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Home My WebLink About20211677.tiffWELD COUNTY WARRANTS AS OF: JUNE 28, 2021 This is to certify that all accounting and budgeting procedures have been completed on the above listed claims as shown on the attached eight (8) Check and Electronic Transmittal Registers, numbering nineteen (19) pages, and dated June 25, 2021; and that payments should be to the respective vendors listed in the amount set opposite their names, with the total amount of $888,042.05. Dated this 28th day of June, 2021. Weld County Financial O SUBSCRIBED AND SWORN TO before me this 28th day of June, 2021. otary Public My Commission Expires: OCo / ail oat -4 CHLOE ALEXANDRA REMPEL NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20164024038 MY COMMISSION EXPIRES JUNE 23. 2024 T T T T T T T T T We, the Board of County Commissioners of Weld County, Colorado, hereby approve the claims as set forth above and warrants in payment thereof are hereby ordered drawn upon the Weld County Treasurer, totaling $888,042.05. Dated this 28th day of June, 2021. ATTEST:da) G. ito%4. Weld my Clerk to thBoard Deputy C AP ED County Attorney BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO Stev Moren9, Chair Date of signature: OCo/e:V/ 11 ike Freeman Lori Sa 2021-1677 Check Register Date : 06/25/2021 CheckStatus CheckDate CheckNumber Weld County Human Services *Check run processed 6/25/2021 by crempel Payee Amount Human Services 06252111S Normal 6/28/2021 5027492 365 REAL PROPERTY MANAGEMENT LLC $6,810.00 Normal 6/28/2021 5027493 AB LITIGATION SERVICES $200.00 Normal 6/28/2021 5027494 AIMS COMMUNITY COLLEGE $450.00 Normal 6/28/2021 5027495 ARAPAHOE COUNTY $22.00 Normal 6/28/2021 5027496 ATMOS ENERGY $195.44 Normal 6/28/2021 5027497 ATMOS ENERGY $181.35 Normal 6/28/2021 5027498 ATMOS ENERGY $414.85 Normal 6/28/2021 5027499 ATMOS ENERGY $125.74 Normal 6/28/2021 5027500 ATMOS ENERGY $416.66 Normal 6/28/2021 5027501 HANS BAKKER $6,200.00 Normal 6/28/2021 5027502 RUTILO BLANCO $7,345.00 Normal 6/28/2021 5027503 BOYS AND GIRLS CLUB $100.00 Normal 6/28/2021 5027504 CARBON VALLEY RECREATION CENTER $4,750.00 Normal 6/28/2021 5027505 CITY OF EVANS $208.65 Normal 6/28/2021 5027506 CITY OF EVANS $545.00 Normal 6/28/2021 5027507 CITY OF FORT LUPTON RECREATION CENTER $1,796.00 Normal 6/28/2021 5027508 COLORADO STATE REGISTRAR OF VITAL STATISTICS $40.00 Normal 6/28/2021 5027509 CRESCENT COVE APARTMENTS PHASE 3 $5,966.57 Normal 6/28/2021 5027510 EATON AREA PARK & RECREATION DISTRICT $898.00 Normal 6/28/2021 5027511 EXPERIAN $30.44 Normal 6/28/2021 5027512 FIRESTONE MEADOWS PH 2 $6,955.39 1 \ 3 2021-1677 CheckStatus CheckDate CheckNumber Payee Amount Normal 6/28/2021 5027513 FRANKLIN FLATS $6,847.40 Normal 6/28/2021 5027514 FRIENDLY VILLAGE OF GREELEY $2,597.15 Normal 6/28/2021 5027515 PAUL E. GAGE JR. $4,150.00 Normal 6/28/2021 5027516 GREELEY/EVANS YOUTH LEAGUE $375.00 Normal 6/28/2021 5027517 GREENWOOD REAL ESTATE INC $4,650.00 Normal 6/28/2021 5027518 HEARTSMART, INC $165.00 Normal 6/28/2021 5027519 JOSEPH FILIPPONI TRUST $4,700.00 Normal 6/28/2021 5027520 KERSEY, TOWN OF $285.00 Normal 6/28/2021 5027521 LONGMEADOW APARTMENTS $955.00 Normal 6/28/2021 5027522 ARTHUR L. MEASNER $10,275.00 Normal 6/28/2021 5027523 JOHN MEASNER $4,250.00 Normal 6/28/2021 5027524 MIMG XIV ASSOCIATES LLC $3,816.00 Normal 6/28/2021 5027525 MOUNTAIN STATES INT'L BLACK BELT ACADEMY $125.00 Normal 6/28/2021 5027526 SHANTIEL OLIVAS $76.80 Normal 6/28/2021 5027527 PC COUNTRY CLUB LLC $10,490.21 Normal 6/28/2021 5027528 PC COUNTRY CLUB LLC $3,129.85 Normal 6/28/2021 5027529 PORTER HOUSE APARTMENTS $10,832.84 Normal 6/28/2021 5027530 ROYAL GARDENS APARTMENTS LLC $2,003.40 Normal 6/28/2021 5027531 SC RENTALS $3,267.00 Normal 6/28/2021 5027532 SC RENTALS $7,956.70 Normal 6/28/2021 5027533 SC RENTALS $2,671.00 Normal 6/28/2021 5027534 PATRICIA TERRY $2,700.00 Normal 6/28/2021 5027535 THE LAW OFFICES OF DAVID S ANDERSON $6,981.00 2 \ 3 CheckStatus CheckDate CheckNumber Payee Amount Normal 6/28/2021 5027536 THOMPSON RIVER PARK AND RECREATION $235.0O Normal 6/28/2021 5027537 UNITED POWER, INC $77.32 Normal 6/28/2021 5027538 VILLA WEST $2,871.62 Normal 6/28/2021 5027539 VINTAGE CORPORATION $4,275.00 Normal 6/28/2021 5027540 VINTAGE CORPORATION $2,175.00 Normal 6/28/2021 5027541 VINTAGE CORPORATION $11,887.18 Normal 6/28/2021 5027542 VINTAGE CORPORATION $4,410.00 Normal 6/28/2021 5027543 VINTAGE CORPORATION $7,772.00 Normal 6/28/2021 5027544 WEST PARK VILLAGE APARTMENTS $4,377.09 Normal 6/28/2021 5027545 WEST PARK VILLAGE APARTMENTS $5,857.00 Normal 6/28/2021 5027546 XCEL ENERGY $130.78 Normal 6/28/2021 5027547 XCEL ENERGY $113.90 Normal 6/28/2021 5027548 XCEL ENERGY $216.94 Normal 6/28/2021 5027549 XCEL ENERGY $331.77 Normal 6/28/2021 5027550 YMCA OF NORTHERN COLORADO $1,110.00 Check Register Summary Transaction Total: 59 Amount Total: $182,791.04 Check Register Date : 06/25/2021 CheckDate CheckNumber Payee Weld County Weld County *Check run processed 6/25/2021 by crempel Amount Weld County, Colorado 062521WELD 6/28/2021 3365509 4 X INDUSTRIAL LLC $51,116.05 6/28/2021 3365510 AGGREGATE INDUSTRIES WR INC $80,948.63 6/28/2021 3365511 ALTITUDE COMMUNITY LAW $15.00 6/28/2021 3365512 AMAZON CAPITAL SERVICES INC $325.29 6/28/2021 3365513 ARISTOCRAT ANGUS $260.75 6/28/2021 3365514 ATMOS ENERGY $14.24 6/28/2021 3365515 ATP OILFIELD SERVICES LLC $900.00 6/28/2021 3365516 SHERIE L. BAKER $84.24 6/28/2021 3365517 FRANK BALL $15.00 6/28/2021 3365518 ROBERT BEAN $350.00 6/28/2021 3365519 FERN BENJAMIN $100.00 6/28/2021 3365520 DON BENKER $540.00 6/28/2021 3365521 BOBCAT OF THE ROCKIES $626.77 6/28/2021 3365522 IRVIN BORENSTEIN $638.15 6/28/2021 3365523 ELSIE BURNETT $45.00 6/28/2021 3365524 ROLETA CARRIKER $175.50 6/28/2021 3365525 ERIC COLOMBE $1,508.75 6/28/2021 3365526 COLORADO DEPT OF PUBLIC HEALTH/ENVIRONMENT $7,262.50 6/28/2021 3365527 COMFORCARE - FORT COLLINS $218.50 6/28/2021 3365528 CONTECH ENGINEERED SOLUTIONS LLC $4,422.40 6/28/2021 3365529 JAMES CRAIG $684.85 1 \ 6 ' CheckDate CheckNumber Payee Amount 6/28/2021 3365530 CRISTANDO HOUSE INC $268.00 6/28/2021 3365531 DAKOTA LAND LLC $15.00 6/28/2021 3365532 DBE MANUFACTURING & SUPPLY LLC $129.59 6/28/2021 3365533 ALEXZONDREA DELACRUZ $15.00 6/28/2021 3365534 DESIREE DELMISSIER $130.00 6/28/2021 3365535 SHERRY DERBIGNY $362.25 6/28/2021 3365536 ELOISE DERRERA $100.00 6/28/2021 3365537 BONNIE DIETZ $15.00 6/28/2021 3365538 DLT SOLUTIONS LLC $601.54 6/28/2021 3365539 DOMINION VOTING SYSTEMS $6,313.50 6/28/2021 3365540 JULIE DOWSWELL $150.00 6/28/2021 3365541 SYLVIA J. DRUMMOND $65.00 6/28/2021 3365542 ENSIGHT SKILLS CENTER INC $197.75 6/28/2021 3365543 EVIDENT INC $945.74 6/28/2021 3365544 EZ LINER INDUSTRIES $1,451.74 6/28/2021 3365545 DOLORES FERNANDEZ $125.00 6/28/2021 3365546 STEPHANIE M. FERRIS $300.00 6/28/2021 3365547 FRANCY LAW FIRM $15.00 6/28/2021 3365548 FRANCY LAW FIRM $15.00 6/28/2021 3365549 FRANCY LAW FIRM $15.00 6/28/2021 3365550 FRONT RANGE INDUSTRIAL & CONSTRUCTION SUPPLY $119.98 6/28/2021 3365551 FRONT RANGE LEGAL PROCESS SERVICE INC $110.00 6/28/2021 3365552 GALETON WATER AND SANITATION DISTRICT $42.00 2 \ 6 CheckDate CheckNumber Payee Amount 6/28/2021 3365553 ROBBIE GARNER $281.96 6/28/2021 3365554 MERLE GASPERS $45.00 6/28/2021 3365555 CHRISTINA GERINGER $150.00 6/28/2021 3365556 ROSEMARIE GONZALES $300.00 6/28/2021 3365557 LACEY HANSEN $15.00 6/28/2021 3365558 DEANNE HEWETT $280.00 6/28/2021 3365559 HILL PETROLEUM $31,366.15 6/28/2021 3365560 HONNEN EQUIPMENT $2,853.84 6/28/2021 3365561 IBM CORPORATION $3,291.20 6/28/2021 3365562 INLAND TRUCK PARTS COMPANY $2,557.50 6/28/2021 3365563 J2 CONTRACTING $41,646.00 6/28/2021 3365564 BARBARA L. KARBS $941.00 6/28/2021 3365565 CAROL KEEFER $245.00 6/28/2021 3365566 SCOTT KOSKIE $469.57 6/28/2021 3365567 DONNA M. KURTZ $300.00 6/28/2021 3365568 LAMAR COMPANIES $1,200.00 6/28/2021 3365569 LIFEMED SAFETY INC $319.42 6/28/2021 3365570 SHIRLEY LIMAS $1,208.00 6/28/2021 3365571 LIVE FULLY LLC $216.00 6/28/2021 3365572 LKQ CORPORATION $460.00 6/28/2021 3365573 LOLINA INC $3,960.00 6/28/2021 3365574 VICKIE LOPEZ $475.00 6/28/2021 3365575 MAGNET FORENSICS USA INC $4,380.00 3 \ 6 CheckDate CheckNumber Payee Amount 6/28/2021 3365576 LINDA MARTINEZ $1,975.00 6/28/2021 3365577 MATTHEW E LEE DDS PLLC $328.00 6/28/2021 3365578 MCKESSON MEDICAL SURGICAL $214.94 6/28/2021 3365579 MEDICAL SYSTEMS OF DENVER INC $54.12 6/28/2021 3365580 GRACE MEDINA $15.00 6/28/2021 3365581 METRO COLLECTION SERVICE $15.00 6/28/2021 3365582 MARIA MIJARES $140.00 6/28/2021 3365583 MIKE MAROONE FORD LONGMONT $510.00 6/28/2021 3365584 KELLY MILLS $132.00 6/28/2021 3365585 CAROLYN MORALI $1,010.00 6/28/2021 3365586 NMS LABS $4,075.00 6/28/2021 3365587 NORTH COLORADO HEALTH ALLIANCE $326.88 6/28/2021 3365588 NORTH RANGE BEHAVIORAL HEALTH $240.00 6/28/2021 3365589 NOVACOAST INC $5,174.04 6/28/2021 3365590 JOHN PETERS $2,784.45 6/28/2021 3365591 POUDRE VALLEY REA $6,081.24 6/28/2021 3365592 POULSEN ACE HARDWARE $2,090.98 6/28/2021 3365593 POWER MOTIVE $6,323.31 6/28/2021 3365594 BEATRICE RANSON $350.00 6/28/2021 3365595 LAUDIE RASCH $700.00 6/28/2021 3365596 JANET RATZLAFF $30.00 6/28/2021 3365597 NANCY RIVAS $15.00 6/28/2021 3365598 ROBERT & ARLENE STONE TRUST $440.00 4 \ 6 CheckDate CheckNumber Payee Amount 6/28/2021 3365599 RODNEY LAW FIRM PC $15.00 6/28/2021 3365600 SAFETY-KLEEN SYSTEMS INC $540.00 6/28/2021 3365601 SANOFI PASTEUR INC $806.02 6/28/2021 3365602 SCANNER ONE $1,095.00 6/28/2021 3365603 SENIOR HELPERS $324.00 6/28/2021 3365604 HARRY L. SIMON $40.00 6/28/2021 3365605 SMARTSHEET INC $2,000.00 6/28/2021 3365606 GARY SMITH $60.00 6/28/2021 3365607 DARLEEN SNIDOW $300.00 6/28/2021 3365608 STABILIS GDS INC $4,336.69 6/28/2021 3365609 STATE OF COLORADO $10,827.96 6/28/2021 3365610 JENNIFER STETSON -STRANGE $1,000.00 6/28/2021 3365611 FRANK STONECYPHER $720.00 6/28/2021 3365612 SUMURI LLC $1,350.00 6/28/2021 3365613 JENNI SWEET $2,200.00 6/28/2021 3365614 THERMO FLUIDS, INC $550.50 6/28/2021 3365615 TRU BLU LLC $600.00 6/28/2021 3365616 VICENTA VAN DRIEL $300.00 6/28/2021 3365617 JEANETTE VANDEWEGHE $55.00 6/28/2021 3365618 VWR INTERNATIONAL $100.62 6/28/2021 3365619 WEBB REPAIR $40.72 6/28/2021 3365620 SANDY WEICKUM $355.50 6/28/2021 3365621 MARILYN WHITE $365.00 5 \ 6 CheckDate CheckNumber Payee Amount 6/28/2021 3365622 DOROTHY L. WILLIAMS $250.00 6/28/2021 3365623 XCEL ENERGY $14,015.73 Check Register Summary Transaction Total: 115 Amount Total: $333,987.05 PeopleSoft Report ID: WDV003 DENTAL/VISION CHECK REGISTER Benefit Year 2021 From Date: 06/28/2021 Thru Date: 06/28/2021 Check No. Check Date Check Amount Employee Name 8092077 06/28/2021 $1,000.00 Jessica L. Lopez 8092078 06/28/2021 $737.00 Alan M Caldwell 8092079 06/28/2021 $374.00 Lee J. Falconburg 8092080 06/28/2021 $239.50 Lee J. Falconburg 8092081 06/28/2021 $226.98 Jerry L. Steinbar 8092082 06/28/2021 $159.00 Eric C Broce 8092083 06/28/2021 $300.00 Inez Josephine Pena 8092084 06/28/2021 $329.50 Jose J Gonzalez 8092085 06/28/2021 $195.00 Jeannine Allen 8092086 06/28/2021 $152.50 Michael Jay Silva 8092087 06/28/2021 $59.00 Yesenia Duran 8092088 06/28/2021 $55.00 Krea J Sledge 8092089 06/28/2021 $212.43 Krea J Sledge Payment Type Total $4,039.91 Year Total $4,039.91 Grand Total $4,039.91 ==>Direct Deposit Total $4,039.91 ==>Paper Check Total $0.00 13 0 Employee ID Svc Type Direct Deposit 1550 D Dental Y 2158 D Dental Y 527 D Dental Y 527 D Dental Y 6048 D Dental Y 6420 D Dental Y 7477 V Vision Y 8183 D Dental Y 8429 D Dental Y 9317 D Dental Y 9679 V Vision Y 9816 V Vision Y 9816 V Vision Y End of Report Page No. 1 Run Date 06/25/2021 Run Time 12:19:47 REPORT FABCHKR Weld County BNPD Data RUN DATE: 06/25/2021 FISCAL YEAR 2021 Batch Disbursement Register TIME: 02:56 PM BANK: E2 TREASURER -SS ELECTRONIC PAYMENTS Check Run: 06/28/2021 PAGE: 1 < CHECK REGISTER CHECK/ < APPROVED AMOUNTS > CHK ADVICE DISCOUNT/ WITHHOLDING/ TYP NUMBER PAYEE/VENDOR NAME A/P DOC# VENDOR INV# GROSS PREV PAID ADDL CHG/TAX NET IND E0002306 LABORATORY CORPORATION OF AMER I2109047 69905438 38.00 0.00 0.00 38.00 B T REPORT FABCHKR Weld County BNPD Data RUN DATE: 06/25/2021 TIME: 02:56 PM 06/28/2021 PAGE: FISCAL YEAR 2021 * RPTNAME: FABCHKR PARAMETER SEQUENCE NUMBER: 334616 NUMBER OF PRINTED LINES PER PAGE: 52 Batch Disbursement Register Check Run: 2 * * * REPORT CONTROL INFORMATION * * REPORT FABCHKR Weld County BNPD Data RUN DATE: 06/25/2021 FISCAL YEAR 2021 Batch Disbursement Register TIME: 02:54 PM BANK: El TREASURER -AP ELECTRONIC PAYMENTS Check Run: 06/28/2021 PAGE: 1 < CHECK REGISTER CHECK/ APPROVED AMOUNTS > CHK ADVICE DISCOUNT/ WITHHOLDING/ TYP NUMBER PAYEE/VENDOR NAME A/P DOC# VENDOR INV# GROSS PREV PAID ADDL CHG/TAX NET IND E0002303 BEARCOM OPERATING L.P. I2109117 5211316 405.00 0.00 0.00 E0002304 MY OFFICE ETC. 63.98 0.00 63.98 0.00 159.95 0.00 0.00 0.00 0.00 405.00 B I2108468 279802-0 63.98 B I2108669 279804-0 63.98 B I2108680 279905-0 159.95 B TOTAL 287.91 E0002305 RAZOR BLADE COMPANY I2108911 96330 874.35 0.00 0.00 T REPORT FABCHKR FISCAL YEAR 2021 BANK TOTAL 1,567.26 874.35 B RUN DATE: 06/25/2021 TIME: 02:54 PM CHECK Weld County BNPD Data Batch Disbursement Register Check Run: 06/28/2021 * RPTNAME: FABCHKR PARAMETER SEQUENCE NUMBER: 334611 NUMBER OF PRINTED LINES PER PAGE: 52 PAGE: 2 * * * REPORT CONTROL INFORMATION * * REPORT FABCHKR Weld County BNPD Data RUN DATE: 06/25/2021 FISCAL YEAR 2021 Batch Disbursement Register TIME: 03:07 PM BANK: 02 TREASURER -SOCIAL SERVICES Direct Deposit Run: 06/28/2021 PAGE: 1 DIRECT DEPOSIT REGISTER CHECK/ APPROVED AMOUNTS > CHK ADVICE DISCOUNT/ WITHHOLDING/ TYP NUMBER PAYEE/VENDOR NAME A/P DOC# VENDOR INV# GROSS PREV PAID ADDL CHG/TAX NET IND !0036787 CALLENDER, LORENZA I2109153 MI052621 170.86 0.00 0.00 170.86 D 10036788 CARVAJAL, SINDY I2109154 MI061821 88.78 0.00 0.00 88.78 D !0036789 FIGUEROA, MARIEFRI I2108979 MI052621 99.47 0.00 0.00 99.47 D 10036790 LUCERO, BOBBY J I2109156 MI061121 231.12 0.00 0.00 231.12 D 10036791 MCLAVEY, JO I2108980 MI061721 97.52 0.00 10036792 WILSON, SHAWNA 297.54 0.00 135.54 0.00 97.52 D 0.00 0.00 0.00 I2108982 MI053021 297.54 D I2109155 MI042921 135.54 D TOTAL 433.08 10036793 WOLF, KRIS I2108983 MI061121 32.94 0.00 0.00 32.94 D DEPOSIT BANK TOTAL 1,153.77 T REPORT FABCHKR Weld County BNPD Data RUN DATE: 06/25/2021 TIME: 03:07 PM 06/28/2021 PAGE: FISCAL YEAR 2021 * RPTNAME: FABCHKR PARAMETER SEQUENCE NUMBER: 334627 NUMBER OF PRINTED LINES PER PAGE: 52 Batch Disbursement Register Check Run: 2 * * * REPORT CONTROL INFORMATION * * REPORT FABCHKR Weld County BNPD Data RUN DATE: 06/25/2021 FISCAL YEAR 2021 Batch Disbursement Register TIME: 03:03 PM BANK: 01 TREASURER -ACCOUNTS PAYABLE Direct Deposit Run: 06/28/2021 PAGE: 1 DIRECT DEPOSIT REGISTER CHECK/ APPROVED AMOUNTS > CHK ADVICE DISCOUNT/ WITHHOLDING/ TYP NUMBER PAYEE/VENDOR NAME A/P DOC# VENDOR INV# GROSS PREV PAID ADDL CHG/TAX NET IND !0036776 CHANG, LILA I2109078 0504-052821 129.60 0.00 0.00 129.60 D !0036777 CYPHERS, MELANIE I2109080 0416-052821 39.96 0.00 0.00 !0036778 DAVIS, CARLEEN A 64.80 0.00 0.00 !0036779 GONZALES, ADAM 30.78 0.00 !0036780 ISLAS, AURELIA 43.20 0.00 !0036781 JOHNSON, JASON 31.32 0.00 0.00 0.00 0.00 39.96 D I2109077 64.80 D I2109161 30.78 D I2109079 43.20 D I2109158 31.32 D !0036782 KHALIQI, PHOEBE I2109098 0505-052021 60.21 0.00 0.00 60.21 D !0036783 NISWENDER, JARED 29.16 0.00 0.00 I2109085 29.16 D !0036784 ROWE-DENNING, ARIANE M I2109028 21CGF78AROWE-DE 390.00 0.00 0.00 390.00 D 10036785 STORM, KASHMIR 34.56 0.00 0.00 I2109160 34.56 D I0036786 WILLIAMS, LOUIS M I2108977 MULTIPLE 39.21 0.00 0.00 BANK TOTAL 892.80 39.21 D REPORT FABCHKR Weld County BNPD Data RUN DATE: 06/25/2021 TIME: 03:03 PM 06/28/2021 PAGE: FISCAL YEAR 2021 * RPTNAME: FABCHKR PARAMETER SEQUENCE NUMBER: 334622 NUMBER OF PRINTED LINES PER PAGE: 52 Batch Disbursement Register Check Run: 2 * * * REPORT CONTROL INFORMATION * * vaetna Re: Funds Transfer Confirmation Prepared Date: Contractholder Name: Attention: Reference#: Activity of: Debit/Pull Amount: Account Name: Credit Bank: Bank Address: Thursday, June 24, 2021 WELD COUNTY GOV S FREY/R FIELDER RE:MEDICAL CLAIMS 54-21174-0798 Wednesday, June 23, 2021 $330,090.94 SFGP/ASC Contractholders Account Bank Of America Connecticut 2601 West Broad Street Richmond VA 23220 Account Number: Please make available for debit the requested funds immediately to avoid late funding interest charges, suspension of services, or termination for nonpayment pursuant to the terms of your contract. ver.3.0.7.0 For any questions, please send emails to Banking-SAMP@aetna.com or call a contact listed below. .411i Litttbt, 4446' '. Kimberly Settle Banking Consultant Phone 330-659-8333 Daphne Fentress Banking Consultant Phone 904-351-5504 J2100910 06/24/2021 Proprietary vaetna Re: Funds Transfer Confirmation Prepared Date: Contractholder Name: Attention: Reference#: Activity of: Friday, June 25, 2021 WELD COUNTY GOV S FREY/R FIELDER RE:MEDICAL CLAIMS 54-21175-0517 Thursday, June 24, 2021 Debit/Pull Amount: $33,481.28 Account Name: Credit Bank: Bank Address: SFGP/ASC Contractholders Account Bank Of America Connecticut 2601 West Broad Street Richmond VA 23220 Account Number: Please make available for debit the requested funds immediately to avoid late funding interest charges, suspension of services, or termination for nonpayment pursuant to the terms of your contract. ver.3.0.7.0 For any questions, please send emails to Banking -SA MP@aetna.com or call a contact listed below. Kimberly Settle Banking Consultant Phone 330-659-8333 Daphne Fentress Banking Consultant Phone 904-351-5504 J2100912 06/25/2021 Proprietary r'" 0.0°o 1829791004 + 3339987.05+ 4903991 + 38000 -i- 19567.26 +' 1;153.77 + 89280 + 3309090 94 + 33948128 + 8889042.05 0 0 0 0 0 1829791°04 +_ 3339987.05 + 4903991 + 38°00 + 1956726 + 19153.77 +, 892.80 + 3309090 94 + 339481.28 + 8889042.05 * ' Hello