether directly from one facsimile device to another by means of a dial -up connection or whether mediated by the worldwide web), by electronic mail in portable document format (.pdf) form, or by any other electronic means intended to preserve the original graphic and pictorial appearance of a document, will have the same effect as physical delivery of the paper document bearing an original or electronic signature. This Agreement may be executed in multiple duplicate originals and all such duplicate originals shall be deemed to constitute one and the same instrument. This Agreement may be executed in counterparts, each of which shall be deemed to be an original, but all of which, taken together, shall be deemed to constitute a single instrument. The Parties warrant and represent that a true and correct copy of the original of this Agreement shall be admissible in a court of law in lieu of the original Agreement for all purposes of enforcement hereof. K. Binding Agreement. The parties hereto warrant and represent that upon execution hereof, this Agreement shall be a legal, valid and binding obligation on them and shall be enforceable against them in accordance with its terms. The individuals signing this Agreement warrant and represent that they are duly authorized to sign this Agreement on behalf of the parties hereto. L. Budgetary Limitations. The parties acknowledge and agree that both parties are governmental entities and, as such, are subject to an annual budgetary processes and the limitations and restrictions of fiscal funding. Notwithstanding any other provision herein, if and to the extent the obligations of this Agreement should continue over into MedStar's or City's subsequent fiscal years following that fiscal year when this Agreement was executed and funds are not appropriated or budgeted for this Agreement and completion of the Term in question, MedStar or City may terminate this Agreement. Each Party shall pay for its own performance in connection with this Agreement out of its own available current revenues. M. Right to Audit. MedStar agrees that City shall, until the expiration of three (3) years after termination or expiration of this Agreement, have access to and the right to examine any directly pertinent books, documents, papers and records of MedStar involving monetary transactions relating to the Agreement. The Parties acknowledge and agree that no money is being exchanged under this Agreement. N. Liability. Each Party shall be solely responsible for its own actions or inaction and the actions or failure to act of its respective employees, agents, officers, officials, and contractors. Neither Party shall be responsible for the actions, errors, omissions, negligence, misfeasance, or malfeasance of the other Party or any employee, agent, officer, official or contractor of the other Party. [Signature page follows] pd-ovonU� Ao� F000O o �°°°° °°°`L�ddd v�o dvo o=d dPa o°° °0000l0000 *�d .t� nEXA?o� Consented to and Agreed as of the Effective Date. MedStar: By: Naine:�N��a71 J .:, Title: C'64J� G�.•,�� o � r Date: CITY: City of Fort Worth Ibt,J✓ By: Valerie Washington (Oct 14, 202012:21 CDT) Name: Valerie Washington Title: Assistant City Manager Date: Oct 14, 2020 Approval Recommended: By: Name Title: Attest: M�r.6e-G Nt�izr�z Mari be[ Martinez (Oct 8, 2020 10:41 CDT) Contract Compliance Manager: By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. By: Justin Cox (Oct 5, 2020 19:09 CDT) Name: Justin Cox Title: Grants Manager Approved as to Form and Legality: Maribel Martinez-Mejia Emergency Management Coordinator By: Name: Title: /o` IFo�azd /0 6MZazef By: for Ronald P. Gonzales (Oct 14, 2020 12:51 CDT) Name: Mary J. Kayser Title: City Secretary Chhs1-onher,4us1-na Christopher Austria (Oct 8, 202012:43 CDT) Christopher Austria Assistant City Attorney Contract Authorization: M&C: N/A OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX EXHIBIT A Texas Standard Incident Reimbursement Form IN STATE MUTUAL AID REIMBURSEMENT INVOICE 20-0013 August Tropical Weather INCIDENT / EVENT: CATEGORY Category B - Emergency Protective Measures 20200820 RESPONSE TYPE Sheltering Operations PERIOD COVERED: FROM: 08/19/20 TO: 09/02/20 DATE SUBMITTED: 09/22/2020 a Ty Name of Responder Metropolitan Area EMS Authority aOUNTY Street Address 2900 Alta Mere Drive DDEPARTMENT City/State/Zip Fort Worth, TX 76116 DINGLE RESOURCE Name Metropolitan Area EMS Authority REMIT PAYMENT TO: (Make Check Payable to and mailing Street/Box 2900 Alta Mere Drive address info) City/State/Zip Fort Worth, TX 76116 COPIES OF RECEIPTS AND PAYMENT VOUCHERS FOR EACH CLAIM ARE ATTACHED: Il YES ❑ NO Force Account Labor Cost Regular Time Overtime Sub Total Time Cost $ 4,977.76 $ 7.58 $ 4,985.34 Benefit Cost $ 2,572.01 $ 1.60 $ 2,573.81 Labor Cost Total = $ 7,558.95 Travel Cost Meals Mileage (Personal Vehicles) lic Report vehicles mileage for the F owned vehicles on the Force Account Equipment form. Lodging Other Travel Cost Total = $ - Force Account Equipment Cost Total = $ 3,225.13 Materials Cost Total $ - Contract Work Cost Total $ Explain Other Costs on line to right and attach dcumenation Rented Equipment Cost Total $ - Other Costs GRAND TOTAL $ 10,784.08 DESCRIPTION OF SERVICES PROVIDED: Hurricane Laura Sheltering Operations for the City of Fort Worth CERTIFIED AND APPROVED BY: SIGNATURE: PRINTED NAME/TITLE: Kenneth J. Simpson, Chief Operations Officer DATE: 9122120 EMAIL ADDRESS: ksim son medstar9l 1.org PHONE NUMBER: 817-923-3700 ❑4UTHORIZED OFFICIAL Certifies that the totals for each category/claim are exact costs expended by the Assisting Agency to perform the services requested. All additional supporting documentation not included with this claim will be maintained by the Assisting Agency for a *period of three (3) years following the above date of submission and may be obtained for audit purposes by notifying INDIVIDUAL the Assisting Agency authorized official named herein, or other appropriate persons. (* In accordance with 44 CFR 13.42 - Retention and access requirements for records.) 9/22/2020 7 CO a0 N N A CO A OI V O A Yi N M N OI V M of A CI N V O N OI C OI CD c N V CD 6 A N CO O N N h CO VD Oi M. n N CAD O m m W O O G O- V V 0UU a HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH J a O M N N M N O �O O A A OI A N A A O A Y1 N �O CO OI A O MO � C N Yf fV Oi V CG Ci Cn N N oo d <r m y d O 2 ti. 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I I . . I. I I. I I. I I O I I. I I. I I. I I. n 2 � a LL W � > > = Q 8 rn S00a pQ; r JJ f7 > O F Z O O r r N K � C Y F N m O O J m N O Q W Q �1Y1 3 2 Q - v rn f y Q U W W C M W 3 fq N G Q 2 N W ^� r a Q H W U p}W W m ° ` W m 2 N r O i O � u N y pp N F K Q Q O Z_ W m N ED n N N N N W f i F n N aD W U N O N O i F O r o v r s O r o v r s U r s U 5wll r s ° 5° U r o U r a 5° U r o v r s 5° O r o U r s 5° U r o O r S 5° U r s rc° o° a° a° a° S 3 Z W 6 > n n n n z z z z z z W s m eEp O w w T o O d m E E r A r F d W Q W LL F L LL y Z N N N N l0 Q A M.N A Q°�j N y N N > d N N H I� N m a Z Z o a d o mwEA-E aaaEE a aE a E E a E0 uz z- 0 z" 0 z- 0 z 0 0 z- z 0 0 z- z- 0 z 0 z- z" z- o z" a a EXHIBIT A Texas Standard Incident Reimbursement Form FRINGE BENEFIT RATE CALCULATION WORKSHEET Force account labor fringe benefits is eligible for reimbursement. Except in extremely unusual cases, fringe benefits for overtime will be significantly less than regular time. Typically, you should not be charging the same rate for regular time and overtime. Generally, only FICA (Social Security) is eligible for overtime; however some entities may charge retirement tax on all income. ❑DEPARTMENT ❑INDMDUAL IMetropolitan Area EMS Authority INCIDENT / EVENT Weather 20200820 following steps will assist in calculating the percentage of fringe benefits paid on an employee's salary. that items and percentages will vary from one entity to another. 1) The normal year consists of 2080 hours (52 weeks x 5 workdays/week x 8 hours/day.) This does not include holidays and vacations. 2) Determine the employee's basic hourly pay rate (annual salary/2080 hours.) 3) Fringe benefit percentage for Vacation time: Divide the number of hours of annual vacation time provided to the employee by 2080 (80 hours (2 weeks)/2080 = 3.85%) 4) Fringe benefit percentage for paid Holidays: Divide the number of paid holiday hours by 2080 (64 hours (8 holidays)/2080 = 3.07%.) 5) Retirement pay: Because this measure varies widely, use only the percentage of salary matched by the employer. 6) Social Security and Medicare: Both are standard percentages of salary. 7) Insurance: This benefit varies by employee. Divide the amount paid by the city or county by the basic pay rate determined in Step 2. B) Workman's Compensation: This benefit also varies by employee. Divide the amount paid by the city or county by the basic pay rate determined in Step 2. Use the rate per $100 to determine the correct percentage. FRINGE BENEFITS REGULAR TIME (BY %) OVERTIME- 1.5 * Regular Time (BY %) OVERTIME - Holiday / Other (BY % PART TIME (BY %) HOLIDAYS 3.07% VACATION LEAVE 3.85% SICK LEAVE 3.85% SOCIAL SECURITY 6.20% 6.20% 6.20% 6.20% MEDICARE 1.45% 1.45% 1.45% 1.45% UNEMPLOYMENT 0.25% 0.17% 0.17% 1 0.17% WORKER'S COMPENSATION 3.00% 2.00% 2.00% 2.00% RETIREMENT 17.00% 11.33% 11.33% HEALTH BENEFITS 12.00% LIFE INSURANCE BENEFITS 1.00% OTHER** TOTAL AS % OF ANNUAL SALARY I 51. % 1 21.15% 1 21.15% 1 9.82% ** Please provide explanation below in the "Comments" I certify that the information above is accurate and supported by budgets, payroll records, or other documents available for audit. E n o o 0 0o rn o �n v o v u> N @ r N OD O GO a N 00 co I� M M M N O N c0 p @ w O U M IA Cl) N N Of co N 1� Of N N w 1� CO N T co N O M V 01 M (O c0 V w OD to Ln N N O) O N N O N O N Cl) O m o r r z L U m O 0o Z fR W VJ W fR W fR W H 6-3 (9 YT (A YT (A (A W W 6 >m > O O d W C d) O M O) O O) O) Q) O O) m N O) N O) d) O) O) O) O) O) O) O) Q) O) N O) J f U O O m n Cl) N N M N M N M N M N Il- Lo n U') CM N M N CM N M N CM N I- m Z�p w W g m V p r H V m 2—a, c w 64 (A fH (A fH (A fH (A fH (!i VJ (A 64 (A w w f U E w z — W LL O N _ 01 01 Lq a (O N N U7 (O Lq N O Q m' ry; f — N CD O N N O O N (O (O M M CD M 0 O co 2 O O N m p U m O m U � J U a p W O O � M F C O h � O N r m z O � O K L cOi U m c Q o M r w E m w M ir L 7 J m m W rc 0 LL O w m N � M O M K rn M W W 7 m N Q O H O U W tlJ M w N W 2 r Q 2 r O M � � p M z rn N W W W N N W O N N V Q W r N m N 6 m O r O (ONLOUO rQ-I.w w j m Q W W r a z LL o m T 3 3 c O T @ @ W C L m m m W U r w Q o E T y p m O C7 C @ O @ C O O M Q CO - m c t U I 1, m c m c a m } P C7 m E U U > d 0 d U U L o Q B W o m co co co 0 o co co co co co 0 LU O U C LL W U W c0 W c0 W c0 W W W c0 W c0 W W G LL W � O N — O U z ; O LU IL a o 0 0 0 o n o o a Q Y c K o @ c c c c m m c c @ m m m @ @ m W V O Q m Z m m m L N L L L M @ @ L L 5 m (7 r c m H ZO r O f o a m N o a = o 0 N 0 o a E a E o a U N o a U a U E w 4 .o y j y°-, M ro M ro M Q Q eo U eo U U Q N J OU W UM M M 2 M'O MM co M.'m�O MMM .'m�O M.'m�O M".d �O M.'m O2r M m d m d m ".d�O ".d�O ".d�O Q 2 U O 2 � 2 QO ircu:3rr_� 214's EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/26/20 Date To: 08/27/2020 Time From: 07:00 Time To: 07:00 3. Name: Kaitlyn Cox ::1 4. ICS Position: Shelter Triage 5. Home Agency (and Unit): MedStar 1 31 6. Resources Assigned: Name ICS Position Home Agency (and Unit) Matthew Duckett Shelter Transport MedStar 806 Matt Hansen Shelter Medical LNO 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 8/26/2020 09:52 Assigned to COFW managed Hurricane Laura Shelter Operations 8/26/202011:00 Received briefing 8/26/202014:00 Walk through of shelter site 8/26/202017:46 Briefed that buses 1-5 are enoute to COFW Shelter 8/26/2020 20:05 Buses 1-5 arrive 8/26/2020 20:26 Available from the incident and end of shift 8. Prepared by: Name: Kaitiyn Cox Position/Title: Shelter Triage Signature: ICS 214, Page 1 Date/Time: 8/26/2020 20:26 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/26/20 Date To: 08/27/2020 Time From: 07:00 Time To: 07:00 3. Name: Matthew Duckett 4. ICS Position: Shelter Transport 5. Home Agency (and Unit): MedStar 806 6. Resources Assigned: Name ICS Position Home Agency (and Unit) Kaitlyn Cox Shelter Triage MedStar 31 Matt Hansen Shelter Medical LNO 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 8/26/2020 09:52 Assigned to COFW managed Hurricane Laura Shelter Operations 8/26/2020 11:00 Received briefing 8/26/202014:00 Walk through of shelter site 8/26/2020 17:46 Briefed that buses 1-5 are enoute to COFW Shelter 8/26/2020 20:00 Assigned to COFW managed Hurricane Laura Shelter Operations 8/26/2020 22:02 Bus 2 arrived and screening operations beginning 8/26/2020 22:04 Bus 3 arrived and screening operations beginning 8/26/2020 22:22 Bus 2 disembarked 8/26/2020 22:42 Bus 3 disembarked 8/26/2020 22:42 Bus 4 unloading and screening operations beginning 8/26/2020 22:51 Bus 4 disembarked 8/26/2020 22:52 Bus 5 unloading and screening operations beginning 8/26/2020 22:55 Bus 5 disembarked 8/26/2020 22:55 Bus 5 disembarked 8/26/2020 22:55 Bus 6 unloading and screening operations beginning 8/26/2020 23:00 Bus 7 unloading and screening operations beginning 8/26/2020 23:05 Bus 7 disembarked 8/26/2020 23:05 Bus 8 unloading and screening operations beginning 8/26/2020 23:30 Bus 8 disembarked 8/26/2020 23:30 Remained on site awaiting additional evacuees and continued screening efforts for evacuees with chronic medical conditions 8/27/2020 02:19 Available from the incident and end of shift 8. Prepared by: Name: Matthew Duckett Position/Title: Shelter Xport Signature: 74"wom ICS 214, Page 1 Date/Time: 8/27/2020 02:19 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/26/20 Date To: 08/27/2020 Time From: 07:00 Time To: 07:00 3. Name: Rodney Marshall :1 4. ICS Position: Shelter Triage 5. Home Agency (and Unit): MedStar 39 6. Resources Assigned: Name ICS Position Home Agency (and Unit) Rodney Marshall/Kayden Bathory Shelter Triage MedStar 39 David Salguero Shelter Medical LNO 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 8/26/2020 20:00 Assigned to COFW managed Hurricane Laura Shelter Operations 8/26/2020 22:02 Bus 2 arrived and screening operations beginning 8/26/2020 22:04 Bus 3 arrived and screening operations beginning 8/26/2020 22:22 Bus 2 disembarked 8/26/2020 22:42 Bus 3 disembarked 8/26/2020 22:42 Bus 4 unloading and screening operations beginning 8/26/2020 22:51 Bus 4 disembarked 8/26/2020 22:52 Bus 5 unloading and screening operations beginning 8/26/2020 22:55 Bus 5 disembarked 8/26/2020 22:55 Bus 5 disembarked 8/26/2020 22:55 Bus 6 unloading and screening operations beginning 8/26/2020 23:00 Bus 7 unloading and screening operations beginning 8/26/2020 23:05 Bus 7 disembarked 8/26/2020 23:05 Bus 8 unloading and screening operations beginning 8/26/2020 23:30 Bus 8 disembarked 8/26/2020 23:30 Remained on site awaiting additional evacuees and continued screening efforts for evacuees with chronic medical conditions 8/27/2020 5:36 Available from the incident 8/27/2020 6:09 End of Shift 8. Prepared by: Name: Rodney Marshall Position/Title: Shelter Triage Signature: 7 i ICS 214, Page 1 Date/Time: 08/27/2020 06:09 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/26/2020 Date To: 08/27/2020 Time From: 07:00 Time To: 07:00 3. Name: Ronald Moren 4. ICS Position: CCP 5. Home Agency (and Unit): MedStar 603 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/26/2020 21:24 Responding to 600 Commerce 08/26/2020 21:47 Response #1461383 — Evacuee in need of insulin. CCP arranged transport to JPS for prescription and voucher. 08/26/2020 23:53 Task Completed 08/26/2020 23:53 Available from the incident 8. Prepared by: Name: Ronald Moren Position/Title: CCP Signature: ICS 214, Page 1 Date/Time: 08/26/2020 23:53 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/26/20 Date To: 08/27/2020 1 Time From: 07:00 Time To: 07:00 3. Name: David Salguero 4. ICS Position: Shelter Med LNO 5. Home Agency (and Unit): MedStar 6. Resources Assigned: Name ICS Position Home Agency (and Unit) Rodney Marshall/Kayden Bathory Shelter Triage MedStar 39 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 8/26/2020 20:00 Briefed by M. Hansen and assumed command 8/26/2020 22:02 Bus 2 arrived and screening operations beginning 8/26/2020 22:04 Bus 3 arrived and screening operations beginning 8/26/2020 22:04 Bus 4 arrived 8/26/2020 22:07 Bus 5 arrived 8/26/2020 22:07 Bus 6 arrived 8/26/2020 22:07 Bus 7 arrived 8/26/2020 22:07 Bus 8 arrived 8/26/2020 22:22 Bus 2 disembarked 8/26/2020 22:36 EMS dispatched to Sheraton shelter for diabetic emergency 8/26/2020 22:42 Bus 3 disembarked 8/26/2020 22:42 Bus 4 unloading and screening operations beginning 8/26/2020 22:51 Bus 4 disembarked 8/26/2020 22:52 Bus 5 unloading and screening operations beginning 8/26/2020 22:55 Bus 5 disembarked 8/26/2020 22:55 Bus 5 disembarked 8/26/2020 22:55 Bus 6 unloading and screening operations beginning 8/26/2020 23:00 Bus 7 unloading and screening operations beginning 8/26/2020 23:05 Bus 7 disembarked 8/26/2020 23:05 Bus 8 unloading and screening operations beginning 8/26/2020 23:30 Bus 8 disembarked 8. Prepared by: Name: David Salquero Position/Title: Shelter MED LNO Signature: `7AM- tw ICS 214, Page 1 Date/Time: 08/27/2020 06:09 EXHIBIT A ACTIVITY LOG (ICS 214) CONT. 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/26/20 Date To: 08/27/2020 Time From: 07:00 Time To: 07:00 3. Name: David Salguero 4. ICS Position: Shelter Med LNO S. Home Agency (and Unit): MedStar 6. Resources Assigned: Name ICS Position Home Agency (and Unit) Rodney Marshall/Kayden Bathory Shelter Triage MedStar 39 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 8/26/2020 23:30 Remained on site awaiting additional evacuees and continued screening efforts for evacuees with chronic medical conditions 8/27/2020 5:36 Available from the incident 8/27/2020 6:09 End of Shift 8. Prepared by: Name: David Salquero Position/Title: Shelter Med LNO Signature: ICS 214, Page 1 Date/Time: 08/27/2020 06:09 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/26/20 Date To: 08/27/20 1 Time From: 07:00 Time To: 07:00 3. Name: Philip Story 4. ICS Position: Sheltering- Medical LNO 5. Home Agency (and Unit): MedStar SET 1 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 8/26/2020 05:40 Clock in/ Gathering supplies 8/26/2020 06:30 Enroute EOC 8/26/2020 07:00 Situation report presented by EOC staff 8/26/2020 07:55 21 Buses expected in DFW. Unknown number of people 8/26/2020 08:00 One bus in Mesquite with 15 more expected. 5 Buses expected in Fort Worth today 8/26/2020 08:42 60 rooms at Embassy suites/200 rooms at Sheraton 8/26/2020 09:10 Buses enroute 8/26/2020 09:10 M. Hanson, K. Cox and M.Duckett enroute Embassy Suites for triage and COVID screening 8/26/202010:19 Fort Worth to Recieve buses 11-15. Currently bus 7 in Mesquite 8/26/202012:00 Lunch 8/26/202016:33 Self Evacuees arriving at Sheraton 8/26/202017:15 4 buses enroute with 25 people each 8/26/202018:25 1st bus arrived, offloaded and departed 8/26/202018:33 Bus 2 offloading with 3 &4 arriving 8/26/2020 19:18 Wheelchair needed at Embassy for evacuee that was unable to bring hers with her. 8/26/202019:19 Resources enroute with 3 wheelchairs 8/26/202019:28 1 bus enroute to Sheraton from Dallas 4 more expected. M800 enroute Sheraton. 8/26/202019:28 Bus 3 offloaded and departed 8/26/202019:30 3 wheelchairs have arrived at Embassy 8/26/202019:44 Dallas Wyndham is full and diverting evacuees to Fort Worth 8/26/2020 20:07 5 buses offloaded and departed 8/26/2020 20:30 End of Shift 8. Prepared by: Name: Philip Position/Title: Med LNO Signature: L 7"- !CS 214, Page 1 Date/Time: 8/26/2020 20:30 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/27/2020 Date To: 08/28/2020 Time From: 07:00 Time To: 07:00 3. Name: James Aycox 4. ICS Position: CCP jMedStar S. Home Agency (and Unit): 604 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/27/2020 08:44 Response #1462636 — CCP contacted the evacuee to ensure she was able to transfer dialysis centers. The evacuee voiced the need for transportation. CCP coordinated with the EOC to provide transportation via COVID Cab. 08/27/2020 09:27 Task Completed 8. Prepared by: Name: Jimmy Aycox Position/Title: CCP Sic inature: ICS 214, Page 1 Date/Time: 08/27/2020 09:� EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/27/2020 Date To: 08/28/2020 Time From: 07:00 Time To: 07:00 3. Name: Chris Roberts 4. ICS Position: MHP 5. Home Agency (and Unit): MedStar 701 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/27/2020 10:52 Response #1461957 — MHP completed a follow-up phone visit with an evacuee to ensure she had obtained a refill on her insulin. 08/27/2020 11:06 Completed Task 8. Prepared by: Name: Chris Roberts Position/Title: MHP Si natur M ICS 214, Page 1 Date/Time: 08/27/2020 11:06 Z7 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/27/2020 Date To: 08/28/2020 Time From: 07:00 Time To: 07:00 3. Name: Matthew Willens 4. ICS Position: CCP 5. Home Agency (and Unit): MedStar 604 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/27/2020 08:26 Arrived at Hurricane Laura Shelter 08/27/2020 08:26 Response #1461608 — Evacuee concerned she would run out of insulin. CCP met with the evacuee and ensured she had an adequate amount for several weeks. 08/27/2020 09:39 Task Completed 08/27/2020 09:45 Response #1461661 — Evacuee had previously broken her foot prior to arriving in Fort Worth; she voiced the need for a wheelchair. CCP secured the evacuee a wheelchair. 08/27/2020 11:05 Task Completed 08/27/2020 09:46 Response #1461673 — Evacuee had a question about her hotter monitor. CCP met with the client to address her concerns. 08/27/2020 09:58 Task Completed 08/27/2020 10:01 Response #1461639 — Evacuee needed assistance in changing her dialysis treatment location. CCP began this process. 08/27/2020 10:24 Task Completed 08/27/2020 13:12 Response # 1461817 — Evacuee called the non -emergency number for chronic back pain. CCP met with the evacuee and navigated him to JPS UCC via POV. 08/27/2020 13:55 Task Completed 08/27/2020 13:55 Available from incident 8. /Prepared by: Name: Matt Willens Position/Title: CCP Simatur Tam ICS 214, Page 1 Date/Time: 08/27/2020 13:55 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/27/2020 Date To: 08/28/2020 1 Time From: 07:00 Time To: 07:00 3. Name: Amy Yang 4. ICS Position: MHP 5. Home Agency (and Unit): MedStar 702 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/27/2020 10:03 Responding to 1701 Commerce 08/27/2020 10:23 Response #1461639 — Evacuee was concerned she would be unable to ambulate to the lobby for meals. MHP ensured the client had an adequate supply of her medications and arranged for meal delivery. 08/27/2020 10:48 Task Completed 08/27/2020 10:47 Response #1461640 — Evacuee requires wound care daily. He is unable to ambulate to the lobby for meals. The evacuee does not have an adequate amount of wound care supplies. MHP contacted Encompass Home Health who agreed to provide wound care while the evacuee was in Fort Worth. Encompass Home Health sent a nurse a few hours later. 08/27/2020 12:06 Task Completed 08/27/2020 12:08 Available from the incident 8. Prepared by: Name: Amy Yang Position/Title: MHP Signature: anR ICS 214, Page 1 Date/Time: 08/27/2020 12:08 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/28/2020 Date To: 08/29/2020 Time From: 07:00 Time To: 07:00 3. Name: Amy Yang 4. ICS Position: MHP 5. Home Agency (and Unit): MedStar 702 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/28/2020 08:21 Response #1462598 — MHP completed a follow-up phone visit on an evacuee to ensure wound care had been initiated. The evacuee confirmed this and he voices no additional needs. 08/28/2020 09:10 Task Completed In 8. Prepared by: Name: Amy Yang ICS 214, Page 1 Position/Title: MHP Siqnature: Date/Time: 08/28/2020 09:10 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/27/20 Date To: 08/27/20 Time From:06:52 Time To: 19:29 3. Name: Matthew Hansen 4. ICS Position: Situational Awareness 5. Home Agency (and Unit): Medstar 6. Resources Assigned: NA Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/27/2020 06:52 Start Shift 08/27/2020 06:52 Assigned to the Joint Emergency Operation Center (JEOC) Fort Worth 200 Texas St. Fort Worth, TX 76102 08/27/2020 07:00 Get daily briefing 08/27/2020 09:03 Report in the JEOS of a female evacuee on the 6th floor of the Sheraton hotel giving birth. Consulting with FWPD and FWFD in the JEOC. Contacted Medstar Dispatch. They advise FWFD E2 on scene and Medstar 66 is still responding. 08/27/2020 09:06 Report of another 911 call at the Sheraton. Medstar dispatch has units responding 08/27/2020 09:15 A total of 3 patients being treated at the Sheraton at this current moment by Medstar 08/27/2020 09:36 Contacting Medstar MIH/CCP supervisor and CCP about getting additional resources from Medstar at the Sheraton. There is a Medstar CCP on scene and the MIH/CCP Supervisor is responding. They are working with patients and dialysis clinics to get appointments scheduled. 08/27/2020 10:11 Run: 1461654 Medstar 28 transporting 1 altered mental status patient from the Sheraton to JPS for dialysis 08/27/2020 10:38 Brandon Pate reports Davilla Dialysis Center is set up to coordinate through Marcia at 866-544- 6741. 08/27/2020 11:19 Brandon Pate reports Fresenius Dialysis has a disaster response team number 800-626-1297 08/27/2020 11:55 Brandon Pate reports that all pending requests for assistance at the Sheraton have been taken care of. 08/27/2020 12:15 JEOC reports the Sheraton has reached capacity with evacuees. 08/27/2020 13:13 Call for medical attention. Medstar CCP assess and says the patient will go POV to urgent care 08/27/2020 13:45 Speaking with Chief Barton about on scene operational medical needs 08/27/2020 15:30 Speaking with Chief Barton about overnight operational medial needs. He believes Tach Med can handle the evening and reach out to MedStar if needed. 08/27/2020 18:00 Discuss with Medstar dispatch and M800 the transport of evacuees back to the hotel from the ER 08/27/2020 19:29 End Shift 8. Prepared by: Name: Matthew Hansen Position/Title: Situational Awareness Signature: Date/Time: 08/27/2020 19:32 ICS 214, Page 1 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/28/2020 Date To: 08/29/2020 Time From: 07:00 Time To: 07:00 3. Name: Ruben Cisneros 4. ICS Position: Hurricane Laura Transport 5. Home Agency (and Unit): MedStar 37 6. Resources Assigned: Name ICS Position Home Agency (and Unit) Ruben Cisneros/Breanna Olivarez Hurricane Laura Transport MedStar 37 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/28/2020 17:52 Assigned to the Incident 08/28/2020 18:25 Response # 1462924 — Evacuee transport from Central Dialysis to 1701 Commerce 08/28/2020 19:03 Task Completed 8. Prepared by: Name: Ruben Cisneros Position/Title: HL Xport Sin u CAM-" ICS 214, Page 1 Date/Time: 08/28/2020 19:0 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/28/2020 Date To: 08/29/2020 Time From: 07:00 Time To: 07:00 3. Name: Tim Gattis 4. ICS Position: CCP 5. Home Agency (and Unit): MedStar 603 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/28/2020 18:32 Assigned to Hurricane Laura Shelter 08/28/2020 18:44 Response #1463409 — An evacuee called the non -emergency number due to a concern that he would run out of his blood pressure medication. CCP navigated him to his PCP for a refill that could be called in to a local pharmacy. 08/28/2020 20:01 Task Completed 08/28/2020 19:24 Response #1463455 — An evacuee called the non -emergency number due to being out of his blood pressure medication. CCP arranged for transportation to JPS UCC. CCP contacted the social worker at JPS and coordinated a refill and voucher for this evacuee's medication. 08/28/2020 20:04 Task Completed 08/28/2020 20:44 Available from the incident 8. Prepared by: Name: Tim Gattis Position/Title: CCP Si na e: ICS 214, Page 1 Date/Ti me: 08/28/2020". EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/30/2020 Date To: 08/31/2020 Time From: 07:00 Time To: 07:00 3. Name: Tim Gattis 4. ICS Position: CCP 5. Home Agency (and Unit): MedStar 604 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/30/2020 18:10 Assigned to Hurricane Laura Shelter 08/30/2020 18:24 Response #1465562 — An evacuee called the non -emergency number regarding her medications. She has a two-day supply left. The evacuee reports she will likely be returning home tomorrow. She was instructed to callback if she were to remain in Fort Worth beyond the two days. 08/30/2020 19:22 Task Complete 08/30/2020 19:29 Available from incident 8. Prepared by: Name: Tim Gattis Position/Title: CCP Si ature: Date/Time: 08/30/20 29 ICS 214, Page 1 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/28/2020 Date To: 08/29/2020 Time From: 07:00 Time To: 07:00 3. Name: Diana Jimenez 4. ICS Position: Hurricane Laura Transport 5. Home Agency (and Unit): MedStar 806 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/28/2020 05:58 Start of Shift 08/28/2020 09:28 Responding to 1701 Commerce- Hurricane Laura Shelter 08/28/2020 09:40 Response #1462660 — Evacuee transport to Frenius dialysis at 3708 E. Rosedale 08/28/2020 10:09 Task Completed 08/28/2020 13:15 Response #1462923- Evacuee transport to Central dialysis at 1000 St. Louis Ave 08/28/2020 15:23 Task Completed 08/28/2020 15:25 Response # 1463080 — Return evacuee from Dialysis to 1701 E. Commerce 08/28/2020 15:54 Task Completed 08/28/2020 15:55 Available from the incident 08/28/2020 18:03 End of Shift 8. Prepared by: Name: Diana Jimenez Position/Title: HL Xport Signature: Diana Jimenez i n ICS 214, Page 1 Date/Time: 08/28/202018:03 EXHIBIT A ACTIVITY LOG (ICS 214) 1- Incident Name. 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/28/20 Date To: 08/29/20 Time From: 07:00 Time To: 07:00 3. Name: Philip Story 4. ICS Position: Sheltering- Medical LNO 5. Home Agency (and Unit): MedStar SET 1 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 8/28/2020 05:45 Arrived at EOC 8/28/2020 07:30 Briefing Working through returning evacuees 8/28/2020 09.00 Set up COVID Cab/M804 to transport evacuee to Dialysis response 1462660 8/28/2020 09:34 Verified no evacuees were in local hospitals 8/28/2020 09:35 Advised by State that dialysis Patients will not be boarding buses and will require additional support until there area is restored and able to support them. 8/28/2020 09:40 State is opening additional shelters in FTW for self -evacuees. Unknown how many shelters, how many people or rooms. 8/28/2020 09:42 TMS is opening it camp grounds to self -evacuees on a private basis. Unknown information there as well. 8/28/2020 09:54 IC request resource to Sheraton for loading 8/28/2020 09:58 CCP enroute to Sheraton 8/28/2020 10:00 146296 M40 8/28/2020 10:06 Contacted Communications about having a standby unit for bus loading at the Sheraton 1100- 1300 if system level allows 8/28/2020 10:27 CCP M604 J. Aycox on scene 8/28/2020 10:30 M40 AMA 8/28/2020 10:55 1462768 M604 Breathing Difficulty Medication Refill 8/28/202012:55 M801 Replaced M604 at Sheraton 8/28/202013:22 1st Bus Arrival 8/28/202014:00 Coordinated Dialysis transfers for 2 dialysis patients 8/28/202015:30 Set up reoccuring diaysis transports 8/28/2020 16:30 801 cleared and M44 remaining OS 8/28/2020 16:56 Embassy Is empty 8/28/2020 17:25 Clear EOC/ End of Shift 8. Prepared by: Name: Philip Story Position/Title: Med LNO Signature: ICS 214, Page 1 Date/Time: 8/28/202017:25 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/28/2020 Date To: 08/29/2020 Time From: 07:00 Time To: 07:00 3. Name: Amy Yang 4. ICS Position: MHP 5. Home Agency (and Unit): MedStar 702 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/28/2020 08:21 Response #1462598 — MHP completed a follow-up phone visit on an evacuee to ensure wound care had been initiated. The evacuee confirmed this and he voices no additional needs. 08/28/2020 09:10 Task Completed In 8. Prepared by: Name: Amy Yang ICS 214, Page 1 Position/Title: MHP Siqnature: Date/Time: 08/28/2020 09:10 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2.Operational Period: Date From: 08/29/20 Date To: 08/30/20 Time From: 07:00 Time To: 07:00 3. Name: Philip Story 4. ICS Position: Sheltering- Medical LNO 5. Home Agency (and Unit): MedStar SET 1 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 8/29/2020 04:40 Clock in/ Gathering supplies 8/29/2020 06:30 Enroute Sheraton 8/29/2020 07:00 Situation report presented by IC 8/29/2020 07:13 Assisted Evacuee with medication refill. Contacting CCP 8/29/2020 07:15 Contacted OLPG and spoke to Dr. Veer for medication refill for evacuee 8/29/2020 08:37 Veer Emailed and said that the prescription was called in. Pharmacy does not open until 0900 8/29/2020 10:06 Contacted Evacuee about her prescription being tailed in. 8/29/2020 13:00 Evacuee Needs compression socks 8/29/2020 13:09 Contacted Brandon Pate about Compression Socks. Given phone Number for JPS patient advocates 8/29/2020 13:15 Contacted JPS Advocates, but unable to help since he was not a patient of theirs 8/29/202013:23 Contacted Evacuee about going to the pharmacy to acquire OTC compression socks 8/29/202016:30 Cleared Sheraton enroute back to NDC 8/29/202017:25 Clocked Out 8. Prepared by: Name: Philip Storx Position/Title: Med LNO Signature: ICS 214, Page 1 Date/Time: 8/29/2020 17:30 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/30/2020 Date To: 08/31/2020 Time From: 07:00 Time To: 07:00 3. Name: Tim Gattis 4. ICS Position: CCP 5. Home Agency (and Unit): MedStar 604 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/30/2020 18:10 Assigned to Hurricane Laura Shelter 08/30/2020 18:24 Response #1465562 — An evacuee called the non -emergency number regarding her medications. She has a two-day supply left. The evacuee reports she will likely be returning home tomorrow. She was instructed to callback if she were to remain in Fort Worth beyond the two days. 08/30/2020 19:22 Task Complete 08/30/2020 19:29 Available from incident 8. Prepared by: Name: Tim Gattis Position/Title: CCP Si ature: Date/Time: 08/30/20 29 ICS 214, Page 1 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/30/2020 Date To: 08/31/2020 Time From: 07:00 Time To: 07:00 3. Name: Dakotah Guess 4. ICS Position: Hurricane Laura Transport 5. Home Agency (and Unit): MedStar 804 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/30/2020 20:24 Assigned to incident 08/30/2020 20:31 Response #1465662— Evacuee transport from 1500 S. Main to 1701 E. Commerce 08/30/2020 20:54 Task Completed 8. Prepared by: Name: Dakotah Guess Position/Title: HL Xport Signature: 7jA1fMww ICS 214, Page 1 Date/Time: 08/30/2020 20:54 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/30/20 Date To: 08/31/20 Time From: 07:00 Time To: 07:00 3. Name: Philip Story 4. ICS Position: Sheltering- Medical LNO 5. Home Agency (and Unit): MedStar SET 1 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 DatelTime Notable Activities 8/30/2020 04:41 Start Shift 8/30/2020 05:30 Gather Supplies 8/30/2020 06:00 Enroute Star for Monitor 8/30/2020 07:00 Arrived at Sheraton 8/30/2020 07:01 M46 response 1465066 57 y/o Male Leg Pain. Transported to JPS. 8/30/2020 08:00 Assisted evacuee with COVID-19 questions 8/30/2020 09:00 Helped Evacuee family with emotional family member. PD approved new room. 8/30/2020 09:45 Assisted evacuee with medication transfer 8/30/202010:00 Assisted Evacuee with medication 8/30/202013:11 M44 transport to JPS.1465261 8/30/202014:45 M531465350 Transport to JPS 8/30/202016:40 Clear Sheraton 8/30/202017:28 End of Shift 8. Prepared by: Name: Philip Story Position/Title: Med LNO Signature: ICS 214, Page 1 Date/Time: 8/30/202017:28 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/31/2020 Date To: 09/01/2020 1 Time From: 07:00 Time To: 07:00 3. Name: Ronald Moren 4. ICS Position: CCP 5. Home Agency (and Unit): MedStar 603 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/31/2020 22:05 Assigned to Hurricane Laura Shelter 08/31/2020 22:25 Response #1466845 — An evacuee called the non -emergency number for a vital signs check. CCP completed a vital sign check. 08/31/2020 23:10 Task Completed 08/31/2020 23:13 Available from the incident 8. Prepared by: Name: Ronald Moren Position/Title: CCP Signature: 1 an9ra ICS 214, Page 1 Date/Time: 08/31/2020 23:13 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/26/2020 Date To: 08/27/2020 Time From: 07:00 Time To: 07:00 3. Name: Ronald Moren 4. ICS Position: CCP 5. Home Agency (and Unit): MedStar 603 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/26/2020 21:24 Responding to 600 Commerce 08/26/2020 21:47 Response #1461383 — Evacuee in need of insulin. CCP arranged transport to JPS for prescription and voucher. 08/26/2020 23:53 Task Completed 08/26/2020 23:53 Available from the incident 8. Prepared by: Name: Ronald Moren Position/Title: CCP Signature: ICS 214, Page 1 Date/Time: 08/26/2020 23:53 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/31/2020 Date To: 09/01/2020 Time From: 07:00 Time To: 07:00 3. Name: Kimberly Villano 4. ICS Position: Hurricane Laura Transport 5. Home Agency (and Unit): MedStar 806 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/31/2020 09:00 Start of Shift 08/31/2020 10:00 Response #1463107 — Evacuee transport to Frenius dialysis at 3708 E. Rosedale 08/31/2020 10:23 Task Completed 08/31/2020 14:10 Response # 1463114 - Evacuee transport to Central dialysis at 1000 St. Louis Ave 08/31/2020 15:05 Task Completed 08/31/2020 15:16 Response # 1463112 — Return evacuee from Frenius Dialysis to 1701 E. Commerce 08/31/2020 15:51 Task Completed 08/31/2020 19:31 Response # 1463119— Return evacuee from Central Dialysis to 1701 E. Commerce 08/31/2020 19:49 Task Completed 08/31/2020 21:05 End of Shift 8. Prepared by: Name: Kimberly Villano Position/Title: HL Xport Signature: 7jw'—vem ICS 214, Page 1 Date/Time: 08/31/2020 21:05 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 08/31/20 Date To: 08/31/20 Time From:06:40 Time To: 19:36 3. Name: Matthew Hansen 4. ICS Position: Sheltering Medical LNO 5. Home Agency (and Unit): Medstar 502 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 08/31/2020 06:40 Start Shift 08/31/2020 06:40 Assigned to the Sheraton Hotel 1701 Commerce St. Fort Worth, TX 76102 08/31/2020 07:45 Speak with wife of dialysis 15:30 dialysis patient to ensure that transport and return trip is set up for this afternoon; she came to the lobby. 08/31/2020 08:00 Receive update from Chief Harrison 08/31/2020 09:30 Speak with dialysis patient about 11:00 dialysis transport and inform them that transport is on the way and that they will be returned after dialysis 08/31/2020 10:45 Assist a disabled evacuee in room 306 in getting down to the lobby so the hotel can take care of an issue in the room. 08/31/2020 12:00 Assist a in getting a disabled evacuee back to room 306 after the hotel staff took care of an issue with their room. 08/31/2020 14:30 Reach out to the 13:30 dialysis patient to ensure that will not miss their appointment as transport is onsite 08/31/2020 15:15 Attend to an evacuee with a complaint of an infected finger. It is red and swollen. She is advised that she needs medical attention at an urgent care or an ER, but asks we treat it. She is told that it is beyond that point. She declines urgent care or an ER. She is told that it will not heal on its own and will only get worse. She is strongly encouraged to seek medical attention, but declines. 08/31/2020 17:30 Follow-up with JPS hospital on several patients that were transported there to see if they were ready for release and to let them know to contact Medstar dispatch to get the patients transported back to the hotel 08/31/2020 18:00 Update from Chief Harrison on plan for 9/1/2020. Buses planned for around 10:00 to take Port Arthur residents back 08/31/2020 19:36 End Shift 8. Prepared by: Name: Matthew Hansen Position/Title: Sheltering Medical LNO Signature: R ICS 214, Page 1 Date/Time: 08/31/2020 19:40 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 09/01/2020 Date To: 09/02/2020 Time From: 07:00 Time To: 07:00 3. Name: George Church 4. ICS Position: Hurricane Laura Transport 5. Home Agency (and Unit): MedStar 804 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 09/01/2020 04:47 Start of Shift 09/01/2020 07:26 Response #1467085— Evacuee transport from 1500 S. Main to 1701 E. Commerce 09/01/2020 08:03 Task Completed 09/01/2020 15:35 Response #1467448— Evacuee transport from 1500 S. Main to 1701 E. Commerce 09/01/2020 16:06 Task Completed 09/01/2020 17:11 End of Shift 8. Prepared by: Name: George Church Position/Title: HL Xoort Signature: 7"'-'q N ICS 214, Page 1 Date/Time: 09/01/2020 17:11 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 09/01/2020 Date To: 09/02/2020 Time From: 07:00 Time To: 07:00 3. Name: Briley White 4. ICS Position: Hurricane Laura Transport 5. Home Agency (and Unit): MedStar 801 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 DatelTime Notable Activities 09/01/2020 18:22 Assigned to the incident 09/01/2020 19:00 Response #1467630— Evacuee transport from 1301 Pennsylvania to 1701 E. Commerce 09/01/2020 19:15 Task Completed 8. Prepared by: Name: Briley White ICS 214, Page 1 Position/Title: HL Xport Signature: r Date/Time: 09/01/2020 19:15 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 09/01/20 Date To: 09/01/20 Time From:06:48 Time To: 19:45 3. Name: Matthew Hansen 4. ICS Position: Sheltering Medical LNO 5. Home Agency (and Unit): Medstar 806 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 09/01/2020 06:48 Start Shift 09/01/2020 06:48 Assigned to the Sheraton Hotel 1701 Commerce St. Fort Worth, TX 76102 09/01/2020 07:45 Received daily report. Report buses will arrive to transport Port Arthur residents home 09/01/2020 09:51 Buses arrive to transport Port Arthur residents 09/01/2020 10:00 Attend to a patient with a bee sting to the hand in the lobby. No ambulance requested 09/01/2020 11:00 Called Medstar dispatch to set up dialysis transports for two dialysis patients for both Wednesday and Friday based on information currently available. 09/01/2020 11:45 Run 1467241 Called for Medstar 80 to transport a patient with swollen and infected finger to JPS ER. She had been encouraged to go to the ER or urgent care yesterday, but declined, looks much worse today and now has an open wound. 09/01/2020 16:25 Meeting with JEOC rep about activities taking place on 09:02/2020. 09/01/2020 17:00 Run 1467522 Called for Medstar 77 to transport a patient having an anxiety attack to THRFW 09/01/2020 17:45 Call Medstar dispatch to confirm and update dialysis transports for two evacuees on 09/02/2020. 11:00 appointment will take place with a return to the Sheraton. The 15:30 appointment will take place, but due to relocating evacuees to the Wyndham in Dallas, per Maribel at the JEOC they will enact the inter local agreement for Medstar to transport this patient from dialysis to the Wyndham in Dallas. Cancelled both Friday dialysis transports. 09/01/2020 19:45 End Shift 8. Prepared by: Name: Matthew Hansen Position/Title: Sheltering Medical LNO Signature: - Date/Time: 09/01/2020 19:48 ICS 214, Page 1 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 2. Operational Period: Date From: 09/02/20 Date To: 09/03/20 1 Time From: 07:00 Time To: 07:00 3. Name: Philip Story 4. ICS Position: Sheltering- Medical LNO 5. Home Agency (and Unit): MedStar SST 1 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 DatefTime Notable Activities 09/02/2020 04:40 Arrived for shift/ Clocked in/ Gather equipment 09/02/2020 06:00 Enroute Sheraton 09/02/2020 06:45 Arrived at Sheraton 09/02/2020 07:00 Meeting with IC 09/02/2020 07:40 Assisted IC with locating Evacuee that was transported to the hospital 09/02/2020 08:00 Assisted IC with Locating Evacuee that was transported to the hospital 09/02/2020 08:22 Moved Dialysis appointment from 1530 to 1100 09/02/2020 10:04 Bus 1 arrival 09/02/2020 10:40 Dialysis Transfer by M804 09/02/202010:57 M804 Clear Dialysis Transfer 09/02/202011:00 Bus 1 loaded and departed. Bus 2 loading 09/02/202011:22 Bus 2 loaded and departed 09/02/202012:34 Bus 3 loaded and departed 09/02/202012:40 Final Sweep Complete 09/02/202012:45 Clear of Sheraton/ Available 8. Prepared by: Name: Philip StW Positionfritle: Med LNO Signature: 7JAIM-aw ICS 214, Page 1 Datefrime: 9/02/202012:45 EXHIBIT A ACTIVITY LOG (ICS 214) 1. Incident Name: 20-0013 August Tropical Weather 20200820 1 2. Operational Period: Date From: 09/02/2020 Date To: 09/03/2020 Time From: 07:00 Time To: 07:00 3. Name: Allyson Roberson 4. ICS Position: Hurricane Laura Transport 5. Home Agency (and Unit): MedStar 804 6. Resources Assigned: Name ICS Position Home Agency (and Unit) 7. Activity Log: Page 1 of 1 Date/Time Notable Activities 09/02/2020 04:41 Start of Shift 09/02/2020 09:30 Response #1467202— Evacuee transport to Central Dialysis at 1000 St. Louis Ave 09/02/2020 10:51 Task Completed 09/02/2020 14:47 Response # 1467202 — Evacuee transport to 2645 LBJ Frway, Dallas from Central Dialysis for charter repopulation 09/02/2020 16:19 Task Completed and returned to home area 09/02/2020 16:59 Arrived in home area 09/02/2020 17:47 End of Shift 8. Prepared by: Name: Allvson Roberson Position/Title: HL Xport Signature ICS 214, Page 1 Date/Time: 09/02/2020 17:47 EXHIBIT A Payroll EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** Voucher Date Voucher Number -' 09/04/2020 61835 Direct Deposit Advice Emp ld 055815 Loc CHP002 Period Begin 08/15/20 Net Pay 1,889.42 SSN XXX-XX-2840 Hire Date 03/05/07 Period End 08/28/20 Dir Dep 1,889.42 Clock XXXX Status A Check Type Reg arr trigsia'mmafy ayrrter # Summary for Volacher 67 $35 Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Amt Regular Earnings 80,00 27,710500 2,216.84 1,427.23 39,143.86 Overtime 9,77 41,565750 406.10 364.93 15,005A8 DIFF PAY 1.16 4.000000 4,64 105.86 423.44 Group Term Life 0.00 1,00 0.00 18.00 Holiday 0.00 0,00 16.76 458A 3 SICK 0.00 0.00 3.77 104,47 STANDBY 0.00 0.00 8.77 239.02 12 Training Reg 0.00 OAO 4.00 1 10.84 VACATION SUYBK 0.00 0.00 192.00 5,293.04 ER MATCH 0.00 216.14 0.00 3,850.560 90.93 2,628.58 2,123,32 60,795.28 Total Gross Pay 2,628.58 Federal 'faxes -572.58 State and Local Taxes 0.00 Other Deductions -166.58 Net Pay Direct Deposits-1,889.42 Net Check Taxes Status Taxable Current Amt Yid Taxable Ytd Amt I �W uUt tctl tt rlUt t t tuttvt t Federal Income Tax S-OA$20 2,491,05 371.75 58,166.38 8,998.11 Company Address OASDI 2,625.14 162,76 60,733.36 3,765.47 _ METROPOLITAN Area EMS Authority Medicare 2,625.14 38,07 60,733.36 880.63 Medstar EMS 2900 ALTA MERE DRIVE Medicare - Additional 2,625.14 0,00 60,733.36 0.00 Fort Worth, TX 76116 Texas SITW 2,481.05 0,00 58,166.38 0.00 572.58 13,644.21 Other Deductions from Pay Current Amt Ytd Amt 457 144.09 2,566,984) DENTAL 3.44 61.929 Group Term Life 1.00 18.00 LIFE EMPLOYEE 4.15 74.70 M W R 10.00 180.00 VISION 3.90 70.20 166.58 2,971.80 Time Off Balances Dollars Hours Di Ireet ®cposlts -- Bank Account Current Amt WELLS FARGO BANK Ends with ***4810 300.00 WELLS FARGO BANK Ends with ***3347 25,00 CHASE Ends with'•'9235 1,564.42 1,889.42 O This code is shown far information only. It has no effect on your net pay. ® This code is not included in your Federal taxable wages. 919/2020 Employee Timecard Detail EXHIBIT A r` Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All - All - .............................................. ............................... ................ v Employee Pay Period Week Output Format Yang, Li M Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 1 & 2 v @ 041 Weekly Time & Attendance Yang, Li 8/17/2020 07:42 ePro BioClock 8/17/2020 20:51 ePro BioClock 13:09 Yang, Li 8/18/202007:40 ePro BioClock 8/18/202018:02 ePro BioClock 10:22 Yang, Li 8/20/202007:40 ePro BioClock 8/20/202019:59 ePro BioClock 12:19 Yang, Li 9/21/2020 07:40 ePro BioClock 8/21/202018:03 ePro BioClock 10:23 Weekly Total: 46:13 (46.22 Hours) Payroll Items from Schedule items in red text are unpaid or belong to salaried employees. 8/17/2020 MHP-2 MHP REG 07:42 20:51 13:09 8/18/2020 MHP-2 MHP REG 07:40 18:02 10:22 8/20/2020 MHP-2 MHP REG 07.40 19:59 12:19 8/21/2020 MHP-2 MHP REG 07:40 18:03 10:23 This timecard was approved on 8/22/2020 7:00:35 PM Weekly Time & Attendance Yang, Li 8/24/2020 07:40 ePro BioClock 8/24/202019:01 ePro BioClock 11:21 Yang, Li 8/25/2020 07:30 <Admin> 8/25/202018:16 ePro BioClock 10:46 Yang, Li 8/27/2020 07:41 ePro BioClock 8/27/202019:08 ePro BioClock 11:27 Yang, Li 8/28/202007:08 <Admin> 8/28/2020 17:07 ePro BioClock 09:59 Weekly Total: 43:33 (43.55 Hours) Payroll Items from Schedule " Items in red text are unpaid or belong to salaried employees. 8/24/2020 MHP-2 MHP REG 07:40 19:01 11:21 8/25/2020 MHP-2 MHP REG 07:30 18A6 10:46 8/27/2020 MHP-2 MHP REG 07:41 19:08 11:27 8/28/2020 MHP-2 MHP REG 07:08 17:07 09:59 This timecard was approved on 8/30/2020 3:42:23 PM https://scheduling.esosuite.net/DefaufLaspx?DB=medstar# 112 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** Ernp Id 056603 Loc CHP002 Period Begin SSN XXX-XX4317 Hire Date 04/06/15 Period End Clock XXXX Status A Check Type I arrlrlgs Summary Total Gross Pay Hours Rare Current Amt Ytd Hours Ytd Amt Regular Fa nines 75.28 2 L961700 1,653,28 1,282.02 27,931.79 Overtime 5.70 32.942550 187.77 322J2 10,541.83 BEREAVEMENT 12.00 21.961700 263.54 36,00 790,62 DIFF PAY 1.96 4.000000 7.84 55.91 223,04 GIFT CARDS 0.00 0.00 0.00 100.00 Group Term Life 0.00 0.37 0 00 6.66 Holiday 0.00 0.00 10.75 233.88 NEOP Ins Reg {Y) 0.60 0.00 8A0 172.08 SICK 0.00 0.00 56.56 1,227.44 STANDBY 0.00 0.00 5.20 114.20 STBERR 0.00 0.00 5.48 120.35 VACATION 0.00 0.00 119.92 2,013.48 ER MATCH 0.00 t71.30 0.00 3,058,690 94.94 2,112.80 1,901.96 44,075.97 Taxes Status Taxable Current Amt Ytd Taxable Ytd Anil Federal Income Tax M-6 1,713.25 26.33 36,900.52 1,128.76 OASDI 1,827.45 113.30 38,939.67 2,414.26 Medicare 1,827.45 26.50 38,939.67 564.63 Medicare - Additional 1,827.45 0.00 38,939,67 0.00 Texas SITW 1,713.25 0.00 36,900.52 0.00 166.13 4,107.65 Other Deductions from Pay Current Amt Ytd Ant 457 114.20 2,039.150 DENTAL 26.59 478.620 GIFT CARDS 0.00 100.00 Group Terns Life 0.37 6.66 HEALTH SAVINGS 100.00 1,806.006 HEALTH 158.76 2,857,680 CHILD LIFE I.I I 1918 LIFE EMPLOYEE 6.23 112.14 LIFE SPOUSE 2.08 37,44 S.T.D 12.92 232.56 VISION 3.90 70.20 426.16 7,754,43 Voucher Date Voucher Number 09/04/2020 61830 Direct Deposit Advice 08/15120 Net Pay 1,520.51 09/28/20 Dir Dep 1,520.51 Reg Total Gross Pay 2,112.80 Federal Taxes -166.13 State and Local Taxes 0.00 Other Deductions 426.16 Net Pay #,5.20.51 Direct Deposits-1,520.51 Net Check 0.00 Company Address METROPOLITAN Area EMS Authority Medstar EMS 24M ALTA MERE DRIVF Fort Worth, TX 76110 Time Off Balances Dollars Hours Bank _ Account Current Anil FROST BANK Ends with'8415 1,520-51 9/9/2020 Employee Timecard Detail EXHIBIT A r Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All - All - Employee Fay Period Week Output format Roberts, Christopher D Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 v 1 & 2 V 0 ° CJ Weekly Time & Attendance Roberts, Christopher 8/18/2020 06:45 ePro BioClock 8/18/2020 18:51 ePro BioClock 12:06 Roberts, Christopher 8/20/2020 06:49 ePro BioClock 8/20/2020 18:28 ePro BioClock 11:39 Roberts, Christopher 8/21/2020 06:44 ePro BioClock 8/21/2020 18:16 ePro BioClock 11:32 Weekly Total: 35:17 (35.28 Hours) Payroll Items from Schedule ' Items in red text ore unpaid or belong to salaried employees. 8/17/2020 MHP-1 Bereavement F 07:00 1.9:00 12:00 8/18/2020 MHP-1 MHP REG 06:45 18:51 12:06 8/20/2020 MHP-1 MHP REG 06:49 18:28 11:39 8/21/2020 MHP-1 MHP REG 06:44 18:16 11:32 This timecard was never approved. Weekly Time & Attendance Roberts, Christopher 8/24/2020 06:50 ePro BioClock 8/24/2020 18:24 ePro BioClock 11:34 Roberts, Christopher 8/25/2020 06:43 ePro BioClock 8/25/2020 18:16 ePro BioClock 11:33 Roberts, Christopher 8/27/2020 06:47 ePro BioClock 8/27/2020 18:26 ePro BioClock 11:39 Roberts, Christopher 8/28/2020 06:46 ePro BioClock 8/28/2020 17:42 ePro BioClock 10:56 Weekly Total: 45:42 (45.70 Hours) Payroll Items from Schedule * Items in red text are unpaid or belong to solaried employees. 8/24/2020 MHP-1 MHP REG 06:50 18:24 11:34 8/25/2020 MHP-1 MHP REG 06:43 18:16 11:33 8/27/2020 MHP-1 MHP REG 06:47 18:26 11:39 8/28/2020 MHP-1 MHP REG 06:46 17:42 10:56 * This timecard was never approved. https:/lscheduling.esosuite.netIDefault.aspx?DB=medstar# 112 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS _ 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** Voucher Date Voucher Number - 09/04/2020 62154 Direct Deposit Advice Emp Id 900211 Loc OPS002 Period Begin 08/15/20 Net Pay 2,021.32 SSN XXX-XX-9315 Hire Date 10/31/16 Period End 08/28/20 Dir Dep 2,021.32 Clock XXXX Status A Check Type Reg arlings summaryay Summary for Voucf�sr 62154 Total Gross Pay Hours Rate Current Amt Yid Hours Ytd Amt Regular Earnings 80.00 21.502000 1,720.15 1,365.07 29,244.78 Overtime 24.96 32.253000 805.04 436.48 14,053.47 E Training OT 0.00 0.00 12.48 402.52 DIFF PAY 35.64 4.000000 142.56 637.31 2,549.24 Holiday 0.00 0.00 8.22 174.44 MISC STIPEND 0.00 80.00 0.00 1,440.00 SICK 0.00 0.00 36.00 774.00 12 Training Reg 0.00 0.00 10.85 233.30 VACATION 6.00 0,00 72.00 1,542.74 140.60 2,747.75 2,578.41 50,414.55 Taxes Status Taxable Current Amt Ytd Taxablc Yid Amt Federal Income Tax S-1 2,676,87 358.45 49,138.71 602.45 OASDI 2,676.87 165.97 49,138.71 3,046.60 Medicare 2,676.87 39.81 49,138.71 712.51 Medicare - Additional 2,676.87 0.00 49,138.71 0.00 Texas SITW s0 2,676,87 0.00 49,138,71 0.00 563.23 10,441.56 Other Deductions from Pay Current Amt Ytd An,t DENTAL 3.44 61.920 HEALTH 57.68 t,038.240 LEGAL SHIELD 1 L95 215.i0 LIFE EMPLOYEE 5.54 99.72 Mutual Omaha Accident 9,76 175,680 M W R 10.00 180.00 S.T.D 10.93 192.51 UNIFORM 50.00 150.00 VISION 3.90 70.20 163.20 2,183.37 Direc# C$posits. Bank Account Current Amt BANK OF AMERICA N., Ends with'**0572 2,021.32 2,021,32 0 This code is not included in your Federal taxable wages. Total Gross Pay 2,747.75 Federal Taxes -563.23 State and Local Taxes 0.00 Other Deductions -163.20 Net Pay 2 02' 32 Direct Deposits-2,021.32 Net CheckT 0.00 Company Addres METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 Time Off Balances Dollars flours 9/9/2020 Employee Timecard Detail EXHIBIT A s Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District -All - v All- v Employee Pay Period Week Output Format Salguero, David . . .............. v Pa Period 19, 2020 : 8/15/2020 - 8/28/2020 v 1 & 2 v y . Weekly Time Attendance Salguero, David 8/17/202017:43 <Admin> 8/18/202006:04 <Admin> 12:21 Salguero, David 8/18/202017:40 <Admin> 8/19/202007:30 <Admin> 13:50 Salguero, David 8/20/2020 09:00 <Admin> 8/20/202017:00 <Admin> 08:00 Salguero, David 8/21/202017:40 ePro BioClock 8/22/202006:27 ePro BioClock 12:47 Weekly Total. 4658 (46.97 Hours) Payroll Items from Schedule ' items in red text ore unpaid or belong to salaried employee5 8/17/2020 118 Advanced REG 17:43 06:04 12:21 8/18/2020 118 Advanced REG 17:40 07:30 1150 8/20/2020 Training Advanced REG 09:00 17:00 08:00 8/21/2020 M80EN2 Advanced REG 17:40 06:27 12:47 ** This timecard was never approved. Weekly Time & Attendance Salguero, David 8/22/202017:40 ePro BioClock 8/23/202006:12 ePro BioClock 12:32 Salguero, David 8/23/202017:40 <Admin> 8/24/2020 06:19 ePro BioClock 12:39 Saiguero, David 8/24/202018:15 <Admin> 8/25/2020 06:40 ePro BioClock 12:25 Saiguero, David 8/25/202017:57 <Admin> 8/26/2020 01:50 ePro BioClock 07:53 Salguero, David 8/26/202017:48 ePro BioClock 8/27/2020 06:19 ePro BioClock 12:31 !Meekly Total: 58:00 (58.00 Hours) Payroll Items from Schedule * items in red text are unpoia or belong to salaried employees. 8/22/2020 118 Advanced REG 17:40 06:12 12:32 8/23/2020 118 Advanced REG 17:40 06:19 12:39 8/24/2020 119 Advanced REG 18:15 06:40 12:225 8/25/2020 120 Advanced REG 17:57 01:50 07:53 8/26/2020 118 Advanced REG 17:48 06:19 1231 ** This timecard was never approved. https:/Ischeduling.esosuite.netfDefault.aspx?DB= medstar# ITE 919/2020 Employee Timecard Detail EXHIBIT A https://scheduling.esosuite.neUDefault.aspx?DB=medstar# 212 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 r *** This is not a check*** Emp Id 900465 Loc OPS002 Period Begin SSN XXX-XX-6575 Hire pate 11/26/18 Period End Clock XXXX Status A Check Type Total Gross Pay Hours 112te Current Amt Ytd Hours Yid Amt Regular Earnings 76.78 14.385900 1,104.55 1,308,35 19,821.81 Overtime 9.29 21,578850 200.47 168.44 3,634.75 DIFF PAY 25.80 4.000000 103.20 409.51 1,638.04 Holiday 0.00 0.00 28,93 414.74 MISC STIPEND 0.00 80-00 0.00 1,440.00 SICK 0.00 0.00 71.95 1,035.06 12 Training Reg 0.00 0.00 4.02 57.83 Tuition Tax 0.06 0.00 0.00 750.00 VACATION 0.00 0.00 21.72 31146 ER MATCH 0.00 94.95 0.00 1,044.450 111.87 1,488.12 2,012.82 28,104.69 Taxes Status Taxable Current Antt Ytd Taxable Yid Amt Federal Income Tax M-0 1,421.49 100.46 27,346A7 2,019.50 OASDI 1,484.78 92.05 28,042,77 1,738.65 Medicare 1,484.78 21.53 28,042.77 406.62 Medicare - Additional 1,484.78 0.00 28,042.77 0.00 Texas SITW $0 1,421.48 0.00 27,340,47 0.00 214.04 4,164.77 Other Deductions from Pay Current Amt _ Ytd Amt 457 63.30 696.300 DENTAL 3.44 6 L920 LIFE. EMPLOYEE 4.57 82.20 Tuition Tax 0.00 750.00 71.31 1,590.48 Direct pposifs Bank Account Current Amt ALLY BANK Ends with '8889 1,202.87 1,202.87 0 This code is shown for information only. It has no effect on your net pay. tat This code is not included in your Federal taxable wages. Voucher Date Voucher Number 09/04/2020 62081 Direct Deposit Advice 08/15/20 Net Pay 1,202.87 08/28/20 Dir Dep 1,202.87 Ree Total Gross Pay 1,488.22 Federal Taxes -214.04 State and Local Taxes 0.00 Other Deductions -71.31 Net Pay Direct Deposits -1,202.87 Net Check i AG Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 Time Off Balances Dollars Hours 91912020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All- -All- ............................... . Employee Pay Period Week Output Format .................................. v Pa Period 19 2020 : S 15/2020 - 8/28/2020 v 1 & 2 Jimenez, Diana y / _ - Weekly Time &. Attendance Jimenez, Diana 8/15/2020 05:47 ePro BioClock 8/15/202018:15 ePro BioClock 12:28 Jimenez, Diana 8/16/2020 05:43 ePro BioClock 8/16/202018.00 ePro BioClock 12:17 Jimenez, Diana 8/19/2020 05:55 ePro BioClock 8/19/202018:08 ePro BioClock 12:13 Jimenez, Diana 8/20/2020 05:52 ePro BioClock 8/20/2020 18:11 ePro BioClock 12:19 Weekly Total; 49:17 (49.28 Hours) Payroll Items from Schedule * items in red text are unpoid or belong io salaried employees. 8/15/2020 29 Basic REG 05:47 18:15 12:28 8/16/2020 29 Basic REG 05:43 18:00 12:17 8/19/2020 29 Basic REG 05:55 18:08 12:13 8/20/2020 29 Basic REG 05:52 18:11 12:19 *� This timecard was never approved. Weekly Time & Attendance Jimenez, Diana 8/24/202005:55 ePro BioClock 8/24/202018:Q2 ePro BioClock 12:07 Jimenez, Diana 8/25/202005:58 ePro BioClock 8/25/202018:33 ePro BioClock 12:35 Jimenez, Diana 8/28/2020 05:58 ePro BioClock 8/28/202018:03 ePro BioClock 12:05 Weekly Total: 36:47 (36.78 Hours) + Payroll Items from Schedule '!terns in red t,>xr arc' unpaid or belong to salaried r, rapinyees. 8/24/2020 29 Basic REG 05:55 18:02 12:07 8/25/2020 29 Basic REG 05:58 1833 12:35 8/28/2020 COVID-19Admin Basic REG 05:58 18:03 12:05 * " This timecard was never approved. https://scheduling.esosuite.net/Default.aspx?DB=medstar# 1/1 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** 1 mp ld 036765 Loc CHP002 Period Begin SSN XXX-XX-6843 Hire Date 03/23/98 Period End Clock XXXX Status A Check Type Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Aml Regular Earnings 80,00 29,751900 2,380.15 1,429.60 42,245.93 Overtime 43,04 44,627850 1,920.79 972.08 38,660.08 E Training OT 3.27 44.627850 145.93 10.03 445.08 BEREAVEMENT 0.00 0.00 12.00 349.68 RIFF PAY 29.58 4.000000 118.32 627,10 2,508.40 Group Term Life 0.00 3.29 0.00 57.75 Holiday 0.00 0.00 24.91 733.53 SICK 0.00 0.00 12.00 349.68 STANDBY 0.00 0.00 8.38 244.19 12 Training Reg 0.00 0.00 2.02 58.86 VACATION BUYBK 0,00 0.00 144.00 4,254.90 ER MATCH O,M 232.06 0.00 4,149.460 155.89 4,568.48 3,142.12 89,908.08 Taxes Status Taxable Current Amt Ytd Taxable Ytd Ami Federal Income Tax M-0 3,065.82 297,78 62,974.74 5,976.58 OASDI 3,994.08 247.63 79,568.88 4,933.27 Medicare 3,994.08 57.92 79,568.88 Lt53.75 Medicare - Additional 3,994,08 0.00 79,568.88 0.00 Texas SITW 3,065.82 0.00 62,974.74 0.00 603.33 12,063,60 Other Deductions from Pay Current Amt Ytd Amt 457 929.26 16,594.140 Accidental Death - Employee 2.75 49.500 Accidental Death - Spouse 2.42 43.560 BANKRUPTCY 63000 6,930.00 DENTAL t 2.1 1 217.980 Group Term Life 3.29 57,75 HEALTH SAVrNGS 269,23 4,940.140 HEALTH 238A6 4,286.880 LEGAL SHIELD 7.36 132,48 LIFE EMPLOYEE 31,93 574.74 LIFE SPOUSE. 190.04 3,420,72 Mutual Omaha Accident 14.01 252.180 Mutual Omaha Critical Illness 35.72 642,960 M W R 5.00 90.00 S.T.D 14.43 259.74 VISION 6.66 119.98 Voucher Date Voucher Number 09/04/2020 61821 Direct Deposit Advice 08/15/20 Net Pay 1,573.78 08/28/20 Dir Dep 1,573.78 Reg Total Gross Pay 4,568.48 Federal Taxes -603.33 State and Local Taxes 0.00 Other Deductions -2,391.37 Net Pay C 1573 7 Direct Deposits-1,573.78 Net Check U.00 Company Address METROPOLITAN Area EMS Authority Medstar EMS 29W ALTA MERE DRIVE Fort Worth, TX 76116 Time Off Balances Dollars Hours 2,391.37 38,518.6.5 9/9/2020 Employee Timecard Detail EXHIBIT A APayroll > Payroll Reports > Employee Timecard Detail Back Cost Center District - All - v -All - *� Employee Pay Period Week Output Format Pa Period Aycox, James © y 19, 202Q : 8/15 2020 8/28/2020 / r' 1 & 2 v �: - ` . Weekly Time & Attendance Aycox, James 8/15/2020 05:46 ePro BioClock 8/15/2020 20:24 ePro BioClock 14:38 Aycox, James 8/16/2020 05:44 ePro BioClock 8/16/202018:29 ePro BioClock 12:45 Aycox, James 8/17/2020 06:52 ePro BioClock 8/17/20201&10 ePro BioClock 11:18 Aycox, James 8/19/2020 05:42 ePro BioClock 8/19/2020 1&07 ePro BioClock 12:25 Aycox, James 8/20/2020 05:45 ePro BioClock 8/20/2020 18:15 ePro BioClock 12:30 Aycox, lames 8/21/202005:47 ePro BioClock 8/21/2020 14:04 ePro BioClock 08:17 Aycox, lames 8/21/202014:14 <Admin> 8/21/202017:30 ePro BioClock 03:16 Meekly Total: 75:09 (75,15 Hours) Payroll Items from Schedule * Items in red text are unpaid or belong to salaried employees. 8/15/2020 201 CCP REG 05A6 20:24 14:38 8/16/2020 201 CCP REG 05:44 18:29 12:45 8/17/2020 MHP-1 MHP REG 06:52 18:10 11:18 8/19/2020 201 CCP REG 05:42 18:07 12:25 8/20/2020 201 CCP REG 05:45 18:15 12:30 8/21/2020 18 Advanced REG 05:47 14:04 08:17 8/21/2020 Training CCP 12 14:14 17:30 03:16 This timecard was approved on 8/24/2020 5:56:27 AM Weekly Time & Attendance Aycox, James 8/24/2020 05:45 ePro BioClock 8/24/202018:20 ePro BioClock 12:35 Aycox, James 8/25/2020 05:43 ePro BioClock 8/25/202018:26 ePro BioClock 12:43 Aycox, James 8/26/202005:43 ePro BioClock 8/26/202018,39 ePro BioClock 12:56 Aycox, James 8/28/2020 05:46 ePro BloClock 8/28/20201.8:42 ePro BioClock 12:56 Weekly Total: 51:10 (51.17 Hours) Payroll Items from Schedule Items in red text are unpaid or belong to salaried employees. 8/24/2020 201 CCP REG 05.45 18:20 12:35 8/25/2020 201 CCP REG 05:43 18:26 12:43 https:llscheduling.esosuite.netiDefault.aspx?DB=medstarlf 1/2 9/9/2020 Employee Timecard Detail REG 05:43 18:39 12:56 REG 05:46 18:42 12:56 EXHIBIT8-26/2020 201 CCP 8/28/2020 201 CCP This timecard was approved on 8/30/2020 5:44:32 AM https:llscheduling.esasuite.netIDefault.aspx?DB=medstar# 212 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** Emp Id 900438 Loc OPS002 Period Begin SSN XXX-XX-9701 Hire Date 10/08/18 Period End Clock XXXX Status A Check Type Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Amt Regular Earnings 77,71 14.385900 I,117,93 891.05 12,918.57 Overtime 12,13 21.578850 261,75 119.14 2,570.90 DIFF PAY 26.60 4.000000 t06.40 289.98 1,159,92 Holiday 0.00 0.00 24.94 358,78 SICK 0.00 0.00 36.24 521,34 12 Training Rep 0.00 0.60 4.30 6 L86 VACATION 0.00 0.00 56,24 809.06 116.44 1,486.08 1,421.89 18,300.43 Taxes Status Taxable Current Amt Ytd Taxable Y1d Amt Federal lncontieTax S-0 1,248.40 124.67 16,059.29 1,639.62 OASDI 1,248.40 77.40 16,059.29 995,68 Medicare 1,248,40 1 & 10 16,059.29 232.86 Medicare -Additional 1,248.40 0.00 16,059.29 0.00 Texas S1TW S0 1,248,40 0.00 16,059.29 0.00 220,17 2,868.16 Other Deductions from Pay Current Amr Yrd Atnt DENTAL 3.44 48.160 HEALTH SAWNGS 25,M 800.000 HEALTH 197,17 1,224.000 LIFE EMPLOYEE 1.22 15.86 MISCELLANEOUS 56.58 437,51 Mutual Omaha Accident 9.76 130.640 Mutual Omaha Critical Illness 2.31 32,340 MWR 10.00 125.69 S.T. D 7.31 91.53 VISION 3.90 46.80 316.69 2,958,53 Bank Account Current Amt WELLS FARGO BANK, Ends with •••5065 949.22 949.22 0 This code is not included in your Federal taxable wages. Voucher Date Voucher Number 09/04/2020 62025 Direct Deposit Advice 08/15/20 Net Pay 949.22 08/28/20 Div Dep 949.22 Reg Total Gross Pay 1,486.08 Federal Taxes -220.17 State and Local Taxes 0.00 Other Deductions -316.69 Net Pay --.._......_...... 949.22 Direct Deposits-949.22 Net Clleck 0,00 Company Address METROPOLITAN Area EMS Authority Medstar EMS 29W ALTA MERE DRIVE Fort Worth. TX 76116 Time Off Balances Dollars "OUTS 9/9/2020 Employee Timecard Detail EXHIBIT A �Fj Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District -Ail - All- v Employee Pay Period Week Output Format v Pa Period -Cox, Kaitlyn y 19, 2020 : 8/15/2020 - 8/28/2020 v 1 & 2 V 0a G � .�, 0 M Weekly Time & Attendance Cox, Kaitlyn 8/17/2020 06:31 ePro BioClock 8/17/202018:42 ePro BioClock 12:11 Cox, Kaitlyn 8/18/2020 05:43 ePro BioClock 8/18/202018:54 ePro BioClock 13:11 Cox, Kaitlyn 8/21/2020 05A3 ePro BioClock 8/21/202018:04 ePro BioClock 12:21 Weekly Total: 37:43 (37.72 Hours) Payroll Items from Schedule ' Items in red text are unpaid or belong to salaried employees, 8/17/2020 30 Basic REG 06:31 18:42 12:11 8/18/2020 30 Basic REG 05:43 18:54 13:11 8/21/2020 30 Basic REG 05:43 18:04 12:21 * This timecard was never approved. Weekly Time & Attendance Cox, Kaitlyn 8/22/2020 05A8 ePro BioClock 8/22/202018:11 ePro BioClock 12:23 Cox, Kaitlyn 8/23/2020 05:44 ePro BioClock 8/23/2020 18:53 ePro BioClock 13:09 Cox, Kaitlyn 8/26/2020 05.45 ePro BioClock 8/26/2020 20:26 ePro BioClock 14:41 Cox, Kaitlyn 8/27/2020 05:49 ePro BioClock 8/27/2020 17:44 ePro BioClock 11:55 Weekly Total: 52:08 (52.13 Hours) Payroll Items from Schedule Items it) red text are unpaid or belong to salaried employees. 8/22/2020 30 Basic REG 05:48 18:11 12:23 8/23/2020 30 Basic REG 05:44 18:53 13:09 8/26/2020 30 Basic REG 05:45 20:26 14:41 8/27/2020 30 Basic REG 05:49 17:44 11:55 * This timecard was never approved. https://scheduling.esosuite.net/Default.aspx?DB=medstar# ill EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** �- AZ1242 055969 09.1)4fN 61992 Kayden J. Bathery 8152 ROMEO LN FORT WORTH, TX 76126 Voucher bate 'Voucher Plumber 09/04/2020 61992 Direct Deposit Advice Direct Deposit Amount ****** 1,716.60 . O.O k" T g316M I , . � I .E,Payv K yder . Be#hory Seplre0i. Q4, � 0 61992 Emp Id 055869 Loc OPS002 Period Begin 08/15/20 Net Pay 1,716.60 SSN XXX-XX-6040 Hire Date 09/10/07 Period End 08/28/20 Dir Dep 1,716.60 Clock XXXX Status A Check Type Reg Total Gross Pay Hours Rate Current Amt Ytd Hours Yid Amt Regular Earnings 80.00 20.330000 1,626.40 318.09 6,466.76 Overtime 10.48 30.495000 319.58 42,65 1,300.61 DIFF PAY 33.15 4.000000 132.60 68.65 274.60 123.63 2,078.58 42939 8,041.97 Taxes Status Taxable Current Amt Yid Taxable Ytd Amt Federal Income Tax M-0 1,892.91 20.57 7,856.30 116.45 OASDI 1,892.91 117,36 7,856.10 487.09 Medicare 1,892.91 27.43 7,856.30 113.92 Medicare -Additional 1,892.91 0,00 7,856.30 0.00 Texas SITW s0 I,892.91 0.00 7,956.30 0,00 165.38 717.46 Other Deductions from Pay Current Amt Ytd Amt Accidental Death - Employee 0.32 0,3249 DENTAL 26.59 26.590 HEALTH 158.76 158.7649 LIFE EMPLOYEE 0.74 0.74 LIFE SPOUSE 0.30 0.30 VISION 9.89 9.89 196.60 196.60 Diireet Deposits' Bank Account Current Antt USAA FEDERAL SAVIN Ends with ***5568 1,716.60 1,716.60 0 This code is not included in your Federal taxable wages. Total Gross Pay 2,078.58 Federal Taxes -165.38 State and Local Taxes 0.00 Other Deductions -196.60 Net Pay Direct Deposits-1,716.60 Net Check b.04 Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 Time Off Balances Dollars Hours 9/9/2020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District -All - All- v Employee Pay Period Week Output Format .. ...... Bathory, Kayden J _ . . v Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 1 & 2 V Weekly Time & Attendance Bathory, Kayden 8/17/202014A1 ePro BioClock 8/18/202003:55 ePro BioClock 13:14 Bathory, Kayden 8/18/202014:40 ePro BioClock 8/19/202005:13 ePro BioClock 14:33 Bathory, Kayden 8/21/202014:43 ePro BioClock 8/22/2020 03.16 ePro BioClock 12,33 Weekly Total: 40:20 (40.33 Hours) Payroll Items from Schedule Items in red text are unpaid or belong to salaried employees. 8/17/2020 94 NewFieldEmp REG 14:41 03:55 13:14 i 8/18/2020 94 NewFieldEmp REG 14:40 05:13 14:33 8/21/2020 94 NewFieldEmp REG 14:43 03:16 12:33 ** This timecard was never approved. Weekly Time & Attendance rn Bathory, Kayden 8/22/202014A2 ePro BioClock 8/23/2020 03:15 ePro BioClock 12:33 Bathory, Kayden 8/23/2020 17:40 ePro BioClock 8/24/2020 06:26 ePro BioClock 12:46 Bathory, Kayden 8/26/202017:40 ePro MoClock 8/27/2020 06:09 ePro BioClock 12:29 Bathory, Kayden 8/27/202018:55 ePro BioClock 8/28/2020 07:16 ePro BioClock 12:21 Weekly Total: 50:09 (50.15 Hours) Payroll items from Schedule Items in red text ore unpaid or belong to salaried employees. 8/22/2020 94 NewFieldEmp REG 14:42 03:15 12:33 8/23/2020 118 NewFieldEmp REG 17:40 06:26 12:46 8/26/2020 118 NewFieldEmp REG 17:40 06:09 12:29 8/27/2020 127 NewFieldEmp REG 18:55 07:16 12:21 * This timecard was never approved. https:llscheduling.esosuite.net/Detault.aspx?DB=medstar# 11i EXHIBIT A 7 METROPOLITAN Area EMS Authority Voucher Date Voucher Number 09/04/2020 62190 c Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 Direct Deposit Advice _. *** This is not a check*** Direct Deposit Amount ****** 1,613.62 --- AZ1242 W517 M4,20 42190 r. Kimberly A. Villano ?' 1635 SADDLE CREEK CIA 1718 ARLINGTON, TX 76015 m kll r rtxaanto -NRM,Pa,v Kimberly A VR aria..5t�ptemb�r ii4� 2.20 62'l9if Emp Id 900517 Loc OPSO02 Period Begin 08/15/20 Net Pay 1,613.62 SSN XXX-XX-9512 Hire Date 04/29/19 Period End 08/28/20 Dir Dep 1,613.62 Clock XXXX Status A Check Type Reg l=arnings Slammary Payment Summary for iloucler 621`9(} Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Am[ Total Gross Pay 1,929.32 Regular Earnings 77.73 19.541900 1,519.00 1,315.14 25,438.02 Federal Taxes -219.99 Overtime 9.87 29.312850 289.32 122.70 3,564,13 State and Luca[ Taxes fl.00 DIFF PAY 30.25 4.000000 121.00 490.48 1,921.92 Holiday 0.00 0.00 19.32 372.26 Other Deductions -95.71 SICK 0.00 0.00 52.23 1,011A2 Net Pay 12 Training Reg 0.00 0.00 4.00 78.17 VACATION 0.00 0.00 50.09 963.09 Direct Deposits -1,613.62 F.R MATCH 0.GO 128,97 0.00 2,297.610 Net Check._ ; 117.85 1,929.32 2,043.96 33,348.61 Taxes Status Taxable Current Amt Ytd Taxable Ytd Amt Federal Income Tax M4 1,843.34 72.41 31,816.81 1,173.73 OASDI 1,929,32 119.61 33,348.61 2,067.61 Medicare 1,929.32 27,97 33,348.61 483.55 Medicare - Additional 1,929.32 0.00 33,348.61 0.00 Texas SITW 50 1,943.34 0.00 31,816.81 0.00 219.99 3,724.89 Other Deductions from Pay Current Amt Ytd Amt 457 8598 1,531.806 S.T.D 9.73 175.14 95.71 1,706.94 Bank Account Current Alnt USAAFEDERALSAVIN Endswith,"7239 1,613.62 1,613.62 O This code is shoxvn for information only. It has no effect on your net pay. 9 This code is not included in your Federal taxable wages. Additional lnfQrmation ComAanv Address _ METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth. TX 76116 Time Off Balances Dollars Hours 919/2020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All - -All - Employee Pay Period Week Output Format Villano, Kimberly Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 v 1 & 2 w ?UJ } .: Weekly Time & Attendance Villano, Kimberly 8/17/2020 08:56 ePro BioClock 8/17/2020 21:10 ePro BioClock 12:14 Villano, Kimberly 8/18/2020 08:55 ePro BioClock 8/18/2020 21:44 ePro BioClock 12:49 Villano, Kimberly 8/21/2020 08:57 ePro BioClock 8/21/2020 21:38 ePro BioClock 12:41 Weekly Total: 37:44 (37.73 Hours) Payroll Items from Schedule Items in red text are unpaid or belong to salaried employees. 8/17/2020 62 Advanced REG 08:56 21:10 12:14 8/18/2020 62 Advanced REG 08:55 21:44 12:49 8/21/2020 62 Advanced REG 08:57 21:38 12:41 ** This timecard was never approved. Weekly Time & Attendance Villano, Kimberly 8/22/2020 08:55 ePro BioClock 8/22/2020 22:07 ePro BioClock 13:12 Villano, Kimberly 8/23/2020 08:50 <Admin> 8/23/2020 21:15 <Admin> 12:25 Villano, Kimberly 8/26/2020 08:55 ePro BioClock 8/26/2020 21:01 ePro BioClock 12:06 Villano, Kimberly 8/27/2020 08:55 ePro BioClock 8/27/2020 21:04 ePro BioClock 12:09 Weekly Total: 49:52 (49.87 Tours) . Payroll Items from Schedule 'items In red text are unpaid or Gelang to sour ied employees. 8/22/2020 62 Advanced REG 08:55 22:07 13:12 8/23/2020 62 Advanced REG 08:50 21:15 12:25 8/26/2020 Light Duty- W/C Advanced REG 08:55 21:01 12:06 8/27/2020 Light Duty - W/C Advanced REG 08:55 21:04 12:09 This timecard was approved on 8/31/202011:02:30 AM https://scheduling.esosuite.net/Default.aspx?DB=medstar# ill EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76110 *** This is not a check*** Voucher Date Voucher Number 09/04/2020 61833 Direct Deposit Advice Emp Id 900375 1" CHP002 Period Begin 081t5120 Net Pay 2,328.33 SSN XXX-XX-8768 Hire Date 02l12118 Period End 08/28/20 Dir Dep 2,32833 Clock XXXX Status A Check Typc Reg Payment Summary fior V©uci�r 6183 Earrings Surnlnary. . Total Gross Pay Hours Race Current Anrt Yid Hours Ytd Amt Total Gross Pay 3,542.24 Regular Eamings 90,00 24.534600 1,962.76 1426,15 34,759.57 Federal Taxes 493.11 Overtime 38.69 36.801900 1,423.87 834,60 30,192.42 State and Local Taxes 0,00 E Training OT 0.00 0.00 10.04 352.97 DIFF PAY 38,73 4.000000 154.92 591.77 2,655.72 Other Deductions-720,80 Group Term Life 0,00 0.69 0.00 12.42 Net Pay 2 28 33 Holiday 0.00 0.00 41.64 1,003.43 - SICK 0.00 0.00 3.17 77,77 Direct Deposits-2,328.33 L -TA Instnictor Regular 0.00 0.00 1,82 44.65 Net Check 12 Training Reg 0.00 0.00 12,03 289.33 ER MATCH 0.00 191.37 0,00 3,432.840 157.42 3,542.24 2,921.22 69,577.28 ACitfilborla� ]rlfiprmailon Taxes Status Taxable Current Amt Ytd Taxable Ytd Amt Federal Income Tax M-1t$20 2,997.98 250.10 59,791.61 5,562.38 Company Address OASDI 3,176.59 196.95 62,995.59 3,905.73 METROPOLITAN Area EMS Authority Medicare 3,176.59 46.06 62,995.58 913.44 Medstar EMS 2900 ALTA MERE DRIVE Medicare - Additional 3,176,59 0.00 62,995.58 0.00 Fort Worth, TX 76116 Texas SITW so 2,997.98 0,00 59,791.61 0.00 493.11 10„181,55 Other Deductions from Pay Current Atot __ Ytd Amt 457 178.61 3,203.970 CHILD SUPPORT 1 159.19 2,852.42 DENTAL 12.11 217.980 Group Term Life 0.69 12.42 HEALTH SAVINGS 11538 2,076.840 HEALTH 238.16 4,286.888 M W R 10.00 180.00 VISION 6.66 119.88 720.90 12,950.39 Bank Account Current Anrt JPMORGAN CHASE BA Ends with ***5314 2,328.33 2,328.33 O This code is shown for information ocrly. It has no effect on your net pay. 0 This code is not included in your Federal taxable wages. Time Off Balances Dollars Hours 9/9/2020 Employee Tirnecard Detail XHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District - All v -All - *� Employee Pay Period Week Output Format Willens, Matthew.._ ............. �+ Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 ............. . v 1 & Z �+ @ T M Weekly Time & Attendance Willens, Matthew 8/15/2020 16:25 MSeProTime07 8/16/2020 04:37 MSeProTie07 12:12 Willens, Matthew 8/17/2020 06:40 ePro BioClock 8/17/2020 18:46 ePro BioClock 12:06 Willens, Matthew 8/18/2020 06:40 ePro BioClock 8/18/2020 18:51 ePro BioClock 12:11 Willens, Matthew 8/19/202006:40 ePro BioClock 8/19/202018:43 ePro BioClock 12:03 Willens, Matthew 8/20/2020 09:00 <Admin> 8/20/2020 17:00 <Admin> 08:00 Willens, Matthew 8/21/202006:40 ePro BioClock 8/21/202018:51 ePro BioClock 12:11 Weekly Total: 68:43 (68.72 Hours) Payroll Items from Schedule ' !terns in red text are unpaid or belong to salaried employees. 8/15/2020 107-N Advanced REG 16:25 04:37 12:12 8/17/2020 203 CCP REG 06:40 18:46 12:06 8/18/2020 203 CCP REG 06:40 18:51 12:11 8/19/2020 203 CCP REG 06:40 18:43 12:03 8/20/2020 Training CCP REG 09:00 17:00 08:00 8/21/2020 203 CCP REG 06:40 18:51 12:11 ** This timecard was never approved. Weekly Time & Attendance Willens, Matthew 8/22/2020 06:40 ePro BioClock 8/22/202019:13 ePro BioClock 12:33 Willens, Matthew 8/23/2020 06:40 ePro BioClock 8/23/20201&48 ePro BioClock 12:08 Willens, Matthew 8/26/2020 06:40 ePro BioClock 8/26/2020 18:44 ePro BioClock 12:04 Willens, Matthew 8/27/2020 06:40 ePro BioClock 8/27/202019:54 ePro BioClock 13:14 Weekly Total: 49:59 (49.98 Hours) Payroll Items from Schedule ' Items in red text are unpaid or he/ang to salaried employees. 8/22/2020 203 CCP REG 06:40 19J3 12:33 8/23/2020 203 CCP REG 06:40 18:48 12:08 8/26/2020 203 CCP REG 06:40 18:44 12:04 8/27/2020 203 CCP REG 06:40 19:54 13:14 https:/lscheduling.esosuite.net De#ault.aspx2DB=medstar# 112 9/9/2020 Employee Timecard Detail EXHI$tT A; *� This timecard was never approved. https:/Ischeduling.esosuite.net/Default.aspx?DB=medstar## 2/2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** Voucher Date Voucher Number 09/04/2020 62039 Direct Deposit Advice Emp Id 900417 Loc OPS002 Period Begin 08/15/20 Net Pay 1,200.22 SSN XXX-XX-7756 Hire Date 08/06/18 Period End 08/28/20 Dir Dep 1,200.22 Clock XXXX Status A Check Type Reg Payment Summary flan Voucher 2035 Earrings Summary Total Gross Pay hours Rate Current Amt Ytd Hours Ytd A,nt Total Gross Pay 1,558.31 Regular Earnings 77.15 14.817500 1,143.16 1,362.80 19,822.73 Federal Taxes-268.26 Overtime 13.58 22.226250 301.83 305,08 6,64150 State and Local Taxes 0.00 E Training OT 0.00 0.00 1.23 26,78 DIFF PAY 29.33 4.000000 113.32 589.01 2,356.04 Other Deductions -89.83 Holiday 0.00 0.00 12.88 186.92 Net Pay � 1,za� SICK 0.00 0.00 50.10 731.3R _ L - TA Instructor Regulat 0.00 0.00 3.93 55.58 Direct Deposits-1,200.22 12 Training Reg 0.00 0.00 2,89 41.94 Net Check 0 QO VACATION 0.00 0.00 48.00 700,26 119.06 1,558.31 2,375.82 30,569.13 Taxes Status Taxable Current Anit Ytd Taxable Ytd Arnt �:ddlt10r16� infOrmati n FederallncomeTax SA 1,493,10 154.04 29,395,35 3,234.58 OASDI 1,493.10 92.57 29,395.35 1,822.51 Company Address Medicare 1,493.10 21.65 29,395.35 426.23 METROPOLITAN Area EMS Authority Medicare - Additional 1,493.10 0.00 29,395.35 0.00 Medstar EMS 2900 ALTA MERE DRIVE Texas SITW 50 1,493.10 0.00 29,395.35 0,00 Fort Worth, TX 76116 268.26 5,483.32 Other Deductions from Pay Current Amt Yid Amt Accidental Death - Employee 1.78 32.040 DENTAL 3.44 61.920 HEALTH 57.68 1,038.240 LIFE EMPLOYEE 3.35 60.30 Mutual Omaha Critical Illness 2.3 t 41.580 MWR 10,00 180.00 S.T.D T37 136.68 VISION 3.90 76.20 89.83 1,620.96 Time Off Balances Dollars Hours Direct Di pos. Bank Account Current Amt WELLS FARGO BANK lands with *'•6238 1,200.22 1,200.22 0 This code is not included in your Federal taxable wages 9/9/2020 Employee Timecard Detail EXHIBIT A l Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All - All - v Employee Pay Period Week Output Format Duckett, Matthew v Pay Period 19, 2020 ! 8/15/2020 - 8/28/2020 v 1 & 2 v OTa Weekly Time & Attendance Duckett, Matthew 8/17/202009:04 ePro BioClock 8/17/2020 21:06 ePro BioClock 12:02 Duckett, Matthew 8/18/2020 09:05 ePro BioClock 8/18/2020 21:42 ePro BioClock 12:37 Duckett, Matthew 8/21/2020 09:09 ePro BioClock 8/21/2020 21:39 ePro BioClock 12:30 Weekly Total: 37:09 (37.15 Hours) '. Payroll items from Schedule items in red text ore unpaid ar belong to soloried ernpioyees, 8/17/2020 62 Basic REG 09:04 21:06 12:02 8/18/2020 62 Basic REG 09:05 21:42 12:37 8/21/2020 62 Basic REG 09:09 21:39 12:30 * This timecard was never approved. Weekly Time & Attendance Duckett, Matthew 8/22/2020 09:08 ePro BioClock 8/22/2020 21:01 ePro BioClock 11:53 Duckett, Matthew 8/23/2020 09:07 ePro BioClock 8/23/2020 20:55 ePro BioClock 11:48 Duckett, Matthew 8/26/2020 09:10 ePro BioClock 8/27/2020 02:19 ePro BioClock 17:09 Duckett, Matthew 8/27/202016:24 ePro BioClock 8/28/2020 05:09 ePro BioClock 12:45 Weekly Total: 53:35 (53.58 Hours) Payroll Items from Schedule ' Items in red text ore unpaid or belonq to salaried employees. 8/22/2020 62 Basic REG 09:08 21:01 11:53 8/23/2020 62 Basic REG 09:07 16:30 07:23 8/23/2020 85 Basic REG 1630 20:55 04:25 8/26/2020 Extral Basic REG 0910 02:19 17:09 8/27/2020 106 Basic REG 16:24 05:09 12:45 ** This timecard was never approved. https:/Ischedulirig.esosuite.net/Default.aspx?DB=medstar# 112 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE. DRIVE Fort Worth. TX 7b 116 *** This is not a check*** Voucher Date Voucher Number 09/04/2020 62066 Direct Deposit Advice Emp Id 56663 Loc OPS002 Period Begin 08/15/20 Net Pay 2,055.25 SSN XXX-XX-9183 Hire Date 11/02/15 Period End 08/28/20 Dir Dep 2,055,25 Clock XXXX Status A Check Type Reg Earrings Summary payrnen..::.Summary fac toucher 62066 Total Gross Pay Flours Rate Current Anmt Ytd Hours Ytd Ami Regular Earnings 80.00 23.340100 1,867.21 1,268.65 29,61DAI Overtinme 3L90 35.010150 1,116.83 225A9 7,894.10 E Training OT 0.00 0.00 1,83 64.07 DIFF PAY 29.28 4.000000 117.12 427,56 1,710.24 Group Term Life 0.00 0.28 0.00 4.83 Holiday 0.00 0.00 15.83 369.47 SICK 0.00 0A0 24.00 560.16 12 Training Reg 0." 0.00 4.83 112,73 VACATION 0.00 0.00 144.00 3,360.96 ER MATCH 0.00 154.04 0.00 2,772.720 141A8 3,101.44 2,112.18 43,686.97 Taxes Status Taxable Current Anil Ytd Taxable Ytd Amt Federal Income Tax M-4 2,446.24 144.05 31,893,37 1,203.80 OASDI 2,651.63 164.40 35,590.39 2,206.60 Medicare 2,651.63 38A5 35,590.39 516.06 Medicare - Additional 2,651.63 0,00 35,590,39 0.00 Texas SITW 2,446.24 0.00 31,893.37 0.00 346.90 3,926.46 Other Deductions from Pa currenc Amt Ytd Amt 457 205.39 3,697,020 DENTAL 26.59 478.620 Group Term Life 0.28 4.83 HEALTH 423.22 7,617.968 CHILD LIFE 1.11 19.98 LIFE EMPLOYEE t6.96 305.28 LIFE SPOUSE 3.99 71.82 S.T_D 11.86 212.76 VISION 9.89 178.02 699.29 12,586.29 Bank Account Current Amt USAA FEDERAL SAVIN Ends with '6524 2,055.25 2,055.25 0 This code is shown for information only. It has no effect on your net pay. 9 This code is not included in your Federal taxable cages. Total Grass Pay 3,101.44 Federal Taxes -346.90 State and Local Taxes 0.00 Other Deductions -699.29 Net Pay _.r i.__2,4.55.25 Direct Deposits-2,055.25 Net Check 0.00 ?Add'stional Information. . . . . ...... ... .. ComDanv Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 70116 Time Off Balances Dollars hours 919/2020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District -AII- -AII- V Employee Pay Period Week Output: Format Hansen, Matthew Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 v 1 & 2 V @ o M ... ................. Meekly Time & Attendance Hansen, Matthew 8/17/2020 05:41 ePro BioClock 8/17/202019:04 ePro BioClock 13:23 Hansen, Matthew 8/18/2020 05:40 ePro BioClock 8/18/2020 19:52 ePro BioClock 14:12 Hansen, Matthew 8/19/2020 14:00 <Admin> 8/19/2020 15:30 <Admin> 01:30 Hansen, Matthew 8/21/2020 05:42 ePro BioClock 8/21/2020 20:28 ePro BioClock 14:46 Weekly Total: 43:51 (43.85 Hours) ' Payroll Items from Schedule Items in rest text are anpeid c(betong to salaried ernptoyees. 8/17/2020 30 Advanced REG 05:41 19:04 13:23 8/18/2020 30 Advanced REG 05.40 19:52 14:12 8/19/2020 Meeting Advanced REG 14:00 15:30 01:30 8/21/2020 30 Advanced REG 05:42 20:28 14:46 This timecard was never approved. Weekly Time & Attendance Hansen, Matthew 8/22/2020 05:42 ePro BioClock 8/22/2020 17:59 ePro BioClock 12:17 Hansen, Matthew 8/23/2020 05:43 ePro BioClock 8/23/2020 19:15 ePro BioClock 13:32 Hansen, Matthew 8/25/2020 04:44 MSeProTime07 8/25/2020 18:47 MSeProTimeW 14:03 Hansen, Matthew 8/26/2020 05:43 ePro BioClock 8/26/2020 21:17 ePro BioClock 15:34 Hansen, Matthew 8/27/202006:52 <Admin> 8/27/202019:29 <Admin> 12:37 Weekly Total: 68:03 (68.05 Hours) Payroll Items from Schedule ` Hems in red text are ua ,id or belong ro salc fed ernph)yec-s. 8/22/2020 30 Advanced REG 05:42 17:59 12:17 8/23/2020 30 Advanced REG 05:43 19:15 13:32 8/25/2020 M80BD1-IV EieldOpsSup REG 04:44 18:47 14:03 8/26/2020 30 Advanced REG 05:43 21:17 15:34 8/27/2020 M80-1 Advanced REG 06:52 19:29 12:37 This timecard was never approved. hops:/fscheduling.esosuite.net/De€ault.aspx?DB=medstar# 112 9/912020 Employee Timecard Detail EXHIBIT A. https:llscheduling.esasuite.net/Default.aspx?DB=medstar# 2/2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** AZ3242 055907 09,N.20 61967 Philip B. Story 4533 Grainland Ct Fort Worth, TX 76179 Emp Id 055907 Loc SSN XXX-XX-0046 Hire Date Clock XXXX Status Voucher Date Voucher Number 09/04/2020 61967 Direct Deposit Advice Direct Deposit Amount NOPS02 Period Begin 08/15/20 Net Pay 10/15/07 Period End 08/28/20 Dir Dep A Check Type Reg RP 610 apt Y @96a14 ^3if�pRnH 2,240.05 2,240.05 Iarrngs Strnlary Paymel Sumrlary for Voucher 61967 Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Amt Regular Eamings 80.00 25.974200 2,077.95 1,396.36 36,269.35 Overtime 32.04 38.961300 1,248.32 439.76 17,133.63 DIFF PAY 25.89 4,000,000 103.56 429.69 1,718.76 Group Term Life 0.00 0.37 0.00 6.66 Holiday 0.00 0.00 18.50 480.52 SICK 0.00 0.00 72.00 1,870.14 12 Training Reg 0.00 0.00 4.00 103.90 VACATION 0.00 0.00 49.00 1,246.76 ER MATCH 0.00 171.43 0.00 3,085.740 137.93 3,430.20 2,408.31 58,829.72 Taxes Status Taxable Current Amt Ytd Taxable Yid Amt Federal Income Tax M-2 2,714,76 215.96 48,351.80 3,825.09 OASDI 21829.05 175.40 50,409.02 3,125.36 Medicare 2,829.05 4L02 50,409.02 730.93 Medicare - Additional 2,829.05 0,00 50,409.02 0,00 Texas SITW 2,714.76 0.00 48,351.80 0.00 432,38 7,68L98 Other Deductions from Pay Current Amt Ytd Amt 457 114.29 2,057.220 DENTAL 26.59 479.620 Group Term Life 0.37 6.60 HEALTH SAVINGS 250.00 2,1W.000 HEALTH 324.56 5,842.080 CHILD LIFE 1.11 19.98 LIFE EMPLOYEE 5.54 99.72 LIFE SPOUSE 2.22 39.96 M W R 10.00 180.00 S.T.D 13.20 236.79 VISION 9.89 178,02 757.77 11,239.05 Bank Account Current Amt UNITY ONE CREDIT UP Ends with *'1467 2,240.05 2,240.05 O This code is shown for information only. it has no effect on your net pay. © This code is not included in your Federal taxable wages. Total Gross Pay 3,430.20 Federal Taxes 432.38 State and Local Taxes 0.00 Other Deductions -757.77 Net Pay 2,240.Q5 Direct Deposits-2,240.05 Net Check C71....,,,,.,..1 a Ad.rfltlon al Information Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth. TX 76116 Time Off Balances Dollars Hours 919/2020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All - All - Employee Pay Period Week Output Format Story, Philip B Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 v 1&2V 0 �) ................ ....... .. Weekly Time & Attendance Story, Philip 8/15/2020 04:40 MSeProTime07 8/15/2020 17:29 MSeProTime07 12:49 Story, Philip 8/16/2020 04:40 MSeProTime07 8/16/2020 17:14 MSeProTie07 12:34 Story, Philip 8/18/2020 04:40 ePro BioClock 8/18/202014:29 ePro BioClock 09:49 Story, Philip 8/19/2020 04:48 MSeProTirne07 8/19/202017:27 MSeProTirne07 12:39 Story, Philip 8/20/2020 04:42 <Admin> 8/20/202017:00 MSeProTime07 12A8 Weekly Total: 60:09 (60.15 Hours) .' Payroll Items from Schedule " items in red text are unpaid or belong to salaried employees. 8/15/2020 19-N Advanced REG 04:40 17:29 12:49 8/16/2020 19-N Advanced REG 04:40 17A4 12:34 8/18/2020 18 Advanced REG 04:40 14:29 09:49 8/19/2020 19-N Advanced REG 04:48 17:27 12:39 8/20/2020 19-N Advanced REG 04:42 17:00 12:18 * This timecard was never approved. Weekly Time&. Attendance Story, Philip 8/24/2020 04:40 MSeProTime07 8/24/202017:09 MSeProTirne07 12:29 Story, Philip 8/25/2020 04:41 MSeProTimeQ7 8/25/2020 17:30 MSeProTimeN 12:49 Story, Philip 8/26/2020 05:40 <Admin> 8/26/2020 20:30 <Admin> 14:50 Story, Philip 8/28/2020 05:45 <Admin> 8/28/2020 17:30 <Admin> 11:45 Weekly Total: 51:53 (51.88 Hours) Payroll Items from Schedule *hems in red text are unpoid or belong to salaried employees. 8/24/2020 19-N Advanced REG 04:40 17:09 12:29 8/25/2020 19-N Advanced REG 04:41 17:30 12:49 8/26/2020 M80-2 Advanced REG 05:40 20:30 14:50 8/28/2020 M80-1 Advanced REG 05:45 17:30 11:45 This timecard was approved on 8/30/2020 11:26:57 AM https://scheduling.esosuite.net/Detault.aspx?DB=medstar# 1/2 919/2020 EXHIBIT A Employee Timecard Detail https:llscheduting.esosuite.net/Default,aspx?DB=medstar# 2/2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** AT1242 900496 09r104r'20 62101 Rodney J. Marshall 3815 Byers Ave Fort Worth, TX 76107 Emp Id 900496 Loc SSN XXX-XX-2728 Hire Date Clock XXXX Status Voucher Date Voucher Number 09/04/2020 62101 Direct Deposit Advice Direct Deposit Amount OPS002 Period Begin 08/15/20 Net Pay 03/11/19 Period End 08/28/20 Dir Dep A Check Type Reg Total Gross Pay Hours Rate Current Arnt Ytd Hours Ytd Amt Regular Earnings 80.00 14.385900 1,150.88 1,366.07 19,543.77 Overtime 21.04 21.578850 454.02 245.74 5,257.58 DIFF PAY 46.43 4.000000 185.72 570.10 2,280.40 Holiday 0.00 0.00 15.13 214.11 SICK 0.00 0,00 36.00 517,99 12 Training Reg 0,00 0.00 4,03 57.98 VACATION 0.00 0.00 48.00 690.52 147.47 1,790.62 2,285.67 28,562.25 Taxes Status Taxable Current Amt Ytd Taxable Ytd Amt Federal Income Tax S-0 1,787,19 199.10 28,500.33 3,035.34 OASDI 1,787.18 110.80 28,500,33 1,767.02 Medicare 1,787.18 25.91 28,500.33 413.25 Medicare - Additional 1,787.18 0.00 28,500.33 0.00 Texas S1TW s0 1,797.18 0.00 28,500.33 0.00 335.81 5,215.61 Other Deductions from Pay Current Amt Yid Anit DENTAL 3.44 61,920 3.44 61.92 Bank Account Current Amt CHASE Ends with ***3492 1,45 L37 1,451,37 0 This code is not included in your Federai taxable wages. om icn� r oivaua�c r.mn,wvtr 1,451.37 1,451.37 Paynienfi LIr1lr�ary fQr Vowher. Total Gross Pay 1,790.62 Federal Taxes -335.81 State and Local Taxes 0,00 Other Deductions -3.44 Net Pay F7714..51.37 Direct Deposits -1,451.37 Net Check 00 Rdditional In. ormafian Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth. TX 76116 Time Off Balances Dollars 9/912020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > E:mployee,Timecard Detail Back Cost Center District All v All - v Employee Pay Period Week Output Format Marshall, Rodney! Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 V 1 & 2 V F [ :- Weekly Time & Attendance Marshall, Rodney 8/15/202016:20 ePro BioClock 8/16/2020 04:31 ePro BioClock 12:11 Marshall, Rodney 8/16/202016:15 ePro BioClock 8/17/2020 06:44 ePro BioClock 14:29 Marshall, Rodney 8/17/202017:46 ePro BioClock 8/18/2020 05:59 ePro BioClock 12:13 Marshall, Rodney 8/18/2020 17:40 ePro BioClock 8/19/202005:59 ePro BioClock 12:19 Weekly Total: 51:12 (51,20 Hours) Payroll Items from Schedule ' hems in red text are unpaid or belong to salaried employees, 8/15/2020 106 Basic REG 16:20 04:31 12:11 8/16/2020 105 Basic REG 16A5 06:44 14:29 8/17/2020 118 Basic REG 17:46 05:59 12:13 8/18/2020 118 Basic REG 17:40 05:59 12:19 This timecard was approved on 8/21/202011:33:38 PIM 'Meekly Time & Attendance Marshall, Rodney 8/22/202016:18 ePro BioClock 8/23/202004:28 ePro BioClock 12:10 Marshall, Rodney 8/23/202017:40 <Admin> 8/24/202006:17 ePro BioClock 12:37 Marshall, Rodney 8/26/2020 17:41 ePro BioClock 8/27/2020 06:06 ePro BioClock 12:25 Marshall, Rodney 8/27/2020 17:42 ePro BioClock 8/28/2020 06:20 ePro BioClock 12:38 Weekly Total: 49:50 (49.83 Hours) Payroll Items from Schedule ` items in red text are unpaid or belong to sulcrried employees. 8/22/2020 105 Basic REG 16:18 04:28 12:10 8/23/2020 118 Basic REG 17:40 06:17 12:37 8/26/2020 118 Basic REG 17A1 06:06 12:25 8/27/2020 118 Basic REG 17:42 06:20 12:38 ** This timecard was never approved. https:llscheduting.esosuite.net/Defauit.aspx?DB=medstar# 1/2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 29M ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** AZI242 036842 09.W-2U 61926 Ronald L. Moren 205 Arnold St Crowley, TX 76036 Emp Id 016842 Loc. SSN XXX-XX-1668 Hire Date Clock XXXX Status Voucher Date Voucher Number 09/04/2020 61826 Direct Deposit Advice Direct Deposit Amount CHP002 Period Begin 08/15/20 Net Pay 10/26/96 Period End 08/28/20 Dir Dep A Check Type Reg Total Gross Pay flours Rate Current Amt Ytd Hours Ytd Amt Regular Earnings 78,16 29.098300 2,273.54 1,381.15 40,175.31 Overtime 8,02 43,632450 349.93 511,07 22,299.27 E Training OT 0.00 0.00 4.00 174.53 RIFF PAY 34.18 4.000000 136.72 674.07 2,696.29 Group Term Life 0.00 3,09 0.00 55.11 Holiday 0.00 0.00 21.38 621.91 SICK 10.00 29.088300 290.88 10.00 290,88 12 Training Reg 0,00 0.00 6.00 174.53 VACATION 12,00 29,088300 349.06 120,00 3,49060 VACATION BUYBK 0.00 0,00 96,00 2,792.48 ER MATCH 0.00 226.89 0.00 4,084.020 142.36 3,403.21 2,823.67 72,770.90 Taxes Status Taxable Current Amt Ytd Taxable Ytd Amt Federal Income Tax S-0 3,171.60 503.68 68,60L92 11,395.24 OASDI 3,322,86 206.02 71,324.60 4,422.13 Medicare 3,322,86 49.19 71,324.60 1,034.21 Medicare - Additional 3,322.86 0.00 71,324.60 0.00 Texas S1TW 3,171.60 0.00 68,601.92 0.00 757.88 16,851.58 Other Deductions from Pay Current Amt Yid Amt 457 151.20 2,722.680 Accidental Death - Child 0.24 4.328 Accidental Death - Employee 1,13 20.340 CHILD SUPPORT 1 0.00 13,200.00 DENTAL 3.44 61.928 Group Term Life 3.09 55.11 HEALTH 57,68 1,038.248 CHILD LIFE L l 1 19.99 LIFE EMPLOYEE 13,15 236,70 Mutual Omaha Critical Illness 17.86 321.480 M W R 10.00 180.00 S.T. D 14.43 259.74 VISION 3.90 70.20 277.28 18,190.71 Ae c,o sm, rb 2,368.05 2,368.05 Payment S. QM fary for V.oucl er 61826 Total Gross Pay 3,403,21 Federal Taxes -757.88 State and Local Taxes 0.00 Other Deductions -277.28 Net Pay iig8,O5p Direct Deposits -2,368.05 Net Check Q0 '1 Additional I13farrrlatiort Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 Time Off Balances Dollars Bank Account Current Amt FORT WORTH CITY CL Ends with ***40W 300,00 919/2020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District -All- ................. �+ -All- .......................... `+ .. Employee Pay Period Week Output Format Moren, Ronald L Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 1 & 2 v 8 Weekly Time & Attendance Moren, Ronald 8/17/2020 17:43 ePro BioClock 8/18/2020 05:46 ePro BioClock 12:03 Moren, Ronald 8/18/2020 17:44 ePro BioClock 8/19/2020 05:39 ePro BioClock 11:55 Moren, Ronald 8/19/2020 17:57 ePro BioClock 8/20/2020 06:10 ePro BioClock 12:13 Moren, Ronald 8/21/2020 17:40 ePro BioClock 8/22/2020 05:30 ePro BioClock 11:50 Weekly Total: 48:01 (48.02 Hours) Payroll Items from Schedule * Iterns in red text are urnpaid or belong to salaried employees. 8/17/2020 206 CCP REG 17:43 05:46 12:03 8/18/2020 206 CCP REG 17:44 05:39 11:55 8/19/2020 206 CCP REG 17:57 06:10 12:13 8/21/2020 206 CCP REG 17:40 05:30 11:50 This timecard was never approved. Weekly Time & Attendance Moren, Ronald 8/22/2020 17:44 ePro BioClock 8/23/2020 05:48 ePro BioClock 12:04 Moren, Ronald 8/23/2020 17:43 <Admin> 8/24/2020 07:35 <Admin> 13:52 Moren, Ronald 8/26/2020 14:45 <Admin> 8/27/2020 02:58 <Admin> 12:13 Meekly Total: 38:09 (39,15 Hours) Payroll Items from Schedule * lten)s in red text are unpaid or belong to salarjed ernpfoyees. 8/22/2020 206 CCP REG 17:44 05:48 12:04 8/23/2020 206 CCP REG 17:43 07:35 13:52 8/25/2020 74 Sick UA 11:30 21:30 10:00 8/26/2020 206 CCP REG 14:45 02:58 12:13 8/27/2020 206 Vacation SA 18:00 06:00 12:00 * This timecard was never approved, http$71/scheduling.esosuite,net/Default,aspx?DB=medstar# 1/2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** A2t242 056092 04•.G120 61924 Tim L. Gattis 2944 Meandering Way Granbury, TX 76049 Emp Id 056092 Loc SSN XXX-XX-7905 Hire Date Clock XXXX Status Voucher Date Voucher Number 09/04/2020 61824 Direct Deposit Advice Direct Deposit Amount CHP002 Period Begin 08/15/20 Net Pay 10/26/09 Period E" 08/28/20 Dir Dep A Check Type Reg 3,369.19 3,369.19 arr nc s � rrlrnary Payment ulnrrla. y for lfqubber 69 24 Total Gross Pay Hours ]ate Current Anit Yid Hours Ytd Amt Regular Famings 80.00 29.139300 2,33IA4 1,430.56 41,685.50 Overtime 56.59 43.708950 2,473.49 1,090.57 47,667.72 E Training OT 0.00 0.00 3.30 144.24 DIFF PAY 34.45 4.000000 137.80 761.99 3,047.96 Group Term Life 0.00 3.08 0,00 55.11 Holiday 0,00 0,00 30.68 893.99 12 Training Reg 0.00 0.00 9A4 275.08 VACATION 0.00 0.00 24.00 699.34 VACATION BUYBK 0.00 0.00 120.00 3,496.72 ER MATCH 0.00 227,28 0.00 4,091.0,40 171.04 4,945.51 3,470.54 97,965.66 Taxes status Taxable Current Amt Ytd Taxable Ytd Amt Federal Income Tax M-1 4,263.22 476.99 85,68444 ]0,009.37 OASDI 4,414.74 273.71 88,411.80 5,4$1.53 Medicare 4,414.74 64,01 98,411.80 1,291.97 Medicare - Additional 4,414.74 0,00 88,411.80 0.00 Texas SITW 41263.22 0,00 85,684.44 0,00 814.71 16,772,87 Other Deductions from Pay Current Amt Ytd Amt 457 151.52 2,727.360 DENTAL 12,11 217,980 Group Term Life 3.08 55,11 HEALTH SAVINGS 230.77 4,153.860 HEALTH 238.16 4,286.880 LEGAL SHIELD 11.95 215.10 LIFE EMPLOYEE 33.91 608.58 LIFE SPOUSE 9.39 169.02 Mutual Omaha Accident 14.01 252.180 Mutual Omaha Critical Illness 35.72 6-42,960 S.T.D 14.43 259,74 VISION 6.66 119.88 761.61 13,708.65 Bank Account Current Amt TEXAS TRUST CREDIT Ends with"*7365 350.00 WASHFNGTON MUTUA Ends with ***5576 3,019.19 3,369.19 Total Gross Pay 4,945.51 Federal Taxes -814.71 State and Local Taxes 0.00 Other Deductions -761.61 Net Pay Lam- 3�6$,19 Direct Deposits-3,369.19 Net Check cl Additional information Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth. TX 76110 Time Off Balances Dollars Hours 9/9/2020 Employee Timecard Detail EXHIBIT A r%&>; Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center district -All - Ali - ................................. Employee Pay Period Week . ................... ................. Gattis, Tim L v Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 V 1 & 2 %" v Output Format Weekly Time & Attendance Gattis, Tim 8/15/2020 19:56 ePro BioClock 8/16/2020 07:40 ePro BioClock 11:44 Gattis, Tim 8/16/2020 17:59 ePro BioClock 8/17/2020 06:27 ePro BioClock 12:28 Gattis, Tim 8/17/202017:20 <Admin> 8/18/2020 05:33 MSeProTime07 12:13 Gattis, Tim 8/18/202017:27 MSeProTime07 8/19/2020 04:33 MSeProTime07 11:06 Gattis, Tim 8/19/202011:35 <Admin> 8/20/2020 00:38 ePro BioClock 13:03 Gattis, Tim 8/20/2020 17:58 ePro BioClock 8/21/2020 06:31 ePro MoClock 12:33 Weekly Total: 73:07 (73.12 Hours) Payroll Items from Schedule * tterns in red text are unpaid or belong to solaried employees. 8/15/2020 204 CCP REG 19:56 07:40 11:44 8/16/2020 204 CCP REG 17:59 06:27 12:28 8/17/2020 114-N Basic REG 17:20 05:33 12:13 8/18/2020 110-N Advanced REG 17:27 04:33 11:06 8/19/2020 204 CCP REG 11:35 00:38 13:03 8/20/2020 204 CCP REG 17:58 06:31 12:33 This timecard was never approved. Weekly Time & Attendance Gatos, Tim 8/24/2020 17:54 ePro BioClock 8/25/2020 06:36 ePro BioClock 12:42 Gatos, Tim 8/25/2020 17:59 ePro BioClock 8/26/2020 06:20 ePro BioClock 12:21 Gattis, Tim 8/26/202018:01 ePro BioClock 8/27/2020 06:23 ePro BioClock 12:22 Gatos, Tim 8/27/202017:55 ePro BioClock 9/28/2020 07:16 ePro NoClock 13:21 Gattis, Tim 8/28/202017:59 ePro BioClock 8/29/2020 06:41 ePro BioClock 12:42 Weekly Total: 63:28 (63.47 Hours) Payroll Items from Schedule Reins in red text ore unpaid or be?oncy to salaried ernpioyees. 8/24/2020 204 CCP REG 17:54 06:36 12:42 8/25/2020 204 CCP REG 17:59 06:20 12:21 8/26/2020 204 CCP REG 18:01 06:23 12:22 https:llscheduling.esosuite.netlDefault.aspx?DB=medstar#k MA, 91972020 E """8A27/2020 206 CCP 8///28/2020 204 CCP Employee Timecard Detail REG 17:55 07:16 13:21 REG 17:59 06:41 12:42 This timecard was never approved. https:ilsr-heduling.esosuite.neVOefauit.aspx?DB=medstar# 2/2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** AM42 036792 09404,10 62020 Ruben B. Cisneros 6152 Bullhead Dr. Fort Worth, TX 76179 Emp Id 036792 Loc SSN XXX-XX-8860 Hire Date Clock XXXX Status Voucher Date Voucher Number 09/04/2020 62020 Direct Deposit Advice Direct Deposit Amount OPS002 Period Begin 08/15/20 Net Pay 08/19/98 Period End 08/28/20 Dir Dep A Check Type Merit - p q v mfWl I .kp,Ps,r 668.80 668.80 I arttngstilmrary Payment Sumaaly for Uotacier 6220 Total Gross Pay Hours Rate Currant Amt Ytd Hours Ytd Amt Regular Earnings 0.00 0.00 1,417.14 38,616.98 Overtime 0.00 0.00 76L97 31,145.50 DIFF PAY 0.00 0.00 322,29 1,289.16 Group Term Life 0.00 0.00 0.00 253.26 Holiday 0.00 0.00 30.64 834.93 Merit Raise 0.00 773.68 0.00 876.30 SICK 0.00 0.00 55.90 1,523,28 12 Training Reg. 0.00 0.00 4.00 109.00 VACATION 0.00 0.00 32,45 894.26 ER MATCH 0.00 0.00 0,00 3,825.900 0.00 773.68 2,624.39 75,532.67 Taxes Status Taxable Current Aint Ytd Taxable` Yid Amt Federal Income Tax S-0 773.69 45.70 62,677.97 10,229.05 OASDI 773.68 47.97 65,228.57 4,044.17 Medicare 773.68 11.21 65,228.57 945.81 Medicare - Additional 773.68 0.00 65,228.57 0.00 Texas SITW 773.09 0,00 62,677.97 0,00 104.88 15,219.03 Other Deductions from Pay Current Amt Yid Ant 457 0.00 2,550.600 DENTAL 0.00 479.620 Group Term Life 0,00 253.26 HEALTH SAVINGS 0.00 3,600.000 HEALTH 0.00 5,942.080 LEGAL SHIELD 0.00 132.48 CHILD LIFE 0.00 19.98 LIFE EMPLOYEE 0.00 1,293.66 LIFE SPOUSE 0,00 202.86 Mutual Omaha Accident 0.00 383.400 M W R 0.00 90.00 S.T.D 0.00 259.74 VISION 0,00 179.02 0.00 15,284,70 Total Gross Pay 773.68 Federal Taxes -104.88 State and Local Taxes 0.00 Other Deductions 0.00 Net Pay 668.$0 Direct Deposits-668.80 Net Check Additional Information ......... . Comnanv Address METROPOLITAN Area EMS Authority Medsiar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 761 16 Time Off Balances Dollars Hours Bank Account Current Amt WELLS FARGO BANK Ends with ***6840 608.90 9/9/2020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All- -All- V Employee Pay Period Week Output Format Cisneros, Ruben B v Pay Period 19, 2020 : 8/15/2020 - 8/28/2020 V 1 & 2 Weekly Time Attendance Cisneros, Ruben 8/17/2020 05:36 ePro BioClock 8/17/2020 18:16 ePro BioCiock 12:40 Cisneros, Ruben 8/18/2020 05:38 ePro BioClock 8/18/2020 17:44 ePro BioClock 12:06 Cisneros, Ruben 8/19/2020 05:32 ePro BioClock 8/19/2020 19:12 ePro BioClock 13:40 Cisneros, Ruben 8/20/2020 05:29 ePro BioClock 8/20/202017:57 ePro BioClock 12:28 Weekly Total: 50:54 (50.90 Hours) Payroll Items from Schedule " Items in red text ore unpofd or belong to salaried employees. 8/17/2020 28 Advanced REG 05:36 18:16 12:40 8/18/2020 28 Advanced REG 05:38 17:44 12:06 8/19/2020 28 Advanced REG 05:32 19:12 13:40 8/20/2020 28 Advanced REG 05:29 1757 12:28 ** This timecard was never approved. Weekly Time & Attendance Cisneros, Ruben 8/22/2020 15:42 ePro BioClock 8/23/2020 00:21 ePro BioClock 08:39 Cisneros, Ruben 8/24/2020 05:25 ePro BioClock 8/24/2020 23:41 ePro BioClock 18:16 Cisneros, Ruben 8/26/2020 05:30 ePro BioClock 8/26/2020 18:41 ePro BioClock 13:11 Cisneros, Ruben 8/27/2020 05:25 ePro BioClock 8/27/2020 23,50 ePro BioClock 18:25 Cisneros, Ruben 8/28/202017:55 ePro BioClock 8/29/202000:58 ePro BioClock 07:03 Weekly Total: 65:34 (65.57 Hours) Payroll Items from Schedule Items in red text ore unpaid or belong to saiaripd employees. 8/22/2020 114-N Advanced REG 15:42 00:21 08:39 8/24/2020 28 Advanced REG 05:25 23:41 18:16 8/25/2020 FMLA-SF LWOP EMLA 05:45 17A5 12:00 8/26/2020 28 Advanced REG 05:30 18:41 13:11 8/27/2020 28 Advanced REG 05:25 17:45 12:20 8/27/2020 94 Advanced REG 17:45 23:50 06:05 8/28/2020 113-N Advanced REG 17:55 00:58 07:03 https:/lscheduling.esosuite.neUDefautt.aspx?DB=medstar# 1/2 9/9/2020 Employee Timecard Detail EXHIBIT A * This timecard was never approved. https:llscheduling.esosuite.neVDefauit.aspx?DB=medstar# 2/2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** Voucher Date Voucher Plumber 09/04/2020 61954 Direct Deposit Advice Emp Id 900272 Loc NOPS02 Period Begin 08/15/20 Net Pay 1,240.69 SSN XXX-XX-8939 Hire Date 051011I7 Period End 08/28/20 Dir Dep 1,240.69 Clock X3CXX Status A Check Type Reg 1=arrins Stmrary Paymlert Summary for Voucher 61954 Total Gross Pay Hours Efate Current Amt Yid Hours Ytd Amt Regular Earnings 78,11 15.196100 1,186.97 1,307,68 19,671,10 Overtime 10.24 22.794150 233.41 151.60 3,422.78 RIFF PAY 34,95 4.000000 139.80 572.72 2,290.88 Holiday 0.00 0,00 17.88 268.89 SICK 0.00 0.00 60.00 900.50 12 Training Reg 0.00 0.00 4.30 65.34 VACATION 0.00 0.00 48.00 714.40 123.30 1,560,18 2,162.18 27,335.99 Taxes Status Taxable Current Anit Ytd Taxable Ytd Amt Federal Income Tax Shc 1,546.98 160,50 27,098.29 2,799.35 OASDI 1,546.98 95.91 27,098.29 1,690.09 Medicare 1,546.99 2244 27,099.29 392.93 Medicare - Additional 1,546.98 0.00 27,098.29 0.00 Texas SITW s0 1,546.98 0.00 27,098.29 OAO 278.85 4,872-37 Other Deductions from Pay Current Amt Ytd Amt DENTAL 3.44 61920 LEGAL SHIELD 5.98 107.64 Mutual Omaha Accident 9.76 175.690 MWR 10.00 180.00 S.T.D 7.56 136.08 VISION 3.90 70.20 40.64 731.52 Bank Account Current Anit FORT WORTH COMML Ends with "*5359 1,240.69 1,240.69 0 This code is not included in your Federal taxable wages. Total Gross Pay 1,560.18 Federal Taxes -278.85 State and Local Taxes 0.00 Other Deductions 40.64 Net Pay . ? 14240 69 Direct Deposits-1,240.69 Net Check L. '0.00 Addifional Irlforma. ion Comlaanv Address METROPOLITAN Area EMS Authority Medstar EMS 29W ALTA MERE DRIVE, Fort Worth, TX 76116 Time Off Balances Dollars Hours 9/9/2020 Employee Timecard Detail EXHIBIT A yCO �.j Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All- AII- v Employee Pay Period Week Output Format Olivarez, Breanna v Pa Period 19, 2020 : 8 15 2020 - 8/28/2020 y / / `� 1 & 2 v �.. (] ,,.; ;• ... .......................... . Weekly Time & Attendance Olivarez, Breanna 8/15/202017:18 MSeProTime07 8/16/2020 05:34 MSeProTime07 12:16 Olivarez, Breanna 8/16/202017J0 MSeProTime07 8/17/2020 06:17 MSeProTime07 13:07 Olivarez, Breanna 8/19/202017:23 MSeProTime07 8/20/2020 05:22 MSeProTime07 11:59 Olivarez, Breanna 8/20/2020 17:10 MSeProTime07 8/21/2020 06:02 MSeProTime07 12:52 Weekly Total: 50:14 (50.23 Hours) , Payroll items from Schedule * items m red Gext are unpoid or belong to soforied employees. 8/15/2020 113-N Basic REG 17:18 05:34 12:16 8/16/2020 113-N Basic REG 17:10 06:17 13:07 8/19/2020 113-N Basic REG 17:23 05:22 1159 8/20/2020 113-N Basic REG 17:10 06:02 12:52 ** This Timecard was never approved. Weekly Time & Attendance Olivarez, Breanna 8/24/2020 17:24 MSeProTime07 8/25/2020 06:02 MSeProTime07 12:38 Olivarez, Breanna 8/25/202017:12 MSeProTime07 8/26/2020 06:50 MSeProTime07 13:38 Olivarez, Breanna 8/28/202017:10 <Admin> 8/29/2020 05:01 MSeProTime07 11:51 Meekly Total: 38:07 (38.12 Hours) Payroll Items from Schedule ' Items in red text are unpaid or belong to sa7orfed employees 8/24/2020 113-N Basic REG 17:24 06:02 12:38 9/25/2020 113-N Basic REG 17:12 06:50 13:38 8/28/2020 113-N Basic REG 17:10 05:01 11:51 * This timecard was never approved. https:/Ischeduling.esosuite.net/Default,aspx?DB=medstar# 111 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** Azt242 900403 09,11920 52435 ALLYSON R. Roberson 1517 GREENWOOD DR DENTON, TX 76209 Voucher Date Voucher Number 09/18/2020 62435 Direct Deposit Advice Direct Deposit Amount ****** 1,290.23 M Ob 6T.11_V 929G2�H cmH ryw}�aryv ALI-YSON R. Roberson Sel�emer 18, ZD2 6245 Emp Id 900403 Loc NOPS02 Period Begin 08/29/20 Net Pay 1,290.23 SSN XXX-XX-7001 Hire Date 06/11/18 Period End 09/11/20 Dir Dep 1,290.23 Clock XXXX Status A Check Type Reg Earrings 5urnmar+ Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Antt Regular Earnings 78.29 14.817500 1,160.07 1,416,22 20,706.93 Overtime 10.51 22.226250 233.60 175.73 3,858.99 DIFF PAY 26,27 4.000000 105.09 465.81 1,863.24 Holiday 6.29 14.8t7500 93.20 15.99 235.83 12 Training Reg 0,00 0.00 6.40 94.23 VACATION 0.00 0.00 57.52 845,74 Molt # 1,591.95 2,137.67 27,604.86 Taxes Status Taxable Current Amt Ytd Taxable Ytd Atnt Federal lneomeTax S0 1,588,51 165.49 27,539.50 2,827.16 OASDI 1,598.51 98.49 27,539.50 1,707,45 Medicare 1,588.51 23.03 27,539.50 399,32 Medicare - Additional 1,588.51 0.00 27,539.50 0.00 Texas SITW SO 1,598.51 0.00 27,539.50 0.00 287.01 4,933.93 Other Deductions from Pay Current Amt Ytd Amt DENTAL 3.44 65.360 S.T.D 7.37 140,03 VISION 3.90 74.10 14.71 279.49 ©rest ©eposits' Bank Aowunt Current Anil DATCU CREDIT UNIOT Ends with ***8615 1,290.23 1,290,23 0 This code is not included in your Federal taxable wages. Total Gross Pay 1,591.95 Federal Taxes -287.01 State and Local Taxes 0.00 Other Deductions -14.71 Net Pay 90.23 Direct Deposits -1,290.23 Net Check Company Address METROPOLITAN Arta EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 Time Off Balances Dollars Hours 919/2020 Employee Timecard Detail ,EXHIBIT A y - Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All- .................................. v All- Employee Pay Period Week Output Format Roberson, Allyson R '+ Pay Period 20, 2020 : 8/29/2020 - 9/11/2020 v 1 & 2 V O-Ljj 0 Weekly Time & Attendance Roberson, Allyson 8/29/2020 04:45 MSeProTime07 8/29/2020 17:22 MSeProTime07 12:37 Roberson, Allyson 8/30/2020 04:40 MSeProTime07 8/30/2020 17:11 MSeProTirne07 12:31 Roberson, Allyson 9/2/2020 04:41 MSeProT!me07 9/2/2020 17:47 MSeProTime07 13:06 Roberson, Allyson 9/3/2020 04:43 MSeProTime07 9/3/2020 16:59 MSeProTime07 12:16 Weekly Total: 50:30 (50.50 Hours) Payroll Items from Schedule * Iterns in red text ore unpaid at- belong to salaried employees. 8/29/2020 Adminl Basic REG 04:45 17:22 12:37 8/30/2020 Extral-N Basic REG 04:40 17:11 12:31 9/2/2020 COVID-19Admin Basic REG 04:41 17A7 13:06 9/3/2020 19-N Basic REG 04:43 16:59 12:16 ** This timecard was never approved. Meekly Time & Attendance Roberson, Allyson 9/7/2020 04:42 M5eProTime07 9/7/2020 17:17 MSePraTime07 12:35 Roberson, Allyson 9/8/2020 04:42 MSeProTime07 9/8/2020 16:59 MSeProTime07 12:17 Weekly Total: 24:52 (24.87 Hours) Payroll Items from Schedule ` Items in red text care unpaid or belong to salaried €mpluvee s. 9/7/2020 19-N Basic REG 04A2 17:17 12:35 9/8/2020 19-N Basic REG 04:42 16:59 12:17 9/11/2020 19-N Basic REG 05:00 17:00 12:00 "* This timecard was never approved. https://scheduting.esosuite.net/Default.aspx?DB=medstar# 1/1 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 29W ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** A71242 09,26t 09d920 h2342 Briley A. White 2544 Grey Kingbird Trl, Fort Worth. TX 76244 Emp Id 056261 Loc SSN XXX-XX4102 Hire Date Clock XXXX Status Voucher Date Voucher Number 09/18/2020 62392 Direct Deposit Advice Direct Deposit Amount NOPS01 Period Begin 06/06/11 Period End A Check Type fralrlgs symmary Total Gross Pay Hours Rutc Current Anit Ytd Hours Ytd Amt Regular Earnings 78,02 33.504900 2,614.05 1,344.24 44,444,98 Overtime 12.20 50.257350 613.14 209.31 10,397.75 DIFF PAY 30.84 4.000000 147.36 57i.12 2,294.48 Group Term Life 0.00 0.96 0.00 18.24 Holiday 2.92 33.504900 97.83 23.71 780.08 SICK OAo 0,00 12.00 393.79 12 Training Reg 0.00 0,00 4.00 134.02 VACATION 0.00 0.00 168.00 5,562.68 ER MATCH 0.06 22L13 0.00 4,146.870 F#04 3,473.34 2,332.38 64,016.02 Taxes Status Taxable Current Amt Ytd Taxable Ytd Am( Federal Income Tax S-1 3,235.31 481.3E 59,537.[3 8,734.88 OASDI 3,412.22 211.55 62,854.74 3,896.99 Medicare 3,412.22 49A7 62,854.74 91139 Medicare - Additional 3,412,22 0.00 62,954.74 0.00 Texas SITW 3,235.31 0.00 59,53T 13 0A0 742.33 13,543.26 Other Deductions from Pay Current Ant Yid Amt 457 176.91 3,317.610 DENTAL 3.44 65.360 Group Term Life 0.96 18.24 HEALTH 57.08 1,095.920 V[S[ON 3.90 74.10 242.89 4,571.23 Bank Account Current Arnt EECU Ends with '9950 2,488,12 2,488.12 0 This code is shown for infomation only. It has no effect on your net pay. 4 This code is not included in your Federal taxable wages. 08/29/20 Net Pay 09/11120 Dir Dep Reg Total Gross Pay Federal Taxes State and Local Taxes Other Deductions Net Pay Direct Deposits Net Check ****** 2,488.12 Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE, DRIVE Fort Worth, TX 76116 Y ­0 � M. gPyY 2,488.12 2,498.12 3,473.34 -742.33 0.00 -242.89 -2,488.12 Time Off Balances Dollars Hours 9/9/2020 Employee Timecard Detail EXHIBIT A . k Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District -All- v - All - v Employee Pay Period Week Output Format White, Briley A Pay Period 20, 2020 : 8/29/2020 - 9/11/2020 V I & 2 � a :: () Weekly Time & Attendance White, Briley 8/31/202016:34 MSeProTime07 9/1/2020 04:59 MSeProTime07 12:25 White, Briley 9/1/2020 16:51 <Admin> 9/2/2020 05,30 <Admin> 12:39 White, Briley 9/4/202016:52 MSeProTime07 9/5/202005:49 MSeProTimeW 1M7 Weekly Total: 38:01 (38.02 Hours) Payroll Items from Schedule ` Items in red text ore unpaid or belong to salaried employees. 8/31/2020 M80EN1-N FieldOpsSup REG 16:34 04:59 12:25 9/1/2020 M80EN1-N FieldOpsSup REG 16:51 05:30 12:39 9/4/2020 M80ENI-N FieldOpsSup REG 16.52 05:49 12:57 * This timecard was never approved. Weekly Time & Attendance White, Briley 9/5/202016A4 MSeProTimeW 9/6/202005:30 MSeProTime07 12:46 White, Briley 9/6/202016:45 MSeProTime07 9/7/2020 05:51 MSeProTime07 13:06 Weekly Total. 25:52 (25.87 Hours) Payroll Items from Schedule iteans in red text are unpaid or belong to salaried en?oloyees. 9/5/2020 M80EN1-N FieldOpsSup REG 16A4 05:30 12:46 9/6/2020 M80EN1-N FieldOpsSup REG 16:45 05:51 13:06 9/9/2020 M80EN1-N FieldOpsSup REG 17:00 05:00 12:00 9/10/2020 M80EN1-N FieldOps5up REG 17:00 05:00 12:00 This timecard was never approved. https:l/scheduling.esosuite.net/Default.aspx?DB=medstar# 3I EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** - - AzI242 9W369 U9:1a:20 63533 Dakotah P. Guess 7024 W Parkhaven Dr. Apt 618 Fort Worth, TX 76137 71 Emp Id 900369 Loc SSN XXX-XX-8608 Hire Date Clock XXXX Status Voucher Date 'Voucher Nuntber 09/18/2020 62533 Direct Deposit Advice Direct Deposit Amount OPS002 Period Begin 02/12/18 Period End A Check Type Earnings Summary Total Gross Pay Hours ]tore Current Amt Ytd Hours Ytd Amt Regular Urnings 75.97 19.735900 1,499.33 1,492.52 29,359.89 Overtime 0.00 0.00 288.06 8,493A5 E Training OT 0.00 0.00 4.59 135.89 COURT TIME 0.00 0.00 L17 23.09 RIFF PAY 36.06 4.000000 144.24 801.08 3,204.32 Group Tenn Life 0.00 0.09 0.00 1.38 Holiday 0.00 0.00 20.78 404.44 SICK 20.66 19.735900 407.74 101.23 1,997.86 12 Training Reg 0.00 0.00 2.51 49.54 VACATION 3.34 19.735900 65,92 39.34 776.41 1##### 2,117.32 2,751.28 44,445.87 Taxes Status Taxable Current Amt Yid Taxable Ytd Anit Federal Income Tax S-0 2,077.81 263.04 43,695.18 5,925.47 OASDI 2,077.81 128.82 43,695.19 2,709.10 Medicare 2,077.81 30.13 43,695.18 633.58 Medicare - Additional 2,077.81 0.00 43,695.18 0A0 Texas SITW SO 2,077.81 0.00 43,695.19 0,00 42199 9,268.15 Other Deductions from Pay Current Amt Ytd Anrr DENTAL 3.44 65.360 Group Temi Life 0.09 1.39 HEALTH 24.00 456.000 LEGAL SHIELD 7.36 139.84 LIFE EMPLOYEE 4.57 96.83 Mutual Omaha Accident 9.70 18S.440 Murual Omaha Critical Illness 2.31 43,890 M W R 10.00 190.00 VISION 3.90 74.10 65.43 1,242.84 = C)i:reCt DepO5ltSs Bank Account Current Arm CHASE Ends with'*'8767 1,629.90 1,629.90 08/29/20 Net Pay 09/11/20 Dir Dep Reg Total Gross Pay Federal Taxes State and Local Taxes Other Deductions Net Pay Direct Deposits Net Check ****** 1,629,90 Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE. Fort Worth, TX 76116 1,629.90 1,629.90 2,117.32 -421.99 0.00 -65.43 -1,629.90 Time Off Balances Dollars Hours 0 This code is not included in your Federal taxable wages 9/9/2020 Employee Timecard Detail EXHIBIT A =, Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District -All- v All- ............. . . ................ v ......... Employee Pay Period Week Output Format Guess, Dakotan v Pay Period 20, 2020 : 8/29/2020 - 9/11/2020 V 1 & 2 V 0 Meekly Time & Attendance Guess, Dakotah 8/29/202016:44 MSeProTime07 8/30/202005:18 MSeProTime07 12.34 Guess, Dakotan 8/30/202016:47 MSeProTime07 8/31/202004:45 MSeProTime07 11:58 Guess, Dakotah 9/3/2020 14:10 ePro BioClock 9/4/2020 04:15 ePro BioClock 14:05 Weekly Total. 38:37 (38.62 Hours) Payroll Items from Schedule * Items in red text are unpaid or belong to salaried employees. 8/29/2020 Extral-N Advanced REG 16:44 05:18 12:34 8/30/2020 Extral-N Advanced REG 16:47 04:45 11:58 9/2/2020 90 Sick UA 14:30 02:30 12:00 9/3/2020 90 Advanced REG 14:10 04:15 14:05 * This timecard was never approved. Payroll Items from Schedule 9/5/2020 90 Advanced 9/6/2020 90 Sick - No Pay 9/9/2020 90 Advanced 9/10/2020 90 Advanced ms In red text are unpaid or belong to salaried employees REG 14:12 02:28 12:16 UA 14:30 02:30 12:00 REG 14:30 02:30 12:00 REG 14:30 02:30 12:00 * This tirecard was never approved. httpsl/scheduling.esosuite.net/Default.aspx?DB=medstar# 1F1 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 29W ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** AZ1212 034902 0908.20 62400 George R. Church 1400 N State Hwy 360 Apt 1527 Mansfield, TX 76063 Voucher Date Voucher Number 09/I W2020 62400 Direct Deposit Advice Direct Deposit Amount Emp Id 036902 Loc NOPS02 Period Begin 08/29/20 Net Pay SSN XXX-XX-7182 Hire Date 05/07/90 Period End 09/11/20 Dir Dep Clock XXXX Status A Check Type Reg Total Gross Pay Hours Rate Current Amt Ytd Hours Yid Amt Regular Earnings 77,85 28,835700 2,244.86 1,499.38 42,814.15 Overtime 27.86 43.253550 1,205.04 558,91 23,915.96 DIFF PAY 24.45 4.000000 97.80 513.47 2,053.88 GIFT CARDS 0.00 0.00 0.00 1,000.00 Group Term Life 0.00 3.18 0.00 56.82 Holiday 0.00 0.00 16.34 1,033.72 SICK 0.00 0.00 22.67 646.59 12 Training Reg 0.00 0.00 5.50 157.70 VACATION 0.00 0.00 12.00 338.91 VACATION BUYBK 0.00 0.00 132.00 3,781,40 ER MATCH 0.06 190.32 0.00 3,580.800 tm"# 3,550.88 2,780.27 75,799.13 Taxes Status Taxable Current Amt V td Taxable Ytd Amt Federal Income Tax S-1 3,252.18 485.02 70,147.32 10,429.22 OASDI 3,379.06 209.50 72,534,55 4,497.14 Medicare 3,379.06 49.00 72,534.55 1,051.75 Medicare - Additional 3,379.06 0.00 72,534,55 0.00 Texas SITW 3,252.18 0.00 70,147.32 0.00 743.52 15,978.11 Other Deductions from Pay _ Current Amt Yid Amt 457 € 26.88 2,387.230 CHILD SUPPORT 1 798.07 15,163.33 DENTAL 3.44 65.360 GIFT CARDS 0.00 1,0010.00 Group Term Life 3.18 56.82 HEALTH SAVINGS 134.62 2,557,780 HEALTH 24.00 456.000 Mutual Omaha Accident 9,76 185.440 S.T.D 14A3 272.73 VISION 3,90 74.10 1,118.28 22,218.79 L ' ect Deposits;; Bank _ Account Current Arar Green Dot Bank Ends with'*'8158 500.00 BANK OF AMERICA N., Ends with'4230 1,089.08 Arnerican Express Centuri, Ends with'*'0444 100.00 1,689.08 ****** 1,699.08 -vale.m r-¢ K ^�n,�w.e,vn^' 1,689.08 1,689.08 Total Gross Pay 3,550.88 Federal Taxes -743.52 State and Local Taxes 0.00 Other Deductions -1,118.28 Net Pay ,� 1A9r08 Direct Deposits-1,689.09 Net Check ompany Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 Time Off Balances Dollars Hours 919/2020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All v - All - v Employee Pay Period Week Output Format Church, George R v Pay Period 20, 2020 : 8/29/2020 - 9/11/2020 V 1 & 2 Weekly Time Attendance Church, George 8/31/2020 04:46 <Admin> 8/31/202018:09 MSeProTime07 13:23 Church, George 9/1/202004:47 MSeProTime07 9/1/202017:11 MSeProTime07 12:24 Church, George 9/4/2020 04:46 M5eProTime07 9/4/2020 16:50 MSeProTime07 12:04 Weekly Total: 37:51 (37.85 Hours) Payroll Items from Schedule * items in red text are unpaid or belong to salaried employees. 8/31/2020 20-N Advanced REG 04:46 18:09 1123 9/1/2020 M80ED1-N FieldOpsSup REG 04:47 17:11 12:24 9/4/2020 47 Advanced REG 04:46 16:50 12:04 * This timecard was never approved. Weekly Time & Attendance Church, George 9/5/2020 04:41 MSeProTime07 9/5/202016:51 MSeProTime07 12:10 Church, George 9/6/2020 04:41 MSeProTirne07 9/6/202016:58 MSeProTime07 12:17 Church, George 9/8/2020 04:47 ePro BioClock 9/8/202013:51 ePro BioClock 09:04 Church, George 9/9/2020 04:48 MSeProTime07 Missiog Punch Weekly Total: 33:31 (33.52 Hours) Payroll Items from Schedule * iterns in red text ore unpaid or belong to soloried employees. 9/5/2020 20-N Advanced REG 04:41 16:51 12:10 9/6/2020 20-N Advanced REG 04:41 16:58 12:17 9/8/2020 18 Advanced REG 04:47 13:51 M04 9/9/2020 20-N Advanced REG 05:00 17:00 12M 9/10/2020 20-N Advanced REG 05:00 17:00 12:00 9/11/2020 18 Advanced REG 05:00 14:00 09:00 * This tlrnecard was Never approved. https://scheduling.esosuite.net/Default.aspx?DB=medstar# 1/2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** AZ1242 9M3 0911902O 62537 Matthew K. Hansen 1164 Harrison Ln Hurst, TX 76053 Voucher Date Voucher Number 09/18/2020 62537 Direct Deposit Advice Direct Deposit Amount Emp Id 56663 Loc 01PS002 Period Begin 08/29/20 Net Pay SSN XXX-XX-9183 Hire Date 11/02/15 Period End 09/11/20 Dir Dep Clock XXXX Status A Check Type Reg Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Amt Regular Earnings 78.75 23.340100 1,838.04 1,347.40 31,448AS Overtire 20.04 35.010150 701.61 245.52 8,595.71 E Training OT 0.00 0.00 1.83 64.07 DIFF PAY 26.08 4.000000 104.32 453,64 1,814.56 Group Tern) Life 0.00 0.28 0.00 5.11 Holiday 0,00 0.00 15,83 369.47 SICK 0,00 0.00 24.00 560.16 12 Training Reg 0.00 0.00 4,83 112.73 VACATION 0.00 0.00 144.00 3,360.96 ER MATCH 0.00 154.04 0.00 2,926.760 k#"## 2,644.25 2,237.05 46,331.22 Taxes Status Taxable Current Art Ytd Taxable Ytd Amt Federal Incore Tax M-4 1,989.05 89.19 33,882.42 1,292.99 OASDI 2,194.44 136.06 37,784.83 2,342.66 Medicare 2,194.44 31.82 37,784.93 547.88 Medicare - Additional 2,194,44 0,00 37,784.83 0.00 Texas SITW 1,989.05 0.00 33,882.42 0.00 Other Deductions from Pay 257.07 Current Art 4,183.53 Ytd A,nt 457 205.39 3,902.410 DENTAL 2659 505.210 Group Term Life 0.28 5.11 HEALTH 423.22 8,041.180 CHILD LIFE 1.1 1 21.09 LIFE EMPLOYEE. 16.96 322.24 LIFE SPOUSE 3.99 75.81 S.T.D 11.86 224.62 VISION 9.99 187.91 699,29 13,285.58 Bank Account Current Art USAA FEDERAL SAVIN Ends with ***6524 1,687.89 1,687,89 O This code is shown for infonnation only. It has no effect on your net pay. * This code is not included in your Federal taxable wages. Total Gross Pay Federal Taxes State and Local Taxes Other Deductions Net Pay Direct Deposits Net Check ****** 1,687.89 carrt2on -n�o u.,cy„r 1,687.89 1,687.89 2,644.25 -257.07 0.00 -699.29 -1,687.89 Company Address i METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVF Fort Worth. TX 76116 Time Off Balances Dollars Hours 9/9/2020 Employee Timecard Detail EXHIBIT A k Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District All - v - All - ............... .... . Employee Pay Period Week Output Format ......................... Hansen, Matthew ..... . Pay Period 20, 2020 : 8/29/2020 - 9/11/2020 1+ 1 & 2 Vg Weekly Time & Attendance Hansen, Matthew 8/31/2020 06:40 ePro BioClock 8/31/202019:36 ePro BioClock 12:56 Hansen, Matthew 9/1/2020 06:48 ePro BioClock 9/1/2020 19:45 ePro BioClock 12:57 Hansen, Matthew 9/4/2020 05:41 ePro BioClock 9/4/2020 18:33 ePro BioClock 12:52 Weekly Total. 38:45 (38.75 Hours) Payroll Items from Schedule * Items in red text are unpaid or belong to salaried employees. 8/31/2020 M80-1 Advanced REG 06:40 19:36 12:56 9/1/2020 M80-1 Advanced REG 06:48 19:45 12:57 9/4/2020 30 Advanced REG 05:41 18:33 12:52 * This timecard was never approved:. Meekly Time & Attendance Hansen, Matthew 9/5/2020 05:44 ePro BioClock 9/5/2020 17:59 ePro BioClock 12:15 Hansen, Matthew 9/6/2020 05:40 ePro BioClock 9/6/202017:57 ePro BioClock 12:17 Hansen, Matthew 9/8/2020 06:15 ePro BioClock 9/8/202017:05 ePro BioClock 10:50 Hansen, Matthew 9/9/2020 05:43 ePro BioClock Missing Punch Weekly 35:22 (35.37 Hours) Payroll Items from Schedule ' items in red text are unpofd or belong to saioried employees. 9/5/2020 30 Advanced REG 05:44 17:59 12:15 9/6/2020 30 Advanced REG 05:40 17:57 12:17 9/8/2020 Misc Advanced REG 06:30 18:30 12:00 9/9/2020 30 Advanced REG 06:00 18:00 12:00 9/10/2020 30 Advanced REG 06:00 18:00 12:00 ** This timecard was never approved. https:/Ischeduling.esosuite.not/Default,aspx?DB=medstar## 1/2 EXHIBIT A METROPOLITAN Area EMS Authority, Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** AZ1242 055"7 &)-18-'20 624Q Philip B. Story 4533 Grainland Cl Fort Worth, TX 76179 Voucher Date Voucher Number 09/18/2020 62442 Direct Deposit Advice Direct Deposit Amount ****** 1,982,85 ,� o.c nnc • ao.a��.=,a..RsmPw Pttlllp ,f3, S#oly epl. b:ec 18, 20 0 69442 Emp Id 055907 Loi NOPS02 Period Begin 08/29/20 Net Pay 1.982.85 SSN XXX-XX-0046 Hire Date 10/15107 Period End 09/11/20 Dir Dep 1,982.85 Clock XXXX Status A Check Type Reg Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Amt Regular Earnings 78.39 25.974200 2,036.11 1,474,75 38,305.46 Overlime 20.61 38.961300 803.00 460.37 17,936.63 DIFF PAY 20,68 4.000000 106.72 456.37 1,825.48 Group Tern? Life 0.00 0.37 0,00 T03 Holiday 6.31 25.974200 163.90 24,81 644.42 SICK 0,00 0.00 72.00 1,870.14 12 Training Reg 0.00 0.00 4.00 103.90 VACATION 0.00 0.00 48,00 1,246.76 ER MATCH 0.00 171.43 0,00 3,257.170 a##### 3,110.10 2,540.30 61,939.82 Taxes Status Taxable Curren[ Amt Yid Taxable Ytd Amt Federal Income Tax M-2 2,394.66 177,55 50,746.46 4,003.24 OASDi 2,508,95 155.55 52,917.97 3,280.91 Medicare 2,508.95 36,38 52,917.97 767.31 Medicare - Additional 2,508.95 0,00 52,917.97 0.00 Texas SITW 2,394.66 0.00 50,746.46 0,00 369.48 8,05L46 Other Deductions from Pay Current Air)( Yid Atnt 457 114,29 2,171.510 DENTAL 26.59 505.210 Group Tenn Life 0.37 7.03 HEALTH SAVINGS 250.00 2,350.000 HEALTH 324.56 0,166.646 CHILD LIFE 1.11 21.09 LIFE EMPLOYEE 5.54 105.26 LIFE SPOUSE 2.22 42.19 MWR 10.00 190.m S.T.D 13.20 249.99 VISION 9,89 187.91 757.77 11,996.82 Bank Account Current Amt UNITY ONE CREDIT Ur lands with' 1467 1,982.85 1,982.85 O This code is shown for information only. It has no effect on your net pay. f3 This code is not included in your Federal taxable wages. Total Gross Pay 3,110.10 Federal Taxes -369.48 State and Local Taxes 0.00 Other Deductions -757.77 Net Pay 10.81.85 Direct Deposits -1,982.85 Net Check F77777.6.04 Company Address METROPOLITAN Area EMS Authority Medstar EMS 2900 ALTA MERE DRIVE Fort Worth, TX 76116 Time Off Balances Dollars Hours 9/9/2020 Employee Timecard Detail EXHIBIT A Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District -All- ......... ... . -All- v ....... Employee Pay Period Week Output Format Story, Philip B Pay Period 20, 2020 : 8/29/2020 - 9/11/2020 v 1 & 2 V w orm 0 q: Weekly Time & Attendance Story, Philip 8/29/2020 04:40 MSeProTime07 8/29/202017:25 MSeProTime07 12:45 Story, Philip 8/30/2020 04:41 MSeProTime07 8/30/202017:28 MSeProTime07 12:47 Story, Philip 9/1/2020 04:40 ePro BioClock 9/1/2020 13:57 ePro BioClock 09:17 Story, Philip 9/2/2020 04:40 <Admin> 9/2/2020 17:12 <Admin> 12:32 Story, Philip 9/3/202004A0 MSeProTime07 9/3/202017:56 MSeProTime07 13:16 Weekly Total: 60:37 (60.62 Hours) Payroll Items from Schedule ' items in red text are unpaid or belong to salaried employees. 8/29/2020 Misc Advanced REG 04:40 17:25 12:45 8/30/2020 Admin2 Advanced REG 04:41 17:28 12:47 9/1/2020 18 Advanced REG 04:40 13:57 09:17 9/2/2020 M80-1 Advanced REG 04:40 17:12 12:32 9/3/2020 19-N Advanced REG 04:40 17:56 13:16 * This timecard was never approved. Weekly Time & Attendance Story, Philip 9/7/2020 04:40 MSeProTime07 9/7/2020 17:17 MSeProTime07 12:37 Story, Philip 9/8/2020 04:42 MSeProTime07 9/8/2020 17:00 MSeProTime07 12J8 Meekly Total: 24:55 (24.92 Hours) Payroll Items from Schedule " items rn red text are unpaid or belong to salaried employees. 9/7/2020 19-N Advanced REG 04:40 17:17 12:37 9/8/2020 19-N Advanced REG 04:42 17:00 12:18 9/9/2020 24-N Call Off CO 05:30 17:30 12:00 9/11/2020 19-N Advanced REG 05:00 17M 12:00 This timecard was never approved. https://scheduling.esosuite,net/Default.aspx?DB=medstar# V2 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 29,00 ALTA MERE DRIVE Fort Worth, TX 76116 *** This is not a check*** AZ1242 03684,'. 09: 18.20 62242 Ronald L. Moren 205 Arnold St Crowley, TX 76036 Voucher Date Voucher Number 09/18/2020 62292 Direct Deposit Advice Direct Deposit Amount ****** 2,699,09 .w om anti r R.oy�o- --ai�a w.fpr,r Ronald; L. Moren S pi1~;rtber 8, ;202� 622.92 Emp Id 036842 Loc CHP002 Period Begin 08/29/20 Net Pay 2,699.09 SSN XXX-XX-1668 Hire Date 10/26/96 Period End "I11120 Dir Dep 2,699.09 Clock XXXX Status A Chick Type Reg Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Amt Regular Eamings 80,00 29.088300 2,327,07 1,461,15 42,502.38 Overtime 30.45 43,632450 1,328.61 541.52 23,627,98 E Training OT 0.00 0.00 4.00 174.53 RIFF PAY 33.95 4.000000 135,80 708.02 2,832.08 Group Term Life 0.W 3.08 0.00 58.19 Holiday 2.93 29,089300 85.23 24.31 707.14 SICK 0.00 0.00 10.00 290.88 12 Training Reg 0.00 0.00 6.00 174.53 VACATION 0,00 0.00 120.00 3,490.60 VACATION BUYBK 0.00 0.00 96.00 2,792.48 ERMATCH 0.00 226.89 0.00 4,310.910 f"ftiq { 3,879.79 2,971 A0 76,650.69 Taxes Status Taxable Current Amt Ytd Taxable Ytd Amt Federal Income Tax S-0 3,648.18 612.77 72,250.10 12,0011,01 OASDI 3,799.44 235,56 75,124.04 4,657.69 Medicare 3,799.44 55.09 75,124.04 1,089.30 Medicare - Additional 3,799.44 0.00 75,124.04 0.00 Texas SITW 3,648.18 0.00 72,250.10 0.00 903A2 17,755.00 Other Deductions from Pay Current Amt Ytd Amt 457 I51.26 2,873.940 Accidental Death - Child 0.24 4.560 Accidental Death - Employee 1.13 21.470 CHILD SUPPORT 1 0.00 0,200.00 DENTAL 3.44 65.360 Group Term Life 3.08 59.19 HEALTH 57.68 1,095.920 CHILD LIFE IA 1 21,09 LIFE EMPLOYEE 13.15 249.85 Mutual Omaha Critical Illness 17.86 339,340 M W R 10.00 190.00 S31) 14.43 274.17 VISION 3,90 74.10 277.28 18,467.99 Total Gross Pay 3,879.79 Federal Takes -903.42 State and Local Taxes 0.00 Other Deductions -277.28 Net Pay 74'69-9161 Direct Deposits-2,699.09 Net Check Company Address -- METROPOLITAN Area EMS Authority Mcdstar EMS 2900 ALTA MERE DRIVF Fort Worth. TX 76116 Time Off Balances Dollars Hours Bank Account Current Anit FORT WORTH CITY CL Ends with ***4010 300.00 9/9/2020 Employee Timecard Detail V ayrbll > Payroll Reports > Employee Timecard Detail Back Cost Center District -All- -All- v Employee Pay Period Week Output Format Moren, Ronald L Pay Period 20, 2020 : 8/29/2020 - 9/11/2020 1 & 2 v e� ocmotl Weekly Time & Attendance Moren, Ronald 8/31/2020 17:52 ePro BioClock 9/1/202005:48 ePro BioClock 11:56 Moren, Ronald 9/1/202017:40 ePro BioClock 9/2/2020 06:09 ePro BioClock 12:29 Moren, Ronald 9/2/202017:44 ePro BioClock 9/3/2020 05:57 ePro BioClock 12:13 Moren, Ronald 9/3/2020 17:43 ePro BioClock 9/4/2020 05:58 ePro BioClock 12:15 Moren, Ronald 9/4/202017:50 ePro BioClock 9/5/2020 05:36 ePro BioClock 11:46 Weekly Total: 60:39 (60.65 Hours) Payroll Items from Schedule ' Items it) red text are unpaid or oelong to salaried employees. 8/31/2020 206 CCP REG 17:52 05:48 11:56 9/1/2020 206 CCP REG 17:40 06:09 12:29 9/2/2020 206 CCP REG 17:44 05:57 12:13 9/3/2020 204 CCP REG 17:43 05:58 1215 9/4/2020 206 CCP REG 17:50 05:36 11:46 * This timecard was never approved. Weekly Time & Attendance Moren, Ronald 9/5/2020 17:43 ePro BioClock 9/6/202005:39 ePro BioClock 11:56 Moren, Ronald 9/6/2020 17:45 ePro BioClock 9/7/202005:52 ePro BioClock 12:07 Moren, Ronald 9/9/2020 06:25 <Admin> 9/9/2020 07:57 ePro BioClock 01:32 Weekly Total: 25:35 (25.58 Hours) Payroll Items from Schedule " items to red text are unpaid or belong to solcried employees. 9/5/2020 206 CCP REG 17:43 05:39 11:56 9/6/2020 206 CCP REG 17:45 05:52 12:07 9/9/2020 Meeting CCP REG 06:30 08:00 01:30 9/9/2020 206 CCP REG 16:00 04:00 12:00 9/10/2020 206 CCP REG 18:00 06:00 12:00 *� This timecard was newer approved. https://scheduiing.esosuite.netIDefault.aspx?DB=medstar# 112 EXHIBIT A METROPOLITAN Area EMS Authority Medstar EMS 29W ALTA MERE DRIVE Fort Worth. TX 76116 *** This is not a check*** Emp Id 056092 Loc CHP002 Period Rtgin SSN XXX-XX-7905 Hire Date 10/2&09 Period End Clock XXXX Status A Check Type Total Gross Pay Hours Rate Current Amt Ytd Hours Ytd Amt RegularF-arnings 66.50 29A39300 1,937.76 1,497.06 43,623.26 Overtime 21,92 43.708950 953.73 1,112.39 48,621.45 E Training OT 0.00 0.00 3.30 144.24 DIFF PAY 37.0E 4.0000M 148.04 799.00 3,196.00 Group Tenn Life 0.00 3.08 0.00 58.19 Holiday 3.02 29.139300 88.00 33.70 981.99 12 Training Reg 0.00 0.00 9.44 275.08 VACATION 24.00 29.139300 699.34 48.00 1,398.68 VACATION BUYBK 0.00 0.00 120.00 3,496.72 ER MATCH 0.00 227.28 0.00 4,319.320 w"" 3,829.95 3,622.89 101,795.61 Taxes Status Federal Income Tax M- I OASDI Medicare Medicare - Additional Texas SITW Voucher Date Voucher Number 09/18/2020 62291 Direct Deposit Advice 08/29/20 Net Pay 2,528.19 09/11/20 Dir Dep 2,528.19 Reg Total Gross Pay 3,829.95 Federal Taxes -540.15 State and Local Taxes 0.00 Other Deductions -761.61 Net Pay 2 528.19 Direct Deposits-2,528.19 Net Check 0A0 Taxable Current Amt Yid Taxable Ytd Amt 3,147.66 287.76 98,832.10 10,297,13 Company Address_ 3,299.18 204.55 91,710.98 5,686.08 METROPOLITAN Area EMS Authority 3,299.18 47.84 91,71698 1,329.81 Medstar EMS 2900 ALTA MERE DRIVE 3,299.18 0.00 91,710.98 0.00 Fort Worth. TX 76116 3,147.66 0,00 88,832.10 0,00 540A 5 17,313,02 Other Deductions from Pay Current Amt Yid Anit 457 151,52 2,878.889 DENTAL 12.11 230.099 Group Term Life 3.08 58.19 HEALTH SAVINGS 230,77 4,394.630 HEALTH 238.16 4,525.040 LEGAL SHIELD 11.95 227.05 LIFE EMPLOYEE 33.81 642.39 LIFE SPOUSE 9.39 179.41 Mutual Omaha Accident 14.01 266.190 Mutual Omaha Critical Illness 35.72 678.690 S.T.D 14.43 274.17 VISION 6.06 126.54 761.61 14,470.26 Bank Account Current Amt TEXAS TRUST CREDIT Ends with ***7365 350.00 WASH INGTON MLITUA Ends with ***5576 2,178,19 Time Off Balances Dollars Hours 2,528.19 9/912020 Employee Timecard Detail "k Ell �X Payroll > Payroll Reports > Employee Timecard Detail Back Cost Center District , -All- v Employee Pay Period Week Output Format Gattis, Tim L v Pay Period 20, 2020 : 8/29/2020 - 9/11/2020 v 1 & 2 v WU 0 0 Weekly Time & Attendance Gattis, Tim 8/29/2020 17:57 ePro BioClock 8/30/2020 07:22 ePro BEoClock 13:25 Gattis, Tim 8/30/2020 17:59 ePro BioClock 8/31/2020 07:04 ePro BioClock 13:05 Weekly Total: 26:30 (26.50 Hours) Payroll Items from Schedule ` Items in red text ore unpaid or belong to salaried employees. 8/29/2020 204 CCP REG 17:57 07:22 13:25 8/30/2020 204 CCP REG 17:59 07:04 13:05 9/2/2020 204 Vacation SA 12:00 00:00 12:00 9/3/2020 204 Vacation SA 18:00 06:00 12:00 This timecard was never approved. Weekly Time & Attendance Gattis, Tim 9/7/2020 17:58 ePro BioClock 9/8/2020 06:45 ePro BioClock 12:47 Gattis, Tim 9/8/2020 17:59 ePro BioClock 9/9/2020 07:54 ePro BioClock 13:55 Weekly Total: 26:42 (26.70 Hours) Payroll Items from Schedule items in red text are unpoid or belong to saloried employees. 9/7/2020 204 CCP REG 17:58 06:45 12:47 9/8/2020 204 CCP REG 18:00 06:00 12:00 9/9/2020 204 CCP REG 18:00 06:00 12:00 9/10/202G 203 CCP REG 14:00 22:00 09:00 9/11/2020 204 CCP REG 17:00 06:00 13:00 * This timecard was never approved. https://scheduling.esosuite.neUDefault.aspx?DB=medstar# 111