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2014-08-12 10:00AM REGULAR MEETING
�^ f c BRAZOSCOUNTY BRYAN,TEXAS NOTICE OF MEETING AND AGENDA BRAZOS COUNTY COMMISSIONERS COURT THE COMMISSIONERS COURT OF BRAZOS COUNTY WILL MEET IN REGULAR SESSION ON AUGUST 12, 2014 AT 10:00 AM IN THE COMMISSIONERS COURTROOM OF THE COUNTY ADMINISTRATION BUILDING, 200 SOUTH TEXAS AVE., SUITE 106, BRYAN, TX 77803 1. Invocation and Pledge of Allegiance - U.S. and Texas Flag - Chaplain G.H. Jones and Commissioner Wassermann. 2. Call for Citizen input and/or concerns. Consider and take action on agenda items 3 - 30: 3. Proclamation 14-026 welcoming Sishoo Vashti Murphy McKenzie to Brazos County. 4. Reappointment of Kristy Roe to the City of Bryan and Brazos County Economic Development Foundation Inc.; term of appointment is 5/1 212 01 4 through 511 212 01 6. 5. Order calling the November 2014 General Election Orden Hernando la E/eccibn General en noviembre de 2014. 6. Order relocating polling place for Election Precincts 80110. Orden pare trasladar el sitio de votac16n porprecinctos de elecciones ndmero 80/10 7. Consider and take action on the Application of Joy Trust. 8. Approval of the following documents for the Brazos County Section 125 (Flexible Spending Account and Dependent Care Account) Plan: • a. Plan Document • b. Summary Plan Description • c. Use or Lose Rule Amendment • d. Cafeteria Plan Checklist g. Request approval from Justice of the Peace Pct 2.1 for the deletion of the following position effective Vol. 205 Pg. /31' August 16 2014 This will have a decrease in the amount of $4.769 for the remainder of FY 14. • Delete Clerk 1 JP 2.1 Class Code 0618 Position 1 Group 10 Step 3, Pay Code 014 10. Request from Justice of the Peace. Pct 2.2 for the creation of the following position effective August 16 2014 This will increase the FY 14 Budget for Justice of the Peace Pct. 2.2 in that amount of $5.063. • Create Clerk III JP 2.2 Class Code 0633 Position 1 Group 12 Step 2, Class Code 014 11. Approval of the iob description for Temporary Attendant Building & Grounds (1040 hours) for the Expo Center (Class Code 832 Position 15). 12. Request from the Information Technology Department to repurpose FY 14 "Project Ex -Novo Licensing' CIP monies to complete the "Upgrade Datacenter Server Licenses" capital improvement proiect 13. Payment Authorization to CC Creations in the amount of $100.00 for artwork and design set -up for the Sheriff's Office: a purchase order was not obtained in advance. 14. Consider and take action on the establishment of a standing balance in the JPMorgan Chase bank account for the Property Tax Collections payments made by creditidebit card of $5.000 15. Approval of Inter - Governmental Agreement between the Federal Bureau of Prisons and Brazos County Office of the Sheriff - Detention Center. 16. Approval of Psychological Evaluations for applicants of the Brazos County Office of the Sheriff. 17. Consider and take action on renewal of contract with Grayson County for juvenile residential services. 18. Consider and take action on renewal of contract with Hays County for juvenile residential services. 19. Renewal of Bid No. 2014 -831k Asphalt Oils and Emulsions Products as follows: • a. Cleveland Asphalt: Sections 1, 2, 3. 5. 6 and 7 • b. Ergon: Section 4 20, Capital Requisition No 00047966 to Marton Roofing in the amount of $3`14,161 for roofing renovations on county buildings This is being purchased through TCPN contract #132203 -TX -1940 21. Consider and take action on the ETC Texas Pipeline utility permit to construct road bore under Rock Prairie Road. Project will lay 16" pipeline for transportation of natural gas. Site is located in Precinct 2. 22. Consider and take action on the ETC Texas Pipeline utility permit to construct road bore under Weedon Loop Project will lay 16" pipeline for transportation of nature] gas Site is located in Precinct 2. 23. Tax Refund Applications for the following: • a. Excel Landscaping & Lawns. Inc.-overpayment-$83.78 • b. Michael & Mary Susan Bealoverpayment4300.19 24. Commissioners Court minutes for the following dates: • a. June 23JuIv 11. 2014 - Budget Workshop Sessions • b. July 1 2014 - Regular Meeting • c. July 7, 2014 - Workshop Session • d. July 8, 2014 - Regular Meeting • e. July 14 -18 2014 - Budget Workshop Sessions • f. July 15 2014 - Regular Meeting • a. July 16, 2014 - Public Hearing • h. July 22 2014 - Regular Meeting • L July 22, 2014 - Public Hearing at 10:30 am • ). July 22 2014 - Public Hearing at 10:45 am Vol. 205 Pg. 13C • k. July 23 -25. 2014 - Budaet Workshop Sessions • I. July 25, 2014 - Special Session • m. July 28.29, 2014 - Budget Workshop Sessions • n. July 29 2014 - Regular Meeting 25. Budget Amendments. Budget Amendments FY 13114 43.1 thru 43.5 26, Approval of the following requisitions to Software House Intemational for server license upgrades for the IT datacenter: • a. Rea. 00047876 - $4.630.80 • b. Rea. 00047943 - $11.923.20 • c. Rea. 00047944 - $1,140.00 • d. Rea. 00047945 - $1,146.00 27. Personnel Change of Status. Personnel Action Foffns 28. Payment of Claims. 29. Convene into Executive Session pursuant to Texas Government Code 551.071 to consult with attorney about pending or contemplated litigation and /or a settlement offer. 30. Consider and possible action on Executive Session. 31. Sheriffs report on inmate population. 32. Announcement of interest items and possible future agenda topics. 33. Call for Citizen input and /or concerns. 34. Adjourn. Vol. 205 Pg. /37 PUBLIC COMMENTS Public Comment during the Commission Meeting may be for all matters, both on and off the agenda, and be limited to four minutes per person. Persons are invited to submit comments in writing on the agenda Items and /or attend and make comment at the Commission meeting. Members of the public are reminded that the Brazos County Commissioners Court is a Constitutional Court, with both judicial and legislative powers, created under Article V, Section 1 and Section 18 of the Texas Constitution. As a Conrtijutional Court, the Brazos County Commissioners Court also possesses the power to issue a Contempt of Court Citation under Section 81.024 of the Texas Local Government Code. Accordingly, members of the public in attendance at any Regular, Special and/or Emergency meeting of the Court shall conduct themselves with proper respect and decorum in speaking to, and/or addressing the Court; in participating in public discussions before the Court; and in all actions in the presence of the Court. Those members of the public who are inappropriately attired and /or who do not conduct themselves in an orderly and appropriate manner will be ordered to leave the meeting. Refusal to abide by the Courts Order and /or continued disruption of the meeting may result in a Contempt of Court Citation. It is not the intention of the Brazos County Commissioners Court to provide a public forum for the demeaning of any individual or group. Neither is R the intention of the Court to allow a member (or members) of the public to insult the honesty antllor integrity of the Court, as a body, or any member or members of the Court, or County employees, individually or collectively. Accordingly, profane, insulting or threatening language directed toward the Court and/or any person in the Court's presence and/or racial, ethnic or gender slurs or epithets will not be tolerated. Violation of these rules may result in the following sanctions. 1. cancellation of a speakers time; 2. removal from the Commissioners Court; 3. a Contempt Citation; and/or 4. such other and/or criminal sanctions as may be authorized under the Constitution, Statutes and Codes of the State of Texas. The County Commissionens Court can deliberate or take action only if a matter has been listed on an agenda properly posted prior to the meeting. During the public comment period, speakers may address matters not listed on the published agenda. The Open Meeting Law does not expressly prohibit responses to public comments by the Commissioners Court. However, responses from the County Judge or Commissioners to unlisted public comment topics could become deliberation on a matter without notice to the public. To ensure the public has notice of all matters the Commissioners Court will consider, the County Judge and/or Commissioners may choose not to respond to public comments, except to correct factual inaccuracies, recite existing policy in response to an inquiry or to ask that a matter be listed on a future agenda. See Texas Open Meetings Act 7 551.D42. INVOCATION Any invocation that may be offered before the official start of the Court meeting shall be to and for the benefit of the Court. The views or beliefs expressed by the invocation speaker have not been previously reviewed or approved by the Court and do not necessarily represent the religious beliefs or views of the Court in part or as a whole. No member of the community is required to attend or participate in the invocation and such decision will have no impact on their light to actively participate in the business of the Court. The Commissioners Courtroom of the County Administration Building, 200 South Texas Ave., Suite 106, Bryan, TX 77803 is wheelchair accessible. Handicap parking spaces are available. Any request for sign Interpretive services must be made two working days before the meeting. To make arrangements, please call (979) 361 -4102. Vol. 205 Pg. 1.3Y' o F� BRAZOSCOUNTY BRYAN,TEXAS MINUTES August 12, 2014 BRAZOS COUNTY COMMISSIONERS COURT REGULAR MEETING 6s Sianature Paae.odf 0 File Stamped Aaenda.odf 0 Sian in sheet.odf A regular meeting of the Commissioners' Court of Brazos County, Texas was held in the Brazos County Commissioners Courtroom in the Administration Building, 200 South Texas Avenue, in Bryan, Brazos County, Texas, beginning at 10:00 a.m. on Tuesday, August 12, 2014 with the following members of the Court present: Duane Peters, County Judge, Presiding; Lloyd Wassermann, Commissioner of Precinct 1; Sammy Catalena, Commissioner of Precinct 2; Kenny Mallard, Commissioner of Precinct 3; Irma Cauley, Commissioner of Precinct 4; Karen McQueen, County Clerk. The attached sheets contain the names of the citizens and officials that were in attendance. Invocation and Pledge of Allegiance - U.S. and Texas Flag - Chaplain G.H. Jones and Commissioner Wassermann. 2. Call for Citizen input and /or concerns. There was no citizen input. Consider and take action on agenda items 3 - 30: Vol. 205 Pg. I-5 `' 3. Proclamation 14 -026 welcoming Bishop Vashti Murphy McKenzie to Brazos County. Lf-'. Item lodf The County Judge read aloud Proclamation #14 -026 proclaiming the month of August 2014 as Bishop Vashti Murphy McKenzie Month throughout Brazos County. Motion: Approve, Moved by Commissioner Irma Cauley, Seconded by Commissioner Kenny Mallard. Passed. 5 -0. Members voting Aye: Catalena , Cauley , Mallard , Peters Wassermann. 4. Reappointment of Kristy Roe to the City of Bryan and Brazos County Economic Development Foundation, Inc.; term of appointment is 5/12/2014 through 5/12/2016. E Item 4.odf Motion: Approve, Moved by Commissioner LLoyd Wassermann, Seconded by Commissioner Kenny Mallard. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard , Peters, Wassermann . 5. Order calling the November 2014 General Election IE Item 5.odf Orden Ilamando la Eleccidn General en noviembre de 2014. Motion: Approve, Moved by Commissioner Sammy Catalena, Seconded by Commissioner LLoyd Wassermann. Passed. 5 -0. Members voting Aye: Catalena, Cauley , Mallard , Peters , Wassermann . 6. Order relocating polling place for Election Precincts 80/10. tl- Item 6.odf Orden para trasladar el sitio de votacion por precinctos de elecciones numero 80110 Election Precincts 80/10 are currently located at Living Hope Baptist Church, 4170 State Highway 6, College Station, Texas but it is no longer available for use. For the convenience of the voters the election precincts 80/10 it is recommended that they be moved to the College Station Fire Station #3 located at 1900 Barron Road, College Station, Texas. Motion: Approve, Moved by Commissioner LLoyd Wassermann, Seconded by Commissioner Sammy Catalena. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann . Consider and take action on the Application of Joy Trust. E Item TO The Court voted unanimously to approve an order denying an application submitted by Joy Trust to establish a junk yard because it posed a detriment to the public health, the location would pose a threat to the environment, the location was within 1,000 feet of the nearest property line, the location would be incompatible with the surrounding development, the location would be detrimental to the economic welfare of Brazos County and the location would be within 1,500 feet of a lake, river, tributary or pond. Attached is a copy of the Order. Motion: Deny, Moved by Commissioner Kenny Mallard, Seconded by County Judge Duane Peters. Passed. 5 -0. Members voting Aye: Catalena , Cauley , Mallard , Peters , Wassermann. 8. Approval of the following documents for the Brazos County Section 125 (Flexible Vol. 205 Pg. 1¢'6 Spending Account and Dependent Care Account) Plan: = Item 8.0 f • a. Plan Document • b. Summary Plan Description • c. Use or Lose Rule Amendment • d. Cafeteria Plan Checklist Motion: Approve, Moved by Commissioner LLoyd Wassermann, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard , Peters, Wassermann . 9. Request approval from Justice of the Peace, Pct. 2.1 for the deletion of the following position effective August 16, 2014. This will have a decrease in the amount of $4,769 for the remainder of FY 14. L' Item 9.0 f . Delete Clerk I, JP 2.1 Class Code 0618 Position 1, Group 10 Step 3, Pay Code 014 Motion: Approve, Moved by Commissioner Sammy Catalena, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena , Cauley, Mallard , Peters , Wassermann . 10. Request from Justice of the Peace, Pct. 2.2 for the creation of the following position effective August 16, 2014. This will increase the FY 14 Budget for Justice of the Peace, Pct. 2.2 in that amount of $5,063. E Item 10.0 f 11. . Create Clerk III, JP 2.2, Class Code 0633 Position 1, Group 12 Step 2, Class Code 014 Motion: Approve , Moved by Commissioner Sammy Catalena, Seconded by Commissioner LLoyd Wassermann. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann . Item 11.odf Approval of the job description for Temporary Attendant, Building & Grounds (1040 hours) for the Expo Center (Class Code 832, Position 15). Motion: Approve, Moved by Commissioner Sammy Catalena, Seconded by Commissioner Kenny Mallard. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann . 12. Request from the Information Technology Department to repurpose FY 14 "Project Ex- Novo Licensing" CIP monies to complete the "Upgrade Datacenter Server Licenses" capital improvement project. Item 12.0 Motion: Approve, Moved by Commissioner Irma Cauley, Seconded by Commissioner Kenny Mallard. Passed. 5 -0. Members voting Aye: Catalena , Cauley , Mallard , Peters , Wassermann. 13. Payment Authorization to CC Creations in the amount of $100.00 for artwork and design set -up for the Sheriffs Office; a purchase order was not obtained in advance. C Item 13.0 f Vol. 205 Pg. /��/ Motion: Approve, Moved by Commissioner Irma Cauley, Seconded by Commissioner Lloyd Wassermann. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard , Peters, Wassermann. 14. Consider and take action on the establishment of a standing balance in the JPMorgan Chase bank account for the Property Tax Collections payments made by credit/debit card of $5,000. G Item 14.odf Motion: Approve, Moved by Commissioner Irma Cauley, Seconded by Commissioner Sammy Catalena. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters , Wassermann . 15. Approval of Inter - Governmental Agreement between the Federal Bureau of Prisons and Brazos County Office of the Sheriff - Detention Center. U Item 15.0 The Court approved as submitted the Inter - Governmental Agreement between the Federal Bureau of Prisons and Brazos County Office of the Sheriff - Detention Center to house federally adjudicated female inmates. Term of the agreement is from September 1, 2014 through August 30, 2017. A copy is attached. Motion: Approve, Moved by Commissioner Irma Cauley, Seconded by Commissioner LLoyd Wassermann. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard , Peters. Wassermann. 16. Approval of Psychological Evaluations for applicants of the Brazos County Office of the Sheriff. ly Item 16.1)df The Court approved as submitted a Memorandum of Understanding between the Brazos County Sheriffs Office and Texas A &M University for the performance of psychological evaluations of applicants for detention officer and deputy sheriff positions and other employees. The term of the agreement is from October 1, 2014 through September 30, 2015. Brazos County will pay $260 per evaluation and $120 for a re- evaluation. A copy is attached. Motion: Approve, Moved by Commissioner Irma Cauley, Seconded by Commissioner Sammy Catalena. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann. 17. Consider and take action on renewal of contract with Grayson County for juvenile residential services. Motion: Table, Moved by Commissioner Irma Cauley, Seconded by Commissioner Kenny Mallard. Passed. 5 -0. Members voting Aye: Catalena , Cauley , Mallard , Peters , Wassermann . 18. Consider and take action on renewal of contract with Hays County for juvenile residential services. E Item 18.odf The Court approved as submitted the renewal of contract with Hays County for Juvenile Residential Services. The term of the contract is from the effective date and will continue for twelve (12) months. Cost to Brazos County will be as follows: $100 per day for each space utilized in Detention services Vol. 205 Pg. ��/� $105 per day for each space utilized in the Boot Camp $140 per day for each space utilized in the Juvenile Intensive Treatment Program Motion: Approve, Moved by Commissioner LLoyd Wassermann, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann . 19. Renewal of Bid No. 2014 -83R Asphalt, Oils, and Emulsions Products as follows: 9Z Item 19.odf • a. Cleveland Asphalt: Sections 1, 2, 3, 5, 6 and 7 • b. Ergon: Section 4 Motion: Approve, Moved by Commissioner LLoyd Wassermann, Seconded by Commissioner Sammy Catalena. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann . 20. Capital Requisition No. 00047966 to Marton Roofing in the amount of $314,161 for roofing renovations on county buildings. This is being purchased through TCPN contract #132203 -TX -1940. 9 Item 20.0 Motion: Approve, Moved by Commissioner Sammy Catalena, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann . 21. Consider and take action on the ETC Texas Pipeline utility permit to construct road bore under Rock Prairie Road. Project will lay 16" pipeline for transportation of natural gas. Site is located in Precinct 2. 9S Item 21.1)df Motion: Approve, Moved by Commissioner Sammy Catalena, Seconded by Commissioner LLoyd Wassermann. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann . 22. Consider and take action on the ETC Texas Pipeline utility permit to construct road bore under Weedon Loop. Project will lay 16" pipeline for transportation of natural gas. Site is located in Precinct 2. U Item 22.nd( Motion: Approve, Moved by Commissioner Sammy Catalena, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena , Cauley, Mallard, Peters, Wassermann . 23. Tax Refund Applications for the following: a. Excel Landscaping & Lawns, Inc.- overpayment- $83.78b. Michael & Mary Susan Beal- overpayment - $300.19 C Item 23.0 • a. Excel Landscaping & Lawns, Inc. overpayment $83.78 • b. Beal Michael M. & Mary Susan Overpayment $300.19 Motion: Approve, Moved by Commissioner Irma Cauley, Seconded by Commissioner Sammy Catalena. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard, Peters. Wassermann. 24. Commissioners Court minutes for the following dates: Vol. 205 Pg. /0 J a. June 23 -July 11, 2014 - Budget Workshop Sessionsb. July 1, 2014 - Regular Meetingc. July 7, 2014 - Workshop Sessiond. July 8, 2014 - Regular Meetinge. July 14- 18, 2014 - Budget Workshop Sessionsf. July 15, 2014 - Regular Meetingg. July 16, 2014 - Public Hearingh. July 22, 2014 - Regular Meetingi. July 22, 2014 - Public Hearing at 10:30 amj. July 22, 2014 - Public Hearing at 10:45 amk. July 23 -25, 2014 - Budget Workshop Sessionsl. July 25, 2014 - Special Sessionm. July 28 -29, 2014 - Budget Workshop Sessionsn. July 29, 2014 - Regular Meeting • a. June 23 -July 11, 2014 Budget Workshop Sessions • b. July 1, 2014 Regular Meeting • c. July 7, 2014 Workshop • d. July 8, 2014 Regular Meeting • e. July 14 -18, 2014 Budget Workshop Sessions • f. July 15, 2014 Regular Meeting • g. July 16, 2014 Public Hearing • h. July 22, 2014 Regular Meeting • i. July 22, 2014 Public Hearing at 10:30 a.m. . j. July 22, 2014 Public Hearing at 10:45 a.m. . k. July 23 -25, 2014 Budget Workshop Session . I. July 25, 2014 Special Session . m. July 28 -29, 2014 Budget Workshop Session . n. July 29, 2014 Regular Meeting Motion: Approve, Moved by Commissioner Lloyd Wassermann, Seconded by Commissioner Sammy Catalena. Passed. 5-0. Members voting Aye: Catalena, Cauley, Mallard, Peters, Wassermann . 25. Budget Amendments. Budget Amendments FY 13/14 43.1 thru 43.5 tf Item 25.odf 43.1 Transfer funds from General Fund Contingency to County Attorney 43.2 Reallocate funds for SO -Jail 43.3 Reallocate funds for Capital Projects 43.4 Transfer funds from Juvenile Services to Detention 43.5 Reallocate funds Jail for Inmate Holding Remodel Motion: Approve, Moved by Commissioner Sammy Catalena, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena, Cauley, Mallard. Peters. Wassermann . 26. Approval of the following requisitions to Software House International for server license upgrades for the IT datacenter: 0 Item 26.0 • a. Req. 00047876 - $4,630.80 • b. Req. 00047943 - $11,923.20 • c. Req. 00047944 - $1,140.00 • d. Req. 00047945 - $1,146.00 Motion: Approve, Moved by Commissioner Irma Cauley, Seconded by County Judge Duane Peters. Passed. 5 -0. Members voting Aye: Catalena , Cauley , Mallard , Peters , Wassermann. 27. Personnel Change of Status. Vol. 205 Pg. /�� Personnel Action Forms t- Item 27.odf A copy of the Personnel Change of Status requests is attached. Motion: Approve, Moved by Commissioner Lloyd Wassermann, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena , Cauley, Mallard, Peters, Wassermann . 28. Payment of Claims. a Claims SheeLOdf L6 BILL LIST 08.12.14.0 7124097 through 7124424 Motion: Approve, Moved by Commissioner Sammy Catalena, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena , Cauley, Mallard, Peters, Wassermann . 29. Convene into Executive Session pursuant to Texas Government Code 551.071 to consult with attorney about pending or contemplated litigation and /or a settlement offer. At this point, the County Judge announced the court would consider items 31 through 33 then return to convene into Executive Session to consult with attorney about pending or contemplated litigation and /or a settlement offer pursuant to Section 551.071 of the Texas Government Code. Having considered the previously noted agenda items, at 10:36 a.m. the County Judge closed the meeting to the public. He asked that the following individuals stay for the session: Candy Gallego, Executive Assistant Bill Ballard, Civil Counsel Kendra Suhling, Civil Counsel Jennifer Salazar, Director Human Resources Allan Munger, Road & Bridge Engineer 30. Consider and possible action on Executive Session. At 10:48 a.m. the County Judge announced the meeting open to the public and on motion by Commissioner Wassermann, seconded by Cauley, the Court voted unanimously to accept the settlement for Howard Hill, Road and Bridge employee in the amount of $10,000.00. Motion: Approve, Moved by Commissioner Lloyd Wassermann, Seconded by Commissioner Irma Cauley. Passed. 5 -0. Members voting Aye: Catalena , Cauley Mallard , Peters , Wassermann . 31. Sheriffs report on inmate population. Sheriff Chris Kirk stated there were 662 inmates in jail, 49 have electronic monitors and 15 are pending for monitors. 32. Announcement of interest items and possible future agenda topics. Commissioner Cauley announced that Health Point in conjunction with Spirit of Texas Vol. 205 Pg. l�P� Bank are offering free school physicals on Saturday, August 16, 2014. She also announced that the Urban County Policy Analysis project has a hearing today at 1:00 p.m. to discuss finance issues and reviewing disability laws. Commissioner Catalena announced that there will be a tire cleanup on Saturday, August 16, 2014 at the Expo Center. Commissioner Mallard announced the Transportation Summit will be selling tickets for tables. There are 8 to a table. He hopes all the Commissioners will be able to attend. He will send out the date for the affair. He also encouraged the Commissioners to try to attend the Urban County Conference because the TAC conferences seem to have the same information. They might learn something new . Again he will send out the dates of the conference. 33. Call for Citizen input and /or concerns. There was no citizen's input. 34. Adjourn. Vol. 205 Pg. 1�a The foregoing minutes of the Commissioners Court meeting held August 12. 2014 have been examined and are approved in open Court this Duane Peters County Judge 6aoaf ct&�- Sammy Catal Commissio Precinct 2 Commissioner, Precinct 4 Attest: Karen McQueen County Clerk zos County, Texas. � day of Lloyd Wassermann Commissioner, Precinct 1 Kenny Mallard Commissioner, Precinct 3 Vol. 205 Pa. / % / BRAZOSCOUNTY COMMISSIONER'S COURT ask DAY OF k,4vr Co AM Name i Pg I of Z 201�k Organization Vol. 205 Pg. /`Zlf 1� Name Pg2, OfZ BRAZOSCOUNTY COMMISSIONER'S COURT DAY OF k us+ , 0 . CC) AM/PM, 20 1 � Organization Vol. 205 Pg. /zI9 'W9Y22ZT9S Bishop Vashti Murphy McKenzie historic election in the year 2000 is the first time in the 200 year history of the African Methodist Episcopal Church in which a woman obtained that level of Episcopal office; and )Odes In 2004, Bishop McKenzie again made history becoming the first woman to become the Titular Head of the denomination as the president of the Council of Bishops, Bishop McKenzie served as the highest - ranking woman in the A.M.E. Church; and 7Y3P2R. Bishop McKenzie served in 2000 -2004 as the chief pastor of the I llh Episcopal District in Southeast Africa where she instituted an ambitious agenda: "Strength to Climb" which included strengthening the District's infra - structure, 37 new church starts, facilitated two USA - African teacher workshops and summits; produced four new classrooms and supplied school supplies for AME schools and scholarships for clergy and High School students. She went on to build nine buildings; purchased four parcels of land, built eight new mission houses, and built twelve new church buildings. Bishop McKenzie opened a not - for -profit computer center, three District office /centers, initiated the AME Schools Annual Conferences, and provided scholarship for 31 students. Bishop McKenzie expanded services to 75 children orphaned or affected by the HIV /Aids pandemic. In addition, the Selulah Sandlah AME Village which include three large group homes was built without government funds to provide home for 36 orphaned children plus house parents; and 'W_4&R' Bishop McKenzie has received many titles and has been honored for her community service, outstanding achievements and being a religious role model by numerous diverse civic, educational, business and governmental leaders; and 'WMYVeEi2S Bishop McKenzie is the National Chaplain for Delta Sigma Them Sorority, Inc. an international public service organization, she is a life member of the NAACP; and 7V912RZ3S Bishop McKenzie is the presiding prelate of the Tenth Episcopal District of the African Methodist Episcopal Church, serves as the 117" elected and consecrated bishop; completing her 'Tour of Texas' by visiting and speaking at the one hundred and jorty -one year old Allen Chapel African Methodist Church of Bryan, Tears and 'W_1Y27_ZsllS Bishop McKenzie is the wife of Dr. Stan McKenzie retired NBA great and the supervisor of missions for the Tenth Episcopal District, mother of Jon - Mikael, Vashti - Jasmine and Joi- Marie; and 7fr.9i2:� Bishop Vashti Murphy McKenzie is the granddaughter of Delta Sigma Them Sorority founder Vashti Turley Murphy, .9UDil; %ERE -WE PrJAJ CLi4dWYD that the Brazos County Commissioners Court extends the warmest welcome and proclaims August 2014 the month of this phenomenal woman, SiShOf1 7?!s%JtY.i1 A1- Y%[,y.AfC✓ eWfe in Brazos County. Proefai)r ed thl.ts 72'x' qCsy'of-of 2014. County Judge Lle Comm ssioner Lloyd Wasserman Cmommissioner Stung Precinct 1 Commissio enny Me d Pr ret 3 Precinct 4 14 -026 Vol. 205 Pg. /J-O I ffiB 0039) OraevnW J Stc6 I 15f T SnOauJ 00G,) 006,1500{ Tem Ekmon Code inJ ORDER OF GENERAL ELECTION (ORDEN DE ELECC/oN GENERAL) An election is hereby ordered to be held on November 4. 2014, in Brazos County, Texas for the purpose of electing the following county and precinct officers as required by Article XVI, Section 65 of the Texas Constitution. (Por la presence se ordena que se lleve a cabo una election el dia noviembre 4. 201 4. en el Condado de Brazos, Texas, can el proposito de elegir los siguentes oftciales del condado y del precinto como requerido por el Articulo XVL Seccion 65, de la Constitution de Texas.) United State Senator ( Senador de Jos Estados Unities) United States Representative, District 17 ( Representaite de los Estados Unidos, Distrito Num. 17) Governor (Gobemador) Lieutenant Governor (Gobernador Tenieme) Attorney General (Procurador General) Comptroller of Public Accounts (Contralor de Cuentas Publicas) Commisssioner of the General Land Office (Comisionado de la Ofrcina General de Tierras) Commissioner of Agriculture (Comisionado de Agricultura) Railroad Commissioner (Comisionado de Ferrocarriles) Chief Justice, Supreme Court (Juez Presidente, Corte Suprema) Justice, Supreme Court, Place 6, Unexpired Term (Juez, Corte Suprema, Lugar Num. 6, Duracidn Restante del Cargo) Justice, Supreme Court, Place 7 (Juez, Corte Suprema, Lugar Num. 7) Justice, Supreme Court, Place 8 (Juez, Corte Suprema, Lugar Num. 8) Judge, Court of Criminal Appeals, Place 3, (Juez, Corte de Apelaciones Criminales, Lugar Num.3) Judge, Court of Criminal Appeals, Place 4 (Juez, Corte de Apelaciones Criminales, Lugar Num. 4) Judge, Court of Criminal Appeals, Place 9 (Juez, Corte de Apelaciones Criminales, Lugar Num.9) Vol. 205 Pg. /S/ State Senator, District 5 ( Senador Estatal, Distrito Ntim. S) State Representative, District 12 ( Representante Estatal, Distrito Num. 12) State Representative, District 14 (Representante Ftatal. Distrito Num. 14) Justice, 10th Court of Appeals District, Place 2 (Juez, Corte de Apelaciones Distrito, Lugar Mm 2) District Judge, W Judicial District (Juez del Distrito, Distrito Judicial Num. 85) District Judge, 361' Judicial District (Juez del Distrito, Distrito Judicial Num. 361) County Judge (Juez del Condado) Judge, County Court at Law, No. 1 (Juez, Corte de Ley del Condado, Lugar I) Judge, County Court at Law, No. 2 (Juez, Corte de Ley del Condado, Lugar 1) District Clerk (Secretario del Distrito) County Clerk (Secretario del Condada) County Treasurer (Tesorero del Condado) County Commissioner, Precinct No. 2 (Comisionado del Condado, Precinto Num. 1) County Commissioner, Precinct No. 4 (Comisionado del Condado, Precinto Num. 4) Justice of the Peace, Precinct No. 1 (Juez de Paz, Precinto Mum. )) Justice of the Peace, Precinct No. 2 (Juez de Paz, Precinto Num. 1) Justice of the Peace, Precinct No. 3 (Juez de Paz, Precinto Num. 3) Justice of the Peace, Precinct No. 4 (Juez de Paz, Precinto Num. 4) Constable, Precinct No. I (Condestable, Precinto Num. 1) Constable, Precinct No. 2 (Condestable, Precinto Num. 2) Constable, Precinct No. 3 (Condestable, Precinto Num. 3) Constable, Precinct No. 4 (Condestable, Precinto Arum. 4) Vol. 205 Pg. / 5 Early voting by personal appearance will be conducted at: (La votacion adelantada en persona se llevara a Cabo de limes a Nernes en:) October 20, 2014 — October 31, 2014 (el 10 de octubre de 1014 — el 31 de octubre de 1014) Brazos County Administration Building — 200 S. Texas Ave, Bryan Arena gall — 2906 Tabor Rd. - Bryan Galilee Baptist Church— 804 N. Logan, Bryan Memorial Student Center - Texas A&M University, College Station College Station Utilities Meeting & Training Facility — 1603 Graham Road, College Station Applications for a ballot by mail should be mailed to: (Las solicitudes para boletus que se votaran adelantada por correo deberan enviarse a:) Karen McQueen. County Clerk TONE. 26 St.. Ste. 120 Bryan, Texas 77806 -0111 Applications for ballots by mail must be received no later than the close of business on: (Las solicitudes para boletas que se votaran adelantada par correo deberan recibirse Para elfin de las Boras de negocio ek) October 24, 2014 (el 14 de octubre de 2014) Issued this the ay of Auaust. 2014. Emitado este dia de agosto de 2014. Duane Peters, Brazos County Iudge 0uez del Condado de Brazos) Vol. 205 Pg. 1,5 � ORDER RELOCATING POLLING PLACE FOR ELECTION PRECINCTS 80/10 WHEREAS, there exists at the present time a certain polling place which can not be used for the purpose of conducting elections; and WHEREAS, the polling place for Election Precincts 80/10 was currently located at Living Hope Baptist Church, 4170 State Hwy 6 South, College Station, Texas; and WHEREAA, the Living Hope Baptist Church is no longer available for use; and WHEREAS, for the convenience of the voters it is recommended that Election Precincts 80/10 be moved to the College Station Fire Station #3 located at 1900 Barron Rd, College Station, Texas: NOW THEREFORE, BE IT RESOLVED BY THE COMMISSIONERS COURT OF BRAZOS COUNTY, TEXAS, THAT: Pursuant to chapter 43 of the Texas Election Code that the location of the polling place be relocated in Brazos County to wit: and THAT the polling place for Election Precincts 80 /10 be located in the College Station Fire Station #3, located at 1900 Barron Rd, College Station, Texas. ADOPTED this � day of 0_ NAYS. ATTEST: C Karen Mc a en, County Clerk 2014 by a vote of 5 AYES and Vol. 205 Pg. /5?% ORDER NO. 14 -010 AN ORDER OF THE BRAZOS COUNTY COMMISSIONERS COURT, PURSUANT TO TEXAS TRANSPORTATION CODE CHAPTER 396 AND ITS ORDER ESTABLISHING RULES FOR JUNKYARDS, AUTOMOTIVE WRECKING AND SALVAGE YARDS, CONSIDERING THE APPLICATION OF JOY TRUST. WHEREAS, Brazos County, Texas ( "County ") is a county of the State of Texas, having been duly created and organized under the constitution and laws of Texas, and further, the Brazos County Commissioners Court ( "Commissioners Court") is the governing body of said County; and, WHEREAS, pursuant to the Texas Transportation Code Chapter 396, and other authority, the County Commissioners, on March 12, 2013, established rules for junkyards, automotive wrecking, and salvage yards ( "Rules "); and, WHEREAS, on June 16, 2014, Brazos County received an application for junkyards, automotive wrecking and salvage yards license from Joy Trust; and, WHEREAS, on July 16, 2014, after proper notice, the Commissioners Court conducted a Public Hearing as required by Article 6, Section A of the Rules; and, WHEREAS, not more than sixty (60) days have passed following the public hearing required by the Rules; and, WHEREAS, the Commissioners Court finds and determines that all public notice, bearing, administrative, and procedural matters required by law have been timely initiated and completed regarding the Application; NOW, THEREFORE, BE IT RESOLVED AND ORDERED by the Brazos County Commissioners Court, for and in behalf of said County and in the public interest, as follows: THE PERMIT /LICENSE APPLIED FOR BY JOY TRUST IS GRANTED _DENIED The Commissioners Court denies the approval of the license /permit of Joy Trust for the following reason(s): the location of the proposed yard would be detrimental to the public health, safety, or welfare; the location of the proposed yard would create a hazard to the environment; ' the location of the nearest boundary of the proposed yard would be within one thousand (1,000) feet of the nearest property line of property on which there is a church, a school, a park, a hospital, a nursing home, or a residence (single - family Vol. 205 Pg. /_�- home, duplex, apartment, townhouse, or mobile home), or the nearest boundary of Aa residential subdivision for which County has approved a survey's plat; the location of the proposed yard would be, incompatible with the surrounding f development; the location of the proposed yard would be detrimental to the economic welfare of Brazos County; the location of the proposed yard would be within one thousand five hundred (1,500) feet of a lake, river, tributary or pond; the location of the proposed yard would he within the one hundred (100) year flood plain; the applicant has not complied with Article 5 of these rules. This order was considered, ordered, approved, and enacted at a public meeting of the Commissioners Court held in compliance with the Texas Open Meetings Act. Petitioner /Applicant shall cease operations immediately upon the Denial of the Permit/License and shall immediately begin the removal of any junk or salvage vehicles located at the location. Removal of all junk and salvage vehicles from the location shall be completed within Thirty (30) days of the signing of this Order. Failure to remove the vehicles within the time allowed under this Order will result in the imposition of civil and or criminal liability. CONSID FRED, ORDERED, APPROVED, AND ENACTED on the ttday of 2014. nik. it .. , _ .. i SIGNED on the Duane Peters, 2014. )UOZ �- Co missioner Lloyd Wassermann ffor sib Sammy Catalena Precinct 1 Z Precin-�12 Commissioner 44 my Malla Precinct 3 ATTEST: ci, Ka n McQueen, County Clerk Vol. 205 Pg. 451 PERMIT# (OFFICE USE ONLYI RECEIVED JUN 16 1611 BRAZOS COUNTY ROAD AND BRIDGE DEPARTMENT APPLICATION FOR JUNKYARDS, AUTOMOTIVE WRECKING AND SALVAGE YARDS LICENSE This application will expire (11 year from date Issued. The undersigned hereby makes application for. k! Operation of a junkyard Operation of an automotive wrectking yard Expansion al any of the above _ Operation of a sewage yard Change of the kxation —'fhb forth must be completely filled out to be accepted. Please type or print all Information. A check, cash or money order for $25.00 must accompany this application. A current drivers license must be provided for a copy to be kept an gb. There wi:l be no refunds once this application is submitted. Name of Businessioperetion: Malting Address City: Nam Appll,,.,11. Residential City: MA AState:� � A): � a,`3U2 Phone: a f!)i i7s' V U Location of deed record In Property Records of Brazos County, Texas O Page Number. Volume Number. Exact Legal Oescripllon of Proposed Operation: ' IDI-i-XI,�fcNey 2-04-A Please attach a detailed drawing of the proposed facility. Is the applicant a partnership? Yea If yes, please provide the name, mailing address, residential street address and business street address for each member of the annerehtp. Name: Address: City: ,c# State: Zip: Phone: Is the applicant a corporation? tL.q Yea If yes, please provide the name, mailing address, residential street address and eusinses street address I& each officer and d or of the corporation and the name and address of process on the registered agent of the corporation. Name: Address: City: Stale: Zip: Phone: Vol. 205 Pg. /, Additional Documents Required: t) If an assumed name (dAYe) is used, a datmstamped copy of Certificate of Assumed Name 2) If the applicant is a general partnership, a copy of the fully exeaded partnership agreement 3) If the applicant is a limited portnerahip, a date - stamped copy of the Certificate of Limited Partnership 4) If the applicant Is a corporation, a date - stamped copy of the Articles of Incorporation filed with the Secretary of State and a cwrHfied copy of the corporate resolution authorizing the corporation to fie an application pursuant to these rotes and designating the officer authorised to execule the application. e) N the applicant is not the owner In fee simple of the proposed yard, a property executed power of ademey or other written evidence of the agency agreement between the applicant and the owner. 'Applicant agroes to comply with The Brazos County Order Establishing Rules For Junkyards, Automotive Wrecking And Salvage Yards. Daly - rltutr (�?atffsi Date slldfl Sbnahn of Owner 'Applicant grants Brazos County suthorlty to place notices pursued to Ankle 3.02 (c) and access to the spa of the proposed yard. AN information contained in sold appgrallon shall be bus and caned to the best of the applicant's knowledge and bedef. Applicant acknowledges that The license applied r shop sub to all provision of the codes and stEtum of the State of Texas' � ec� 6&'n/rre) Data G li�hy S%nga&o of Owner Q�7'e{o1ya4 �ie�Nr7 Owrrers Drtver I.karrse err ACKNOWLEDGMENT STATE OF TEXAS COUNTY OF BRAZOS Before me, the unaeralgrted authority, on this day personally appeared ALW % I AA LRLAL„f t knoryrt to me to be the pensi whose name(s) "re signed to the foregoing application and duly swum by , aBWi states under Ilk that the has road the Bald application and l�wt 9p fads therein sat forth are into and corned. Sworn to before me, thle __ I LQ _t' tv aL_ __ �,11b.0_ _ __ -2g _M riCO/L Chia W '"' IINDA K. HARROD NOTA Y PUBLIC ^f /fif' Notary Public. Srats al Toxas MY Commiesbn ExOires �'t � Isbruary 26,2015 'THIS APPLICATION WILL FJIPIRE 111 YEAR FROM DATE ISSUED" usy.91037MMU T This Request is Approved_ (or) Denied_ by the County Engineers Office on . 20_ County Engineer or authorized agent 711 7Oat I ad (or) Denied s! by Commbslonera Court an ����J YOWL• E. Duarte Peters, County Judge I hereby certify that the application of ,,iiii1f����,,,,,,,,'''' """ 7 was Approved, for) Denied V by the Brame County Commissioners Court onPULA 20_1_�. , ./ ✓) Vol. 205 Pg. Amendment Number 9 "Use -or- Lose" Rule Amendment to the Brazos County Flexible Benefit Cafeteria Plan Section 1. General Rules 1.1. Purpose and Adoption. The purpose of this Amendment is to adopt the modified "use -or -lose" rule for health flexible spending arrangements (health FSAs) set forth in proposed regulations under section 125 of the Internal Revenue Code Notice 2013 -71. This amendment shall apply notwithstanding any other statements In the Plan, the summary plan description (SPD), or any other documents. Brazos County Cthe Employer') hereby adopts the following Amendment to its Brazos County Flexible Benefit Cafeteria Plan permitting carryovers of up to $500 (or a lower amount specified in the plan) of unused health FSA amounts remaining at the end of a Plan Year to reimburse medical expenses Incurred during the following Plan Year. 1,2. Precedence. The requirements of this Amendment will take precedence over any inconsistent provisions of the Plan, including any previous amendments adopted by the Employer. 1.3. Requirements of Treasury Regulations Incorporated. All matters addressed under this Article will be determined and made in accordance with the Internal Revenue Code ( "Code ") and the Treasury Regulations sections 1.125- 1(c)(7)(C), 1.125.1(0), and 1.125 -5(c). 1.4. Effective Date. Unless otherwise stated by the regulations, this Amendment shall be effective retroactively to the first day of the Plan Year January 1, 2014. Section 2. Amendment 2.1. Carryover of Health FSA Accounts and Use-or -Lose Rule. The Plan is hereby amended to incorporate the following changes governing the forfeiture of health FSA accounts. a) An employee may carry over up to $500 of unused health FSA amounts remaining at the end of a Plan Year to reimburse medical expenses incurred during the following Plan Year. The carryover of up to $500 (or a lower amount specified In the Plan) may be used to pay or reimburse medical expenses under the health FSA incurred during the entire Plan Year to which it is carried over. For this purpose, the amount remaining unused as of the end of the Plan Year is the amount unused after medical expenses have been reimbursed at the and of the Plan's run -out period for the Plan Year. b) Unused amounts relating to a health FSA may not be cashed out or converted to any other taxable or nontaxable benefit. c) The amount that may be carried over to the following Plan Year is equal to the lesser of (1) any unused amounts from the immediately preceding Plan Year or (2) $500 (or a lower amount specified in the Plan). Any unused amount in excess of $500 (or a lower amount specified in the Pan) that remains unused as of the end of the Plan Year (that is, at the end of the run -out period for the Plan Year) is forfeited. Any unused amount remaining In an employee's health FSA as of termination of employment also is forfeited (unless, if applicable, the employee elects COBRA continuation coverage with respect to the health FSA). 2.2 Adoption. IN WITNESS WHEREOF he undersigned s execute this A dment to the Brazos County Flexible Ben starts Plan o day of 20 Brazo Coun By: Vol. 205 Pg. /� Brazos County Flexible Benefit Cafeteria Plan SUMMARY OF MATERIAL MODIFICATIONS To: Participants of Brazos County Flexible Benefit Cafeteria Plan From: Brazos County Date: December 17, 2013 On J I P/4, the Brazos County amended the Brazos County Flexible Benefit Cafeteria Plan (the Plan) permitting carryovers of up to $500 (or a lower amount specified In the plan) of unused health FSA amounts remaining at the end of a plan year to reimburse medical expenses incurred during the following plan year. This Amendment shall be effective retroactively to the first day of the Plan Year January 1, 2014. The Plan is amended by incorporating the following changes governing the forfeiture of unused health FSA accounts under the terms of the plan: Carryover of Health FSA Accounts and Use -or -Lose Rule. The Plan is hereby amended to incorporate the following changes governing the forfeiture of health FSA accounts. a) An employee may carry over up to $500 of unused health FSA amounts remaining at the end of a plan year to reimburse medical expenses incurred during the following plan year. The carryover of up to $500 (or a lower amount specified in the plan) may be used to pay or reimburse medical expenses under the health FSA incurred during the entire plan year to which it is carried over. For this purpose, the amount remaining unused as of the end of the plan year Is the amount unused after medical expenses have been reimbursed at the end of the plan's run -out period for the plan year. b) Unused amounts relating to a health FSA may not be cashed out or converted to any other taxable or nontaxable benefit. c) The amount that may be carried over to the following plan year is equal to the lesser of (1) any unused amounts from the immediately preceding plan year or (2) $500 (or a lower amount specified in the plan). Any unused amount in excess of $500 (or a lower amount specified in the plan) that remains unused as of the end of the plan year (that Is, at the end of the run -out period for the plan year) is forfeited. Any unused amount remaining in an employee's health FSA as of termination of employment also is forfeited (unless, if applicable, the employee elects COBRA continuation coverage with respect to the health FSA). d) The annual contribution limit is not affected by the carryover amount. If you have any questions on this Summary or the Amendment to your Plan, contact your Plan Administrator: Brazos County 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979) 3613181 Vol. 205 Pg. 4 Cafeteria Plan Checklist DO NOT USE THIS CHECKLIST IN LIEU OF THE PLAN DOCUMENT. 1. Adopting Employer (Enter primary adopting Employer here. Enter other members of affiliated companies in item 16.) BRAZOS COUNTY 2. Plan Name - The legal name of the Plan is: BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN 3. Dates a. Effective Date (Effective date of this document): 05/01/2011 b. Adoption Date (date document is to be executed): 05/01/2011 (If this field is left blank, it must be manually entered in the printed document.) This Plan is a c. New plan El d. Restatement of a plan originally effective: 03101/1987 PART I. The following identifying information pertains to the Employer and the Plan and Trust: 1. Employer Address : 200 S. Texas Ave, Ste 206 (City, State, Zip) BRYAN TX 77803 2. Employer Telephone :(979)361 -4181 3. Employer Tax ID : 74- 6000433 4. Three Digit Plan Number : 501 5. Plan Year : 01/01/2011 to 1213112011 (Must be 12 consecutive months.) 6. Short Initial Plan Year to 7. Legal Representative : BRAZOS COUNTY (same as Employer) 200 S. Texas Ave, Ste 206 BRYAN TX 77803 (979)361.4181 8. Plan Administrator : BRAZOS COUNTY El (same as Employer) 200 S. Texas Ave, Ste 206 BRYAN TX 77803 (979) 351 -4181 _1- Vol. 205 Pg. /�/ Appointed to keep the records for the Plan and be responsible for the administration of the Plan: ❑ a. Plan Administrator ❑ b. HR Manager ❑ c. Benefits Administrator ❑ d. Office Manager ❑ e. Other 9. Plan Administrator ID Number : 74- 6000433 10.Bensfit Coordinator : Brazos County 11. Named Fiduciary : Brazos County 12.Document Provider : David K. Young Consulting, LLC 13.Trust This is a Trusteed Plan The Trust shall be known as: Trust ID Number Plan Trustees 14.1-egal Organization of Employer ❑ a. Sole Proprietorship ❑ b. Partnership ❑ c. C Corporation ❑ d. S Corporation ❑ e. Limited Liability Company (LLC) ❑ f. Limited Liability Partnership (LLP) g. Not for Profit Corporation ❑ h. Professional Service Corporation ❑ 1. Medical Corporation ❑ j. Church or Government Plan (Exempt from ERISA) ❑ k. Other - Explain 15.State of Legal Construction : Texas 16.Affiliated Companies: (Complete only for those Affiliated Companies that will be adopting the Plan.) Affiliated Companies: El a. Other Companies: 17.Plan Is administered by a Third Party Administrator: ❑x a. Yes. Plan is administered by Third Party Administrator (default) ❑ b. No, Plan is NOT administered by Third Party Administrator -2- Vol.205 _Pg 1t!-� PART II. Unless specifically provided to the contrary, only one selection may be made for each design category. Section references are relevant to Plan Sections. Defined terms have the meanings provided in the Plan. A. Eligibility and Entry Date Provisions 1. Eligible Employees - The Eligibility and Participation section of the document provides that all Employees. Including Employees of certain related businesses and Leased Employees are eligible and including members of a collective bargaining unit and non - resident aliens. (Select all applicable) x❑ a. Exclude members of collective bargaining unit 0 b. Exclude non - resident aliens x❑ c. Exclude Leased Employees ❑x d. Exclude part time Employees who regularly work less than 40 hours per week 0 e. Exclude seasonal Employees who regularly work less than 6 months per year (Not to exceed 6 months) 0 f. Other - Specify: A temporary employee (Plan) temporary employees (SPD) 2. Elialbility Requirements - An Employee is eligible to participate in the Plan if he satisfies the following requirements. (Select all applicable. Selecting more than one option means that an Employee must meet all Indicated requirements for eligibility.) ❑ a. No age or service required ❑ b. Requirements are same as group medical insurance plan ❑ c. Minimum age of _ years. (Not to exceed 21. Partial years may be used.) 0 d. Minimum of 40 Hours required during each 0 Week ❑ Month for part time Employees ❑ e. Minimum of _ months per Plan Year for seasonal Employees f. Minimum of 30 consecutive 0 days ❑ non- consecutive ❑ weeks ❑ months, counting his or her employment Commencement Date as the first day ❑ g. Other - Specify: (Plan) (SPD) 3. Entry Date - The Eligibility and Participation section of the document provides that an Employee who satisfies the eligibility requirements enters the Plan on the Entry Date. The Entry Date is: ❑ a. ❑ b. ❑ C. O d. ❑ e. ❑ f. ❑ g• ❑ h. the date the eligibility requirements have been met the same day as the Employer's group medical plan the first day of the pay period next following the date eligibility requirements have been met the first day of the next month following satisfaction of the eligibility requirements the first day of the month coinciding with or following the date the eligibility requirements have been met as of the earliest eligibility date for any of the component plans the first day of the month following the date of hire Other - Specify: .3- Vol. 205 Pg. />o (Plan) (SPD) 4. First Plan Year Elections - If an Eligible Employee fails to file an Election Form /Salary Reduction Agreement Within the time period described in Method and Timing of Elections for the first plan year, then the Employee: Ms. is considered to have elected not to participate for the initial Plan Year and may not elect any Benefits under the Plan until the next Open Enrollment Period or until an event occurs that would justify a mid -year election change, as described under Irrevocability of Elections; Exceptions ❑ b. shall continue with the same benefit choices as the prior year for Premium Insurance Benefits and will pay for them with after -tax dollars outside of this Plan ❑ c. if a new hire, shall have 30 days after their date of hire to return the election Form /Salary Reduction Agreement ❑ d. "will automatically be enrolled in the Premium component, with the employee's salary reduced pretax to pay for a portion of the cost of the coverage, unless the employee affirmatively elects otherwise before a date specified in the open enrollment materials. ❑ e. Other - Specify: (Plan) (SPD) NOTE ` An automatic enrollment must be preceded by a notice informing employees about the automatic enrollment, the cost of coverage, and the procedure for opting out and the timing for making an opt -out. Additionally, some state wage withholding laws may limit an employer's ability to initiate automatic and evergreer ✓ rolling elections, based on wage withholding laws. 5. Subsequent Plan Year Elections - If an Eligible Employee fails to file an Election Form /Salary Reduction Agreement for subsequent Plan Years, then the Employee: ❑ a. is considered to have elected not to participate for the new Plan Year and may not elect any Benefits under the Plan (a) until the next Open Enrollment Period; or (b) until an event occurs that would justify a mid -year election change. © b. shall continue with same elections as prior year for p b.1. insured /premium benefit($) ❑ b.2. reimbursement benefit(s) ❑ c. Other - Specify: (Plan) (SPD) 6. Treatment of Rehires - Less than 30 Days - If a Participant terminates his or her employment for any reason, including (but not limited to) disability, retirement, layoff, or voluntary resignation, and then is rehired within 30 days or less after the date of termination of employment and is otherwise eligible to participate in the Plan, then the Employee: ❑ a. will immediately rejoin the Plan and be reinstated with the same elections that the individual had before termination. ❑ b. will immediately rejoin the Plan, but would not be allowed to elect new Benefits unless an applicable Change in Status occurs. ❑ c. will not be allowed to rejoin the Plan until the first day of the following Plan Year unless an applicable Change in Status occurs. ❑x d. Other - Specify: the Employee will be treated as a new hire and must resatisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan (Plan) you will be treated as a new hire and must re- satisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan (SPD) 7. Treatment of Rehires - More than 30 Days - If a former Participant is rehired more than 30 days following termination of employment and is otherwise eligible to participate in the Plan, the Employee: ❑ a. may immediately rejoin the Plan and may make new benefit elections. Any unused reimbursement benefits account balance prior to the initial separation of service date will be forfeited. ❑ b. will not rejoin the Plan until the first day of the following Plan Year, unless the Employee should incur an applicable Change in Status. Any unused reimbursement benefit account balance prior to the initial -4- Vol. 205 Pg. separation of service date will be forfeited. ❑ c. will not rejoin the Plan until the first day of the following Plan Year, regardless of whether or not the Employee should Incur an applicable Change in Status. Any unused reimbursement benefit account balance prior to the initial separation of service date will be forfeited. ❑x d. will be treated as a new hire and must resatisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan. 8. Participation after loss of Ellaibiltty - If an Employee ceases to be an Eligible Employee for any reason other than for termination of employment, Including, but not limited to, a reduction of hours, and then becomes an Eligible Employee again, the Employee (select one) ❑x a. must re- satisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan (or before becoming eligible to participate in the Plan) ❑ b. may rejoin the Plan without having to re- satisfy (complete the waiting period) Plan eligibility requirements 9, Termination of Participation ❑ a. Eligibility continues beyond the date on which the Employee ceases to be an Eligible Employee, for purposes of pre- taxing COBRA coverage. 0 b. Eligibility does not continue beyond the date on which the Employee ceases to be an Eligible Employee, for purposes of pre - taxing COBRA coverage. 10. FMLA Continuation Coverage - if a Participant goes on a qualifying leave under the FMLA, then to the extent required by the FMLA, the Employer will continue to maintain the Participant's coverage an the same terms and conditions as if the Participant were still an active Employee. ❑ a. FMLA Coverage is not offered ❑ b. FMLA coverage is offered ❑ c. Employer pays 100% of FMLA costs ❑x d. Employee pays FMLA costs based an the following: (select all applicable) 0 d.1. Pre -pay with after -tax dollars ❑ d.2. Pre -pay with pre -tax dollars x❑ d.3. Pay -as- you -go Method d.4. Catch -up Method 11.Non -FMLA Continuation Coverage - If a Participant goes on an unpaid leave of absence that does not affect eligibility, then the Participant will continue to participate and the Contributions due for the Participant will be paid in one of the following ways: (Options must be at least as favorable as those offered to employees not on FMLA leave.) ❑ a. Employer pays 100% of Non -FMLA costs 0 b. Employee pays Non -FMLA costs based on the following: (select all applicable) ❑x d.1. Pre -pay with after -tax dollars ❑ d.2. Pre -pay with pre -tax dollars J@ d.3. Pay -as- you -go Method ❑x d.4. Catch -up Method -5- Vol. 205 Pg. /G✓`� B. Funding and Contribution 1. Fundina Method - Funding for the Plan is provided by: (select all applicable) ea. Salary Reduction ❑ b. Flex Credits 2. Employer Contribution - The Employer may contribute a portion of the Contributions as provided in the open enrollment materials fumished to Employees and /or on the Election Form /Salary Reduction Agreement. (You may select one of a, b, c, d, or f,• however, option 'e' may be selected in combination with other options.) ❑ a. All Participants receive the same number of Flex Credits $ or % per plan year ❑ b. Participants are provided with an amount of Flex Credits equal to _ credits per _ dollars of salary not to exceed _ credits ❑ c. Flex Credits based on salary ranges: Compensation Rance Number of Flex Credits $ to $ $ to $ _ $ to $ $ to $ $ . to $ $ to $ — $ to $ _ $ to $ _ $ to $ $ to $ ❑ d. Deferring participants receive matching contributions equal to their amount of total deferrals ❑ d.1. but not more than $ . (Check if matching contributions are limited.) ❑ e. Limit Employer contribution to Health FSA to less than $500 ❑ f. Other - Specify: (Plan) (SPD) Compensation Definition - Compensation is defined as: ❑ 9• ❑ h. ❑ I. Gross Compensation Base Compensation - Other - Specify: _ Bonus and Overtime excluded (Plan) (SPD) Employer Premium Adjustments - Select if the employer wants the option to temporarily adjust premium contributions (select all applicable) ❑ J. temporarily increase the Employers share of premiums (premium holiday) ❑ k. temporarily increase the Participants cost NOTE: Employer contributions to a health FSA (e.g., flex credits, matching, etc.) will be subject to the $2,500 annual limit and taken into account when determining whether an employee has exceeded the limit unless the contributions cannot be cashed out or used for any other purpose. (Select option 3.a. No cash -out option offered.) 3. Unused Flex Credits -NOTE: The term 'cash -out option'refers to a plan provision under which the participant may be paid additional cash compensation in exchange for forgoing a benefit that the employer otherwise would have paid for. Before an employer offers a cash -out option, they should always check with its Insurance carrier to make sure the offering does not violate minimum participation requirements or other insurance contract terms. (Check one box only) -6- Vol. 205 ft- /C4 ❑ a. No rash-out option offered ❑ b. Unused Flex Credits not applied by the Participant toward the cost of Benefits shall be applied to an Eligible Employee 401(k) in an amount not to exceed % (not less than 1.00 %.) ❑ c. Credits not applied toward the cost of Benefits shall be paid as cash compensation in a maximum amount of ❑ $ or ❑ % (not less than 1.00% or $1.00 whichever is greater) for any Plan Year. Such compensation shall be paid ❑ c.1. per pay period ❑ c.2. monthly ❑ c.3. quarterly ❑ c.4. seml- annually ❑ c.5. annually, end of Plan Year ❑ c.6, annually, beginning of Plan Year ❑ d. Credits not applied toward the cost of Benefits shall be paid as cash compensation in a maximum amount of ❑ $ or ❑ % (not less than 1.00% or $1.00 whichever is greater) for any Plan Year provided the Participant has submitted an Election FormlSalary Reduction Agreement. Such compensation shall be paid ❑ d.1. per pay period ❑ d.2. monthly ❑ d.3. quarterly ❑ d.4. semi - annually ❑ d.5. annually, end of Plan Year ❑ d.6. annually, beginning of Plan Year ❑ e. Other - Specify: (Plan) (SPD) 4. Maximum Employee Contribution - Participants who elect Benefits under the Plan may pay for the cost of that coverage on a pre -tax salary reduction basis by completing an Election Form /Salary Reduction Agreement ❑ a. A fixed dollar amount: $_ ❑ b. A Percent of Salary: _% © c. Sum of costs of most expensive benefit choices ❑ d. Other - Specify: (Plan) (SPD) 5. Benefit Acceleration -Salary Reduction Balance Upon Termination of Coverage ❑ If, as of the date that any elected coverage under this Plan terminates, a Participant's year -lo -date salary reductions exceed or are less than the Participant's required Contributions for the premium insurance coverage, the Employer will, as applicable, either return any unused premiums to the Participant as additional taxable wages or recoup the due salary reduction amounts from any remaining Compensation. 6. Funding Assets - Contribution and Reimbursement Assets are handled In the following manner: O a. ❑ b. ❑ c. ❑ d. Amounts payable may be paid from the general assets of the Employer, but Premium Payment Benefits are paid as provided In the applicable insurance policy. Only contributions for reimbursement benefits are made to the Trust and paid out of the Trust All contributions are deposited in the Trust and payments made out of the Trust Other - Specify: -7- Vol. 205 Pg. 4;7 (Plan) (SPD) C. Premium Component 1. Premium Component Availability - Premium Insurance benefits that may be offered under the Premium Payment Component for premium -type benefits pursuant to an insurance policy Issued by an insurance company, or a contract with a point of service organization to provide medical, dental, vision, or other qualified benefits under Section 125. El a. Premium Component Is Available ❑ b. Outside /Individual Insurance Policies Accepted 2. Insurance Benefits Provided - Insurance benefits provided by the insurance provider(s) include: (select all applicable) 0 a. Basic Health ❑ a.t. Participant Only p a.2. Participant and Dependents ❑ a.3. Dependents Only ❑ b. HMO ❑ b.1. Participant Only ❑ b.2. Participant and Dependents ❑ b.3. Dependents Only p C. PPO ❑ c.1. Participant Only ❑x 0.2. Participant and Dependents ❑ c.3. Dependents Only ❑ d. POS ❑ d.1. Participant Only ❑ d.2. Participant and Dependents ❑ d.3. Dependents Only ❑x e. Dental ❑ e.1. Participant Only ❑x e.2. Participant and Dependents ❑ e.3. Multiple Plan Deductibles ❑ e.4. Orthodontic Coverage ❑ f. Vision ❑ f.1. Participant Only ❑ U. Participant and Dependents ❑ g. Group Term Life insurance ❑ g.1. Multiple Coverage ❑ h. Disability Benefits ❑ h.1. Multiple Coverage ❑ i. Other Premium Benefits: Benefit Title 1: ❑ Described in another document. Document Name: ❑ Described in this document: (Plan) (SPD) Benefit Title 2: ❑ Described in another document. Document Name: ❑ Described In this document: (Plan) (SPD) Benefit Title 3: ❑ Described in another document. Document Name: ❑ Described in this document: -B- Vol. 205 Pg. / (Plan) (SPD) Benefit Title 4: ❑ Described in another document. Document Name: ❑ Described in this document: (Plan) (SPD) 3. Premium Grace Period -A Participant's salary reductions during a Plan Year maybe applied by the Employer to pay the Participant's share of the Contributions for Premium Insurance Benefits that are provided to the Participant during the Grace Period, an additional period of time (not to exceed 2.5 months) immediately following the close of that Plan Year. M] a. Grace Period does not apply to the Premium Component ❑ b. Grace period of _ additional ❑ Days ❑ Months following the end of each Plan Year 4. Change in Status - A Participant may make a new election upon the occurrence of certain events, including a Change in Status. The events constituting a Change in Status are: a. All of the events constituting a Change in Status under the regulations shall be allowed ❑ b. A Participant may change an election as described below upon the occurrence of the staled events: (If restrictions apply, select all applicable) ❑ b.1. Change in Employee's Legal Marital Status ❑ b.2. Change in the number of Employee's Dependents ❑ b.3. Change in Employment Status of Employee, Spouse or Dependent that Affects Eligibility ❑ b.4. Change in Participant's Residence ❑ b.5. Event Causing Employee's Dependent to Satisfy or Cease to Satisfy Eligibility Requirements ❑ b.8. Cost Changes with Automatic Increase /Decrease in Elective Contributions ❑ b.7. Significant Cost Increase or Significant Cost Decrease ❑ b.8. Significant Curtailment of Coverage (With or Without Loss of Coverage) ❑ b.9. Addition or Significant Improvement of a Benefit Package Option ❑ b.10.Change in Coverage Under Another Employer Cafeteria Plan or Qualified Benefits Plan ❑ b.11.Medicare or Medicaid Entitlement -9- Vol. 205 Pg. y D. Reimbursement Components 1. Health FSA Component - (Leave blank if Health FSA is not offered) 0 A Health Flexible Spending Account Component is available 2. Health FSA Elialbility Requirements - An Employee Is eligible to participate in the Health FSA if he satisfies the following requirements. (Select all applicable. Selecting more than one option means that an Employee must meet all indicated requirements for eligibility.) 0 a. Eligibility Requirements are the same as described in Question A.2 of the checklist ❑ b. Requirements are same as group medical insurance plan ❑ c. Minimum age of _ years. (Not to exceed 21. Partial years may be used.) ❑ d. Minimum of _ Hours required during each ❑ Week ❑ Month for part time Employees ❑ e. Minimum of _ (Not to exceed 6) months per Plan Year for seasonal Employees ❑ f. Minimum of ❑ consecutive ❑ days ❑ nonconsecutive ❑ weeks ❑ months, counting his or her employment Commencement Date as the first day ❑ g. Other- Specify: (Plan) (SPD) 3. Health FSA Entry Date - The Health FSA section of the Plan Document provides that an Employee who satisfies the eligibility requirements enters the Health FSA on the Entry Date. The Entry Date is: 0 a. Entry Date is the same as described in Question A.3 of the checklist ❑ b. The same day as the Employer's group medical plan ❑ c. The date the eligibility requirements have been met ❑ d. the first day of the pay period next following the date eligibility requirements have been met ❑ e. the first day of the next month following satisfaction of the eligibility requirements ❑ f. the first day of the month coinciding with or following the date the eligibility requirements have been met ❑ g. Other -Specify: (Plan) (SPD) 4. Available Health FSA Coverage - The Health FSA section of the Plan Document provides the following coverage options (Select all applicable. Option b is Employee HSA compatible, options c and d are Spouse HSA compatible.) ❑x a. General - Purpose Option - Participant or his or her Spouse or Dependents for medical care ❑ General- Purpose Option exclusions: ❑ b. Limited Option - Participant or his or her Spouse or Dependents for vision /dental /preventative care. ❑ Exclude preventive care ❑ General- Purpose Option exclusions: ❑ c. Employee -Only General- Purpose Option - Participant only for medical care ❑ General- Purpose Option exclusions: ❑ d. Employee -Plus- Children General- Purpose Option - Participant or Participant's Dependents (excluding Spouse) for medical care ❑ General- Purpose Option exclusions: ❑ e. Post - Deductible Option - Participant or his or her Spouse or Dependents for preventive care or medical expenses incurred after the minimum annual deductible under Code section 223(cK2)(AKi) is satisfied. ❑ f. Exclude Adult Children under Notice 2010 -36 & Code sections 105(b) and 106 .to- Vol. 205 Pg. / 70 5. Maximum Annual Benefits for Health FSA The Maximum Annual Benefits Reimbursement for the General- Purpose Health and /or Limited - Purpose Health FSA x❑ a. Statutory Salary Reduction "Limit of $2500 (Effective 11112013) ❑ b. Other - Specify: b.1 General- Purpose Health FSA is $_ b.2 Limited- Purpose Health FSA is $_ ❑ c. $2,500 limit to increase with inflation beginning 1/1/2014 The $2,500 limit applies to health FSA "salary reduction contributions" (on a plan -year basis), and not to other employer contributions. Therefore, nonelective employer contributions to a health FSA (e.g., flex credits, matching contributions, etc. that cannot be cashed out or used for any other purpose) are not subject to the limit and are not taken into account when determining whether an employee has exceeded the limit. 6. Minimum Annual Benefits for Health FSA The Minimum Annual Benefits Reimbursement for the Health FSA is $_ (Leave blank if no Maximum) 7. Health FSA Proration Rule - If a Participant enters the Health FSA Component mid -year or wishes to increase his or her election mid -year, then the Participant's maximum dollar limit could be prorated based on a percentage of the plan year remaining. (Leave blank if not applicable) ❑ Proration of Maximum limit applies 8. Over The Counter (OTC) Drugs - Over - the - counter (OTC) drugs or medicines may be reimbursed from a Participant's Health FSA Account only if such medicine or drug is a prescribed drug (determined without regard to whether such drug is available without a prescription) or is insulin. (Leave b/ankif not applicable) p OTC Reimbursement is available 9. Health FSA Grace Period - A Participant's salary reductions during a Plan Year may be applied by the Employer to pay the Participant's share of the Contributions for Health FSA Benefits that are provided to the Participant during the Grace Period, an additional period of time (not to exceed 2.5 months) immediately following the close of that Plan Year. p a. Grace Period does not apply to Health FSA ❑ b. Grace period ofi additional O Days ❑ Months following the end of each Plan Year 10.Health FSA Plan Year Adiudlcation - If the Health FSA has a Grace Period, the Participant may not choose to have the claim adjudicated against all applicable Plan Years. (Leave blank if not applicable) ❑ The Employee can specify against which Plan Year a claim may be adjudicated 11. Health FSA Change In Status - A Participant may make a new election upon the occurrence of the following permitted election changes: ❑x a. All of the events constituting a Change in Status under the regulations shall be allowed ❑ b. A Participant may change an election as described below upon the occurrence of the stated events: (If restrictions apply, select all applicable) ❑ b.1. Change in Employee's Legal Marital Status ❑ b.2. Change in the Number of Employee's Dependents ❑ b.3. Change in Employment Status of Employee, Spouse or Dependent that Affects Eligibility ❑ b.4. Event Causing Employee's Dependent to Satisfy or Cease to Satisfy Eligibility Requirements ❑ b.5. Medicare or Medicaid Entitlement ❑ C. Limit the number of Change in Status elections per Year -11- Vol. 205 Pg. 171 Maximum number of changes: _ ❑ d. Only'Increase' in election allowed. 12.ERISA Coverage of Health FSA -A Health FSA can bean employer- sponsored employee benefit plan. In such a case it falls under the rules of ERISA. ❑x a. The Health FSA does not fall under ERISA ❑ b. The Health FSA falls under ERISA 13.Health FSA Reimbursement After Termination: COBRA -To the extent required by COBRA, the following Participants shall be given the opportunity to continue Health FSA Benefits on a self -pay basis for the year in which the COBRA qualifying event occurs, with premiums generally to be paid after -tax: ❑ a. Only Participants with positive Health FSA Account balances at the time of the COBRA qualifying event. ❑ b. All Participants, whether they have positive or negative Health FSA Account balances. ❑x c. If Employer Contributions (Flex Credits) and the Health FSA qualifies as a Special Limited COBRA Obligation, only Participants with positive Health FSA Account balances at the time of the COBRA qualifying event, may extend coverage beyond the current Plan Year in which the COBRA qualifying event occurs. 14.Ouallfted Reservist Distributions - This will allow a Participantfreservist who is called to active duty for 179 days or more and not able to fully use amounts credited in his or her health FSA to cash out, on a taxable, penalty free basis, the unused benefits and not forfeit them under the "use-lit-or-lose-it" rule that applies to health FSAs. The amount available as a qualified reservist distribution will be determined by the: (Leave blank if not applicable.) El a. Contributed amount reduced by reimbursements: The qualified reservist distribution amount is the amount contributed to the health FSA as of the date of the qualified reservist distribution request, minus health FSA reimbursements received as of that date. ❑ b. Other -Specify: (Plan) (SPD) 16.Deoendent Care Assistance Plan WCAP) Availability - (Leave blank if DCAP is not offered) ❑A Dependent Care Assistance Component is available 16.DCAP Ellalbility Reauirements - An Employee is eligible to participate in the DCAP Plan if he /she satisfies the following requirements. (Select all applicable. Selecting more than one option means that an Employee must meet all indicated requirements for eligibility.) ❑x a. Eligibility Requirements are the same as described in Question A.2 of the checklist ❑ b. Requirements are same as group medical insurance plan ❑ c. Minimum age of _ years. (Not to exceed 21. Partial years may be used.) ❑ d. Minimum of _ Hours required during each ❑ Week ❑ Month for part time Employees ❑ e. Minimum of _ (Not to exceed 6) months per Plan Year for seasonal Employees ❑ f. Minimum of _ ❑ consecutive ❑ days ❑ non- consecutive ❑ weeks ❑ months, counting his or her employment Commencement Date as the first day ❑ g. Other -Specify: (Plan) (SPD) 17.DCAP Entry Date - The DCAP section of the Plan Document provides that an Employee who satisfies the eligibility requirements enters the DCAP on the Entry Date. The Entry Date is: _12- Vol. 205 Pg. �� ❑x a. the same as described In Question A.3 of the Checklist p b. the same day as the Employer's group medical plan ❑ c. The date the eligibility requirements have been met ❑ d. the first day of the pay period next following the date eligibility requirements have been met ❑ e. the first day of the next month following satisfaction of the eligibility requirements ❑ f. the first day of the month coinciding with or following the date the eligibility requirements have been met ❑ g. Other -Specify: (Plan) (SPD) 18.Maximum Annual Benefits for DCAP The Maximum Annual Benefits Reimbursement for DCAP is ❑x a. Statutory limit of $5000 ❑ b. Other - Specify: _ (Not to exceed statutory limit) 19.1111inimum Annual Benefits for DCAP The Minimum Annual Benefits Reimbursement for DCAP is $_ (Leave blank If no Minimum) 20.DCAP Proration Rule - If a Participant enters the DCAP Component mid -year or wishes to Increase his or her election mid -year, then the Participant's maximum dollar limit could be prorated based on a percentage of the plan year remaining. (Leave blank If not applicable) ❑ Proration of Maximum limit applies 21.DCAP Grace Period -A Participant's salary reductions during a Plan Year maybe applied by the Employer to.pay the Participant's share of the Contributions for DCAP Benefits that are provided to the Participant during the Grace Period, an additional period of time (not to exceed 2.5 months) Immediately following the close of that Plan Year. Q a. Grace Period does not apply to DCAP ❑ b. Grace period of_ additional ❑ Days ❑ Months following the end of each Plan Year 22.DCAP Plan Year Adjudication -If the DCAP has a Grace Period, the Participant may not choose to have the claim adjudicated against all applicable Plan Years. (Leave blank if not applicable) ❑ The Employee can specify against which Plan Year a claim may be adjudicated 23.—DCAP Chance in Status - A Participant may make a new election upon the occurrence of the following permitted election changes: p a. All of the events constituting a Change in Status under the regulations shall be allowed ❑ b. A Participant may change an election as described below upon the occurrence of the stated events: (if restrictions apply, select all applicable) ❑ b.1. Change in Employee's Legal Marital Status [] -b.2. Change in the Number of Employee's Dependents ❑ b.3. Change in Employment Status of Employee, Spouse or Dependent that Affects Eligibility ❑ b.4.. Event Causing Employee's Dependent to Satisfy or Cease to Satisfy Eligibility Requirements E3 b.5. Significant Cost Changes: Significant Cost Increase or Significant Cost Decrease ❑ b.8. Significant Curtailment of Coverage (With or Without Loss of Coverage) ❑ V. Addition or Significant Improvement of a Benefit Package Option p b.8. Change in Coverage Under Another Employer Cafeteria Plan or Qualified Benefits Plan c. - Only'lncrease' in election allowed. - 24. DCAP Reimbursements After Termination - Participants shall be given the opportunity to obtain reimbursement of Dependent Care Expenses incurred during the following timeframes: -13- Vol. 205 Pg. / 73 p a. During the Period of Coverage prior to termination ❑ b. During the Period of Coverage prior to termination - including expenses incurred In the month following termination if such month is in the current Plan Year ❑ c. During the Period of Coverage following termination - that is, through the balance of the Plan Year if such expenses are otherwise qualifying expenses under the Code 25.Other Reimbursement Benefits - Other Reimbursement Benefits offered besides Health FSA and DCAP ❑ Other Reimbursement Benefits: Benefit Title 1: Described in another document. Document Name: _ ❑ Described in this document: (Plan) (SPD) Benefit Title 2: p Described in another document. Document Name: ❑ Described In this document: Benefit Title 3: ❑ Described in another document. Document Name: ❑ Described in this document: Benefit Title 4: ❑ Described in another document. Document Name: ❑ Described in this document: -14- Vol. 205 Pg. /% (Plan) (SPD) (Plan) (SPD) (Plan) (SPD) E. HSA Component 1. Health Savinas Account (HSAI Availability - (Leave blank if HSA not offered) ❑ A Health Savings Account Is available 2. ERISA Coverage of HSA - An HSA can be an employer - sponsored employee benefit plan. in such a case it falls under the rules of ERISA. ❑ a. The HSA does not fall under ERISA ❑ b. The HSA falls under ERISA NOTE: HSAs funded with salary reductions or cashable flex credits generally will not be subject to ERISA and is not considered an Employer- sponsored plan (unless the Employer imposes restrictions). If an Employer makes contributions outside of the Cafeteria plan, they must make comparable contributions to all participating Employees. 3. Employer and Participant Contributions for Cost of Coveraae for HSA - The HSA will be funded: (Specify amount, not to exceed the statutory maximum limit.) ❑ a. Solely with Employee's pre -tax salary reductions ❑ b. Employee's pre -tax salary reductions and Employer contributions in the form of flex credits (Complete section '8. Funding and Contributions' Ouestion f.b. Flex Credits.) -15- Vol. 205 Pg. F. Other Administrative Provisions 1. COBRA Continuation Coverage - A Participant and his or her Dependents, whose coverage terminates under the medical insurance plan because of a COBRA qualifying event, shall be given the opportunity to continue on a self -pay basis the same coverage that he or she had under the medical insurance plan the day before the qualifying event for the periods prescribed by COBRA. ❑x a. COBRA Continuation Coverage is offered ❑ b. An alternate coverage is available in place of continuation coverage Note: Selection of an alternate coverage causes loss of rights to continuation coverage COBRA Administrative Information (select all applicable) ❑ c. Provide COBRA Continuation Coverage regardless of employee count ❑ d. Employer pays the cost of COBRA ❑ e. Coverage is suspended during grace period (late COBRA payment) for non - payment f. COBRA payments are due the_ day of the month g. Days to notify Administrator of other Qualifying Event _ (Must be at least 60 days) COBRA Administrator ❑ (same as Plan Administrator) ❑ h. Include COBRA Initial Notice in SPD 2. HIPAA Privacy Provislons - Provision of Protected Health Information to Employer ❑ a. Plan is not subject to HIPAA privacy requirements El b. HIPAA privacy requirements apply Effective Date: 03/08/2004 Protected Health Information (PHI) PHI access is allowed by the following (select all applicable) ❑ b.1. Human Resource Manager ❑x b.2. Human Resource and payroll staff performing Health FSA functions ❑ b.3. Benefits Manager ❑x b.4. Plan Administrator ❑ b.5. Other- Specify: (Plan) (SPD) HIPAA Privacy Officer ❑ (same as Plan Administrator) 3. Debit Card Availability - Debit card, stored value card, or credit card that allows a Participant to access funds in a Health FSA or Health Savings Account to pay the service provider at the point -of -sale. -16- Vol. 205 Pg. /fie ❑x Debit card is offered 4. Appeals Procedure - If a claim for reimbursement under this Plan is wholly or partially denied, The claim shall be administered in accordance with the claims procedure set forth below: a. Days until denial notice: 30 (must be 30 days or less) b. Days to return additional Information: 45 (must be 45 days or greater) c. Days Employee has to request review: 180 (must be 180 days or greater) d. Additional Days to Process Claim: 15 (must be 15 days or less) e. Days unlit Review Decision: 60 (must be 60 days or less) 5. Plan Expenses - Plan expenses are paid by: ❑x a. completely by the Employer ❑ b. partially by the Employer and partially by the Employees ❑ c. entirely by the Employees 6. Run-out Period - Period after the close of a Plan Year or other period during which the Participants may request reimbursement for expenses incurred during the period of coverage. a. ROP for current employees: 90 Days ❑ Weeks ❑ Months b. ROP for employees that terminated or for loss of eligibility begins: ❑x b.1. from termination date or loss of eligibility date ❑ b.2. from plan year end 7. Forfeitures - All forfeitures under this Plan shall be used as follows: El a. To offset losses, administration of the Plan or use toward Benefits for subsequent Plan Years. ❑ b. Other -Specify: (Plan) (SPD) 8. Makina New Election if Exception to Irrevocability Applies - A Participant who becomes eligible to make a new election must do so: (selections are required for both a and b) p a. within 30 days (Typically 30, 60 or 90 days) ❑x b. A Participant's new election shall be effective as of: ❑x b.1. The First day of the next calendar month ❑ b.2. Other -Specify: (Plan) (SPD) -17- Vol. 205 Pg. / 7 Execution: To record the adoption of this Plan and Trust the Employer and each affiliated employer, if any, has caused this Agreement to be executed by its duly qualified officers and the Truq6e-has cu Agrr#ment, as of the day and year first above written Sign lories. j L \l�a 0 l4- -18- Vol. 205 Pg. BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN SUMMARY PLAN DESCRIPTION Effective May 1, 2011 7 Duane Peters Date County Judge Vol. 205 Pg. /7 7 Summary Plan Description With Premium Payment, Health FSA, and DCAP Components Table of Contents Article I INTRODUCTION Article II 2 PARTICIPATION IN YOUR PLAN 2 How can I participate in the Cafeteria Plan? 2 What are the Eligibility Requirements to participate in the Plan? 2 Are there any Employees who are not eligible to participate in the Plan? 2 How do I become a Participant and when is my Entry Date? 2 What is the "Open Enrollment Period" and the "Plan Year"? 3 What happens if my employment ends during the Plan Year or I lose eligibility 3 for other reasons? What is "Continuation Coverage" and how does it work? 3 How does a leave of absence (such as under FMLA) affect my benefits? 4 Article III PAYING FOR YOUR BENEFITS UNDER YOUR PLAN How do employees pay for benefits on a pre -tax basis? Will 1 pay any administrative costs under the Cafeteria Plan? Can I change my elections under the Cafeteria Plan during the Plan Year? When Can I Change Elections Under the Cafeteria Plan During the Plan Year? Article IV WHAT BENEFITS ARE PROVIDED UNDER THE PLAN What benefits may be elected under the Cafeteria Plan? Article V 11 HOW BENEFITS ARE TAXED 11 What tax savings.are.possible under the Cafeteria Plan? 11 How will participating in the Cafeteria Plan affect my Social Security benefits? 11 Will I be taxed on the Health FSA Benefits that I receive? 11 Will I be taxed on the DCAP Benefits that I receive? 11 Article VI PREMIUM INSURANCE BENEFIT ACCOUNT What are "Premium Payment Benefits "? How are my Premium Payment Benefits paid? 13 13 13 13 Article VII 14 HEALTH FSA ACCOUNT 14 What are "Health FSA Benefits "? 14 What is my "Health FSA Account " ?. 14 How are my Health FSA Benefits paid for under the Cafeteria Plan? 14 What are the maximum and minimum Health FSA Benefits that I may elect? 14 What amounts will be available for Health FSA reimbursement at any 14 particular time during the Plan Year? What are "Medical Care Expenses" that may be reimbursed from the Health is FSA? Vol. 205 Pg. / 96 When must the Medical Care Expenses be incurred for the Health FSA? 16 Can I Continue Health FSA Coverage After Terminating Employment or 16 Incurring a COBRA Event? 19 What must I do to be reimbursed for Medical Care Expenses from the Health 16 FSA? 19 Is there any risk of losing or forfeiting the amounts I elect for Health FSA 17 Benefits? 19 Qualified Reservist Distribution 17 What are the time limits that affect forfeiture of my Health FSA Benefits (and 17 what happens to amounts that are forfeited)? 20 Will I be taxed on the Health FSA Benefits that I receive? 17 Article VIII 19 DEPENDENT CARE REIMBURSEMENT ACCOUNT 19 What are "DCAP Benefits "? 19 What is my "DCAP Account'? 19 What are the maximum and minimum DCAP Benefits that I may elect under 19 the Cafeteria Plan? 27 How are my DCAP Benefits paid for under the Cafeteria Plan? 19 What amounts will be available for DCAP reimbursement at any particular 20 time during the Plan Year? 28 What are "Dependent Care Expenses" that may be reimbursed? 20 When must the Dependent Care Expenses be incurred? 21 Can I Continue DCAP Coverage After Terminating Employment? 21 What must I do to be reimbursed for my Dependent Care Expenses? 21 Is there any risk of losing or forfeiting the amounts that I elect for DCAP 22 Benefits? What are the time limits that affect forfeiture of my DCAP Benefits? 22 Will I be taxed on the DCAP Benefits I receive? 22 If I elect DCAP Benefits, can I still claim the Dependent Care Tax Credit on 23 my federal income tax return? What is the Dependent Care Tax Credit? 23 Would it be better to include the DCAP Benefits in my Income and claim the 23 Dependent Care Tax Credit, instead of treating the reimbursements as tax free? Article IX 24 CLAIMS PROCEDURE 24 What happens if my claim for benefits is denied? 24 Article X 27 FUNDING 27 Funding This Plan 27 How long will the Cafeteria Plan remain in effect? 27 Article XI 28 GENERAL INFORMATION 28 What other general information should I know? 28 Vol. 205 Pg. / b'/ BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN With Premium Payment, Health FSA, and DCAP Components Summary Plan Description Article I INTRODUCTION BRAZOS COUNTY, (the "Employer") sponsors the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN (with Premium Payment, Health FSA, and DCAP Components) (the "Cafeteria Plan ") that allows Eligible Employees to choose from a menu of different benefits to suit their needs and to pay for those benefits with pre -tax dollars. Alternatively, Eligible Employees may choose to pay for any of the benefits with after -tax contributions on a payroll - reduction basis. This Summary Plan Description (SPD) describes the basic features of the Cafeteria Plan, how it operates, and how to get the maximum advantage from it. This Summary does not describe every detail of the Cafeteria Plan and is not meant to interpret or change the provisions of your Plan. A copy of your Plan is on file at your Employer's office and may be read by you, your Beneficiaries, or your legal representatives at any reasonable time. In the event of any inconsistencies or conflict between the actual provisions of the Cafeteria Plan document and this Summary, the Cafeteria Plan Document shall govern. -t- Vol. 205 Pg. �� Article II PARTICIPATION IN YOUR PLAN How can I participate In the Cafeteria Plan? Once an Employee has met the Plan's eligibility requirements, and provided that the election procedures outlined under'How do I become a Participant and when is my Entry Date ?' section are followed, the Eligible Employee may participate in the Plan. What are the Eligibility Requirements to participate In the Plan? Employees who regularly work 40 or more hours per week, have been employed by the Employer for 30 consecutive days, counting his or her Employment Commencement Date as the first such day and are employed by a participating Employer may participate in the Plan once they meet the eligibility requirements and provided that the election procedures outlined under'How do I become a Participant ?' section are followed. Eligibility for the Premium Insurance Benefits is also subject to the additional eligibility requirements, if any, specified in the Medical Insurance Plan. Are there any Employees who are not eligible to participate in the Plan? The following Employees are excluded from participating in the Plan: Employees covered by a collective bargaining agreement as to which retirement benefits were the subject of good faith bargaining, unless such agreement expressly provides for participation in the Plan, Non - resident aliens with no US source of income, "Leased employees" within the meaning of Section 414(n), Part-time employees who regularly work less than 40 hours per week, Seasonal employees who regularly work less than 6 months per year, temporary employees, and self - employed individuals, partners in a partnership, or mare - than -2% shareholders in a Subchapter S corporation. How do I become a Participant and when is my Entry Date? After you satisfy the eligibility requirements described under'What are the Eligibility Requirements to participate in the Cafeteria Plan ?', you may enter the plan on the first day of the next month following satisfaction of the eligibility requirements by signing an individual Election Form /Salary Reduction Agreement. The Election Form /Salary Reduction Agreement will be available by the first day of the Open Enrollment Period. You must complete the Election Form/Salary Reduction Agreement and return it to Brazos County within the time period specified in the enrollment materials. (If you have not received the enrollment materials and /or the Election Form /Salary Reduction Agreement, ask Brazos County for copies.) An Eligible Employee who fails to complete, sign, and return an Election Form /Salary Reduction Agreement, (or waiver of pre -tax premiums) as required, for the first plan year is considered to have elected not to participate for the initial Plan Year and may not elect any Benefits under the Plan (a) until the next Open Enrollment Period, or (b) until an event occurs that would justify a mid -year election change, as described under'Can I change my elections under the Cafeteria Plan during the Plan Year ?'. An Eligible Employee who fails to complete, sign, and return an Election Form/Salary Reduction Agreement, (or waiver of pre -tax premiums) as required, for subsequent Plan Years, then the Employee: shall continue with same elections as prior year for insured /premium benefits. If an Employee who fails to file an Election Form /Salary Reduction Agreement is eligible for Premium Insurance Benefits and has made an effective election for such Benefits, then the Employee's share of the Contributions for such Benefits will be paid with after -tax dollars outside of this Plan until such time as the Employee files, during a subsequent Open Enrollment Period (or after an event occurs that would justify a mid -year election change as explained under 'Can I change my elections under the Cafeteria Plan during the Plan Year ?'), a timely Election Form/Salary Reduction Agreement to elect Premium Payment Benefits. Until the Employee flies such an election, the Employer's portion of the Contribution will also be paid outside of this Plan. Employees who actually participate in the Cafeteria Plan are called "Participants." An Employee continues to participate in the Cafeteria Plan until: (a) termination of the Cafeteria Plan; or (b) the date on which the Participant ceases to be an Eligible Employee (because of retirement, termination of employment, layoff, reduction of hours, or any other reason). -2- Vol. 205 Pg. / 83 However, for purposes of pre - taxing COBRA coverage for Premium Insurance Benefits and Health FSA Benefits, certain Employees may be able to continue eligibility in the Cafeteria Plan for certain periods. See What is Continuation Coverage and how does It work ?', and 'What happens if my employment ends during the Plan Year or I lose eligibility for other reasons7 for information about how termination of participation affects your Benefits. What is the "Open Enrollment Period" and the "Plan Year "? The Open Enrollment Period is the period during which you have an opportunity to participate under the Cafeteria Plan by signing and returning an individual Election FormlSalary Reduction Agreement. You will be notified of the timing and duration of the Open Enrollment Period prior to the beginning of the new Plan Year. The Plan Administrator will inform all Participants of the applicable dates for each annual enrollment period. What happens if my employment ends during the Plan Year or I lose eligibility for other reasons? If your employment with the Employer is terminated during the Plan Year, then your active participation in the Cafeteria Plan will cease and you will not be able to make any more contributions to the Cafeteria Plan for the Premium insurance benefits, Health FSA, and DCAP benefits. The Premium Insurance Benefits will terminate as of the date specified in the Medical Insurance Plan See'What is Continuation Coverage and how does it work ?' and the booklets for the Medical Insurance Plan for information on your right to continued or converted group health coverage after termination of your employment For reimbursement of expenses from the Health FSA Account after termination of employment, see 'What must I do to be reimbursed for Medical Care Expenses from the Health FSA?'. For reimbursement of expenses from the DCAP Account after termination of employment, see 'What must I do to be reimbursed for my Dependent Care Expenses ?. For purposes of pre - taxing COBRA coverage for Premium Insurance Benefits and Health FSA Benefits, certain Employees may be able to continue eligibility in the Cafeteria Plan for certain periods. See 'What Is Continuation Coverage and how does it work?'. If you are rehired within 30 days or less during the same Plan Year and are eligible for the Cafeteria Plan, you will be treated as a new hire and must re- satisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan. If you are rehired more than 30 days after you terminated employment, and are eligible for the Cafeteria Plan, you will be treated as a new hire and must re- satisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan. Any unused reimbursement benefit account balance prior to the initial separation of service date will be forfeited. If you cease to be an Eligible Employee for reasons other than termination of employment, such as a reduction of hours, then you must complete the waiting period described under'How can I participate In the Cafeteria Plan ?' before again becoming eligible to participate in the Plan. What is "Continuation Coverage" and how does It work? To the extent required by COBRA, a Participant and his or her Spouse and Dependents, as applicable, whose coverage terminates under the medical insurance plan because of a COBRA qualifying event (and who is a qualified beneficiary as defined under COBRA), may be given the opportunity to continue on a self -pay basis the same coverage that he or she had under the medical insurance plan the day before the qualifying event for the periods prescribed by COBRA. Such continuation coverage shall be subject to all conditions and limitations under COBRA. Contributions for COBRA coverage for medical insurance benefits may be paid on a pre -tax basis for current Employees receiving taxable compensation (as may be permitted by the Plan Administrator on a uniform and consistent basis, but may not be prepaid from contributions in one Plan Year to provide coverage that extends into a subsequent Plan Year) where COBRA coverage arises either: (a) because the Employee ceases to be eligible because of a reduction in hours; or (b) because the Employee's Dependent ceases to satisfy the eligibility requirements for coverage. For all other individuals (e.g., Employees who cease to be eligible because of -3- Vol. 205 Pg. / �� retirement, termination of employment, or layoff), Contributions for COBRA coverage for medical insurance benefits shall be paid on an after -tax basis (unless may be otherwise permitted by the Plan Administrator on a uniform and consistent basis, but may not be prepaid from contributions in one Plan Year to provide coverage that extends into a subsequent Plan Year). To the extent required by COBRA, a Participant and his or her Spouse and Dependents, as applicable, who has a separation from service or whose coverage terminates under the Health FSA Benefit because of a COBRA qualifying event (and who is a qualified beneficiary as defined under COBRA) may be given the opportunity to continue on a self -pay basis the same coverage that he or she had under the Health FSA Benefit the day before the qualifying event for the periods prescribed by COBRA. Such individuals will be notified if they are eligible for COBRA continuation coverage. If COBRA is elected, it will be available only for the remainder of the applicable Period of Coverage; such COBRA coverage for the Health FSA Benefit will cease at the end of the Plan Year and cannot be continued for the next Plan Year. Such continuation coverage shall be subject to all conditions and limitations under COBRA. Contributions for coverage for Health FSA Benefits may be paid on a pre -tax basis for current Employees receiving taxable compensation (as may be permitted by the Plan Administrator on a uniform and consistent basis, but may not be prepaid from contributions in one Plan Year to provide coverage that extends into the new Plan Year) where COBRA coverage arises either: (a) because the Employee ceases to be eligible because of a reduction of hour, or (b) because the Employee's Dependent ceases to satisfy the eligibility requirements for coverage. For all other individuals (e.g., Employees who cease to be eligible because of retirement, termination of employment, or layoff), Contributions for COBRA coverage for Health FSA Benefits may be paid on an after -tax basis (unless permitted otherwise by the Plan Administrator on a uniform and consistent basis, but may not be prepaid from contributions in one Plan Year to provide coverage that extends into the new Plan Year). USERRA Continuation and reinstatement rights may also be available if you are absent from employment due to service in the uniformed services pursuant to the Uniformed Services Employment and Reemployment Rights Act of 1994 ( USERRA). More information about coverage under USERRA is available from the Plan Administrator. How does a leave of absence (such as under FMLA) affect my benefits? FMLA Leaves of Absence If you go on a qualifying leave under the Family and Medical Leave Act of 1993 (FMLA), then to the extent required by the FMLA your Employer will continue to maintain your Premium insurance benefits, and Health FSA benefits on the same terms and conditions as if you were still active (that is, your Employer will continue to pay its share of the contributions to the extent that you opt to continue coverage). Your Employer may require you to continue all Premium Insurance Benefits and Health FSA Benefits coverage while you are on paid leave (so long as Participants on non -FMLA paid leave are required to continue coverage). If so, you will pay your share of the contributions by the method normally used during any paid leave (for example, on a pre -tax salary- reduction basis). If you are going on unpaid FMLA leave (or paid FMLA leave where coverage is not required to be continued) and you opt to continue your Premium Insurance Benefits and Health FSA Benefits, then you may pay your share of the contributions in one of the following ways: with after -tax dollars, by sending monthly payments to the Employer by the due date established by the Employer; Pay -as- you -go Wth their share of premium payments on the same schedule as payments would be made if the Employee were not on leave, or under another schedule permitted under Department of Labor regulations; or under another arrangement agreed upon between the Participant and the Plan Administrator (e.g., the Plan Administrator may fund coverage during the leave and withhold "catch -up" amounts from the Participant's Compensation on a pre -tax or after -tax basis) upon the Participant's return. If your Employer requires all Participants to continue Premium Insurance Benefits and Health FSA Benefits during the unpaid FMLA leave, then you may discontinue paying your share of the required contributions until you return from leave. Upon returning from leave, you must pay your share of any required contributions that you did not pay during the leave. Payment for your share will be withheld from your compensation either on a pre -tax or after -tax basis, depending on what you and the Plan Administrator agree to. If your Premium Insurance Benefits or Health FSA Benefits coverage ceases while you are on FMLA leave (e.g,, for non - payment of required contributions), you will be permitted to re -enter such Benefits, as applicable, upon return from such leave on the same basis as when -4- Vol. 205 Pg. / YY� you were participating in the Plan before the leave or as otherwise required by the FMLA. You may be required to have coverage for such Benefits reinstated so long as coverage for Employees on non -FMLA leave is required to be reinstated upon return from leave. But despite the preceding sentence, with regard to Health FSA Benefits, if your coverage ceased you will be permitted to elect whether to be reinstated in the Health FSA Benefit at the same coverage level as was in effect before the FMLA leave (with increased contributions for the remaining period of coverage) or at a coverage level that is reduced pro rata for the period of FMLA leave during which you did not pay contributions. If you elect the pro rata coverage, the amount withheld from your compensation on a payroll -by payroll basis for the purpose of paying for reinstated Health FSA Benefits will equal the amount withheld before FMLA leave. If you are commencing or returning from FMLA leave, then your election for non - health benefits (such as life insurance, etc.) will be treated in the same way as under your Employer's policy for providing such Benefits for Participants on a non -FMLA leave (see below). If that policy permits you to discontinue contributions while on leave, then upon returning from leave you will be required to repay the contributions not paid by you during leave. Payment will be withheld from your compensation either on a pre -tax or after -tax basis, as agreed to by the Plan Administrator and you or as the Plan Administrator otherwise deems appropriate. Non -FMLA Leaves of Absence If you go on an unpaid leave of absence that does not affect eligibility, then you will continue to participate and the contribution due from you (if not otherwise paid by your regular salary reductions) will be paid: with after -tax dollars, by sending monthly payments to the Employer by the due date established by the Employer; with their share of premium payments on the same schedule as payments would be made if the Employee were not on leave, or under another schedule permitted under Department of Labor regulations; or under another arrangement agreed upon between the Participant and the Plan Administrator (e.g., the Plan Administrator may fund coverage during the leave and withhold "catch -up" amounts from the Participant's Compensation on a pre -tax or after -tax basis) upon the Participant's return. If you go on an unpaid leave that does affect eligibility, then the Change in Status rules will apply (see 'When Can I Change Elections Under the Cafeteria Plan During the Plan Year ?'). -5- Vol. 205 Pg. / b'� Article III PAYING FOR YOUR BENEFITS UNDER YOUR PLAN How do employees pay for benefits on a pre -tax basis? An Employee's election to pay for benefits on a pre -tax or after -tax basis is made by entering into an Election Form/Salary Reduction Agreement with the Employer (ask Brazos County for a copy if you have not received one). Under that Agreement, if you elect to pay for benefits on a pre -tax basis, you agree to a salary reduction to pay for your share of the cost of coverage (also known as contributions) with pre -tax funds instead of receiving a corresponding amount of your regular pay that would otherwise be subject to taxes. From then on, you must pay contributions for such coverage by having that portion deducted from each paycheck on a pre -tax basis (generally an equal portion from each paycheck, or an amount otherwise agreed to or as deemed appropriate by the Plan Administrator). Will I pay any administrative costs under the Cafeteria Plan? No. The cost of the plan includes administrative expenses and is paid entirely by the Employer. The cost of the plan includes administrative expenses and is paid in part by the use of forfeitures, if any. (See What are the time limits that affect forfeiture of my Health FSA Benefits? and What are the time limits that affect forfeiture of my DCAP Benefits ?) The rest of the cost of administering the Cafeteria Plan is paid entirely by the Employer. Can I change my elections under the Cafeteria Plan during the Plan Year? You generally cannot change your election to participate in the Cafeteria Plan or vary the salary reduction amounts that you have selected during the Plan Year (known as the irrevocability rule). Of course, you can change your elections for benefits and salary reductions during the Open Enrollment Period, but those election changes will apply only for the following Plan Year. During the Plan Year, however, there are several important exceptions to the irrevocability rule. See the various "Change in Election Events" that are described under'When Can I Change Elections Under the Cafeteria Plan ?'. The Plan Administrator may also reduce your salary reductions (and increase your taxable regular pay) during the Plan Year If you are a key employee or highly compensated individual as defined by the Internal Revenue Code ( "the Code "), if necessary to prevent the Cafeteria Plan from becoming discriminatory within the meaning of the federal income tax law. Additionally, if a mistake is made as to your eligibility or participation, the allocations made to your account, or the amount of benefits to be paid to you or another person, then the Plan Administrator shall, to the extent that it deems administratively possible and otherwise permissible under the Code and other applicable law, allocate, withhold, accelerate, or otherwise adjust such amounts as will in its judgment accord the credits to the account or distributions to which you are or such other person is properly entitled under the Cafeteria Plan. Such action by the Plan Administrator may Include withholding of any amounts due from your compensation. When can I change elections under the cafeteria plan during the Plan Year? Participants can change their elections under the Cafeteria Plan during a Plan Year if an event occurs that is a Change in Election Event and certain other conditions are met, as described below. For details, see the various 'Change in Election Events' headings below for the specific type of Change in Election Event: Leaves of absence, including FMLA leave (defined under'How do leaves of absence (such as under FMLA) affect my benefits ?'); Changes in Status; Special Enrollment Rights; Certain Judgments, Decrees, and Orders; Medicare or Medicaid; Changes in Cost; Changes in Coverage; and Changes in HSA Elections. Note also that no changes can be made with respect to Medical Insurance Benefits if they are not permitted under the Medical Insurance Plan. If any Change in Election Event occurs, you must inform the Plan Administrator and complete a new Election Form/Salary Reduction Agreement within 30 days after the occurrence. If the change involves a loss of your Spouse's or Dependent's eligibility for Medical Insurance Benefits, then the change will be deemed effective as of the date that eligibility Is lost due to the occurrence of the Change in Election Event. Vol. 205 Pg. / �,7 1. Leaves of Absence (Applies to Medical Insurance Benefits, Health FSA, and DCAP Benefits) You may change an election under the Cafeteria Plan upon FMLA and non -FMLA leave only as described under 'How do leaves of absence (such as under FMLA) affect my benefits ?' 2. Change in Status. (Applies to Medical Insurance Benefits, Health FSA, and DCAP Benefits) If one or more of the following Changes in Status occur, you may revoke your old election and make a new election, provided that both the revocation and new election are on account of and correspond with the Change in Status (as described in hem 3 below). Those occurrences that qualify as a Change in Status include the events described below, as well as any other events that the Plan Administrator, in its sole discretion and on a uniform and consistent basis, determines are permitted under IRS regulations: a change in your legal marital status (such as marriage, death of a Spouse, divorce, legal separation, or annulment); a change in the number of your Dependents (such as the birth of a child, adoption or placement for adoption of a Dependent, or death of a Dependent); any of the following events that change the employment status of you, your Spouse, or your Dependent and that affect benefits eligibility under a cafeteria plan (including this Cafeteria Plan) or other employee benefit plan of you, your Spouse, or your Dependents. Such events include any of the following changes in employment status: termination or commencement of employment; a strike or lockout; a commencement of or return from an unpaid leave of absence; a change in worksite; switching from salaried to hourly -paid, union to non - union, or full -time to part -time (or vice versa); incurring a reduction or increase in hours of employment; or any other similar change that makes the individual become (or cease to be) eligible for a particular employee benefit; an event that causes your Dependent to satisfy or cease to satisfy an eligibility requirement for a particular benefit (such as attaining a specific age, or a similar circumstance); or a change in your, your Spouse's, or your Dependent's place of residence. 3. Change in Status-Other Requirements. (Applies to Medical insurance Benefits, Health FSA, and DCAP Benefits) If you wish to change your election based on a Change in Status, you must establish that the revocation is on account of and corresponds with the Change in Status. The Plan Administrator, in its sole discretion and on a uniform and consistent basis, shall determine whether a requested change is on account of and corresponds with a Change in Status. As a general rule, a desired election change will be found to be consistent with a Change in Status event if the event affects coverage eligibility (for DCAP Benefits, the event may also affect eligibility of Dependent Care Expenses (as defined under'What are "Dependent Care Expenses" that may be reimbursed? ') for the dependent care tax exclusion). In addition, you must satisfy the following specific requirements in order to alter your election based on that Change in Status: Loss of Spouse or Dependent Eligibility; Special COBRA Rules. For accident and health benefits (the Medical Insurance Plan and the Health FSA Benefits), a special rule governs which type of election changes are consistent with the Change in Status. For a Change in Status involving your divorce, annulment, or legal separation from your Spouse, the death of your Spouse or your Dependent, or your Dependent's ceasing to satisfy the eligibility requirements for coverage, you may elect only to cancel the accident or health benefits for the affected Spouse or Dependent. A change in election for any individual other than your Spouse involved in the divorce, annulment, or legal separation, your deceased Spouse or Dependent, or your Dependent that ceased to satisfy the eligibility requirements would fail to correspond with that Change in Status. Example: Employee Mike is married to Sharon, and they have one child. The employer offers a calendar -year cafeteria plan that allows employees to elect any of the following: no medical coverage, employee -only coverage, employee -plus- one - dependent coverage, or family coverage. Before the plan year, Mike elects family coverage for himself, his wife Sharon, and their child. Mike and Sharon subsequently divorce during the plan year; Sharon loses eligibility for coverage under the plan, while the child is still eligible for coverage under the plan. Mike now wishes to revoke his previous election and elect no medical coverage. The divorce between Mike and Sharon constitutes a Change in Status. An election to cancel medical coverage for Sharon is consistent with this Change in Status. However, an election to cancel coverage for Mike and/or the child is not consistent with this Change in -7- Vol. 205 Pa. 37 Status. In contrast, an election to change to employee -plus -one dependent coverage would be consistent with this Change in Status. However, if you, your Spouse, or your Dependent elects COBRA continuation coverage under the Employers plan because you ceased to be eligible because of a reduction of hours or because your Dependent ceases to satisfy eligibility requirements for coverage, and if you remain a Participant under the terms of this Cafeteria Plan, then you may in certain circumstances be able to Increase your contributions to pay for such coverage. Ses'What Is "Continuation Coverage" and how does it work ?'. Gain of Coverage Eligibility Under Another Employer's Plan. For a Change in Status in which you, your Spouse, or your Dependent gains eligibility for coverage under another employers cafeteria plan (or qualified benefit plan) as a result of a change in your marital status or a change in your, your Spouse's, or your Dependent's employment status, your election to cease or decrease coverage for that individual under the Cafeteria Plan would correspond with that Change in Status only if coverage for that individual becomes effective or is increased under the other employers plan. DCAP Benefits. With respect to the DCAP Benefits, you may change or terminate your election with respect to a Change in Status event only if (a) such change or termination is made on account of and conforms with a Change In Status that affects eligibility for coverage under the DCAP; or (b) your election change is on account of and conforms with a Change in Status that affects the eligibility of Dependent Care Expenses for the available tax exclusion. Example: Employee Mike is married to Sharon, and they have a 12- year -old daughter. The employers plan offers a DCAP as part of its cafeteria plan. Mike elects to reduce his salary by $2,000 during a plan year to fund dependent care coverage for his daughter. In the middle of the plan year when the daughter turns 13 years old, however, she is no longer eligible to participate in the DCAP. This event constitutes a Change in Status. Mike's election to cancel coverage under the DCAP would be consistent with this Change in Status. 4. Special Enrollment Rights. (Applies to Medical Insurance Benefits) In certain circumstances, enrollment for Medical Insurance Benefits may occur outside the Open Enrollment Period, as explained in materials provided to you separately describing the Medical Insurance Benefits. (The Employer's Special Enrollment Notice also contains important information about the special enrollment rights that you may have, a copy of which was previously furnished to you. Contact the Human Resources Manager if you need another copy.) When a special enrollment right explained in those separate documents applies to your Medical Insurance Benefits, you may change your election underthe Cafeteria Plan to correspond with the special enrollment right. 5. Certain Judgments, Decrees, and Orders. (Applies to Medical Insurance Benefits and Health FSA Benefits) If a judgment, decree, or order from a divorce, separation, annulment, or custody change requires your child (including a foster child who is your Dependent) to be covered under the Medical Insurance Benefits or Health FSA Benefits, you may change your election to provide coverage for the child. If the order requires that another individual (such as your former Spouse) cover the child, then you may change your election to revoke coverage for the child, provided that such coverage is, in fact, provided for the child. 6. Medicare or Medicaid. (Applies to Medical Insurance Benefits and Health FSA Benefits) If you, your Spouse, or your Dependent becomes entitled to (i.e., becomes enrolled in) Medicare or Medicaid, then you may reduce or cancel that person's accident or health coverage under the Medical Insurance Plan, and/or your Health FSA coverage. Similarly, if you, your Spouse, or your Dependent who has been entitled to Medicare or Medicaid loses eligibility for such coverage, then you may elect to commence or increase that person's accident or health coverage (here, Medical Insurance Benefits and /or Health FSA Benefits, as applicable). 7. Change In Cost. (Applies to Medical Insurance Benefits and DCAP Benefits) If the cost charged to you for your Medical Insurance Benefits or DCAP Benefits significantly increases during the Plan Year, then you may choose to do any of the following: (a) make a corresponding increase in your contributions; (b) revoke your election and receive coverage under another benefit package option (if any) that provides similar coverage, or elect similar coverage under the plan of your Spouse's employer; or (c) drop your coverage, but only if no other benefit package option provides similar coverage. (Note that, for purposes of this definition, (a) the Health FSA is not similar coverage with respect to the Medical Insurance Benefits; and (b) coverage under another employer plan, such as the plan of a Spouse's or Dependent's employer, may be treated as similar coverage if it otherwise meets the requirements of similar coverage.) -8- Vol. 205 Pg. /�/` For insignificant increases or decreases in the cost of benefits, however, the Plan Administrator will automatically adjust your election contributions to reflect the minor change in cost. The Plan Administrator generally will notify you of increases in the cost of Medical Insurance benefits; you generally will have to notify the Plan Administrator of increases in the cost of DCAP benefits. The change in cost provision applies to DCAP Benefits only If the cost change is imposed by a dependent care provider who is not your relative. 8. Change In Coverage. (Applies to Medical Insurance Benefits and DCAP Benefits) You may also change your election if one of the following events occurs: Significant Curtailment of Coverage. If your Medical Insurance Benefits and DCAP Benefits coverage is significantly curtailed without a loss of coverage (for example, when there is an increase in the deductible under the Medical Insurance Benefits), then you may revoke your election for that coverage and elect coverage under another benefit package option that provides similar coverage. (Coverage under a plan is significantly curtailed only if there is an overall reduction of coverage under the plan generally -loss of one particular physician in a network does not constitute significant curtailment.) If your Medical Insurance Benefits and DCAP Benefits coverage is significantly curtailed with a loss of coverage (for example, if you lose all coverage under the option by reason of an overall lifetime or annual limitation), then you may either revoke your election and elect coverage under another benefit package option that provides similar coverage, elect similar coverage under the plan of your Spouse's employer, or drop coverage, but only if there Is no option available under the plan that provides similar coverage. (The Plan Administrator generally will notify you of significant curtailments in Medical Insurance Benefits coverage; you generally will have to notify the Plan Administrator of significant curtailments in DCAP Benefits coverage.) Addition or Significant Improvement of Cafeteria Plan Option. If the Cafeteria Plan adds a new option or significantly improves an existing option, then the Plan Administrator may permit Participants who are enrolled in an option other than the new or improved option to elect the new or improved option. Also, the Plan Administrator may permit eligible Employees to elect the new or improved option on a prospective basis, subject to limitations imposed by the applicable option. Loss of Other Group Health Coverage. You may prospectively change your election to add group health coverage for you, your Spouse or Dependent, if any of you loses coverage under any group health coverage sponsored by a governmental or educational institution, including (but not limited to) the following: a state children's health insurance program (SCRIP); a medical care program of certain Indian Tribal programs or a tribal organization; a state health benefits risk pool; or a foreign government group health plan, subject to the terms and limitations of the applicable Benefit Package Option(s). An election change on account of a HIPAA special enrollment attributable to an employee or dependent becoming eligible for a state premium assistance subsidy under the plan from Medicaid or SCHIP may, subject to the provisions of the underlying group health plan, be effective retroactively (up to 60 days). Change In Election Under Another Employer Plan. You may make an election change that is on account of and corresponds with a change made under another employer plan (including a plan of the Employer or a plan of your Spouse's or Dependent's employer), so long as (a) the other cafeteria plan or qualified benefits plan permits its participants to make an election change permitted under the IRS regulations; or (b) the Cafeteria Plan permits you to make an election for a period of coverage (for example, the Plan Year) that is different from the period of coverage under the other cafeteria plan or qualified benefits plan, which it does. For example, if an election to drop coverage is made by your Spouse during his or her employer's open enrollment, you may add coverage under the Cafeteria Plan to replace the dropped coverage. DCAP Coverage Changes. You may make a prospective election change that is on account of and corresponds with a change by your dependent care service provider. For example: (a) if you terminate one dependent care service provider and hire a new dependent care service provider, then you may change coverage to reflect the cost of the new service provider; and (b) if you terminate a dependent care service provider because a relative becomes available to take care of the child at no charge, then you may cancel coverage. Article IV WHAT BENEFITS ARE PROVIDED UNDER THE PLAN -g- Vol. 205 Pg. / % 0 What benefits may be elected under the Cafeteria Plan? The Cafeteria Plan includes the following benefit plans: Premium Payment Component (currently including Premium Insurance Benefits) - permits an Employee to pay for his or her share of contributions for the Medical Insurance Plan with pre -tax dollars. "Medical Insurance Plan" means the major medical plan that your Employer maintains for Employees, their Spouses, and Dependents, providing major medical type benefits through a group insurance policy. Here, these benefits include Basic Health, PPO, and Dental options. Benefits provided under the Medical Insurance Plan are called "Premium Insurance Benefits." Benefits provided generally under the Premium Payment Component (including any benefits that may be added at a later date) are called "Premium Payment Benefits'; Health Flexible Spending Arrangement (Health FSA) also called a medical expense reimbursement plan - permits an Employee to pay for his or her qualifying Medical Care Expenses (defined under'What are Medical Care Expenses that may be reimbursed from the Health FSA7) that are not otherwise reimbursed by Insurance with pre -tax dollars. Benefits provided under the Health FSA are called "Health FSA Benefits." As described under' What are Medical Care Expenses that may be reimbursed from the Health FSA7, the Health FSA election may be for: General- Purpose Health FSA Coverage, Dependent Care Assistance Program (DCAP) also called a dependent care flexible spending account - permits an Employee to pay for his or her qualifying Dependent Care Expenses (defined under'What are Dependent Care Expenses that may be reimbursed ?') with pre -tax dollars. Benefits provided under the DCAP are called "DCAP Benefits." If you select one or more of the above benefits, you will pay all or some of the contributions; the Employer may contribute some or no portion of them. The applicable amounts will be described in documents furnished separately to you. -10- Vol. 205 Pg. Article V HOW BENEFITS ARE TAXED What tax savings are possible under the Cafeteria Plan? You may save bath federal income tax and FICA (Social Security) taxes by participating in the Cafeteria Plan. Here is an example of the possible tax savings of paying for your share of the contributions for Premium Insurance Benefits under the Cafeteria Plan. Suppose that you are married and have one child and that your share of the required contributions for Premium Insurance Benefits for family coverage is an annual total of $6,400. Suppose also that your gross pay is $75,000 and your Spouse (a student) cams no income and that you file a joint tax return. As illustrated in detail by the Table below, if you elect to salary-reduce $6,400 to pay for the Premium Insurance contributions, then your annual take -home pay would be $56,732. If Instead you elect to pay the contributions on an after -tax basis, then your annual take-home pay would be only $55,282. This is because by participating in the Cafeteria Plan for Premium Insurance contributions, you will be considered for tax purposes to have received $68,600 in gross pay, so you save $1,450 per year. How much an employee actually saves will depend on what family members are covered and the contributions for the coverage, the total family income, and the tax deductions and exemptions claimed. There may be state tax savings, too. And salary reductions also lower earned income, which can impact the earned income credit for eligible taxpayers. Caution: The amount of the contributions used in this example is not meant to reflect your actual contributions -the actual contribution amounts will be determined by you. The standard deduction, exemptions, and federal income tax rates for 2009 are found in IRS Rev. Proc. 2004 -71, 2004.50 I.R.B. 970. The FICA tax rate is found at http:// www. ssa. gov/ pressoffice /factsheets /colafacts2009.htm (as visited November 24, 2009). How will participating In the Cafeteria Plan affect my Social Security and other benefits? Participating In the Cafeteria Plan will reduce the amount of your taxable compensation. Accordingly, there could be a decrease in your Social Security benefits and/or other benefits (e.g., pension, disability, and life Insurance), which are based on taxabie compensation. However, the tax savings that you realize through Cafeteria Plan participation will often more than offset any reduction in other benefits. WIII I be taxed on the Health FSA Benefits that I receive? Generally, you will not be taxed on your Health FSA Benefits, up to the limits set forth under'What are the maximum Health FSA Benefits that I may electT. However, the Employer cannot guarantee that specific tax consequences will flow from your participation in the Plan. The tax benefits that you receive depend on the validity of the claims that you submit. For example, to quality for tax -free treatment, your Medical Care Expenses must meet the definition of "medical care" as defined in the Code. If you are reimbursed for a claim that is later determined to not be for Medical Care Expenses, then you will be required to repay the amount. WIII I be taxed on the DCAP Benefits I receive? -11- Vol. 205 Pg. / i� Cafeteria Plan* No Cafeteria Plan 1. Adjusted Gross Income $75,000 $76,00 1 2. Salary Reductions for Premiums 400 . $0 3. W -2 Gross Wages $68,600- $76,000 4. Standard Deduction $10,000 000 4110,000) 5. Exemptions $9,600 ($9,600) 6. Taxable Income line 3 minus lines 4 8 5 $49,000 $56,40D 7. W -2 Gross WS 903 $68,600 1$75,000 8 Federal Income Tax line 6 C tax schedule ($6,620) $7 850 9. FICA Tax 7.65 °6 of line 3 $5,248 $5,738 10. After -Tax Premium Pa ments I $0 $6 400 1 L11. Pay After Taxes and Premium Payments line 7 minus lines 8, 9 & 1 1$56,732 1 S55,282 The standard deduction, exemptions, and federal income tax rates for 2009 are found in IRS Rev. Proc. 2004 -71, 2004.50 I.R.B. 970. The FICA tax rate is found at http:// www. ssa. gov/ pressoffice /factsheets /colafacts2009.htm (as visited November 24, 2009). How will participating In the Cafeteria Plan affect my Social Security and other benefits? Participating In the Cafeteria Plan will reduce the amount of your taxable compensation. Accordingly, there could be a decrease in your Social Security benefits and/or other benefits (e.g., pension, disability, and life Insurance), which are based on taxabie compensation. However, the tax savings that you realize through Cafeteria Plan participation will often more than offset any reduction in other benefits. WIII I be taxed on the Health FSA Benefits that I receive? Generally, you will not be taxed on your Health FSA Benefits, up to the limits set forth under'What are the maximum Health FSA Benefits that I may electT. However, the Employer cannot guarantee that specific tax consequences will flow from your participation in the Plan. The tax benefits that you receive depend on the validity of the claims that you submit. For example, to quality for tax -free treatment, your Medical Care Expenses must meet the definition of "medical care" as defined in the Code. If you are reimbursed for a claim that is later determined to not be for Medical Care Expenses, then you will be required to repay the amount. WIII I be taxed on the DCAP Benefits I receive? -11- Vol. 205 Pg. / i� Generally, you will not be taxed on your DCAP Benefits, up to the limits set forth under What are the maximum and minimum DCAP Benefits that I may elect under the Cafeteria Plan ?'. However, the Employer cannot guarantee that specific tax consequences will flow from your participation in the DCAP. The tax benefits that you receive depend on the validity of the claims that you submit. For example, to qualify for tax -free treatment, you will be required to file IRS Form 2441 ( "Child and Dependent Care Expenses ") with your annual tax return (Form 1040) or a similar form. You must list on Form 2441 the names and taxpayer identification numbers (TINS) of any entities that provided you with dependent care services during the calendar year for which you have claimed a tax -free reimbursement. If you are reimbursed for a claim that is later determined to not be for Dependent Care Expenses, then you will be required to repay the amount. Ultimately, it is your responsibility to determine whether any reimbursement under the DCAP constitutes Dependent Care Expenses that quality for the federal income tax exclusion. Ask the Plan Administrator if you need further information about which expenses are, and are not likely to be reimbursable. _12_ Vol. 205 Pa. /i� Article VI PREMIUM INSURANCE BENEFIT ACCOUNT What are "Premlum Payment Benefits "? As described under'How do employees pay for benefits on a pre -tax basis ?', if you elect Premium Payment Benefits you will be able to pay for your share of contributions for Premium Insurance Benefits with pre -tax dollars by entering into an Election Form /Salary Reduction Agreement with your Employer. Because the share of the contributions that you pay will be with pre -tax funds, you may save both federal income taxes and FICA (Social Security) taxes. See'How Beneffts Are Taxed?'. The only Premium Payment Benefits offered under your Plan are for Premium Insurance Benefits, this is major medical insurance, including Basic Health, PPO, and Dental options. How are my Premium Payment Benefits paid? As described under'How do employees pay for benefits on a pre -tax basis?' and'What are "Premium Payment Sensfits ?', if you select the Medical Insurance Plan described under What are Premium Payment Benefits ?', then you may be required to pay a portion of the contributions. When you complete the Election Form/Salary Reduction Agreement, if you elect to pay for benefits on a pre -tax basis you agree to a salary reduction to pay for your share of the cost of coverage (also known as contributions) with pre -tax funds instead of receiving a corresponding amount of your regular pay that would otherwise be subject to taxes. From then on, you must pay a contribution for such coverage by having that portion deducted from each paycheck on a pre -tax basis (generally an equal portion from each paycheck, or an amount otherwise agreed to or as deemed appropriate by the Plan Administrator). -13- Vol. 205 Pg. /�� Article VII HEALTH FSA ACCOUNT What are "Health FSA Benefits "? As described under'What benefits may be elected under the Cafeteria Plan?', a Health FSA permits Eligible Employees to pay for coverage with pre -tax dollars that will reimburse them for Medical Care Expenses not reimbursed elsewhere (for example, you cannot be reimbursed for the same expense from the Medical Insurance Plan). As described under'How do employees pay for benefits on a pre -tax basis ?', if you elect Health FSA Benefits, then you will be able to provide a source of pre -tax funds to reimburse yourself for your eligible Medical Care Expenses by entering into an Election Form/Salary Reduction Agreement with your Employer. Because the share of the contributions that you pay will be with pre -tax funds, you may save both federal income taxes and FICA (Social Security) taxes. See What tax savings are possible under the Cafeteria Plan ?' for an example dealing with pre- tax payment of Premium Insurance contributions. Health FSA Benefits are intended to pay benefits solely for Medical Care Expenses not reimbursed elsewhere. Accordingly, the Health FSA shall not be considered to be a group health plan for coordination of benefits purposes, and Health FSA Benefits shall not be taken into account when determining benefits payable under any other plan. After you satisfy the eligibility requirements described above, you may participate in the Health FSA on the first day of the next month following satisfaction of the eligibility requirements by signing an Individual Election Form /Salary Reduction Agreement as described under'How do I become a Participant and when is my Entry Date ?' What is my "Health FSA Account "? If you elect Health FSA Benefits, then an account called a "Health FSA Account" will be set up in your name to keep a record of the reimbursements that you are entitled to, as well as the contributions that you have paid for such benefits during the Plan Year. Your Health FSA Account is merely a recordkeeping account; it is not funded (all reimbursements are paid from the general assets of the Employer), and It does not bear Interest. A Health FSA election may be for: General- Purpose Health FSA Coverage. How are my Health FSA Benefits paid for under the Cafeteria Plan? When you complete the Election Form /Salary Reduction Agreement, you specify the amount of Health FSA Benefits that you wish to pay for with your salary reduction. From then on, you must pay a contribution for such coverage by having that portion deducted from each paycheck on a pre -tax basis (generally an equal portion from each paycheck or an amount otherwise agreed to or as deemed appropriate by the Plan Administrator). For example, suppose that you have elected to be reimbursed up to $1,000 per year for Medical Care Expenses and that you have chosen no other benefits under the Cafeteria Plan. If you pay all of your contributions, then your Health FSA Account would be credited with a total of $1,000 during the Plan Year. If you are paid bi- weekly, then your Health FSA Account would reflect that you have paid $38.46 ($1,000 divided by 26) each pay period in contributions for the Health FSA Benefits that you have elected. The Employer makes no contribution to your Health FSA Account. What are the maximum Health FSA Benefits that I may elect? You may choose any amount of Medical Care Expenses reimbursement that you desire under the Health FSA, subject to the maximum salary reduction contributions of $2,500 under the General- Purpose Health FSA and the maximum salary reduction contributions of $2,500 under the Limited - Purpose Health FSA per Plan Year. You will be required to pay the annual Health FSA contribution equal to the coverage level that you have chosen. What amounts will be available for Health FSA reimbursement at any particular time during the Plan Year? The full amount of Health FSA coverage that you have elected (reduced by prior reimbursements made during the same Plan Year) will be available to reimburse you for qualifying Medical Care Expenses incurred during the Plan -14- Vol. 205 Pg. / 95 Year, regardless of the amount that you have contributed when you submitted the claim (so long as you have continued to pay the contributions). For example, suppose that you elected $1,000 of coverage and contributed to your Health FSA Account (as described under'How are my Health FSA Benefits paid for under the Cafeteria Plan?) during January and February-that means that by February 24 you would have contributed $153.84 ($36.46 times four pay periods). You haven't made any prior claims for reimbursement during the calendar year, but on February 26 you incur a Medical Care Expense in the amount of $300. You submit that claim for reimbursement on February 27. So long as the claim meets all applicable requirements, the $300 would be available to you for that expense, even though you have only contributed $153.84 to your Health FSA Account at that point. What are "Medical Care Expenses" that may be reimbursed from the Health FSA? Your Health FSA election may be for: General- Purpose Health FSA Coverage. Each of these Health FSA coverage options is described in detail below. The eligible "Medical Care Expenses" vary according to the type of Health FSA coverage option that is elected, as described below. (a) General- Purpose Health FSA Coverage Option. For purposes of the General- Purpose Health FSA Coverage Option, "Medical Care Expense" means expenses incurred by you, your Spouse, or your Dependents for "medical care" as defined in Code § 213(d), and shall include amounts paid for medicines or drugs only K (1) the medicine or drug requires a prescription, (2) is available without a prescription (an over- the - counter medicine or drug) and the individual obtains a prescription, or (3) is insulin, as described in Code section 106(f). Additionally, the following list specifies certain expenses that are not reimbursable, even if they meet the definition of "medical care" under Code § 213(d) and may otherwise be reimbursable under regulations governing Health FSAS. Note that many expenses that are not on the list of exclusions below will still not be reimbursable if such expenses do not meet the definition of "medical care" under Code § 213(d) and other requirements for reimbursement under the Health FSA. EXCLUSIONS: health insurance premiums for any other plan (including premiums for a plan sponsored by the Employer, such as the Medical Insurance Plan); long -term care services; cosmetic surgery or other similar procedures, unless the surgery or procedure is necessary to ameliorate a deformity arising from or directly related to a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease. "Cosmetic surgery" means any procedure that is directed at improving the patient's appearance and that does not meaningfully promote the proper function of the body or prevent or treat illness or disease; the salary expenses of a nurse to care for a healthy newborn at home; funeral and burial expenses; household and domestic help (even if recommended by a qualified physician due to an Employee's or Dependent's inability to perform physical housework); custodial care; costs for sending a problem child to a special school for benefits that the child may receive from the course of study and disciplinary methods; social activities, such as dance lessons (even if recommended by a physician for general health improvement); bottled water; cosmetics, toiletries, toothpaste, etc.; uniforms or special clothing, such as maternity clothing; automobile insurance premiums; marijuana and other controlled substances that are in violation of federal law, even if prescribed by a physician; any item that doesn't constitute "medical care" under Code § 213(d); and any item that isn't reimbursable under applicable regulations. Ask the Plan Administrator if you need further information regarding which expenses are reimbursable under your -15- Vol. 205 Pg. / /�� plan Note: For purposes of the new income exclusions under Code sections 105(b) and 106, the term "child" includes adult children under the age of 27 that is the employee's son, daughter, stepson, stepdaughter, legally adopted individual (or an individual placed with the employee for adoption), and eligible foster child. Under Notice 2010 -38, such a child does not have to satisfy the age limits, residency, support and other tests described in Section 152 of the Code in order to be considered an employee's child for purposes of these new income exclusions. When must the Medical Care Expenses be Incurred for the Health FSA? For Medical Care Expenses to be reimbursed to you from your Health FSA Account for the Plan Year, they must have been incurred during that Plan Year. The Plan Year for the Health FSA is the same as the Plan Year for the Cafeteria Plan, a 12 -month period beginning on January 1st and ending on December 31st. A Medical Care Expense is incurred when the service that causes the expense is provided, not when the expense was paid. If you have paid for the expense but the services have not yet been rendered, then the expense has not been incurred. For example, if you prepay on the first day of the month for medical care that will be given during the rest of the month, the expense is not incurred until the end of that month (and cannot be reimbursed until after the end of that month). You may not be reimbursed for any expenses arising before the Health FSA or the Cafeteria Plan became effective, before your Election Form/Salary Reduction Agreement became effective, for any expense incurred after the close of the Plan Year, or after a separation from service (except for Continuation Coverage, as described under What is "Continuation Coverage" and how does It work ?'). Can I Continue Health FSA Coverage After Terminating Employment or Incurring a COBRA Event? The only way a Participant and his or her Spouse and Dependents, as applicable, may continue the same coverage that he or she had under the Health FSA Benefit before the qualifying event, is to elect COBRA either on a self -pay basis or, if applicable, or to continue with salary reductions. In no event shall the Employer allocation to the health FSA equal or exceed $500.00 Such individuals will be notified if they are eligible for COBRA continuation coverage. If COBRA is elected, it will be available only for the remainder of the applicable Period of Coverage. COBRA coverage generally ends for the Health FSA Benefit at the end of the Plan Year and cannot be continued for the next Plan Year. Such continuation coverage shall be subject to all conditions and limitations under COBRA. Please refer to your COBRA Notice for further explanation regarding your specific situation. Contributions for COBRA continuation for Health FSA Benefits may be paid on a pre -tax basis for current Employees receiving taxable compensation, but may not be prepaid from contributions in one Plan Year to provide coverage that extends into a subsequent Plan Year. Generally for Employees who have incurred a COBRA qualifying event as a result of no longer being actively employed, payments must be made on an after -tax basis. What must I do to be reimbursed for Medical Care Expenses from the Health FSA? When you incur an expense that is eligible for payment, you must submit a claim to the Plan Administrator on a Health FSA Reimbursement Request Form that will be supplied to you. You must include written statements and /or bills from independent third parties stating that the Medical Care Expenses have been incurred and stating the amount of such Medical Care Expenses, along with the Health FSA Reimbursement Request Form. Generally, this requires including an Explanation of Benefits (EOB) Form from the insurance provider (or a bill from a doctor's office) indicating the amounts that you are obligated to pay. Further details about what must be provided are contained in the Health FSA Reimbursement Request Form. You will be reimbursed for your eligible Medical Care Expenses within 30 days after the date you submitted the Health FSA Reimbursement Request Form (subject to a 15 day extension for matters beyond the Plan Administrator's control-see 'What happens If my claim for benefits Is denied ?'). Claims will be paid in the order in which they are approved. Remember, though, that you can't be reimbursed for any total expenses above the annual reimbursement amount that you have elected. You will have until the 90th day after the end of the Plan Year in which to submit a claim for reimbursement for Medical Care Expenses incurred during the previous Plan Year. However, if you have ceased to be eligible as a Participant, you will only have until 90 days after the date you ceased to be eligible in which to submit claims for reimbursement for Medical Care Expenses incurred prior to the date on which you ceased to be eligible. To have your claims processed as soon as possible, please read 'What happens if my claim for benefits is -16- Vol. 295 —Pg. / 7 denied?'. Note that it is not necessary for you to have actually paid the amount due for a Medical Care Expense, only for you to have incurred the expense (as defined under'When must the Medical Care Expenses be incurred for the Health FSA?') and that it is not being paid for or reimbursed from any other source. If the Employer implements an electronic payment card program (debit card, credit card, or similar method) to pay expenses from the Health FSA, some expenses may be validated at the time the expense is incurred (like co -pays for medical care). For other expenses, the card payment is only conditional and you will still have to submit supporting documents. Is there any risk of losing or forfeiting the amounts that I elect for Health FSA Benefits? Yes. If the Medical Care Expenses that you incur during the Plan Year are less than the annual amount that you elected for Health FSA Benefits, you will forfeit the rest of that amount -this is called the "use- it -or- lose -it" rule under applicable tax laws. In other words, you cannot be reimbursed for (or receive any direct or indirect payment of) any amounts that were not incurred for Medical Care Expenses during the Plan Year, even if amounts are still left in your Health FSA Account. The difference between what you elected and what Medical Care Expenses were reimbursed will be forfeited at the end of the time limits described under 'What are the time limits that affect forfeiture of my Health FSA Benefits ?'. Qualified Reservist Distribution Under the Health FSA Component, a Participant may receive a distribution of all or a portion of the balance in their account if the distribution qualifies as a "Qualified Reservist Distribution ". In order for a distribution to be a "qualified reservist distribution ", a number of requirements must be satisfied. First, a "qualified reservist distribution" can be made only to a member of a "reserve component" (as defined in section 101 of title 37 of the United States Code), which means a member of the Army National Guard; U.S. Army, Navy, Marine Corps, Air Force, or Coast Guard Reserve; Air National Guard of the United States; or the Reserve Corps of the Public Health Service. Second, the distributions can be made only to a reservist that, by reason of being a member of a "reserve component ", has been ordered or called into active duty (i) in excess of 179 days or more or (ii) for an indefinite period, Third, the amount of the distribution must be for "all or a portion of the balance in the employee's account ". Fourth, the distribution must be made within a certain timetrame. The period for making a qualified reservist distribution must be made on or before the last day of the coverage period that includes the date of the reservist's call to active duty and ends on the last day that reimbursements could otherwise be made for the plan year that includes the first day of the distribution period. A Qualified Reservist will be allowed to cash out the unused benefits and not forfeit them under the "use it or lose if' rule that applies to health FSAs. Specifically, the HEART Act allows for a taxable, penalty -free "qualified reservist distributions" from a health FSA without subjecting other amounts in the cafeteria plan or health FSA to immediate taxation. What are the time limits that affect forfeiture of my Health FSA Benefits (and what happens to amounts that are forfeited)? You will forfeit any amounts in your Health FSA Account that are not applied to pay expenses submitted by the 90th day following the end of the Plan Year for which the election was effective (except that if you have ceased to be eligible as a Participant, you may forfeit such amounts at an earlier date —see 'What must I do to be reimbursed for Medical Care Expenses from the Health FSA?'). Forfeited amounts will be used as follows: first, to offset any losses experienced by the Employer as a result of making reimbursements in excess of contributions paid by all Participants; second, to reduce the cost of administering the Health FSA during the Plan Year and subsequent Plan Year; and third, to provide increased benefits or compensation to Participants in subsequent years in any weighted or uniform fashion that the Plan Administrator deems appropriate, consistent with applicable regulations. Also, any Health FSA Account benefit payments that are unclaimed (for example, uncashed benefit checks) by the close of the Plan Year following the Plan Year in which the Medical Care Expense was incurred shall be forfeited and applied as described above. Will I be taxed on the Health FSA Benefits that I receive? Generally, you will not be taxed on your Health FSA Benefits, up to the limits set forth under What are the maximum and minimum Health FSA Benefits that I may elect ?'. However, the Employer cannot guarantee that specific tax consequences will flow from your participation in -17- Vol. 205 Pg. the Plan. The tax benefits that you receive depend on the validity of the claims that you submit. For example, to qualify for tax -free treatment, your Medical Care Expenses must meet the definition of "medical care" as defined in the Code. If you are reimbursed for a claim that is later determined to not be for Medical Care Expenses, then you will be required to repay the amount. Ask the Plan Administrator if you need further information about which expenses are and are not likely to be reimbursable. -1 g- Vol. 205 Pg. / q9 Article VIII DEPENDENT CARE REIMBURSEMENT ACCOUNT What are "DCAP Benefits "? As described under'What benefits may be elected under the Cafeteria PlanT. a DCAP permits eligible Employees to pay for coverage with pre -tax dollars that will reimburse them for Dependent Care Expenses not reimbursed elsewhere (for example, you cannot be reimbursed for the same expense from your Spouse's DCAP). As described under'How do employees pay for Benefits on a pre -tax basis ?', if you elect DCAP Benefits, then you will be able to provide a source of pre -tax funds to reimburse yourself for your eligible Dependent Care Expenses by entering into an Election Form /Salary Reduction Agreement with your Employer. Because the share of the contributions that you pay will be with pre -tax funds, you may save both federal income taxes and FICA (Social Security) taxes. See'What tax savings are possible under the Cafeteria Plan?' for an example dealing with pre- tax payment of Premium Insurance contributions. After you satisfy the eligibility requirements described above, you may participate In the DCAP on the first day of the next month following satisfaction of the eligibility requirements by signing an individual Election Form/Salary Reduction Agreement as described under'How do I become a Participant and when Is my Entry Date ?' What is my "DCAP Account "? If you elect DCAP Benefits, an account called a "DCAP Account" will be set up in your name to keep a record of the reimbursements that you are entitled to, as well as the contributions that you have paid for such benefits during the Plan Year. Your DCAP Account is merely a recordkeeping account; it is not funded (all reimbursements are paid from the general assets of the Employer), and it does not bear interest. What are the maximum DCAP Benefits that I may elect under the Cafeteria Plan? You may choose any amount of Dependent Care Expenses reimbursement that you desire under the DCAP, subject to the maximum reimbursement amount described below. You must commit to a salary reduction to pay the annual DCAP contribution equal to the coverage level that you have chosen (e.g.. if you elect $3,000 in DCAP Benefits, you'll pay for the benefits with a $3,000 salary reduction). The amount of Dependent Care Expense reimbursement that you choose cannot exceed $5,000 for a calendar year or, if lower, the maximum amount that you have reason to believe will be excludable from your income under Code § 129 when your election is made. The $5,000 maximum will apply to you if: you are married and file a joint federal income tax return; you are married and file a separate federal income tax return, and meet the following conditions: (1) you maintain as your home a household that constitutes (for more than half of the taxable year) the principal place of abode of a Qualifying Individual (i.e., the Dependent for whom you are eligible to receive reimbursements under the DCAP); (2) you furnish over half of the cost of maintaining such household during the taxable year; and (3) during the last six months of the taxable year, your Spouse is not a member of such household (i.e., your Spouse maintained a separate residence); or you are single or the head of the household for federal income tax purposes. If you are married and reside with your Spouse but you file a separate federal income tax return, then the maximum DCAP Benefit that you may exclude from your income under Code § 129 is $2,500 for a calendar year. These maximums ($5,000 or $2,500 for a calendar year, as applicable) are just the largest amount that is possible; the maximum amount that you are able to exclude from your income may be less because of other limitations, as described under'What are "Dependent Care Expenses" that may be reimbursed ?' (for example, note that you cannot exclude more than the amount of your or your Spouse's earned income for the calendar year). How are my DCAP Benefits paid for under the Cafeteria Plan? When you complete the Election Form /Salary Reduction Agreement, you specify the amount of DCAP Benefits that you wish to pay with your salary reduction. From then on, you must pay a contribution for such coverage by having that portion deducted from each paycheck on a pre -tax basis (generally an equal portion from each paycheck or an amount otherwise agreed to or as deemed appropriate by the Plan Administrator). If you pay all of your contributions, then your DCAP Account will be credited with the portion of your gross income that you have elected to give up through salary reduction. These portions will be credited as of each pay period. For example, suppose that you have elected to be reimbursed for $2,600 per year for Dependent Care Expenses and that you have chosen no other benefits under the Cafeteria Plan. Your DCAP Account would be credited with a total of $2,600 by the end of the Plan Year. If you are paid bi- weekly, then your DCAP Account would reflect that you have paid $100 ($2,600 divided by 26) each pay period in contributions for the DCAP Benefits that you have elected. The Employer makes no contribution to your DCAP Account. What amounts will be available for DCAP reimbursement at any particular time during the Plan Year? The amount of coverage that is available for reimbursement of qualifying Dependent Care Expenses at any particular time during the Plan Year will be equal to the amount credited to your DCAP Account at the time your claim is paid, reduced by the amount of any prior reimbursements paid to you during the Plan Year. Using the example under'How are my DCAP Benefits paid for under the Cafeteria Plan ?', suppose that you incur $1,500 of Dependent Care Expenses by the end of March. At that time, your DCAP Account would only have been credited with $700 ($100 times seven pay periods), so only $700 would be available for reimbursement at the end of March (assuming that you had not received any prior reimbursements). What are "Dependent Care Expenses" that may be reimbursed? "Dependent Care Expenses" means employment - related expenses incurred on behalf of a person who meets the requirements to be a "Qualifying Individual," as defined in the first bulleted item below. All of the following conditions must be met for such expenses to qualify as Dependent Care Expenses that are eligible for reimbursement: Each person for whom you incur the expenses must be a Qualifying Individual, that is, he or she must be: a person under age 13 who is your "qualifying child" under the Code (in general, the person must: (1) have the same principal abode as you for more than half the year; (2) be your child or stepchild (by blood or adoption), foster child, sibling or stepsibling, or a descendant of one of them; and (3) not provide more than half of his or her own support for the year); your Spouse who is physically or mentally incapable of caring for himself or herself and has the same principal place of abode as you for more than half of the year; or a person who is physically or mentally Incapable of caring for himself or herself, has the same principal place of abode as you for more than half of the year, and is your tax dependent under the Code (for this purpose, status as a tax dependent is determined without regard to the gross income limitation for a "qualifying relative" and certain other provisions of the Code's definition). Under a special rule for children of divorced or separated parents, a child is a Qualifying Individual with respect to the custodial parent when the noncustodial parent is entitled to claim the dependency exemption for the child. See the Plan Administrator for more information on which individuals will qualify as your Qualifying Individuals. No reimbursement will be made to the extent that such reimbursement would exceed the balance in your DCAP Account. The expenses are incurred for services rendered after the date of your election to receive DCAP Benefits and during the Plan Year to which the election applies. The expenses are incurred in order to enable you (and your Spouse, if you are married) to be gainfully employed, which generally means working or looking for work. There is an exception: If your Spouse is not working or looking for work when the expenses are incurred, he or she must be a full -time student or be physically or mentally Incapable of self -care. The expenses are incurred for the care of a Qualifying Individual or for household services attributable in part to the care of a Qualifying Individual. If the expenses are incurred for services outside of your household for the care of a Qualifying Individual other than a person under age 13 who is your qualifying child, then the Qualifying Individual must regularly spend at least eight hours per day in your household. If the expenses are incurred for services provided by a dependent care center (that is, a facility that provides care for more than six individuals not residing at the facility), the center complies with all applicable state and local laws and regulations. The person who provided care was not your Spouse, a parent of your under - age -13 qualifying child, or a person for whom you (or your Spouse) are entitled to a personal exemption under Code §151(c) . If your child provided the care, then he or she must be age 19 or older at the end of the year in which -20- Vol. 205 Pg. �a� the expenses are incurred. The expenses are not paid for services outside of your household at a camp where the Qualifying Individual stays overnight. For more information about what items are —and are not — deductible Dependent Care Expenses, consult IRS Publication 503 ( "Child and Dependent Care Expenses ") under the heading "Tests to Claim the Credit." But use the Publication with caution, because it was meant only to help taxpayers figure out whether they can claim the household and dependent care services tax credit under Code §21 ( "the Dependent Care Tax Credit," discussed further below), not what is reimbursable under a DCAP. In fact, some of the statements in the Publication aren't correct when determining whether that same expense is reimbursable under your DCAP. This is because there are several fundamental differences between what expenses qualify for the Dependent Care Tax Credit (under Code §21 ) and what expenses are reimbursable under a DCAP (under Code §129 ). Not all expenses that qualify for the Dependent Care Tax Credit are reimbursable under a DCAP. (For example, for an expense to qualify for the Dependent Care Tax Credit in a given year, it must have been paid during that year, but to be reimbursed from the DCAP, the expense must have been incurred during the Plan Year for which reimbursement is sought. (See F1 B'When must the Dependent Care Expenses be incurred ?').) Ask the Plan Administrator if you need further information about which expenses are, and are not, likely to be reimbursable. You will also be asked to certify that you have no reason to believe that the requested reimbursement, when added to your other reimbursements to date for Dependent Care Expenses incurred during the same calendar year, will exceed the applicable statutory limit. Your statutory limit is the smallest of the following amounts: your earned income for the calendar year (after your salary reductions under the Cafeteria Plan); the earned income of your Spouse for the calendar year (your Spouse will be deemed to have earned income of $250 ($500 if you have two or more Qualifying Individuals) for each month in which your Spouse is (a) physically or mentally incapable of self -care; or (b) a full -time student); or either $5,000 or $2,500 for the calendar year, depending on your marital and tax filing status, as described further under "What are the maximum and minimum DCAP Benefits that I may elect under the Cafeteria Plan ?'. Any reimbursements that the Employer has reason to believe will exceed your statutory limit will be subject to FICA and income tax withholding. Note that if you are married and your Spouse also participates in a DCAP, the maximum amount that you and your Spouse together can exclude from income is $5,000. When must the Dependent Care Expenses be incurred? For Dependent Care Expenses to be reimbursed to you from your DCAP Account for the Plan Year, the expenses must have been incurred during that Plan Year, The Plan Year for the DCAP is the same as the Plan Year for the Cafeteria Plan, a 12 -month period beginning on January 1st and ending on December 31st. Can I Continue DCAP Coverage After Terminating Employment? When you cease to be a Participant under the DCAP Benefit, your salary reductions and election to participate will terminate also. Therefore, the Participant will not be able to receive reimbursements for Dependent Care Expenses incurred after the end of the day on which the Participant's employment terminates or the Participant otherwise cease to be eligible. What must I do to be reimbursed for my Dependent Care Expenses? When you incur an expense that is eligible for payment, you must submit a claim to the Plan Administrator on a DCAP Reimbursement Request Form that will be supplied to you. You must include written statements andlor bills from independent third parties stating that the Dependent Care Expenses have been incurred and stating the amount of such Dependent Care Expenses, along with the DCAP Reimbursement Request Form, Further details about what must be provided are contained in the DCAP Reimbursement Request Form. If there are enough credits to your DCAP Account, then you will be reimbursed for your eligible DCAP Expenses within 30 days after the date you submitted the DCAP Reimbursement Request Form (subject to a 15 -day extension for matters beyond the Plan Administrator's control -see 'What happens if my claim for benefits is denied ?'). If a claim is for an amount larger than that remaining in your current DCAP Account balance, then the excess part of the claim will be carried over into the following months, to be paid out as your balance becomes -21- Vol. 205 Pg. 6 2 adequate. Remember, though, that you can't be reimbursed for any total expenses above your available annual credits to your DCAP Account. You will have until 90 days after the end of the Plan Year in which to submit a claim for reimbursement for Dependent Care Expenses incurred during the previous Plan Year. However, if you have ceased to be eligible as a Participant, you will only have until 90 days after the date you ceased to be eligible In which to submit a claim for reimbursement for Dependent Care Expenses incurred prior to the date you ceased to be eligible. You will be notified in writing if any claim for benefits is denied. (See 'What happens if my claim for benefits is denied ?.) To have your claims processed as soon as possible, please read 'What happens If my claim for benefits is denied ?'. Note that it is not necessary for you to have actually paid the bill in an amount due for a Dependent Care Expense, only for you to have incurred the expense (as defined under'When must the Dependent Care Expenses be Incurred ?') and that It Is not being paid for or reimbursed from any other source. If the Employer implements an electronic payment card program (debit card, credit card, or similar method) to pay expenses from the Dependent Care Account, some expenses may be validated at the time the expense is incurred. For other expenses, the card payment is only conditional and you will still have to submit supporting documents. Is there any risk of losing or forfeiting the amounts that I elect for DCAP Benefits? Yes. If the Dependent Care Expenses that you incur during the Plan Year are less than the annual amount that you elected for DCAP Benefits, you will forfeit the rest of that amount in your DCAP Account -this is called the "use- it -or- lose-it" rule under applicable tax laws. In other words, you cannot be reimbursed for (or receive any direct or indirect payment of) any amounts that were not incurred for Dependent Care Expenses during the Plan Year, even if amounts are still left in your DCAP Account. The difference between what you elected and what Dependent Care Expenses were reimbursed will be forfeited at the time periods described under'What are the time limits that affect forfeiture of my DCAP Benefits ?'. What are the time limits that affect forfeiture of my DCAP Benefits? You will forfeit any amounts in your DCAP Account that are not applied to DCAP Benefits for any Plan Year by the 90th day following the end of the Plan Year for which the election was effective (except that if you have ceased to be eligible as a Participant, you will forfeit such amounts if they have not been applied within 90 days after the date you ceased to be eligible-see What must I do to be reimbursed for my Dependent Care Expenses ?'). Forfeited amounts will be used as follows: first, to offset any losses experienced by the Employer as a result of making reimbursements in excess of contributions paid by all Participants; second, to reduce the cost of administering the DCAP during the Plan Year and the subsequent Plan Year; and third, to provide increased benefits or compensation to Participants in subsequent years in any weighted or uniform fashion that the Plan Administrator deems appropriate, consistent with applicable regulations. Also, any DCAP Account benefit payments that are unclaimed (for example, uncashed benefit checks) by the close of the Plan Year following the Plan Year in which the Dependent Care Expense was incurred shall be forfeited and applied as described above. Will I be taxed on the DCAP Benefits I receive? Generally, you will not be taxed on your DCAP Benefits, up to the limits set forth under'What are the maximum and minimum DCAP Benefits that I may elect under the Cafeteria Plan?. However, the Employer cannot guarantee that specific tax consequences will flow from your participation in the DCAP. The tax benefits that you receive depend on the validity of the claims that you submit. For example, to qualify for tax -free treatment, you will be required to file IRS Farm 2441 ( "Child and Dependent Care Expenses ") with your annual tax return (Form 1040) or a similar form. You must list on Form 2441 the names and taxpayer identification numbers (TINS) of any entities that provided you with dependent care services during the calendar year for which you have claimed a tax -free reimbursement. If you are reimbursed for a claim that is later determined to not be for Dependent Care Expenses, then you will be required to repay the amount. Ultimately, it is your responsibility to determine whether any reimbursement under the DCAP constitutes Dependent Care Expenses that qualify for the federal income tax exclusion. Ask the Plan Administrator if you need further information about which expenses are, and are not likely to be reimbursable, but remember that the Plan Administrator is not providing legal advice. -22- Vol. 205 Pa. -7 6 If 1 elect DCAP Benefits, can 1 still claim the Dependent Care Tax Credit on my federal income tax return? You may not claim any other tax benefit for the amount of your pre -tax salary reductions under the DCAP, although your Dependent Care Expenses in excess of that amount may be eligible for the Dependent Care Tax Credit (see' What is the Dependent Care Tax Credit ?'). For example, if you elect $3,000 in coverage under the DCAP and are reimbursed $3,000, but you had Dependent Care Expenses totaling $5,000, then you could count the excess $2,000 when calculating the Dependent Care Tax Credit if you have two or more Dependents. What is the Dependent Care Tax Credit? The Dependent Care Tax Credit is a credit against your federal income tax liability under the Code. It is a non- refundable tax credit, which means that any portion of it that exceeds your federal income tax liability will be of no value to you. The credit is calculated as a percentage of your annual Dependent Care Expenses. In determining what the tax credit would be, you may take into account $3,000 of such expenses for one Dependent or $6,000 for two or more Dependents. Depending on your adjusted gross income, the percentage could be as much as 35% of your qualifying expenses (to a maximum credit amount of $1,050 for one Dependent or $2,100 for two or more Dependents), to a minimum of 20% of such expenses (producing a maximum credit of $600 for one Dependent or $1,200 for two or more Dependents). The maximum 35% rate is reduced by 1% (but not below 20 %) for each $2,000 portion (or any fraction of $2,000) by which your adjusted gross incomes exceeds $15,000. Example: Assume that you have one Dependent for whom you have incurred Dependent Care Expenses of $3,600, and that your adjusted gross income is $20,000. Since only one Dependent is Involved, the credit will be calculated by applying the appropriate percentage to the first $3,000 of the expenses. The percentage is 32 %. Thus, your tax credit would be $3,000 x 32% _ $960. If you had incurred the same expenses for two or more Dependents, your credit would have been $3,600 x 32% _ $1,152, because the entire expense would have been taken into account, not just the first $3,000. For more information about how the Dependent Care Tax Credit works, see IRS Publication No. 503 ( "Child and Dependent Care Expenses "). Would it be better to Include the DCAP Benefits in my Income and claim the Dependent Care Tax Credit, instead of treating the reimbursements as tax free? For most individuals, participating in a DCAP will produce the greater federal tax savings, but there are some for whom the opposite Is true. Because the preferable method for treating benefits payments depends on certain factors such as a person's tax fling status (e.g., married, single, head of household), number of Dependents, earned income, etc., each Participant will have to determine his or her tax position individually in order to make the decision. Use IRS Form 2441 ( "Child and Dependent Care Expenses ") to help you. Ask the Plan Administrator if you need further information about the DCAP or the Dependent Care Tax Credit, but remember that the Plan Administrator is not providing legal advice. Your Employer may also be able to provide you with a worksheet or tax calculator to help you make the comparison, ask the Human Resources Manager if you would like to use one or both of these. -23- Vol. 205 Pg. ao Article IX CLAIMS PROCEDURE What happens if my claim for benefits is denied? Premium Insurance Benefits The applicable insurance company will decide your claim in accordance with its claims procedures. If your claim is denied, you may appeal to the insurance company for a review of the denied claim. If you don't appeal on time, you will lose your right to file suit in a state or federal court, as you will not have exhausted your internal administrative appeal rights (which generally is a prerequisite to bringing a suit in state or federal court). Note that under certain circumstances, you may also have the right to obtain external review (review outside of the plan). For more information about how to file a claim and for details regarding the medical insurance company's claims procedures, consult the claims procedure applicable under that plan or policy, as described in the plan document or summary plan description for the Medical Insurance Plan, Claims Under the Cafeteria Plan However, if (a) a claim for reimbursement under the Health FSA or DCAP Components of the Cafeteria Plan is wholly or partially denied, or (b) you are denied a benefit under the Cafeteria Plan (such as the ability to pay for Premium insurance benefits, Health FSA, and DCAP benefits on a pre -tax basis) due to an issue germane to your coverage under the Cafeteria Plan (for example, a determination of a Change In Status; a "significant' change in contributions charged; or eligibility and participation matters under the Cafeteria Plan document), then the claims procedure described below will apply. If your claim is denied in whole or in part, you will be notified in writing by the Plan Administrator within 30 days after the date the Plan Administrator received your claim. (This time period may be extended for an additional 15 days for matters beyond the control of the Plan Administrator, including in cases where a claim is incomplete. The Plan Administrator will provide written notice of any extension, including the reasons for the extension and the date by which a decision by the Plan Administrator is expected to be made. Where a claim is Incomplete, the extension notice will also specifically describe the required information, will allow you 45 days from receipt of the notice in which to provide the specified information and will have the effect of suspending the time for a decision on your claim until the specified information is provided.) Notification of a denied claim will set out: a statement of the specific reason(s) for the denial; the specific Plan provision on which the denial is based; a description of any additional material or information necessary for you to validate the claim and an explanation of why such material or information is necessary; appropriate information on the steps to be taken if you wish to appeal the Plan Administrator's decision, including your right to submit written comments and have them considered, your right to review (upon request and at no charge) relevant documents and other information, and your right to file suit under ERISA (where applicable) with respect to any adverse determination after appeal of your claim. Appeals If your claim is denied in whole or part, then you (or your authorized representative) have the right to an internal appeal and, if applicable, an external review to an independent review organization. You may request review upon written application to the "Appeals Committee" for an internal review. You will not be allowed to take legal action against the Plan, the Employer, the Administrator, or any other entity to whom administrative or claims processing functions have been delegated unless you exhaust your internal appeal rights. But you do not have to pursue external review in order to preserve your right to file a lawsuit. In fact, as explained later in this summary, you may be unable to take further legal action if you pursue an external appeal because the external appeal process results in a binding determination. Requirements for an Internal Appeal Your internal appeal must be in writing, must be provided to the Administrator, and must include the fallowing information: Your name and address; The fact that you are disputing a denial of a claim or the Administrator's act or omission; The date of the notice that the Administrator informed you of the denied claim; and The reason(s), in clear and concise terms, for disputing the denial of the claim or the Administrator's -24- Vol. 205 Pg. o2G✓' act or omission. You should also include any documentation that you have not already provided to the Administrator Deadline for Filing an Internal Appeal Your internal appeal must be delivered to the Administrator within 180 days after receiving the denial notice or the Administrator's act or omission. If you do not file your internal appeal within this 180 day period, you lose your right to appeal. Your internal appeal will be heard and decided by the Committee. Decision on Review Anytime before the internal appeal deadline, you may submit copies of all relevant documents, records, written comments, testimony, and other Information to the Committee. The Cafeteria Plan is required to provide you with reasonable access to and copies of all documents, records, and other information related to the claim. When reviewing your internal appeal, the Administrator will take into account all relevant documents, records, comments, and other information that you have provided with regard to the claim, regardless of whether or not such information was submitted or considered in the initial determination. If the Administrator receives new or additional evidence that it considered, relied upon, or generated in connection with the claim, other than evidence that you have provided to it, you will be provided with this information and given a reasonable opportunity to respond to the evidence before the due date for the Administrator's notice of final internal adverse benefit determination. Similarly, if the Administrator identifies a new or additional reason for denying your claim, that new or additional reason will be disclosed to you and you will be given a reasonable opportunity to respond to that new rationale before the due date for the Administrator's notice of final internal adverse benefit determination. Your appeal will be reviewed and decided by the Committee or other entity designated in the Plan in a reasonable time not later than 60 days after the Committee receives your request for review. The Committee may, in its discretion, hold a hearing on the denied claim. Any medical expert consulted in connection with your appeal will be different from and not subordinate to any expert consulted in connection with the initial claim. If your internal appeal is denied, the notice that you receive from the Committee will include the following information: Information about your claim, including the date of service, health care provider, claim amount, and any diagnosis and treatment code and their corresponding meanings, to the extent such information is available; The specific reason for the denial upon review; A reference to the specific Plan provision(s) on which the denial is based; Any denial code (and its corresponding meaning) that was used in denying the claim; A statement providing that you are required to receive, upon request and free of charge, reasonable access to and copies of all documents, records, and other information relevant to your claim for benefits; If an internal rule, guideline, protocol, or similar criterion was relied upon in making the review determination, either the specific rule, guideline, or protocol, or a statement that such a rule, guideline, protocol, or similar criterion was relied upon in making the review determination and that a copy of such rule, guideline, protocol, or similar criterion will be provided to you free of charge upon request; and A statement of your right to bring an external appeal or a civil action under ERISA §502(a), where applicable. You have the right to an external review of the Administrator's denial of your internal appeal of the Health FSA claim unless the Benefit denial was based on your (or your Spouse's or Dependent's) failure to meet the Plan's eligibility requirements. Requirements for an External Appeal You may request an external appeal by completing the form provided to you by the Administrator which must include the following information: Your name, address, daytime telephone number and email address; and A brief description of why you disagree with the decision, along with any additional information, such as a physician's letter, bills, medical records, or other documents to support your claim. -25- Vol. 205 Pg. �� Return the Request for External Review and your denial notice as instructed on the form You should also Include any documentation that you have not already provided to the Administrator. Deadline for filing an External Appeal Your external appeal must be filed with the external reviewer within four (4) months of the date you were served with the Administrator's response to your internal appeal request. If you do not file your appeal within this 4 -month period, you lose your right to appeal. For example, If you received the internal appeal decision on January 3, 2012 you must appeal the decision by May 3, 2012 (or, if that is not a business day, the next business day thereafter). The plan must complete a preliminary review within five (5) business days upon receipt of your external review request to determine if you were covered under the plan, you provided all of the necessary information to process the external review and that you have exhausted the Internal appeals process. The plan must provide you with a written notice of its preliminary review determination within one (1) business day after completing its review. If your request is complete, but not eligible for external review, the notice must state the reasons for the ineligibility and provide you with the Employee Benefits Security Administration (EBSA) contact information. If your request is incomplete, the notice must describe the information or materials needed to complete the request. The plan must permit you to "perfect" (i.e.. complete) the external review request within the four -month filing period or, if later, 48 hours after receipt of the notice. Decision on Review of External Appeal The plan must assign an accredited Independent Review Organization to perform the external review. The external reviewer must notify you and the Administrator of its decision on your external appeal within 45 days after its receipt of your request for external review. The external reviewer's decision is binding upon the parties unless other State or Federal law remedies are available. Such remedies may or may not exist. Therefore, unless another legal right exists under your claim, use of the external review process may terminate your right to bring a lawsuit on your claim. Duty of Beneficiary/Third Party Recoveries Any Beneficiary under the Plan that receives a payment, whether by lawsuit, settlement, or otherwise, from third parties for costs associated with sickness or injury resulting from the acts or omissions of another person or party must reimburse the Plan to the extent the Beneficiary has received payments from the Plan for such sickness or injury. The Plan has a first lien upon any such recovery. Any recovery by the Plan Administrator from such payments is subject to a deduction for reasonable attorney fees and court costs incurred by the Beneficiaries in securing the third -party payments, and shall be prorated, to reflect that portion of the total recovery reimbursed to the Plan Administrator for the benefits it had paid from the Plan. However, the Plan's share of the recovery will not be reduced because the Beneficiary has not received the full damages claimed, unless the Plan Administrator agrees in writing to such a reduction. The Plan further requires covered Beneficiaries promptly advise the Plan Administrator of third -party claims and to execute any assignments, liens, or other documents the Plan Administrator requests. The Plan may withhold Benefits until such documents are received. Subrogation/Acts of Third Parties The Plan Administrator, on behalf of the Plan, has the right to recover any payments made to Beneficiaries, whether by lawsuit, settlement, or otherwise, by third parties for costs associated with sickness or injury resulting from the acts or omissions of another person or party. The Plan has a first lien upon any such recovery. Any recovery by the Plan Administrator from such payments is subject to a deduction for reasonable attorney fees and court costs incurred by the Beneficiaries in securing the third -party payments, and shall be prorated, to reflect that portion of the total recovery reimbursed to the Plan Administrator for the benefits it had paid from the Plan. However, the Plan's share of the recovery will not be reduced because the Beneficiary has not received the full damages claimed, unless the Plan Administrator agrees in writing to such a reduction. -26- Vol. 205 Pg. �� Article X FUNDING Funding This Plan All of the amounts payable under this Plan may be paid from the general assets of the Employer, but Premium Payment Benefits are paid as provided in the applicable insurance policy. Nothing herein will be construed to require the Employer or the Plan Administrator to maintain any fund or to segregate any amount for the benefit of any Participant, and no Participant or other person shall have any claim against, right to, or security or other interest in any fund, account, or asset of the Employer from which any payment under this Plan may be made. There is no trust or other fund from which Benefits are paid. While the Employer has complete responsibility for the payment of Benefits out of its general assets (except for Premium Payment Benefits paid as provided in the applicable insurance policy), it may hire an unrelated third -party paying agent to make Benefit payments on its behalf. How long will the Cafeteria Plan remain In effect? Although the Employer expects to maintain the Cafeteria Plan indefinitely, it has the right to amend or terminate all or any part of the Cafeteria Plan at any time for any reason. It is also possible that future changes in state or federal tax laws may require that the Cafeteria Plan be amended accordingly. -p7- Vol. 205 Pg. Article XI GENERAL INFORMATION What other general Information should I know? This question contains certain general information that you may need to know about the Plan. Note: This Summary Plan Description does not describe the Medical Insurance Plan. Consult the Medical Insurance Plan documents and the separate Summary Plan Description for the Medical Insurance Plan. General Plan Information Name: BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Plan Number: 501 Effective Date: May 1, 2011 Plan Year: January 1 st to December 31 at. Your Plan's records are maintained on this 12 -month period of time. Type of Plan: Fringe Benefit and Welfare plan providing Benefits Your plan shall be governed by the Laws of the State of Texas Employer[Plan Sponsor Information Name and Address: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979)361.4181 Federal Employer Tax Identification Number (EIN): 74- 6000433 Plan Administrator Information Name, address, and business telephone number: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979) 3614181 The Plan Administrator appoints the Plan Administrator to keep the records for the Plan and to be responsible for the administration of the Plan. However, the Appeals Committee acts on behalf of the Plan Administrator with respect to appeals. The Plan Administrator will answer any questions that you may have about our Plan. You may contact the Plan Administrator at the above address for any further information about the Plan. Funding and Type of Plan Administration This is a contract administration plan. A third -party administrator processes claims for the Plan. A health insurance issuer is not responsible for the financing or administration (including payment of claims) of the Plan. All of the amounts payable under this Plan may be paid from the general assets of the Employer, but Premium Payment Benefits are paid as provided in the applicable insurance policy. Nothing herein will be construed to require the Employer or the Plan Administrator to maintain any fund or to segregate any amount for the benefit of any Participant, and no Participant or other person shall have any claim against, right to, or security or other interest in any fund, account, or asset of the Employer from which any payment under this Plan may be made. There is no trust or other fund from which Benefits are paid. While the Employer has complete responsibility for the payment of Benefits out of its general assets (except for Premium Payment Benefits paid as provided in the applicable insurance policy), it may hire an unrelated third -party paying agent to make Benefit payments on its behalf. Named Fiduciary The named fiduciary for the Health FSA Component is: Brazos County Agent for Service of Legal Process The name and address of the Plan's agent for service of legal process is: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 -28- Vol. 205 Pg. X0 (979) 361 -4181 Qualified Medical Child Support Order The Medical Insurance Plan and the Health FSA will provide benefits as required by any qualified medical child support order (QMCSO), as defined in ERISA § 609(a). The Plan has detailed procedures for determining whether an order qualifies as a QMCSO. Participants and beneficiaries can obtain, without charge, a copy of such procedures from the Plan Administrator. Newborns' and Mothers' Health Protection Act of 1996 (NMPHA) Group health plans and health Insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery or to less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours, as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Women's Health and Cancer Rights Act of 1998 ( WHCRA) The Women's Health and Cancer Rights Act of 1998 ( WHCRA) is a federal law that provides protections to patients who choose to have breast reconstruction in connection with a mastectomy. This law applies generally both to persons covered under group health plans and persons with individual health insurance coverage. But WHCRA does NOT require health plans or Issuers to pay for mastectomies. If a group health plan or health insurance issuer chooses to cover mastectomies, then the plan or issuer is generally subject to WHCRA requirements. Michelle's Law "Michelle's Law", enacted October 9, 2008, requires group and individual health plans to continue to cover otherwise eligible dependent children taking a medical leave of absence from a postsecondary educational institution (e.g., a college, university, or vocational school) due to a serious illness or injury. Dependent children on a leave of absence must be covered until the earlier of one year from the first day of the leave of absence or the date on which the coverage otherwise would terminate. The Genetic Information Nondiscrimination Act of 2008 (GINA) GINA (Genetic Information Non - Discrimination Act) prohibits discrimination by health insurers and employers based on individuals' genetic information. Genetic information includes the results of genetic tests to determine whether someone is at increased risk of acquiring a condition in the future, as well as an individual's family medical history. GINA imposes the following restrictions: prohibits the use of genetic information in making employment decisions; restricts the acquisition of genetic information by employers and others; imposes strict confidentiality requirements; and prohibits retaliation against individuals who oppose actions made unlawful by GINA or who participate in proceedings to vindicate rights under the law or aid others in doing so. Health Information Technology for Economic and Clinical Health Act (HITECH Act) Health Information Technology for Economic and Clinical Health Act was passed as part of the American Recovery and Reinvestment Act of 2009 to strengthen the privacy and security protection of health information, and to improve the workability and effectiveness of HIPAA Rules. HITECH defines an EHR as "electronic record of health - related information on an individual that is created, gathered, managed, and consulted by authorized health care clinicians and staff." The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 This new law amends the Employee Retirement Income Security Act (ERISA), the Public Health Service Act (PHSA), and the Internal Revenue Code (IRC) and applies to all ERISA group health plans and to health insurers that provide insurance coverage to group health plans. In general, this new law requires group health plans that provide mental health or substance use disorder benefits to provide such benefits on par with medical - surgical benefits. Medical Insurance Plan Documents and Information This Summary Plan Description does not describe the Medical Insurance Plan: Consult the Medical Insurance Plan document and the separate Summary Plan Description for the Medical Insurance Plan. -29- Vol. 205 Pg.b BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN With Premium Payment, Health FSA and DCAP Components Effective: May 1, 2011 ovo Duane Pam county Judge I '� BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN With Premium Payment, Health FSA and DCAP Components TABLE OF CONTENTS ARTICLE I Introduction 1.1 Amendment and Restatement of Plan 1.2 Legal Status ARTICLE II Definitions ARTICLE III Eligibility and Participation 6 3.1 Eligibility to Participate 6 3.2 Termination of Participation 6 3.3 Participation Following Termination of Employment or Loss of Eligibility 6 3.4 FMLA Leaves of Absence 6 3.5 Non -FMLA Leaves of Absence 7 ARTICLE IV Insurance Benefits Provided Under the Plan Method and Timing of Elections 9 4.1 Elections When First Eligible 9 4.2 Elections During Open Enrollment Period 9 4.3 Failure of Eligible Employee to File an Election Form /Salary Reduction 9 7.7 Agreement 4.4 Irrevocability of Elections 9 ARTICLE V Benefits Offered and Method of Funding 10 5.1 Benefits Offered 10 5.2 Participant Contributions 10 5.3 Funding This Plan 10 5.4 Maximum Contribution 10 ARTICLE VI Premium Payment Component 11 6.1 Benefits 11 6.2 Contributions for Cost of Coverage 11 6.3 Events Permitting Exception to Irrevocability Rule 11 6.4 Insurance Benefits Provided Under the Plan 11 6.5 Medical Insurance Benefits, COBRA 12 6.6 Premium Insurance Benefits Grace Period 12 ARTICLE VII Health FSA Component 13 7.1 Health FSA Benefits 13 7.2 Contributions for Cost of Coverage of Health FSA Benefits 13 7.3 Eligible Medical Care Expenses for Health FSA 13 7.4 Events Permitting Exception to Irrevocability Rule 13 7.5 Maximum Benefits for Health FSA 14 7.6 Health FSA Benefits Grace Period 14 7.7 Establishment of Health FSA Account 14 7.8 Forfeiture of Health FSA Accounts, Use- It -or- Lose -It Rule 15 Vol. 205 Pg. �� 7.9 Reimbursement Claims Procedure for Health FSA 15 7.10 Reimbursements From Health FSA After Termination of Participation, 15 Contributions for Cost of Coverage for DCAP Benefits COBRA 8.3 7.11 Qualified Reservist Distribution 16 7.12 Named Fiduciary for Health FSA 16 7.13 Coordination of Benefits with Other Plans 16 ARTICLE VIII DCAP Component 17 8.1 DCAP Benefits 17 8.2 Contributions for Cost of Coverage for DCAP Benefits 17 8.3 Eligible Dependent Care Expenses 17 8.4 Events Permitting Exception to Irrevocability Rule 18 8.5 Maximum and Minimum Benefits for DCAP 18 8.6 Establishment of DCAP Account 19 8.7 DCAP Benefits Grace Period 19 8.8 Forfeiture of DCAP Accounts, Use -It -0r- Lose -It Rule 19 8.9 Reimbursement Claims Procedure for DCAP 20 8.10 Reimbursements From DCAP After Termination of Participation 20 8.11 Report to DCAP Participants 20 ARTICLE IX HIPAA Provisions for Health FSA 21 9.1 Provision of Protected Health Information to Employer 21 9.2 Permitted Disclosure of EnrollmenUDisenrollment Information 21 9.3 Permitted Uses and Disclosure of Summary Health Information 21 9.4 Permitted and Required Uses and Disclosure of PHI 21 9.5 Conditions of Disclosure for Plan Administration Purposes 21 9.6 Adequate Separation Between Plan and Employer 22 9.7 Certification of Plan Sponsor 22 Irrevocability of Elections, Exceptions 23 10.1 Irrevocability of Elections 23 10.2 Procedure for Making New Election If Exception to Irrevocability Applies 23 10.3 Change in Status Defined 23 10.4 Election Modifications Required by Plan Administrator 27 ARTICLE XI Fiduciary Liability 32 Appeals Procedure 28 11.1 Procedure If Benefits Are Denied Under This Plan 28 11.2 Claims Procedures for Medical Insurance Benefits 30 ARTICLE XII Recordkeeping and Administration 31 12.1 Plan Administrator 31 12.2 Powers of the Plan Administrator 31 12.3 Reliance on Participant, Tables, etc. 32 12.4 Provision for Third -Parry Plan Service Providers 32 12.5 Fiduciary Liability 32 12.6 Compensation of Plan Administrator 32 12.7 Bonding 32 12.8 Insurance Contracts- 32 12.9 Inability to Locate Payee 32 12.10 Effect of Mistake 32 1 I rr P ARTICLE XIII General Provisions 13.1 Expenses 13.2 No Contract of Employment 13.3 Amendment and Termination 13.4 Governing Law 13.5 Code and ERISA Compliance 13.6 No Guarantee of Tax Consequences 13.7 Indemnification of Employer 13.8 Non - Assignability of Rights 13.9 Headings 13.10 Plan Provisions Controlling 13.11 Severability Appendix A Vol. 205 Pg. �-/`t 33 33 33 33 33 33 33 33 33 33 34 34 35 BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN (With Premium Payment, Health FSA and DCAP Components) ARTICLE I Introduction 1.1 Amendment and Restatement of Plan BRAZOS COUNTY, ( "the Employer") hereby amends and restates the provisions of the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN ( "the Plan "). as amended, effective as of May 1, 2011. The Plan was originally effective March 1, 1987. Capitalized terms used in this Plan that are not otherwise defined shall have the meanings set forth in Article II, Definitions. This Plan is designed to permit an Eligible Employee to pay for his or her share of Contributions on a pre -tax salary reduction basis under the Premium Component, and contribute to the reimbursement benefit(s) on a pre -tax salary reduction basis. 1.2 Legal Status This Plan is intended to qualify as a "cafeteria plan" under Code section 125 and the regulations issued thereunder and shall be Interpreted to accomplish that objective. The Health FSA Component is intended to qualify as a "self- insured medical reimbursement plan" under Code section 105, and the Medical Care Expenses reimbursed thereunder are intended to be eligible for exclusion from participating Employees' gross Income under Code section 105(b). Although reprinted within this document, the Health FSA Component is a separate plan for purposes of administration and all reporting and nondiscrimination requirements imposed by Code section 105. The Health FSA Component is also a separate plan for purposes of applicable provisions of ERISA and COBRA. The DCAP Component is intended to qualify as a "dependent care assistance program" under Code section 129, and the Dependent Care Expenses reimbursed thereunder are intended to be eligible for exclusion from participating Employees' gross income under Code section 129(a). Although reprinted within this document, the DCAP Component is a separate plan for purposes of administratlon and all reporting and nondiscrimination requirements Imposed by Code section 129. -1- -01.205 Pg. �/� ARTICLE II Definitions "Account(s)" means the Health FSA Accounts described in Article VII and the DCAP Accounts described in Article VIII. "Appeals Committee" means the Committee appointed by the Employer that acts on behalf of the Plan Administrator with respect to appeals. An external review is available if required by law. The documents assume that no claim under the Cafeteria Plan would constitute a claim for urgent care, so a 24 -hour response procedure is notneeded. "Benefits" mean cash, Flex credits and the various qualified benefits under Section 125(f) of the Code sponsored by the Employer and made available by the Employer through the Plan, including, but not limited to, premium insurance benefits as described in Section 6.1, medical reimbursement as described In Section 7.1 and dependent care reimbursement as described in Section 8.1. "Benefit Package Option" means a qualified benefit under Code section 125(f) that Is offered under a cafeteria plan or an option for coverage under an underlying accident or health plan. "Change in Status" has the meaning described in Section 10.3. "COBRA" means the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended. "Code" means the Internal Revenue Code of 1986, as amended. "Compensation" means all the earned income, salary, wages and other earnings paid by the Employer to a Participant during a Plan Year, including any amounts contributed by the Employer pursuant to a salary reduction agreement which are not includable in gross income under sections 125, 132((X4), 401(k), 403(b), 408(k) or 457(b) of the Code. "Contributions" means the amount contributed to pay for the cost of Benefits (Including self - funded Benefits as well as those that are insured), as calculated under Section 6.2 for Premium Payment Benefits, Section 7.2 for Health FSA Benefits and Section 8.2 for DCAP Benefits. "DCAP" means dependent care assistance program. "DCAP Component" means the benefits of this Plan described In Article VIII. "Dependent" means for purposes of accident or health coverage, to the extent funded under the Premium Payment Component, and for purposes of the Health FSA Component, (1) a dependent as defined as in Code section 152, determined without regard to subsections (bX1), (b)(2), and (dX1)(B) thereof, (2) any child (as defined in Code section 152(f)(1)) of the Participant who as of the end of the taxable year has not attained age 27, and (3) any child of the Participant to whom IRS Rev. Proc. 2008 -48 applies (regarding certain children of divorced or separated parents who receive more than half of their support for the calendar year from one or both parents and are in the custody of one or both parents for more than half of the calendar year). For purposes of the new income exclusions under Code sections 105(b) and 106, the term "child" includes adult children under the age of 27 that is the employee's son, daughter, stepson, stepdaughter, legally adopted individual (or an individual placed with the employee for adoption), and eligible foster child. Under Notice 2010 -38, such a child does not have to satisfy the age limits, residency, support and other tests described in Section 152 of the Code in order to be considered an employee's child for purposes of these new income exclusions. For purposes of the DCAP component, a dependent means a qualifying individual as defined elsewhere. Notwithstanding the foregoing, the Health FSA Component will provide benefits in accordance with the applicable requirements of any QMCSO, even if the child does not meet the definition of "Dependent." "Dependent Care Expenses" has the meaning described in Section 8.3 -2- Vol .-2DL P9 A-4 "Earned Income" means all income derived from wages, salaries, lips, self- employment, and other Compensation (such as disability or wage continuation benefits), but only If such amounts are includible in gross income for the taxable year. Earned Income does not include (a) any amounts received pursuant to any DCAP established under Code section 129; or(b) any other amounts excluded from earned Income under Code section 32(c)(2), such as amounts received under a pension or annuity or pursuant to workers' compensation. "Effective Date" of this Plan has the meaning described in Section 1.1 "Election Form /Salary Reduction Agreement" means the agreement by an Employee authorizing the Employer to reduce the Employee's Compensation while a Participant during the Plan Year for purposes of obtaining Benefits under the Plan. "Electronic Payment Card" means a debit card, stored value card, or credit card that allows a Participant to access funds in a flexible reimbursement arrangement to pay the service provider at the point -of -sale (i.e.. the time a service or item is provided). "Electronic Protected Health Information" has the meaning described in 45 C.F.R. Section 160.103 and generally includes Protected Health Information that is transmitted by electronic media or maintained in electronic media. Unless otherwise specifically noted, Electronic Protected Health Information shall not Include enrollmenddisenrollment information and summary health Information. "Eligible Employee" means any Employee who Is employed by a participating Employer other than (a) An Employee covered by a collective bargaining agreement as to which retirement benefits were the subject of good faith bargaining, unless such agreement expressly provides for participation in the Plan; (b) A non - resident alien with no US source of income; (c) A "leased employee" within the meaning of Section 414(n); (d) Employees who regularly work less than 40 hours per week; (e) Employees who regularly work less than 6 months per year, (f) A temporary employee (g) Employees who are self - employed individuals as defined in section 401(c) of the Internal Revenue Code (including sole proprietors and partners in a partnership); (h) Employees who own (or are considered to own within the meaning of section 318 of the Internal Revenue Code) more than two percent (2 %) of the outstanding stock of an S corporation or stock possessing more than two percent (2 %) of the total combined voting power of all stock of such corporation. In the event an individual who Is not characterized or treated by the Participating Employer as a common law employee of a Participating Employer is reclassified as a common law employee of a Participating Employer who meets the definition of an Eligible Employee, the individual shall continue to be excluded from the Plan until the Plan is amended to classify such individual as an Eligible Employee (lo the extent such individual otherwise qualifies as an Eligible Employee hereunder). In no event shall such individual be eligible to participate in the Plan prior to the effective date of such Amendment. The Plan Administrator shall have full and complete discretion to determine eligibility for participation and benefits under this Plan, including, without limitation, the determination of those individuals who are deemed Employees of the Employer (or any controlled group member.) The Plan Administrator's decision shall be final, binding, and conclusive on all parties having or claiming a benefit under this Plan. This Plan is to be construed to exclude, and the Plan Administrator is authorized to exclude, all individuals who are not considered Employees for purposes of the Employer's payroll system. "Employee" means a person who is currently or hereafter employed by the Employer and any Related Employers that have adopted the Plan. Former Employees are also considered "Employees" of the Employer strictly for the limited purpose of allowing continued eligibility for benefits under the Plan for the remainder of the Plan Year in -3- Vol. 205 Pg. �1 which an Employee ceases to be employed by the Employer, but only to the extent specifically provided elsewhere under this Plan. "Employer" means BRAZOS COUNTY, "Employment Commencement Date" means the first regulady - scheduled working day on which the Employee first performs an hour of service for the Employer for Compensation. "Entry Date" means the date that an Eligible Employee actually becomes a Participant in the Plan. Eligibility requirements are defined in Section 3.1 and the specific Entry Dates for the Plan are listed in Section 3.1. "FMLA" means the Family and Medical Leave Act of 1993, as amended. "General- Purpose Health FSA Option" has the meaning described in Section 7.3(b). "Health FSA" means health flexible spending arrangement which consists of one (1) option: the General- Purpose Health FSA Option. "Health FSA Component" means the benefits of this Plan described in Article VII, "High Deductible Health Plan" means the high deductible health plan offered by the Employer that is intended to qualify as a high deductible health plan under Code section 223(cX2), as described in materials provided separately by the Employer. The High Deductible Health Plan may or may not be the sole Medical Insurance Plan eligible for pre -tax salary reduction funding hereunder. "HIPAA" means the Health Insurance Portability and Accountability Act of 1996, as amended. "HITECH" means the Health Information Technology for Economic and Clinical Health Act. "Medical Care Expenses" has the meaning defined in Section 7.3. "Medical Insurance Plan" means the plans) that the Employer maintains for its Employees (and for their Spouses and Dependents that may be eligible under the terms of such plan), providing major medical type benefits through a group insurance policy or policies, dental care, vision care, etc. The Employer may substitute, add, subtract, or revise at any time the menu of such plans and/or the benefits, terms, and conditions of any such plans. Any such substitution, addition, subtraction, or revision will be communicated to Participants and will automatically be incorporated by reference under this Plan. "Open Enrollment Period" means with respect to a Plan Year the month preceding the Plan Year, or such other period as may be prescribed by the Plan Administrator. "Participant" means a person who is an Eligible Employee and who enters the Plan after meeting the eligibility requirements of Section 3.1. Participants Include those who elect any benefits) offered under the Plan including those covered through COBRA and their respective beneficiaries. "Participating Employer" means BRAZOS COUNTY and any Related Employer that adopts the Plan. "Period of Coverage" means the Plan Year, with the following exceptions: (a) for Employees who Hirst become eligible to participate, it shall mean the portion of the Plan Year following the date on which participation commences, as described in Section 3.1; and (b) for Employees who terminate participation, it shall mean the portion of the Plan Year prior to the dale on which participation terminates, as described in Section 3.2. "Plan" means the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN as set forth herein and as amended from time to time. "Plan Administrator" means BRAZOS COUNTY or such other person or committee as may be appointed by the Employer to administer the Plan. "Plan Year" means the 12 -month period commencing January 1st and ending on December 31st -4- Vol. 205 Pg. �/� "Premium Payment Component" means the benefits of this Plan described in Article VI "Protected Health Information" (PHI) shall have the meaning described in 45 C.F.R. Section 160.103 and generally includes individually Identifiable health Information held by, or on behalf of, the Plan. "QMCSO" means a qualified medical child support order, as defined in ERISA Section 609(a). "Qualified Reservist Distribution" means a distribution of all or a portion of the balance In the employee's account under such arrangement if: (A) such individual is a member of a "reserve component" (as defined in section 1D1 of title 37, United States Code, which means a member of the Army National Guard; U.S. Army, Navy, Marine Corps, Air Force, or Coast Guard Reserve; Air National Guard of the United States; or the Reserve Corps of the Public Health Service); (B) has been ordered or called to active duty for a period in excess of 179 days or for an indefinite period; (C) the amount of the distribution must be for "all or a portion of the balance in the employee's account "; and (D) the distribution must be made within a certain timeframe. The period for making a qualified reservist distribution begins on the date the reservist Is called or ordered to duty and ends on the last day that reimbursements could otherwise be made for the plan year that includes the first day of the distribution period. "Qualifying Dependent Care Services" has the meaning described In Section 8.3. "Qualifying Individual" has the meaning described in Section 8.3. "Related Employer" means any employer affiliated with BRAZOS COUNTY that, under Code Sections 414(b), (c), or (m), is treated as a single employerwith BRAZOS COUNTY for purposes of Code section 125(8)(4). "Run-Out Period" means a period after the close of a Plan Year or other period during which Participants in a flexible spending arrangement (FSA) may request reimbursement for expenses incurred during the Period of Coverage. "Salary Reduction" means the amount by which the Participant's Compensation is reduced and applied by the Employer under this Plan to pay for one or more of the Benefits, as permitted for the applicable Component, before any applicable state andlor federal taxes have been deducted from the Participant's Compensation (i.e., on a pre- tax basis). "Spouse" means an individual who is legally married to a Participant as determined under applicable state law (and who is treated as a spouse under the Code). Notwithstanding the above, for purposes of the DCAP Component the term "Spouse" shall not include (a) an individual legally separated from the Participant under a divorce or separate maintenance decree; or (b) an individual who, although married to the Participant, files a separate federal Income tax return, maintains a principal residence separate from the Participant during the last six months of the taxable year, and does not furnish more than half of the cast of maintaining the principal place of abode of the Participant. "Timely Submitted" means, unless the Plan Administrator has specific and special cause to alter the definition of this phrase, within 30 calendar days of event that has triggered the Change in Status as described in Section 10.2(a). "USERRA" means the Uniformed Services Employment and Reemployment Rights Act of 1994, as amended. -5- Vol. 205 Pg. J!/` ARTICLE III Eligibility and Participation 3.1 Eligibility to Participate An individual Is eligible to participate In this Plan, including the Premium Payment Component, the Health FSA Component, and the DCAP Component, if the individual satisfies all of the following: (a) is an Eligible Employee; (b) is working 40 or more hours per week; and (c) has been employed by the Employer for 30 consecutive days, counting his or her Employment Commencement Date as the first such day. Once an Employee has met the Plan's eligibility requirements, the Eligible Employee may commence participation on the first day of the next month following satisfaction of the eligibility requirements or for any subsequent Plan Year, in accordance with the procedures described In Article IV, Method and Timing of Elections. 3.2 Termination of Participation A Participant will cease to be a Participant in this Plan upon the earlier of: - the date on which the Plan terminates; - the date on which the Employee ceases (because of retirement, termination of employment, layoff, reduction of hours, or any other reason) to be an Eligible Employee; - the date on which the Employee fails to make a contribution required under the terms of the Plan; of - the end of the Plan Year for Eligible Employees; Termination of participation in this Plan will automatically revoke the Participant's elections. The Premium Insurance Benefits will terminate as of the date specified in the Premium Plan. Reimbursements from the Health FSA Account after termination of participation will be made pursuant to Section 7.10 for Health FSA Benefits. Reimbursements from the DCAP Account after termination of participation will be made pursuant to Section 8.10 for DCAP Benefits. 3.3 Participation Following Termination of Employment or Loss of Eligibility If a Participant terminates his or her employment for any reason, including, but not limited to, disability, retirement, layoff, or voluntary resignation, and then is rehired within 30 days or less after the date of termination of employment, and is otherwise eligible to participate in the Plan, the Employee the Employee will be treated as a new hire and must resatisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan. If a former Participant is rehired more than 30 days following termination of employment and is otherwise eligible to participate in the Plan, then the Employee will be treated as a new hire and must resatisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan. Notwithstanding the above, an election to participate in the Premium Payment Component will be reinstated only to the extent that coverage under the Premium Insurance Benefits is reinstated. If an Employee (whether or not a Participant) ceases to be an Eligible Employee for any reason (other than for termination of employment), including, but not limited to, a reduction of hours, and then becomes an Eligible Employee again, the Employee must re- satisfy (complete the waiting period) Plan eligibility requirements to rejoin the Plan as described in Section 3.1 (or before becoming eligible to participate in the Plan). 3.4 FMLA Leaves of Absence (a) Health Benefits. Notwithstanding any provision to the contrary in this Plan, if a Participant goes on e -6- Vol. 205 Pg. A'? 6 qualifying leave under the FMLA, then to the extent required by the FMLA, the Employer will continue to maintain the Participant's Premium Insurance Benefits and Health FSA Benefits on the same terms and conditions as if the Participant were still an active Employee. That is, If the Participant elects to continue his or her coverage while on leave, the Employer will continue to pay Its share of the Contributions. An Employer may require participants to continue all Premium Insurance Benefits and Health FSA Benefits coverage for Participants while they are on paid leave, provided that Participants on non -FMLA paid leave are required to continue coverage. If so, the Participant's share of the Contributions shall be paid by the method normally used during any paid leave (e.g., on a pre -tax salary reduction basis). In the event of unpaid FMLA leave (or paid FMLA leave where coverage is not required to be continued), a Participant may elect to continue his or her Premium Insurance Benefits or Health FSA Benefits during the leave. If the Participant elects to continue coverage while on FMLA leave, then the Participant may pay his or her share of the Contributions in one of the following ways: with after -tax dollars, by sending monthly payments to the Employer by the due date established by the Employer; Pay -as- you -go with their share of premium payments on the same schedule as payments would be made If the Employee were not on leave, or under another schedule permitted under Department of Labor regulations and In a manner approved by the Plan Administrator; or under another arrangement agreed upon between the Participant and the Plan Administrator (e.g.. the Plan Administrator may fund coverage during the leave and withhold "catch -up" amounts from the Participant's Compensation on a pre -tax or after -tax basis) upon the Participant's return. If the Employer requires all Participants to continue Premium Insurance Benefits or Health FSA Benefits during an unpaid FMLA leave, then the Participant may elect to discontinue payment of the Participant's required Contributions until the Participant returns from leave. Upon returning from leave, the Participant will be required to repay the Contributions not paid by the Participant during the leave. Payment shali be withheld from the Participant's Compensation either on a pre-tax or after -tax basis, as agreed to by the Plan Administrator and the Participant through a written notice to the Employer. If a Participant's Premium Insurance Benefits or Health FSA Benefits coverage ceases while on FMLA leave (e.g., for non- payment of required contributions), then the Participant is permitted to re -enter the Premium Insurance Beneflts or Health FSA Benefits as applicable, upon return from such leave on the same basis as when the Participant was participating in the Plan prior to the leave, or as otherwise required by the FMLA. In addition, the Plan may require Participants whose Premium Insurance Benefits or Health FSA Benefits coverage terminated during the leave to be reinstated in such coverage upon return from a period of unpaid leave, provided that Participants who return from a period of unpaid, non -FMLA leave are required to be reinstated in such coverage. Notwithstanding the preceding sentence, with regard to Health FSA Benefits a Participant whose coverage ceased will be permitted to elect whether to be reinstated In the Health FSA Benefits at the same coverage level as was In effect before the FMLA leave (with Increased contributions for the remaining Period of Coverage) or at a coverage level that is reduced pro rata for the period of FMLA leave during which the Participant did not pay Contributions. If a Participant elects a coverage level that is reduced pro rata for the period of FMLA leave, then the amount withheld from a Participant's Compensation on a pay- period- by -pay- period basis for the purpose of paying for reinstated Health FSA Benefits will be equal to the amount withheld prior to the period of FMLA leave. (b) Non - Health Benefits. If a Participant goes on a qualifying leave under the FMLA, then entitlement to non- health benefits (such as DCAP Benefits) is to be determined by the Employer's policy for providing such Benefits when the Participant is on non -FMLA leave, as described in Section 3.5. 3.5 Non -FMLA Leaves of Absence If a Participant goes on an unpaid leave of absence that does not affect eligibility, then the Participant will continue to participate and the Contributions due for the Participant will be paid in one of the following ways: - with after -tax dollars, by sending monthly payments to the Employer by the due date established by the Employer; - with their share of premium payments on the same schedule as payments would be made if the Employee r 1 r� were not on leave, or under another schedule permitted under Department of Labor regulations; or - under another arrangement agreed upon between the Participant and the Plan Administrator (e.g., the Plan Administrator may fund coverage during the leave and withheld "catch -up" amounts from the Participant's Compensation on a pre -tax or after -tax basis) upon the Participant's return. If a Participant goes on an unpaid leave that affects eligibility, then the election change rules in Section 10.3 will apply. Vol. 205 Pg. ARTICLE IV Method and Timing of Elections 4.1 Elections When First Eligible Once an Employee has met the Plan's eligibility requirements, the Employee may enter the plan on the first day of the next month following satisfaction of the eligibility requirements provided that an Election Form /Salary Reduction Agreement Is submitted to the Plan Administrator before the first day of the month in which participation will commence. Eligibility for Premium Payment Benefits shall be subject to the additional requirements, if any, as specified by the insurance benefits provider(s). The provisions of this Plan are not intended to override any exclusions, eligibility requirements, or waiting periods specified by the insurance benefits provider(s). 4.2 Elections During Open Enrollment Period During each Open Enrollment Period with respect to a Plan Year, the Plan Administrator shall provide an Election Form /Salary Reduction Agreement to each Eligible Employee. The Election Form/Salary Reduction Agreement shall enable the Employee to elect to participate in the various Components of this Plan for the next Plan Year and to authorize the necessary salary reductions to pay for the Benefits elected. The Election Form/Salary Reduction Agreement must be returned to the Plan Administrator on or before the last day of the Open Enrollment Period, and it shall become effective on the first day of the next Plan Year. 4.3 Failure of Eligible Employee to File an Election Form /Salary Reduction Agreement If an Eligible Employee falls to file an Election Form/Salary Reduction Agreement (or waiver of pre-tax premiums) within the time period described in Method and Timing of Elections for the first plan year, then the Employee is considered to have elected not to participate for the initial Plan Year and may not elect any Benefits under the Plan (a) until the next Open Enrollment Period; or (b) until an event occurs that would justify a mid -year election change, as described under Section 10.3. If an Eligible Employee fails to file an Election Form /Salary Reduction Agreement for subsequent Plan Years, then the Employee shall continue with same elections as prior year for insured /premium benefits. If an Employee who fails to file an Election Form /Salary Reduction Agreement is eligible for Premium Insurance Benefits and has made an effective election for such Benefits, then the Employee's share of the Contributions for such Benefits will be paid with after -tax dollars outside of this Plan until such time as the Employee files, during a subsequent Open Enrollment Period (or after an event occurs that would justify a mid -year election change as described under Section 10.3), a timely Election Form/Salary, Reduction Agreement to elect Premium Payment Benefits. Until the Employee files such an election, the Employer's portion of the Contribution will also be paid outside of this Plan. 4.4 Irrevocability of Elections Unless an exception applies, as described in Article X. a Participant's election under the Plan is irrevocable for the duration of the Period of Coverage to which it relates. -g- V"I 10S Pu 1 ARTICLE V Benefits Offered and Method of Funding 5.1 Benefits Offered When first eligible or during the Open Enrollment Period as described under Article IV, Participants will be given the opportunity to elect specific Benefits offered under this Plan: (a) Premium Payment Benefits, as described in Article VI; (b) Health FSA Benefits, as described in Article VII; (c) DCAP Benefits, as described in Article VIII; In no event shall Benefits under the Plan be provided in the form of deferred compensation. 5.2 Participant Contributions Participants who elect Benefits under the Plan may pay for the cost of that coverage on a pre -tax salary reduction basis by completing an Election Form /Salary Reduction Agreement. (a) Salary Reductions. The salary reduction for a pay period for a Participant is, for the Benefits elected, an amount equal to (1) the annual Contributions for such Benefits (elected under the Plan as applicable), divided by the number of pay periods in the Period of Coverage; (2) an amount otherwise agreed upon between the Employer and the Participant; or (3) an amount deemed appropriate by the Plan Administrator (i.e., in the event of shortage in reducible Compensation, amounts withheld and the Benefits to which salary reductions are applied may fluctuate). If a Participant increases his or her election under the benefits elected under the Plan to the extent permitted under Section 10.4, the salary reductions per pay period will be, for the Benefits affected, an amount equal to: (1) the new reimbursement limit elected pursuant to Section 10.4, less the salary reductions made prior to such election change, divided by the number of pay periods in the balance of the Period of Coverage commencing with the election change; (2) an amount otherwise agreed upon between the Employer and the Participant; or (3) an amount deemed appropriate by the Plan Administrator (i.e., in the event of shortage of reducible Compensation, amounts withheld and the benefits to which salary reductions are applied may fluctuate). (b) Considered Employer Contributions for Certain Purposes. Salary reductions are applied by the Employer to pay for the Participant's share of the Contributions for the benefits elected under the Plan and, for the purposes of this Plan and the Code, are considered to be Employer contributions. (c) After -Tax Contributions for Premium Payment Benefits. For those Participants who elect to pay their share of the Contributions for any of the Premium Insurance Benefits with after -tax deductions, both the Employee and Employer portions of such Contributions will be paid outside of this Plan. 5.3 Funding This Plan All of the amounts payable under this Plan may be paid from the general assets of the Employer, but Premium Payment Benefits are paid as provided in the applicable insurance policy. Nothing herein will be construed to require the Employer or the Plan Administrator to maintain any fund or to segregate any amount for the benefit of any Participant, and no Participant or other person shall have any claim against, right to, or security or other interest in any fund, account, or asset of the Employer from which any payment under this Plan may be made. There is no trust or other fund from which Benefits are paid. While the Employer has complete responsibility for the payment of Benefits out of its general assets (except for Premium Payment Benefits paid as provided in the applicable insurance policy), it may hire an unrelated third -party paying agent to make Benefit payments on its behalf. 5.4 Maximum Contribution The maximum contribution that may be made under this Plan for a Participant is the total of the maximums that may be elected as Employer and Participant Contributions, as described under each Component. -10- Vol. 205 Pg..,221 ARTICLE VI Premium Payment Component 6.1 Benefits The premium Insurance benefits that may be offered under the Premium Payment Component for premium -type benefits pursuant to an insurance policy issued by an insurance company, or a contract with a point of service organization are medical, dental, vision, or other qualified benefits under Section 125. Notwithstanding any other provision in this Plan, the premium insurance benefits are subject to the terms and conditions of the respective insurance policy. No changes can be made with respect to such premium insurance benefits under this Plan (such as mid -year changes in election) if such changes are not permitted under the applicable insurance policy. Unless an exception applies, as described in Article X. such election is irrevocable for the duration of the Period of Coverage to which it relates. 6.2 Contributions for Cost of Coverage The annual Contribution for a Participant's Premium Payment Benefits is equal to the amount as set by the Employer, which may or may not be the same amount charged by the insurance provider. 6.3 Events Permitting Exception to Irrevocability Rule A Participant may make a new election upon the occurrence of certain events, including a Change in Status as described in Section 10.3, but only if such election change is made on account of and corresponds with a Change in Status that affects eligibility for coverage under a plan of the Employer or a plan of the Spouse's or Dependent's employer (referred to as the general consistency requirement). A Change in Status that affects eligibility for coverage under a plan of the Employer or a plan of the Spouse's or Dependent's employer includes a Change in Status that results in an increase or decrease in the number of an Employee's family members (i.e., a Spouse and/or Dependents) who may benefit from the coverage. Change in Status means any of the events described below, as well as any other events included under subsequent changes to Code section 125 or regulations issued thereunder, which the Plan Administrator, in its sole discretion and on a uniform and consistent basis, determines are permitted under IRS regulations and under this Plan. A Participant may change an election under the regulations for the Premium Component of this Plan as described below upon the occurrence of the stated events: (a) Open Enrollment Period (b) Change in Status: (b.1) Change in Employee's Legal Marital Status (b.2) Change in the Number of Employee's Dependents (b.3) Change in Employment Status of Employee, Spouse or Dependent that Affects Eligibility (b.4) Event Causing Employee's Dependent to Satisfy or Cease to Satisfy Eligibility Requirements (b.5) Change in Place of Residence (c) Cost Changes with Automatic Increase/Decrease in Elective Contributions (d) Significant Cost Increase or Significant Cost Decrease (e) Significant Curtailment of Coverage (With or Without Loss of Coverage) (f) Addition or Significant Improvement of a Benefit Package Option (g) Change in Coverage Under Another Employer Cafeteria Plan or Qualified Benefits Plan (h) Loss of Coverage Under Other Group Health Coverage (i) HIPAA Special Enrollment Rights (j) COBRA Qualifying Events (k) Certain Judgments, Decrees and Orders (QMCSO) (1) Medicare and Medicaid Eligibility (m) FMLA Leaves of Absence 6.4 Insurance Benefits Provided Under the Plan Insurance benefits will be provided by the insurance provider(s), not this Plan. The types and amounts of insurance -11- Vol. 205 Pg. �� benefits, the requirements for participating in each insurance plan, and the other terms and conditions of coverage and benefits of the insurance plan(s) are set forth by the insurance provider. Ali claims to receive benefits under the insurance plan shall be subject to and governed by the terms and conditions of the insurance plan and the rules, regulations, policies, and procedures adopted in accordance therewith, as may be amended from time to time. 6.5 Medical Insurance Benefits; COBRA Notwithstanding any provision to the contrary in this Plan, to the extent required by COBRA, a Participant and his or her Spouse and Dependents, as applicable, whose coverage terminates under the medical insurance plan because of a COBRA qualifying event (and who is a qualified beneficiary as defined under COBRA), shall be given the opportunity to continue on a self -pay basis the same coverage that he or she had under the medical Insurance plan the day before the qualifying event for the periods prescribed by COBRA. Such continuation coverage shall be subject to all conditions and limitations under COBRA. Contributions for COBRA coverage for medical insurance benefits may be paid on a pre -tax basis for current Employees receiving taxable compensation (as may be permitted by the Plan Administrator on a uniform and consistent basis, but may not be prepaid from contributions in one Plan Year to provide coverage that extends Into a subsequent Plan Year) where COBRA coverage arises either (a) because the Employee ceases to be eligible because of a reduction in hours; or (b) because the Employee's Dependent ceases to satisfy the eligibility requirements for coverage. For all other Individuals (e.g., Employees who cease to be eligible because of retirement, termination of employment, or layoff), Contributions for COBRA coverage for medical insurance benefits shall be paid on an after -tax basis (unless may be otherwise permitted by the Plan Administrator on a uniform and consistent basis, but may not be prepaid from contributions in one Plan Year to provide coverage that extends Into a subsequent Plan Year). 6.6 Premium Insurance Benefits Grace Period No grace period applies to the Premium Component of this Plan. -12- VA�.205 -��� a,24 ARTICLE VII Health FSA Component 7.1 Health FSA Benefits An Eligible Employee can elect to participate in the Health FSA Component by electing (a) to receive benefits in the form of reimbursements for Medical Care Expenses from the Health FSA (Health FSA Benefits); and (b) to pay the Contribution for such Health FSA Benefits on a pre -tax salary reduction basis. Unless an exception applies (as described in Article X), any such election is irrevocable for the duration of the Period of Coverage to which it relates, Once an Employee has met the Plan's eligibility requirements, the Eligible Employee may commence participation on the date the eligibility requirements have been met. 7.2 Contributions for Cost of Coverage of Health FSA Benefits The annual Contribution for a Participant's Health FSA Benefits is equal to the annual benefit amount elected by the Participant, if applicable. 7.3 Eligible Medical Care Expenses for Health FSA Under the Health FSA Component, a Participant may receive reimbursement for Medical Care Expenses incurred during the Period of Coverage for which an election is in force. (a) Incurred. A Medical Care Expense is incurred at the time the medical care or service giving rise to the expense is furnished and not when the Participant is formally billed for, is charged for, or pays for the medical care. (b) Medical Care Expenses. "Medical Care Expenses" will vary depending on which Health FSA coverage option the Participant has elected. General - Purpose Health FSA Option. For purposes of this Option, "Medical Care Expenses" means expenses incurred by a Participant or his or her Spouse or Dependents for medical care, as described in Code section 213(d), and shall Include amounts paid for medicines or drugs only if (1) the medicine or drug requires a prescription, (2) Is available without a prescription (an over -the- counter medicine or drug) and the individual obtains a prescription, or (3) is insulin, as described in Code section 106(f). Additionally, this term does not include expenses that are excluded under Appendix A to this Plan, nor any expenses for which the Participant is reimbursed for the expense through the Medical Insurance Plan, other Insurance, or any other accident or health plan. If only a portion of a Medical Care Expense has been reimbursed elsewhere (e.g., because the Medical Insurance Plan imposes co- payment or deductible limitations), then the Health FSA can reimburse the remaining portion of such Expense if it otherwise meets the requirements of this Article. 7.4 Events Permitting Exception to Irrevocability Rule A Participant may make a new election upon the occurrence of certain events, including a Change in Status as described In Section 10.3, but only if such election change is made on account of and corresponds with a Change in Status that affects eligibility for coverage under a plan of the Employer or a plan of the Spouse's or Dependent's employer (referred to as the general consistency requirement). A Change in Status that affects eligibility for coverage under a plan of the Employer or a plan of the Spouse's or Dependent's employer includes a Change in Status that results in an increase or decrease in the number of an Employee's family members (i.e., a Spouse and/or Dependents) who may benefit from the coverage. "Change In Status" means any of the events described below, as well as any other events Included under subsequent changes to Code section 125 or regulations issued thereunder, which the Plan Administrator, in its sale discretion and on a uniform and consistent basis, determines are permitted under IRS regulations and under this Plan. A Participant may change an election under the regulations for the Health FSA Component of this Plan as described below upon the occurrence of the stated events: (a) Open Enrollment Period -13- Vol. 205 Pg. 2z% (b) Change in Status: (b.1) Change in Employee's Legal Marital Status (b.2) Change in the Number of Employee's Dependents (b.3) Change In Employment Status of Employee, Spouse or Dependent that Affects Eligibility (b.4) Event Causing Employee's Dependent to Satisfy or Cease to Satisfy Eligibility Requirements (c) HIPAA Special Enrollment Rights (only if plan is subject to HIPAA) (d) COBRA Qualifying Events (e) Certain Judgments, Decrees and Orders (QMCSO) (f) Medicare and Medicaid Eligibility (g) FMLA Leaves of Absence 7.5 Maximum Benefits for Health FSA (a) Maximum Annual Salary Reduction Contributions Limit; Uniform Coverage. The maximum dollar amount elected by the Participant for reimbursement of Medical Care Expenses incurred during a Period of Coverage (reduced by prior reimbursements during the Period of Coverage) shall be available at all times during the Period of Coverage, regardless of the actual amounts credited to the Participant's Health FSA Account pursuant to Section 7.7. Notwithstanding the foregoing, no reimbursements will be available for Medical Care Expenses Incurred after coverage under this Plan has terminated, unless the Participant has elected COBRA as provided in Section 7.10. Payment shall be made to the Participant in cash as reimbursement for Medical Care Expenses incurred during the Period of Coverage for which the Participant's election is effective, provided that the other requirements of this Article have been satisfied. (b) Maximum Annual Salary Reduction Contributions Limit. The maximum annual salary reduction contribution that a Participant may elect to receive under this Plan in the form of reimbursements for Medical Care Expenses incurred in any Period of Coverage for the General- Purpose Health FSA shall be $2,500, subject to Section 7.7(c). Reimbursements due for Medical Care Expenses incurred by the Participant's Spouse or Dependents shall be charged against the Participant's Health FSA Account. (c) Changes to Dollar Limits. For subsequent Plan Years, the maximum dollar limit may be changed by the Plan Administrator and shall be communicated to Employees through the Election Form /Salary Reduction Agreement or another document. If a Participant enters the Health FSA Component mid -year or wishes to increase his or her election mid -year as permitted under Section 7.4, then the Participant may elect coverage up to the maximum dollar limit or may increase coverage to the maximum dollar limit, as applicable. 7.6 Health FSA Benefit Grace Period No grace period applies to the Health FSA Component of this Plan. 7.7 Establishment of Health FSA Account The Plan Administrator will establish and maintain a Health FSA Account with respect to each Participant for each Plan Year or other Period of Coverage who has elected to participate in the Health FSA Component, but it will not create a separate fund or otherwise segregate assets for this purpose. The Account so established will merely be a recordkeeping account with the purpose of keeping track of contributions and determining forfeitures under Section 7.8. (a) Crediting of Accounts. A Participant's Health FSA Account for a Plan Year or other Period of Coverage will be credited periodically during such period with an amount equal to the Participant's salary reductions elected to be allocated to such Account. (b) Debiting of Accounts. A Participant's Health FSA Account for a Plan Year or other Period of Coverage will be debited for any reimbursement of Medical Care Expenses incurred during such period. (c) Available Amount Not Based on Credited Amount. As described in Section 7.5, the amount available for reimbursement of Medical Care Expenses is the Participant's annual benefit amount, reduced by prior reimbursements for Medical Cale Expenses Incurred during the Plan Year or other Period of Coverage. Thus, a Participant's Health FSA Account may have a negative balance during a Plan Year or other Period of Coverage, but the aggregate amount of reimbursement shall in no event exceed the maximum dollar amount elected by the Participant under this Plan. -14- Vol. 205 Pg. �,2 7.8 Forfeiture of Health FSA Accounts and Use- It -or- Lose -It Rule (a) Use-ft-or-Lose-lit Rule. If any balance remains in the Participant's Health FSA Account for a Period of Coverage after all reimbursements have been made for the Period of Coverage, then such balance shall not be carried over to reimburse the Participant for Medical Care Expenses incurred during a subsequent Plan Year. The Participant shall forfeit all rights with respect to such balance. (b) Use of Forfeitures. All forfeitures under this Plan shall be used as follows: first, to offset any losses experienced by the Employer during the Plan Year as a result of making reimbursements (i.e., providing Health FSA Benefits) with respect to all Participants in excess of the Contributions paid by such Participants through salary reductions; second, to reduce the cost of administering the Health FSA Component during the Plan Year or the subsequent Plan Year (all such administrative costs shall be documented by the Plan Administrator); and third, to provide Increased benefits or compensation to Participants in subsequent years in any weighted or uniform fashion that the Plan Administrator deems appropriate, consistent with applicable regulations. In addition, any Health FSA Account benefit payments that are unclaimed (e.g., uncashed benefit checks) by the close of the Plan Year following the Run -Out Period in which the Medical Care Expense was Incurred shall be forfeited and applied as described above. 7.9 Reimbursement Claims Procedure for Health FSA (a) Claims Substantiation. A Participant who has elected to receive Health FSA Benefits for a Period of Coverage may apply for reimbursement by submitting a request in writing to the Plan Administrator in such form as the Plan Administrator may prescribe, by no later than the 90th day following the close of the Plan Year in which the Medical Care Expense was Incurred (except that for a Participant who ceases to be eligible to participate, this must be done no later than 90 days after the date that eligibility ceases, as described in Section 7.10) setting forth: - the person(s) on whose behalf Medical Care Expenses have been Incurred; - the nature and date of the Expenses so incurred; - the amount of the requested reimbursement; - a statement that such Expenses have not otherwise been reimbursed and that the Participant will not seek reimbursement through any other source; and - other such details about the expenses that may be requested by the Plan Administrator in the reimbursement request form or otherwise (e.g.. a statement from a medical practitioner that the expense is to treat a specific medical condition, or a more detailed certification from the Participant). The request shall be accompanied by bills, invoices, or other statements from an independent third party showing that the Medical Care Expenses have been incurred and showing the amounts of such Expenses, along with any additional documentation that the Plan Administrator may request. If the Health FSA is accessible by an electronic payment card (e.g., debit card, credit card, or similar arrangement), the Participant will be required to comply with substantiation procedures established by the Plan Administrator in accordance with Rev. Rul. 2003 -43, IRS Notice 2006 -69, or other IRS guidance. (b) Timing. Within 30 days after receipt by the Plan Administrator of a reimbursement claim from a Participant, the Employer will reimburse the Participant for the Participant's Medical Care Expenses (if the Plan Administrator approves the claim), or the Plan Administrator will notify the Participant that his or her claim has been denied. This time period may be extended by an additional 15 days for matters beyond the control of the Plan Administrator, including in cases where a reimbursement claim Is incomplete. The Plan Administrator will provide written notice of any extension, including the reasons for the extension, and will allow the Participant 45 days in which to complete the previously incomplete reimbursement claim. (c) Claims Denied. For reimbursement claims that are denied, see the appeals procedure In Article XI 7.10 Reimbursements From Health FSA After Termination of Participation; COBRA When a Participant ceases to be a Participant under Section 3.2, the Participant's salary reductions and election to participate will terminate. The Participant will not be able to receive reimbursements for Medical Care Expenses incurred after the and of the day on which the Participant's employment terminates or the Participant otherwise ceases to be eligible. However, such Participant (or the Participant's estate) may claim reimbursement for any Medical Care Expenses incurred during the Period of Coverage prior to the date that the Participant ceases to be -15- eligible, provided that the Participant (or the Participant's estate) files a claim within 90 days after the date that the Participant ceases to be a Participant. Notwithstanding any provision to the contrary in this Plan, to the extent required by COBRA, a Participant and his or her Spouse and Dependents, as applicable, whose coverage terminates under the Health FSA Component because of a COBRA qualifying event (and who is a qualified beneficiary as defined under COBRA) shall be given the opportunity to continue on a self -pay basis the same coverage that he or she had under the Health FSA Component the day before the qualifying event for the periods prescribed by COBRA. Such Individuals will be notified H they are eligible for COBRA continuation coverage. If COBRA is elected, it will be available only for the remainder of the applicable Period of Coverage; such COBRA coverage for the Health FSA Component will cease at the end of the Plan Year and cannot be continued for the next Plan Year. Such continuation coverage shall be subject to all conditions and limitations under COBRA. Contributions for coverage for Health FSA Benefits may be paid on a pre -tax basis for current Employees receiving taxable compensation (as may be permitted by the Plan Administrator on a uniform and consistent basis, but may not be prepaid from contributions in one Plan Year to provide coverage that extends Into a subsequent Plan Year) where COBRA coverage arises either (a) because the Employee ceases to be eligible because of a reduction of hours or (b) because the Employee's Dependent ceases to satisfy the eligibility requirements for coverage. For all other individuals (e.g., Employees who cease to be eligible because of retirement, termination of employment, or layoff), Contributions for COBRA coverage for Health FSA Benefits shall be paid on an after -tax basis (unless permitted otherwise by the Plan Administrator on a uniform and consistent basis, but may not be prepaid from contributions in one Plan Year to provide coverage that extends Into a subsequent Plan Year). 7.11 Qualified Reservist Distribution Under the Health FSA Component, a Participant may receive a distribution of all ore portion of the balance in the employee's account if the distribution qualifies as a "Qualified Reservist Distribution ", "Qualified Reservist Distribution ". In order for a distribution to be a "qualified reservist distribution ", a number of requirements must be satisfied. First, a "qualified reservist distribution" can be made only to a member of a "reserve component" (as defined in section 101 of title 37 of the United States Code), which means a member of the Army National Guard; U.S. Army, Navy, Marine Corps, Air Force, or Coast Guard Reserve; Air National Guard of the United States; or the Reserve Corps of the Public Health Service. Second, the distributions can be made only to a reservist that, by reason of being a member of a "reserve component ", has been ordered or called into active duty (1) in excess of 179 days or more or (ii) for an indefinite period. Third, the amount of the distribution must be for "all or a portion of the balance in the employee's account ". Fourth, the distribution must be made within a certain timeframe. The period for making a qualified reservist distribution must be made on or before the last day of the coverage period that Includes the date of the reservist's call to active duty and ends on the last day that reimbursements could otherwise be made for the plan year that Includes the first day of the distribution period. A Qualified Reservist will be allowed to cash out the unused benefits and not forfeit them under the "use it or lose it" rule that applies to health FSAs. Specifically, the HEART Act allows for a taxable, penalty-free "qualified reservist distributions" from a health FSA without subjecting other amounts in the cafeteria plan or health FSA to Immediate taxation. 7.12 Named Fiduciary for Health FSA Brazos County is the named fiduciary for the Health FSA Component for purposes of ERISA Section 402(a). 7.13 Coordination of Benefits with Other Plans Health FSA Benefits are intended to pay benefits solely for Medical Care Expenses for which Participants have not been previously reimbursed and will not seek reimbursement elsewhere. Accordingly, the Health FSA shall not be considered to be a group health plan for coordination of benefits purposes, and Health FSA Benefits shall not be taken into account when determining benefits payable under any other plan. -16- Vol. 205 Pg. 1O ARTICLE VIII DCAP Component 8.1 DCAP Benefits An Eligible Employee can elect to participate in the DCAP Component by electing to receive benefits in the form of reimbursements for Dependent Care Expenses and to pay the Contribution for such benefits on a pre -tax salary reduction basis. Unless an exception applies (as described in Article X), such election of DCAP Benefits is irrevocable for the duration of the Period of Coverage to which it relates. Once an Employee has met the Plan's eligibility requirements, the Eligible Employee may commence participation on the date the eligibility requirements have been met. 8.2 Contributions for Cost of Coverage for DCAP Benefits The annual Contribution for a Participant's DCAP Benefits Is equal to the annual benefit amount elected by the Participant subject to the dollar limits set forth in Section 8.5(b). 8.3 Eligible Dependent Care Expenses Under the DCAP Component, a Participant may receive reimbursement for Dependent Care Expenses incurred during the Period of Coverage for which an election is In force. (a) Incurred. A Dependent Care Expense is incurred at the time the Qualifying Dependent Care Services giving rise to the expense is furnished, not when the Participant is formally billed for, is charged for, or pays for the Qualifying Dependent Care Services (e.g., services rendered for the month of June are not fully incurred until June 30 and cannot be reimbursed in full until then). (b) Dependent Care Expenses. "Dependent Care Expenses" are expenses that are considered to be employment - related expenses under Code section 21(b)(2) (relating to expenses for the care of a Qualifying Individual necessary for gainful employment of the Employee and Spouse, if any), and expenses for incidental household services, if paid for by the Eligible Employee to obtain Qualifying Dependent Care Services, provided, however, that this term shall not include any expenses for which the Participant or other person incurring the expense is reimbursed for the expense through insurance or any other plan. If only a portion of a Dependent Care Expense has been reimbursed elsewhere (e.g., because the Spouse's DCAP imposes maximum benefit limitations), the DCAP can reimburse the remaining portion of such expense if it otherwise meets the requirements of this Article. (c) Qualifying Individual. "Qualifying Individual" means: - a tax dependent of the Participant as defined in Code section 152 who is under the age of 13 and who Is the Participant's qualifying child as defined in Code section 152(axt ); - a tax dependent of the Participant as defined in Code section 152 who is physically or mentally incapable of self -care and who has the same principal place of abode as the Participant for more than half of the year; or - a Participant's Spouse who is physically or mentally incapable of self -care, and who has the same principal place of abode as the Participant for more than half of the year. Notwithstanding the foregoing, in the case of divorced parents, a Qualifying Individual who is a child shall, as provided in Code section 21(e)(5), be treated as a Qualifying Individual of the custodial parent (within the meaning of Code section 152(eK3)(A)) and shall not be treated as a Qualifying Individual with respect to the non - custodial parent. (d) Qualifying Dependent Care Services. "Qualifying Dependent Care Services" means the following: services that both (1) relate to the care of a Qualifying Individual that enable the Participant and his or her Spouse to remain gainfully employed after the date of participation in the DCAP Component and during the Period of Coverage; and (2) are performed: - in the Participant's home; or - outside the Participant's home for (1) the care of a Participant's qualifying child who is under age 13; or -17- Vol. 205 Pg. �� (2) the care of any other Qualifying Individual who regularly spends at least eight hours per day in the Participant's household. In addition, if the expenses are incurred for services provided by a dependent care center (i.e., a facility that provides care for more than six individuals not residing at the facility and that receives a fee, payment, or grant for such services), then the center must comply with all applicable state and local laws and regulations. (e) Exclusions. Dependent Care Expenses do not include amounts paid to: - an individual with respect to whom a personal exemption is allowable under Code section 151(c) to a Participant or his or her Spouse; - a Participant's Spouse; or - a Participant's child (as defined in Code section 152(f)(1)) who is under 19 years of age at the end of the year In which the expenses were incurred. 8.4 Events Permitting Exception to Irrevocability Rule A Participant may make a new election upon the occurrence of certain events, including a Change in Status as described in Section 10.3, but only if such election change Is made on account of and corresponds with a Change in Status that affects eligibility for coverage under a plan of the Employer ore plan of the Spouse's or Dependent's employer (referred to as the general consistency requirement)- A Change in Status that affects eligibility for coverage under a plan of the Employer or a plan of the Spouse's or Dependent's employer Includes a Change in Status that results in an increase or decrease in the number of an Employee's family members (i.e., a Spouse and/or Dependents) who may benefit from the coverage. "Change in Status" means any of the events described below, as well as any other events Included under subsequent changes to Code section 125 or regulations issued thereunder, which the Plan Administrator, In Its sole discretion and on a uniform and consistent basis, determines are permitted under IRS regulations and under this Plan. A Participant may change an election under the regulations for the DCAP Component of this Plan as described below upon the occurrence of the stated events: (a) Open Enrollment Period (b) Change in Status: (b.1) Change in Employee's Legal Marital Status (b.2) Change in the Number of Employee's Dependents (b.3) Change In Employment Status of Employee, Spouse or Dependent that Affects Eligibility (b.4) Event Causing Employee's Dependent to Satisfy or Cease to Satisfy Eligibility Requirements (c) Significant Cost Changes: Significant Cost Increase or Significant Cost Decrease (d) Significant Curtailment of Coverage (With or Without Loss of Coverage) (e) Addition or Significant Improvement of a Benefit Package Option (f) Change In Coverage Under Another Employer Cafeteria Plan or Qualified Benefits Plan (g) FMLA Leaves of Absence 8.5 Maximum Benefits for DCAP (a) Maximum Reimbursement Available. The maximum dollar amount elected by the Participant for reimbursement of Dependent Care Expenses Incurred during a Period of Coverage (reduced by prior reimbursements during the Period of Coverage) shall only be available during the Period of Coverage to the extent of the actual amounts credited to the Participant's DCAP Account pursuant to Section 8.8. No reimbursement will be made to the extent that such reimbursement would exceed the balance in the Participant's Account (that Is, the year -to -date amount that has been withheld from the Participant's Compensation for reimbursement for Dependent Care Expenses for the Period of Coverage, less any prior reimbursements). Payment shall be made to the Participant In cash as reimbursement for Dependent Care Expenses incurred during the Period of Coverage for which the Participant's election is effective, provided that the other requirements of this Article VIII have been satisfied. (b) Maximum Dollar Limits. The maximum annual benefit amount that a Participant may elect to receive under this Plan In the form of reimbursements for Dependent Care Expenses incurred in any Period of Coverage shall be the maximum limit as indexed under Code section 129(ax2). Or if lower, the maximum amount that the Participant has reason to believe will be excludable from his or her income at the time the election is made as a result of the applicable statutory limit for the Participant. The applicable statutory limit -18- Vol. 205 Pg. for a Participant is the smallest of the following amounts: - the Participant's Earned Income for the calendar year; - the Earned Income of the Participant's Spouse for the calendar year (Note: A Spouse who (1) is not employed during a month in which the Participant incurs a Dependent Care Expense; and (2) is either physically or mentally incapable of self -care or a Student shall be deemed to have Earned Income in the amount indexed under Code section 129(b)(2) per Qualifying Individual for whom the Participant incurs Dependent Care Expenses, up to a maximum amount indexed under Code section 129(b)(2)); or - either the maximum statutory limit Indexed under Code section 129(a)(2) for the calendar year, as applicable: (1) Statutory maximum amount as indexed under Code section 129(a)(2) for the calendar year if one of the following applies: - the Participant is married and files a joint federal Income tax return; - the Participant is married, files a separate federal income tax return, and meets the following conditions: (1) the Participant maintains as his or her home a household that constitutes (for more than half of the taxable year) the principal abode of a Qualifying Individual (i.e., the Dependent for whom the Participant is eligible to receive reimbursements under the DCAP); (2) the Participant furnishes over half of the cost of maintaining such household during the taxable year; and (3) during the last six months of the taxable year, the Participant's Spouse is not a member of such household (i.e,, the Spouse maintained a separate residence); or - the Participant is single or is the head of the household for federal income tax purposes; or (2) Statutory maximum amount Indexed under Code section 129(aN2) for the calendar year if the Participant is married and resides with the Spouse but files a separate federal income tax return. (c) Changes. For subsequent Plan Years, the maximum dollar limit may be changed by the Plan Administrator and shall be communicated to Employees through the Election Form /Salary Reduction Agreement or another document. If a Participant enters the DCAP Component mid -year or wishes to increase his or her election mid -year as permitted under Section 8.4, then the Participant may elect coverage up to the maximum dollar limit or may increase coverage up to the maximum dollar limit, as applicable. 8.6 Establishment of DCAP Account The Plan Administrator will establish and maintain a DCAP Account with respect to each Participant for each Plan Year or other Period of Coverage who has elected to participate In the DCAP Component, but it will not create a separate fund or otherwise segregate assets for this purpose. The Account so established will merely be a recordkeeping account with the purpose of keeping track of contributions and determining forfeitures under Section 8.8. (a) Crediting of Accounts. A Participant's DCAP Account for a Plan Year or other Period of Coverage will be credited periodically during such period with an amount equal to the Participant's salary reductions elected to be allocated to such Account. (b) Debiting of Accounts. A Participant's DCAP Account will be debited during each Period of Coverage for any reimbursement of Dependent Care Expenses incurred during the Period of Coverage. (c) Available Amount Is Based on Credited Amount. As described in Section 8.5, the amount available for reimbursement of Dependent Care Expenses may not exceed the year -to -date amount credited to the Participant's DCAP Account, less any prior reimbursements (i.e., it is based on the amount credited to the DCAP Account at a particular point in time). Thus, a Participant's DCAP Account may not have a negative balance during a Period of Coverage. 8.7 DCAP Benefits Grace Period No grace period applies to the DCAP Component of this Plan. 8.8 Forfeiture of DCAP Accounts; Use- It -or- Lose -It Rule If any balance remains in the Participant's DCAP Account for a Period of Coverage after all reimbursements have been made for the Period of Coverage, then such balance shall not be carried over to reimburse the Participant for Dependent Care Expenses incurred during a'subsequent Plan Year: The Participant shall forfeit all rights with respect to such balance. All forfeitures under this Plan shall be used as follows: first, to offset any losses experienced by the Employer during the Plan Year as a result of making reimbursements (i.e., providing DCAP Benefits) with respect to all Participants in excess of the Contributions paid by such Participants through salary reductions; second, to reduce the cost of administering the DCAP during the Plan Year or the subsequent Plan -19- Vol. 205 Pg. 133 Year (all such administrative costs shall be documented by the Plan Administrator); and third, to provide increased benefits or compensation to Participants in subsequent years in any weighted or uniform fashion the Plan Administrator deems appropriate, consistent with applicable regulations. In addition, any DCAP Account benefit payments that are unclaimed (e.g., uncashed benefit checks) by the close of the Plan Year following the Period of Coverage in which the Dependent Care Expense was Incurred shall be forfeited and applied as described above. 8.9 Reimbursement Claims Procedure for DCAP (a) Claims Substantiation. A Participant who has elected to receive DCAP Benefits for a Period of Coverage may apply for reimbursement by submitting a request for reimbursement in writing to the Plan Administrator in such form as the Plan Administrator may prescribe, by no later than the 90th day following the dose of the Plan Year in which the Dependent Care Expense was incurred (except for a Participant who ceases to be eligible to participate, by no later than 90 days after the date that eligibility ceases, as described In Section 8.10), setting forth: - the person(s) on whose behalf Dependent Care Expenses have been Incurred; - the nature and date of the Expenses so Incurred; - the amount of the requested reimbursement; - the name of the person, organization or entity to whom the Expense was or is to be paid, and taxpayer Identification number (Social Security number, if the recipient is a person); - a statement that such Expenses have not otherwise been reimbursed and that the Participant will not seek reimbursement through any other source; - the Participant's certification that he or she has no reason to believe that the reimbursement requested, added to his or her other reimbursements to date for Dependent Care Expenses Incurred during the same calendar year, will exceed the applicable statutory limit for the Participant as described in Section 8.5(b); and - other such details about the expenses that may be requested by the Plan Administrator in the reimbursement request form or otherwise (e.g., a more detailed certification from the Participant). The request shall be accompanied by bills, invoices, or other statements from an independent third party showing that the Dependent Care Expenses have been incurred and showing the amounts of such Expenses, along with any additional documentation that the Plan Administrator may request. (b) Timing. Within 30 days after receipt by the Plan Administrator of a reimbursement claim from a Participant, the Employer will reimburse the Participant forthe Participant's Dependent Care Expenses (if the Plan Administrator approves the claim), or the Plan Administrator will notify the Participant that his or her claim has been denied. This time period may be extended by an additional 15 days for matters beyond the control of the Plan Administrator, including in cases where a reimbursement claim Is incomplete. The Plan Administrator will provide written notice of any extension, including the reasons for the extension, and will allow the Participant 45 days in which to complete the previously incomplete reimbursement claim. (c) Claims Denied. For reimbursement claims that are denied, see the appeals procedure in Article XI. 8.10 Reimbursements From DCAP After Termination of Participation When a Participant ceases to be a Participant under Section 3.2, the Participant's salary reductions and election to participate will terminate. The Participant will not be able to receive reimbursements for Dependent Care Expenses incurred after the end of the day on which the Participant's employment terminates or the Participant otherwise ceases to be eligible. 8.11 Report to DCAP Participants On or before January 31 of each year, the Plan Administrator shall furnish to each Participant who has received reimbursement for Dependent Care Expenses during the prior calendar year a written statement showing the Dependent Care Expenses paid during such year with respect to the Participant, or showing the salary reductions for the year for the DCAP Component, as the Plan Administrator deems appropriate. -20- Vol. 205 Pg..2 3S� ARTICLE IX HIPAA Provisions for Health FSA 9.1 Provision of Protected Health Information to Employer Members of the Employer's workforce have-access to the Individually identifiable health Information of Plan participants for administrative functions of the Health FSA. When this health information is provided from the Health FSA to the Employer, it is Protected Health Information (PHI). The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations restrict the Employer's ability to use and disclose PHI. The following HIPAA definition of PHI applies for purposes of this Article: Protected Health Information. Protected health information means Information that is created or received by the Plan and relates to the past, present, or future physical or mental health or condition of a participant; the provision of health care to a participant; or the past, present, or future payment for the provision of health care to a participant; and that identifles the participant or for which there is a reasonable basis to believe the information can be used to identify the participant. Protected health information includes Information of persons living or deceased. The Employer shall have access to PHI from the Health FSA only as permitted under this Article or as otherwise required or permitted by HIPAA. The Health Information Technology for Economic and Clinical Health Act passed as part of the American Recovery and Reinvestment Act of 2009 to strengthen the privacy and security protection of health Information, and to Improve the workability and effectiveness of HIPAA Rules. HITECH defines an EHR as "electronic record of health - related Information on an individual that is created, gathered, managed, and consulted by authorized health care clinicians and staff." 9.2 Permitted Disclosure of Enrollment/Disenrollment Information The Health FSA may disclose to the Employer information on whether the individual Is participating in the Plan. 9.3 Permitted Uses and Disclosure of Summary Health Information The Health FSA may disclose Summary Health Information to the Employer, provided that the Employer requests the Summary Health Information for the purpose of modifying, amending, or terminating the Health FSA. "Summary Health Information" means information (a) that summarizes the claims history, claims expenses, or type of claims experienced by individuals for whom a plan sponsor had provided health benefits under a health plan; and (b) from which the information described at 42 CFR Section 164.514(b)(2Xi) has been deleted, except that the geographic information described in 42 CFR Section 184.514(bX2)(IXB) need only be aggregated to the level of a five -digit ZIP code. 9.4 Permitted and Required Uses and Disclosure of PHI for Plan Administration Purposes Unless otherwise permitted by law, and subject to the conditions of disclosure described in Section 9.5 and obtaining written certification pursuant to Section 91, the Health FSA may disclose PHI to the Employer, provided that the Employer uses or discloses such PHI only for Plan administration purposes. "Plan administration purposes" means administration functions performedi by the Employer on behalf of the Health FSA, such as quality assurance, claims processing, auditing, and monitoring. Plan administration functions do not Include functions performed by the Employer In connection with any other benefit or benefit plan of the Employer, and they do not Include any employment - related functions. Notwithstanding the provisions of this Plan to the contrary, in no event shall the Employer be permitted to use or disclose PHI in a manner that is inconsistent with 45 CFR Section 154.504(f). 9.5 Conditions of Disclosure for Plan Administration Purposes The Employer agrees that with respect to any PHI (other than enrollment/disenrollment information and Summary Health Information, which are not subject to these restrictions) disclosed to it by the Health FSA, the Employer shall: - not use or further disclose the PHI other than as permitted or required by the Plan or as required by law; - ensure that any agent,`Induding a subcontractor,,, to whom It provides PHI received from the Health FSA agrees to the same restrictions and conditions that apply to the Employer with respect to PHI; - not use or disclose the PHI for employment - related actions and decisions or in connection with any other benefit or employee benefit plan of the Employer; - report to the Plan any use or disclosure of the information that Is inconsistent with the uses or disclosures -21- Vol. 205 Pg. �3s� provided for of which it becomes aware; make available PHI to comply with HIPAA's right to access in accordance with 45 CFR Section 164.524; make available PHI for amendment and Incorporate any amendments to PHI in accordance with 45 CFR Section 164.526; make available the information required to provide an accounting of disclosures in accordance with 45 CFR Section 184.528; make its internal practices, books, and records relating to the use and disclosure of PHI received from the Health FSA available to the Secretary of Health and Human Services for purposes of determining compliance by the Health FSA with HIPAA's privacy requirements; If feasible, return or destroy all PHI received from the Health FSA that the Employer still maintains in any form and retain no copies of such information when no longer needed for the purpose for which disclosure was made, except that, if such return or destruction is not feasible, limit further uses and disclosures to those purposes that make the return or destruction of the information Infeasible; and ensure that the adequate separation between the Health FSA and the Employer (Le., the'Yrewall "), required in 45 CFR Section 504(f)(2)(iii), is satisfied. The Employer further agrees that if it creates, receives, maintains, or transmits any electronic PHI (otherthan enrolimentidisenroliment information and Summary Health Information, which are not subject to these restrictions) on behalf of the Health FSA, It will implement administrative, physical, and technical safeguards that reasonably and appropriately protect the confidentiality, integrity, and availability of the electronic PHI, and it will ensure that any agents (including subcontractors) to whom it provides such electronic PHI agrees to implement reasonable and appropriate security measures to protect the information. The Employer will report to the Health FSA any security Incident of which it becomes aware. 9.6 Adequate Separation Between Plan and Employer The Employer shall allow the following persons access to PHI: Human Resource and payroll staff performing Health FSA functions, the Plan Administrator, and any other Employee who needs access to PHI in order to perform Plan administration functions that the Employer performs for the Health FSA (such as quality assurance, claims processing, auditing, monitoring, payroll, and appeals). No other persons shall have access to PHI. These specified employees (or classes of employees) shall only have access to and use PHI to the extent necessary to perform the plan administration functions that the Employer performs for the Health FSA. In the event that any of these specified employees does not comply with the provisions of this Section, that employee shall be subject to disciplinary action by the Employer for non - compliance pursuant to the Employer's employee discipline and termination procedures. The Employer will ensure that the provisions of this Section are supported by reasonable and appropriate security measures to the extent that the designees have access to electronic PHI. 9.7 Certification of Plan Sponsor The Health FSA shall disclose PHI to the Employer only upon the receipt of a certification by the Employer that the Plan has been amended to incorporate the provisions of 45 CFR Section 164.504(f)(2xii), and that the Employer agrees to the conditions of disclosure set forth in Section 9.5. r I 'r ARTICLE X Irrevocability of Elections; Exceptions 10.1 Irrevocability of Elections Except as described in this Article, a Participant's election under the Plan Is irrevocable for the duration of the Period of Coverage to which it relates, In other words, unless an exception applies, the Participant may not change any elections for the duration of the Period of Coverage regarding: participation in this Plan; salary reduction amounts; or election of particular Benefit Package Options (including the various Health FSA Options). 10.2 Procedure for Making New Election If Exception to Irrevocability Applies (a) Timeframe for Making New Election. A Participant (or an Eligible Employee who, when first eligible under Section 3.1 or during the Open Enrollment Pedod under Section 4.2, declined to be a Participant) may make a new election within 30 days of the occurrence of an event described in Section 10.3, as applicable, but only If the election under the new Election Form /Salary Reduction Agreement is made on account of and is consistent with the event and if the election is made within any specified time period. Notwithstanding the foregoing, a Change in Status (e.g., a divorce) that results in a beneficiary becoming Ineligible for coverage under the Medical Insurance Plan shall automatically result in a corresponding election change, whether or not requested by the Participant within the normal 30 -day period. (b) Effective Date of New Election. Elections made pursuant to this Section shall be effective for the balance of the Period of Coverage following the change of election unless a subsequent event allows for a further election change. Except as provided in Section 10.3 for HIPAA special enrollment rights in the event of birth, adoption, or placement for adoption, all election changes shall be effective on a prospective basis only (i.e., election changes will become effective no earlier than the first day of the next calendar month following the date that the election change was filed, but, as determined by the Plan Administrator, election changes may become effective later to the extent that the coverage in the applicable Benefit Package Option commences later). (c) Effect of New Election Upon Amount of Benefits. For the effect of a changed election upon the maximum and minimum benefits under the Health FSA, see Section 7.5 and DCAP Component, see Section 8.5. 10.3 Change In Status Defined A Participant may make a new election upon the occurrence of certain events as described below, including a Change in Status, for the applicable Component, but only if such election change Is made on account of and corresponds with a Change in Status that affects eligibility for coverage under a plan of the Employer or a plan of the Spouse's or Dependent's employer (referred to as the general consistency requirement). A Change in Status that affects eligibility for coverage under a plan of the Employer or a plan of the Spouse's or Dependent's employer includes a Change in Status that results In an increase or decrease in the number of an Employee's family members (i.e., a Spouse and/or Dependents) who may benefit from the coverage. "Change in Status" means any of the events described below, as well as any other events included under subsequent changes to Code section 125 or regulations issued thereunder, which the Plan Administrator, in its sole discretion and on a uniform and consistent basis, determines are permitted under IRS regulations and under this Plan: (a) Open Enrollment Period. A Participant may change an election during the Open Enrollment Period in accordance with Section 4.2. (b) Termination of Employment. A Participant's election will terminate under the Plan upon termination of employment in accordance with Sections 3.2 and 3.3, as applicable. (c) Legal Marital Status. A change in a Participant's legal marital status, including marriage, death of a -23- Vol. 205 Pg. >ZJ7 Spouse, divorce, legal separation, or annulment; (d) Number of Dependents. Events that change a Participant's number of Dependents, including birth, death, adoption, and placement for adoption; (e) Employment Status. Any of the following events that change the employment status of the Participant or his or her Spouse or Dependents: (1) a terminatlon or commencement of employment; (2) a strike or lockout; (3) a commencement of or return from an unpaid leave of absence; (4) a change in worksite; and (5) if the eligibility conditions of this Plan or other employee benefits plan of the Participant or his or her Spouse or Dependents depend on the employment status of that Individual and there Is a change in that individual's status with the consequence that the individual becomes (or ceases to be) eligible under this Plan or other employee benefits plan, such as if a plan only applies to salaried employees and an employee switches from salaried to hourly -paid, union to non-union, or full -time to part -time (or vice versa), with the consequence that the employee ceases to be eligible for the Plan; (f) Dependent Eligibility Requirements. An event that causes a Dependent to satisfy or cease to satisfy the Dependent eligibillty requirements for a particular benefit, such as attaining a specified age, or any similar circumstance; and (g) Change in Residence. A change in the place of residence of the Participant or his or her Spouse or Dependents that causes the gain or loss of eligibility for coverage option. (h) Leaves of Absence. A Participant may change an election under the Plan upon FMLA leave in accordance with Section 3.4 and upon non -FMLA leave In accordance with Section 3.5. Assuming that the general consistency requirement is satisfied, a requested election change must also satisfy the following specific consistency requirements In order for a Participant to be able to alter his or her election based on the specified Change in Status: (h.1) Loss of Spouse or Dependent Eligibility; Special COBRA Rules. For a Change in Status involving a Participant's divorce, annulment or legal separation from a Spouse, the death of a Spouse or a Dependent, or a Dependent's ceasing to satisfy the eligibility requirements for coverage, a Participant may only elect to cancel accident or health insurance coverage for (a) the Spouse involved in the divorce, annulment, or legal separation; (b) the deceased Spouse or Dependent; or (c) the Dependent that ceased to satisfy the eligibility requirements. Canceling coverage for any other individual under these circumstances would fail to correspond with that Change in Status. Notwithstanding the foregoing, if the Participant or his or her Spouse or Dependent becomes eligible for COBRA (or similar health plan continuation coverage under state law) under the Employer's plan (and the Participant remains a Participant under this Plan In accordance with Section 3.2), then the Participant may Increase his or her election to pay for such coverage (this rule does not apply to a Participant's Spouse who becomes eligible for COBRA or similar coverage as a result of divorce, annulment, or legal separation). (h.2) Gain of Coverage Eligibility Under Another Employer's Plan. For a Change in Status in which a Participant or his or her Spouse or Dependent gains eligibility for coverage under a cafeteria plan or qualified benefit plan of the employer of the Participant's Spouse or Dependent as a result of a change in marital status or a change in employment status, a Participant may elect to cease or decrease coverage for that individual only if coverage for that individual becomes effective or is increased under the Spouse's or Dependent's employer's plan. The Plan Administrator may rely on a Participant's certification that the Participant has obtained or will obtain coverage under the Spouse's or Dependent's employer's plan, unless the Plan Administrator has reason to believe that the Participant's certification is incorrect. (1) HIPAA Special Enrollment Rights. If a Participant or his or her Spouse or Dependent is entitled to special enrollment rights under a group health plan (other than an excepted benefit), as required by HIPAA under Code section 9801((), then a Participant may revoke a prior election for group health plan coverage and make a new election (including, when required by HIPAA, an election to enroll in another benefit package under a group health plan), provided that the election change corresponds with such HIPAA special enrollment right. As required by HIPAA, a special enrollment right will arise in the following circumstances: (i.1) a Participant or his or her Spouse or Dependent declined to enroll in group health plan coverage because he or she had coverage, and eligibility for such coverage is subsequently lost because: (1) the coverage was provided under COBRA and the COBRA coverage was exhausted; or (2) the coverage was 1 0 EWA non-COBRA coverage and the coverage terminated due to loss of eligibility for coverage or the employer contributions for the coverage were terminated; or (i.2) a new Dependent Is acquired as a result of marriage, birth, adoption, or placement for adoption. An election to add previously eligible Dependents as a result of the acquisition of a new Spouse or Dependent child shall be considered to be consistent with the special enrollment right. An election change on account of a HIPAA special enrollment attributable to the birth, adoption, or placement for adoption of a new Dependent child may, subject to the provisions of the underlying group health plan, be effective retroactively (up to 30 days). An election change on account of a HIPAA special enrollment attributable to an employee or dependent becoming eligible for a state premium assistance subsidy under the plan from Medicaid or SCHIP may, subject to the provisions of the underlying group health plan be effective retroactively (up to 60 days). 0) Certain Judgments, Decrees and Orders. If a judgment, decree, or order (collectively, an "Order ") resulting from a divorce, legal separation, annulment, or change in legal custody (including a OMCSO) requires accident or health coverage for a Participant's child (Including a foster child who is a Dependent of the Participant), then a Participant may (1) change his or her election to provide coverage for the child (provided that the Order requires the Participant to provide coverage); or (2) change his or her election to revoke coverage for the child if the Order requires that another individual (Including the Participant's Spouse or former Spouse) provide coverage under that individual's plan and such coverage is actually provided. (k) Medicare and Medicaid. If a Participant or his or her Spouse or Dependent who is enrolled in a health or accident plan under this Plan becomes entitled to (i.e., becomes enrolled in) Medicare or Medicaid (other than coverage consisting solely of benefits under Section 1828 of the Social Security Act providing for pediatric vaccines), then the Participant may prospectively reduce or cancel the health or accident coverage of the person becoming entitled to Medicare or Medicaid. (1) Change in Cost. For purposes of this Section, "similar coverage" means coverage for the same category of benefits for the same individuals (e.g., family to family or single to single). For example, two plans that provide major medical coverage are considered to be similar coverage. For purposes of this definition, (1) a health FSA is not similar coverage with respect to an accident or health plan that is not a health FSA; (2) an HMO and a PPO are considered to be similar coverage; and (3) coverage by another employer, such as a Spouse's or Dependent's employer, may be treated as simllar coverage if it otherwise meets the requirements of similar coverage. (m) Increase or Decrease for Insignificant Cost Changes. Participants are required to increase their elective contributions (by increasing salary reductions) to reflect insignificant Increases in their required contribution for their Benefit Package Option(s), and to decrease their elective contributions to reflect insignificant decreases in their required contribution. The Plan Administrator will determine whether an increase or decrease Is insignificant based upon all the surrounding facts and circumstances, including but not limited to the dollar amount or percentage of the cost change. The Plan Administrator, on a reasonable and consistent basis, will automatically effectuate this increase or decrease in affected employees' elective contributions on a prospective basis. (n) Significant Cost Increases. If the Plan Administrator determines that the cost charged to an Employee of a Participant's Benefit Package Option(s) significantly increases during a Period of Coverage, then the Participant may (a) make a corresponding prospective increase in his or her elective contributions (by increasing salary reductions); (b) revoke his or her election for that coverage, and in lieu thereof, receive on a prospective basis coverage under another Benefit Package Option that provides similar coverage (such as an HMO, but not the Health FSA); or (c) drop coverage prospectively if there is no other Benefit Package Option available that provides similar coverage. (o) Significant Cost Decreases. If the Plan Administrator determines that the cost of any Benefit Package Option significantly decreases during a Period of Coverage, then the Plan Administrator may permit the following election changes: (a) Participants who are "enrolled in a Benefit Package Option (such as an HMO, but not the Health FSA) other than the Benefit Package Option that has decreased in cost may change their election on a prospective basis to elect the Benefit Package Option that has decreased in cost (such as the PPO for the Medical Insurance Plan); and (b) Employees who are otherwise eligible under Section 3.1 may elect the Benefit Package Option that has decreased In cost (such as the PPO) on a prospective basis, W, ) rr subject to the terms and limitations of the Benefit Package Option. (p) Limitation on Change In Cost Provisions for DCAP Benefits. The "Change in Cost" provisions apply to DCAP Benefits only if the cost change is imposed by a dependent care provider who is not a "relative" of the Employee. For this purpose, a relative is an individual who is related as described in Code section 152(d)(2)(A) through (G), incorporating the rules of Code section 152(fxl) and 152(fx4). (q) Change In Coverage. For purposes of this Section, "similar coverage" means coverage for the same category of benefits for the same individuals (e.g., family to family or single to single). For example, two plans that provide major medical coverage are considered to be similar coverage. For purposes of this definition, (1) a health FSA is not similar coverage with respect to an accident or health plan that is not a health FSA; (2) an HMO and a PPO are considered to be similar coverage; and (3) coverage by another employer, such as a Spouse's or Dependent's employer, may be treated as similar coverage if it otherwise meets the requirements of similar coverage. (r) Significant Curtailment. If coverage is "significantly curtailed" (as defined below), Participants may elect coverage under another Benefit Package Option that provides similar coverage. In addition, as set forth below, if the coverage curtailment results in a "Loss of Coverage" (as defined below), then Participants may drop coverage if no similar coverage is offered by the Employer. (0) Significant Curtailment Without Loss of Coverage. If the Plan Administrator determines that a Participant's coverage under a Benefit Package Option under this Plan (or the Participant's Spouse's or Dependent's coverage under his or her employer's plan) is significantly curtailed without a Loss of Coverage during a Period of Coverage, the Participant may revoke his or her election for the affected coverage, and in lieu thereof, prospectively elect coverage under another Benefit Package Option that provides similar coverage (such as the HMO, but not the Health FSA). Coverage under a plan is deemed to be "significantly curtailed" only if there Is an overall reduction in coverage provided under the plan so as to constitute reduced coverage generally. (r.2) Significant Curtailment With a Loss of Coverage. If the Plan Administrator determines that a Participant's Benefit Package Option coverage under this Plan (or the Participant's Spouse's or Dependent's coverage under his or her employer's plan) is significantly curtailed, and if such curtailment results in a Loss of Coverage during a Period of Coverage, then the Participant may revoke his or her election for the affected coverage and may either prospectively elect coverage under another Benefit Package Option that provides similar coverage (such as the HMO, but not the Health FSA) or drop coverage if no other Benefit Package Option providing similar coverage is offered by the Employer. (r.3) Definition of Loss of Coverage. For purposes of this Section, a "Lass of Coverage" means a complete loss of coverage (including the elimination of a Benefit Package Option, an HMO ceasing to be available where the Participant or his or her Spouse or Dependent resides, or a Participant or his or her Spouse or Dependent losing all coverage under the Benefit Package Option by reason of an overall lifetime or annual limitation). In addition, the Plan Administrator may treat the following as a Loss of Coverage: - a substantial decrease in the medical care providers available under the Benefit Package Option (such as a major hospital ceasing to be a member of a preferred provider network or a substantial decrease in the number of physicians participating in the PPO for the Medical Insurance Plan or in an HMO); - a reduction in benefits for a specific type of medical condition or treatment with respect to which the Participant or his or her Spouse or Dependent is currently in a course of treatment; or - any other similar fundamental loss of coverage. (s) Addition or Significant Improvement of a Benefit Package Option. If during a Period of Coverage the Plan adds a new Benefit Package Option or significantly improves an existing Benefit Package Option, the Plan Administrator may permit the following election changes: (a) Participants who are enrolled in a Benefit Package Option other than the newly added or significantly improved Benefit Package Option may change their elections on a prospective basis to elect the newly added or significantly improved Benefit Package Option; and (b) Employees who are otherwise eligible under Section 3.1 may elect the newly added or significantly improved Benefit Package Option on a prospective basis, subject to the terms and limitations of 1 ( rr the Benefit Package Option. (t) Loss of Coverage Under Other Group Health Coverage. A Participant may prospectively change his or her election to add group health coverage for the Participant or his or her Spouse or Dependent, if such indlvidual(s) loses coverage under any group health coverage sponsored by a governmental or educational institution, Including (but not limited to) the following: a state children's health insurance program (SCHIP) under Title XXI of the Social Security Act; a medical care program of an Indian Tribal government (as defined in Code §7701(a)(40) ), the Indian Health Service, or a tribal organization; a state health benefits risk pool; or a foreign government group health plan, subject to the terms and limitations of the applicable Benefit Package Option(s). (u) Change in Coverage Under Another Employer Plan. A Participant may make a prospective election change that is on account of and corresponds with a change made under an employer plan (including a plan of the Employer or a plan of the Spouse's or Dependent's employer), so long as (a) the other cafeteria plan or qualified benefits plan permits its participants to make an election change that would be permitted under applicable IRS regulations; or (b) the Plan permits Participants to make an election for a Period of Coverage that is different from the Plan Year under the other cafeteria plan or qualified benefits plan. 10.4 Election Modifications Required by Plan Administrator The Plan Administrator may, at any lime, require any Participant or class of Participants to amend the amount of their salary reductions for a Period of Coverage if the Plan Administrator determines that such action is necessary or advisable in order to (a) satisfy any of the Code's nondiscrimination requirements applicable to this Plan or other cafeteria plan; (b) prevent any Employee or class of Employees from having to recognize more income for federal Income tax purposes from the receipt of benefits hereunder than would otherwise be recognized; (c) maintain the qualified status of benefits received under this Plan; or (d) satisfy Code nondiscrimination requirements or other limitations applicable to the Employer's qualified plans. In the event that contributions need to be reduced for a class of Participants, the Plan Administrator will reduce the salary reduction amounts for each affected Participant, beginning with the Participant In the class who had elected the highest salary reduction amount and continuing with the Participant in the Gass who had elected the next - highest salary reduction amount, and so forth, until the defect is corrected. r I ENT. r ARTICLE XI Appeals Procedure 11.1 Procedure If Benefits Are Denied Under This Plan If a claim for reimbursement or benefit under this Plan is wholly or partially denied, such claim shall be administered in accordance with the procedure set forth below and in the summary plan description of this Plan. The Appeals Committee, separate and distinct from the individual(s) that adjudicate the claims, shall act on behalf of the Plan Administrator with respect to appeals. An external review process shall be provided as legally required and as further set forth below. Claims Under the Health FSA or DCAP Components If (a) a claim for reimbursement under the Health FSA or DCAP Components of the Cafeteria Plan is wholly or partially denied, or (b) Participant is denied a benefit under the Plan due to an issue germane to said coverage under the Plan, then the procedure described below will apply. If a claim is denied in whole or in part, Participant will be notified In writing by the Plan Administrator within 30 days after the date the Plan Administrator received the claim. (This time period may be extended for an additional 15 days for matters beyond the control of the Plan Administrator, Including In cases where a claim is incomplete. The Plan Administrator will provide written notice of any extension, Including the reasons for the extension and the date by which a decision by the Plan Administrator is expected to be made. Where a claim is Incomplete, the extension notice will also specifically describe the required information, will allow the Participant 45 days from receipt of the notice in which to provide the specified Information and will have the effect of suspending the time for a decision on the claim until the specified information is provided.) Notification of a denied claim will include: - a statement of the specific reason(s) for the denial; - reference(s) to the specific Plan provision(s) on which the denial is based; - a description of any additional material or information necessary for Participant to validate the claim and an explanation of why such material or information is necessary; - appropriate information on the steps to be taken if Participant wishes to appeal the Plan Administrator's decision, including their right to submit written comments and have them considered, their right to review (upon request and at no charge) relevant documents and other information, and their right to file suit under ERISA (where applicable) with respect to any adverse determination after appeal of their claim. Appeals If a claim is denied in whole or in part, then the Participant (or authorized representative) may request review upon written application to the Appeals Committee. The appeal must be made in writing within 180 days after Participant's receipt of the notice that the claim was denied. If Participant does not appeal on time, Participant will lose the right to appeal the denial and the right to file suit in court. Participant's written appeal should state the reasons that they feel their claim should not have been denied. It should include any additional facts and /or documents that they feel support their claim. Participant will have the opportunity to ask additional questions and make written comments, and Participant may review (upon request and at no charge) documents and other information relevant to their appeal. Participant will not be allowed to take legal action against the Plan, the Employer, the Administrator, or any other entity to whom administrative or claims processing functions have been delegated unless they exhaust the internal appeal rights. A Participant does not have to pursue external review in order to preserve the right to file a lawsuit; however, a Participant may be unable to take further legal action if they pursue an external appeal because the external appeal process results in a binding determination. r I �r Decision on Review of Internal Appeal Participant's internal appeal will be reviewed and decided by the Appeals Committee within a reasonable time not later than 60 days after the Appeals Committee receives Participant's request for review. The Appeals Committee may, in its discretion, hold a hearing on the denied claim. Any medical expert consulted in connection with their internal appeal will be different from and not subordinate to any expert consulted in connection with the initial claim denial. The identity of a medical expert consulted in connection with the Internal appeal will be provided. If the decision on review affirms the Initial denial of the claim, Participant will be furnished with a notice of adverse benefit determination on review setting forth: - a statement of the specific reason(s) for the decision on review; - reference(s) to the specific Plan provision(s) on which the decision is based; - a statement of Participant's right to review (upon request and at no charge) relevant documents and other Information; - if an "internal rule, guideline, protocol, or other similar criterion" Is relied on in making the decision on review, then a description of the specific rule, guideline, protocol, or other similar criterion or a statement that such a rule, guideline, protocol, or other similar criterion was relied on and that a copy of such rule, guideline, protocol, or other criterion will be provided free of charge to Participant upon request; and - a statement of Participant's right to bring an external appeal or a civil action under ERISA Section 502(a) (where applicable). Participant may have the right to an external review of the Administrator's denial of the internal appeal of the Health FSA claim unless the Benefit denial was based on the Participant's (or their Spouse's or Dependent's) failure to meet the Plan's eligibility requirements. Requirements for an External Appeal Participant may request an external appeal by completing the form provided by the Administrator which must include the following information: - Participant's name, address, daytime telephone number and email address; and - A brief description of why the Participant disagrees with the decision, along with any additional information, such as a physician's letter, bills, medical records, or other documents to support their claim. Deadline for filing an External Appeal Participant's external appeal must be filed with the external reviewer within four (4) months of the date the Participant was served with the Administrator's response to their internal appeal request. If Participant does not file an external appeal within this 4 -month period, the Participant shall lose the right to appeal. For example, if Participant received the Internal appeal decision on January 3, 2012, they must appeal the decision by May 3, 2012 (or, if that is not a business day, the next business day thereafter). The plan must complete a preliminary review within five (5) business days upon receipt of the external review request to determine if the claimant was covered under the plan, the claimant provided all of the necessary information to process the external review and that the claimant has exhausted the Internal appeals process. The plan must provide the claimant written notice of its preliminary review determination within one (1) business day after completing its review. If the request Is complete, but not eligible for external review, the notice must state the reasons for the ineligibility and provide EBSA contact information. If the request is incomplete, the notice must describe the information or materials needed to complete the request. The plan must permit the claimant to "perfect" (i.e., complete) the external review request within the four -month filing period or, if later, 48 hours after receipt of the notice. Decision on Review of External Appeal The plan must assign an accredited Independent Review Organization (IRO) to perform the external review. The external reviewer must notify you and the Administrator of its decision on your external appeal within 45 days after its receipt of your request for external review. The external reviewer's decision is binding upon the parties unless other State or Federal law remedies are available. Such remedies may or may not exist. Therefore, unless another legal right exists under your claim, use of the external review process may terminate your right to bring a lawsuit on your claim. Duty of Beneficiary/third Party Recoveries Any Beneficiary under the Plan that receives a payment, whether by lawsuit, settlement, or otherwise, from third 501 parties for costs associated with sickness or injury resulting from the acts or omissions of another person or party must reimburse the Plan to the extent the Beneficiary has received payments from the Plan for such sickness or injury. The Plan has a first lien upon any such recovery. Any recovery by the Plan Administrator from such payments is subject to a deduction for reasonable attorney fees and court costs Incurred by the Beneficiaries in securing the third -party payments, and shall be prorated, to reflect that portion of the total recovery reimbursed to the Plan Administrator for the benefits it had paid from the Plan. However, the Plan's share of the recovery will not be reduced because the Beneficiary has not received the full damages claimed, unless the Plan Administrator agrees in writing to such a reduction. The Plan further requires covered Beneficiaries promptly advise the Plan Administrator of third -party claims and to execute any assignments, liens, or other documents the Plan Administrator requests. The Plan may withhold Benefits until such documents are received. Subrogation/Acts of Third Parties The Plan Administrator, on behalf of the Plan, has the right to recover any payments made to Beneficiaries, whether by lawsuit, settlement, or otherwise, by third parties for costs associated with sickness or injury resulting from the acts or omissions of another person or party. The Plan has a first lien upon any such recovery. Any recovery by the Plan Administrator from such payments Is subject to a deduction for reasonable attorney fees and court costs incurred by the Beneficiaries in securing the third -party payments, and shall be prorated, to reflect that portion of the total recovery reimbursed to the Plan Administrator for the benefits it had paid from the Plan. However, the Plan's share of the recovery will not be reduced because the Beneficiary has not received the full damages claimed, unless the Plan Administrator agrees in writing to such a reduction. 11.2 Claims Procedures for Medical Insurance Benefits Claims and reimbursement for Medical Insurance Benefits shall be administered in accordance with the claims procedures for the Medical Insurance Benefits, as set forth by the provider. -30- ARTICLE XII Recordkeeping and Administration 12.1 Plan Administrator The administration of this Plan shall be under the supervision of the Plan Administrator. It is the principal duty of the Plan Administrator to see that this Plan is carried out, in accordance with its terms, for the exclusive benefit of persons entitled to participate In this Plan without discrimination among them. 12.2 Powers of the Plan Administrator The Plan Administrator shall have such duties and powers as it considers necessary or appropriate to discharge its duties. It shall have the exclusive right to Interpret the Plan and to decide all matters thereunder, and all determinations of the Plan Administrator with respect to any matter hereunder shall be conclusive and binding on all persons, Without limiting the generality of the foregoing, the Plan Administrator shall have the following discretionary authority: (a) to construe and interpret this Plan, Including all possible ambiguities, Inconsistencies, and omissions in the Plan and related documents, and to decide all questions of fact, questions relating to eligibility and participation, and questions of benefits under this Plan (provided that, notwithstanding the first paragraph In this Section the Appeals Committee shall exercise such exclusive power with respect to an appeal of a claim as outlined in the Appeals Procedure Section); (b) to prescribe procedures to be followed and the forms to be used by Employees and Participants to make elections pursuant to this Plan; (c) to prepare and distribute information explaining this Plan and the benefits under this Plan in such manner as the Plan Administrator determines to be appropriate; (d) to request and receive from all Employees and Participants such information as the Plan Administrator shall from time to time determine to be necessary for the proper administration of this Plan; (e) to furnish each Employee and Participant with such reports with respect to the administration of this Plan as the Plan Administrator determines to be reasonable and appropriate, including appropriate statements setting forth the amounts by which a Participant's Compensation has been reduced in order to provide benefits under this Plan; (f) to provide the Employer with such tax or other information it may require in connection with the Plan; (g) to receive, review, and keep on file such reports and information regarding the benefits covered by this Plan as the Plan Administrator determines from time to time to be necessary and proper; (h) to employ any agents, attorneys, accountants or other parties (who may also be employed by the Employer) and to allocate or delegate to them such powers or duties as is necessary to assist in the proper and efficient administration of the Plan, provided that such allocation or delegation and the acceptance thereof is in writing; (1) to appoint and employ such individuals or entities to assist in the administration of this Plan as it determines to be necessary or advisable, including legal counsel and benefit consultants; Q) to sign documents for the purposes of administering this Plan, or to designate an individual or individuals to sign documents for the purposes of administering this Plan; (k) to secure independent medical or other advice and require such evidence as it deems necessary to decide any claim or appeal: and (1) to maintain the books of accounts, records, and other data in the manner necessary for proper administration of this Plan and to meet any applicable disclosure and reporting requirements. -31- (m) to report to the Employer, or any party designated by the Employer, after the and of each Plan Year regarding the administration of the Plan, and to report any significant problems as to the administration of the Plan and to make recommendations for modifications as to procedures and benefits, or any other change which might ensure the efficient administration of the Plan. However, nothing in this Section Is meant to confer upon the Plan Administrator any powers to amend the Plan or change any administrative procedure or adopt any other procedure involving the Plan without the express written approval of the Employer regarding any amendment or change in administrative procedure, or Benefit Provider. Notwithstanding the preceding sentence, the Plan Administrator is empowered to take any actions he or she sees fit to assure that the Plan complies with the nondiscrimination requirements of Section 125 of the Code. 12.3 Reliance on Participant, Tables, etc. The Plan Administrator may rely upon the direction, information, or election of a Participant as being proper under the Plan and shall not be responsible for any act or failure to act because of a direction or lack of direction by a Participant. The Plan Administrator will also be entitled, to the extent permitted by law, to rely conclusively on all tables, valuations, certificates, opinions, and reports that are furnished by accountants, attorneys, or other experts employed or engaged by the Plan Administrator. 12.4 Provision for Third -Party Plan Service Providers The Plan Administrator, subject to approval of the Employer, may employ the services of such persons as it may deem necessary or desirable in connection with the operation of the Plan. Unless otherwise provided in the service agreement, obligations under this Plan shall remain the obligation of the Employer. 12.5 Fiduciary Liability To the extent permitted by law, the Plan Administrator shall not incur any liability for any acts or for failure to act except for their own willful misconduct or willful breach of this Plan. 12.6 Compensation of Plan Administrator Unless otherwise determined by the Employer and permitted by law, any Plan Administrator that is also an Employee of the Employer shall serve without compensation for services rendered in such capacity, but all reasonable expenses incurred in the performance of their duties shall be paid by the Employer. 12.7 Bonding Fiduciaries shall be bonded to the extent required by ERISA. 12.8 Insurance Contracts The Employer shall have the right to: (a) enter into a contract with one or more insurance companies for the purpose of providing any benefits under the Plan; and (b) replace any of such insurance companies or contracts. Any dividends, retroactive rate adjustments, or other refunds of any type that may become payable under any such insurance contract shall not be assets of the Plan but shall be the property of and be retained by the Employer, to the extent that such amounts are less than aggregate Employer contributions toward such Insurance. 12.9 Inability to Locate Payee If the Plan Administrator is unable to make payment to any Participant or other person to whom a payment is due under the Plan because it cannot ascertain the Identity or whereabouts of such Participant or other person after reasonable efforts have been made to identify or locate such person, then such payment and all subsequent payments otherwise due to such Participant or other person shall be forfeited following a reasonable time after the date any such payment first became due. 12.10 Effect of Mistake In the event of a mistake as to the eligibility or participation of an Employee, the allocations made to the account of any Participant, or the amount of benefits paid or to be paid to a Participant or other person, the Plan Administrator shall, to the extent that it deems administratively possible and otherwise permissible under Code section 125 or the regulations issued thereunder, cause to be allocated or cause to be withheld or accelerated, or otherwise make adjustment of, such amounts as it will in its judgment accord to such Participant or other person the credits to the account or distributions to which he of she is properly entitled under the Plan. Such action by the Plan Administrator may include withholding of any amounts due to the Plan or the Employer from Compensation paid by the Employer. -32- Vnl )gq Pa 2eA ARTICLE XIII General Provisions 13.1 Plan Expenses All reasonable expenses incurred in administering the Plan are currently paid by the Employer. The Employer has the discretion to decide upon an appropriate expense amount to offset experience gains. 13.2 No Contract of Employment Nothing herein contained is intended to be or shall be construed as constituting a contract or other arrangement between any Employee and the Employer to the effect that such Employee will be employed for any specific period of time. All Employees are considered to be employed at the will of the Employer. 13.3 Amendment and Termination This Plan has been established with the Intent of being maintained for an indefinite period of lime. Nonetheless, the Employer may amend or terminate all or any part of this Plan at any time for any reason by resolution of the Employer's Board of Directors or by any person or persons authorized by the Board of Directors to take such action, and any such amendment or termination will automatically apply to the Related Employers that are participating in this Plan. 13.4 Governing Law This Plan shell be construed, administered, and enforced according to the laws of the State of Texas, to the extent not superseded by the Code, ERISA, or any other federal law. 13.5 Code and ERISA Compliance It is intended that this Plan meet all applicable requirements of the Code and ERISA and of all regulations issued thereunder. (ERISA applies to the Medical Insurance Plan and the Health FSA Component or the DCAP Component.) This Plan shall be construed, operated, and administered accordingly, and in the event of any conflict between any part, clause, or provision of this Plan and the Code and/or ERISA, the provisions of the Code and ERISA shall be deemed controlling, and any conflicting part, clause, or provision of this Plan shall be deemed superseded to the extent of the conflict. To the extent applicable, the Plan will provide coverage and benefits in accordance with the requirements of all applicable laws, including USERRA, COBRA, HIPAA, NMHPA, WHCRA, FMLA, MHPA, MHPAEA, HITECH. Michelle's Law, GINA. and PPACA. 13.6 No Guarantee of Tax Consequences Neither the Plan Administrator nor the Employer makes any commitment or guarantee that any amounts paid to or for the benefit of a Participant under this Plan will be excludable from the Participant's gross Income for federal, state, or local income tax purposes. It shall be the obligation of each Participant to determine whether each payment under this Plan Is excludable from the Participant's gross income for federal, state, and local income tax purposes and to notify the Plan Administrator if the Participant has any reason to believe that such payment is not so excludable. 13.7 Indemnification of Employer If any Participant receives one or more payments or reimbursements under this Plan on a tax -free basis and if such payments qualify fi l Code. Participant a indemnify reimburse Em loY er for anY ati IY that t may incur for fa ure to w hho d federal ncometaxes,Soc a Securiitttax s, her taxes from such payments or reimbursements. 13.8 Non - Assignability of Rights The right of any Participant to receive any reimbursement under this Plan shall not be alienable by the Participant by assignment or any other method and shall not be subject to claims by the Participant's creditors by any process whatsoever. Any attempt to cause such right to be so subjected will not be recognized, except to the extent required by law. 13.9 Headings The headings of the various Articles and Sections are inserted for convenience of reference and are not to be -33- Vnl 70K Pa regarded as part of this Plan or as indicating or controlling the meaning or construction of any provision 13.10 Plan Provisions Controlling In the event that the terms or provisions of any summary or description of this Plan are in any construction interpreted as being in conflict with the provisions of this Plan as set forth in this document, the provisions of this Plan shall be controlling, 13.11 Severability Should any part of this Plan subsequently be invalidated by a court of competent jurisdiction, the remainder of the Plan shall be given effect to the maxlmum extent possible. kk• IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing instrument comprising the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN, BRAZOS COUNTY has caused this Plan to be executed in its name and on its behalf, on this 1st day of May, 2011. Employer: BRAZOS COUNTY vill wa I 'r Appendix A Exclusions - Medical Expenses That Are Not Reimbursable From the Health FSA The BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN document contains the general rules governing what expenses are reimbursable. This Appendix A, as referenced in the Plan document, specifies certain expenses that are excluded under this Plan with respect to reimbursement from the Health FSA -that is, expenses that are not reimbursable, even if they meet the definition of "medical care" under Code section 213(d) and may otherwise be reimbursable under the regulations governing Health FSAs. Exclusions: The following expenses are not reimbursable from the Health FSA, even if they meet the definition of 'medical care" under Code section 213(d) and may otherwise be reimbursable under regulations governing Health FSAs: (subject to change per IRS) - Health insurance premiums for any other plan (including a plan sponsored by the Employer). - Long -term care services. - Cosmetic surgery or other similar procedures, unless the surgery or procedure Is necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal Injury resulting from an accident or trauma, or a disfiguring disease. "Cosmetic surgery" means any procedure that is directed at improving the patient's appearance and does not meaningfully promote the proper function of the body or prevent or treat illness or disease. - The salary expense of a nurse to care for a healthy newborn at home. - Funeral and burial expenses. Household and domestic help (even if recommended by a qualified physician due to an Employee's or Dependent's inability to perform physical housework). Custodial care. Costs for sending a problem child to a special school for benefits that the child may receive from the course of study and disciplinary methods. Social activities, such as dance lessons (even if recommended by a physician for general health improvement). Bottled water. - Cosmetics, toiletries, toothpaste, etc. Uniforms or special clothing, such as maternity clothing. Automobile Insurance premiums. - Marijuana and other controlled substances that are in violation of federal laws, even if prescribed by a physician. Any item that does not constitute "medical care" as defined under Code section 213(d). Any item that is not reimbursable under Code section 213(d) due to the rules in Prop. Trees. Reg. Section 1.125 -2, 0- 7(bx4) or other applicable regulations. t I WI I U7111111111-W-0 I Amendment Number 1 to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN for Qualified Reservist Distribution Pursuant to section 13.3 Amendment and Termination of the Plan, the Employer hereby amends the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN as follows: The Plan is hereby amended by adding a "Qualified Reservist Distribution" under Article II Definitions and Article VII the Health FSA Component with the following language: Notwithstanding any other provision of the Plan to the contrary, a Participant who meets each of the following requirements may elect to receive a distribution of certain funds from his or her account in the Health FSA Component for a Plan Year (Qualified Reservist Distribution): The Participant's contributions to his or her Health FSA Account for the Plan Year as of the date of the request for a Qualified Reservist Distribution exceed the reimbursements he or she has received from his or her Health FSA Account for the Plan Year as of that date. The Participant is ordered or called to active military duty for a period of at least 180 days or for an indefinite period by reason of being a member of the Army National Guard of the United States, the Army Reserve, the Navy Reserve, the Marine Corps Reserve, the Air National Guard of the United States, the Air Force Reserve, the Coast Guard Reserve, or the Reserve Corps of the Public Health Service. The Participant has provided the Administrator (or its designee) with a copy of the order or call to active duty. An order or call to active duty of less than 180 days' duration must be supplemented by subsequent calls or orders to reach a total of 180 or more days. The Participant Is ordered or called to active military duty on or after May 1, 2011, or his or her period of active duty begins before May 1, 2011 and continues on or after that date. During the period beginning on the date of the order or call to active duty and ending on the last day of the Plan Year during which the order or call occurred, the Participant delivers a written election to the Administrator (or its designee) in such form as the Administrator may prescribe, requesting a Qualified Reservist Distribution. The Administrator will review all requests for Qualified Reservist Distributions on a uniform and consistent basis. Requests for qualified reservist distributions that are approved by the Administrator shall be paid within a reasonable time, not to exceed 60 days after the date of the Participant's request. The amount of any Qualified Reservist Distribution made under this provision shall be equal to the Participant's contributions to his or her Health FSA Account for the Plan Year as of the date of the request for a Qualified Reservist Distribution, minus the reimbursements he or she has received from his or her Health FSA Account for the Plan Year as of that date. Notwithstanding any other provision of the Plan to the contrary, this portion of the Participant's balance may be distributed without regard to whether Medical Care Expenses have been incurred. Any portion of the distribution that is not a reimbursement for substantiated Medical Care Expenses will be included In the Participant's grass Income and wages. A Participant who has requested a Qualified Reservist Distribution shall forfeit the right to receive reimbursements for Medical Care Expenses incurred during the Plan Year and on or after the date of the distribution request. However, such a Participant may claim reimbursement for Medical Care Expenses incurred during the Plan Year (or other Period of Coverage, if applicable) and before the date of the distribution request, even if such claims are submitted after the date of his or her distribution, so long as the total dollar amount of such claims does not exceed the amount of the Participant's election under the Health FSA Component for the Plan Year, less the sum of his or her Qualified Reservist Distribution under this provision and the reimbursements he or she has received from his or her Health FSA Account for the Plan Year. t W1 I IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing amendment to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN has caused this Amendment to be executed In its name and on its behalf, on this day of 20_ BRAZOS COUNTY By: EVEN IM BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Summary of Material Modification To: Participants of BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN From: BRAZOS COUNTY Date: May 1st, 2011 This is a summary of a recent change to your Plan. The Plan's Health FSA Component has been amended to permit qualified reservist distributions, as further described below. This amendment allows certain employees called or ordered to active military service to receive taxable distributions from their Health FSA Accounts on or after May 1, 2011. Please file this "Summary of Material Modification" with your Summary Plan Description (the booklet that explains your Plan). If you would like to see the full text of the changes, you may inspect the Plan Document or receive a copy of the changes as explained in the "ERISA Rights" section of your Summary Plan Description. Conditions for Electing a Qualified Reservist Distribution. The following conditions must be met in order for you to elect a qualified reservist distribution from your Health FSA Account: Your contributions to your Health FSA Account for the Plan Year as of the date you request a qualified reservist distribution exceed the reimbursements you have received from your Health FSA Account for the Plan Year as of that date. You are ordered or called to active military duty for a period of at least 180 days or for an indefinite period by reason of being a member of the Army National Guard of the United States, the Army Reserve, the Navy Reserve, the Marine Corps Reserve, the Air National Guard of the United States. the Air Force Reserve, the Coast Guard Reserve, or the Reserve Corps of the Public Health Service. You have provided the Administrator with a copy of the order or call to active duty. An order or call to active duty of less than 180 days' duralion must be supplemented by subsequent calls or orders to reach a total of 180 or more days. You are ordered or called to active military duty on or after May 1, 2011, or your period of active duty begins before May 1, 2011 and continues on or after that date. • During the period beginning on the date of your order or call to active duty and ending on the last day of the Plan Year during which the order or call occurred, you submit a qualified reservist distribution election form to the Administrator. Amount of Qualified Reservist Distribution. If you meet these conditions, you will receive a distribution from your Health FSA Account equal to your contributions to your Health FSA Account for the Plan Year as of the date of the distribution request, minus any reimbursements received by you for the Plan Year as of that date. No Reimbursement For Expenses Incurred After Distribution Request. Once you request a qualified reservist distribution, you forfeit the right to receive reimbursements for medical care expenses incurred during the period that begins on the date of your distribution request and ends on the last day of the Plan Year. In contrast, you can continue to submit claims for medical care expenses that were incurred before the date of your distribution request (even if the claims are submitted after the date of your qualified reservist distribution), so long as the total dollar amount of your claims does not exceed the amount of your Health FSA election for the Plan Year, minus the sum of your qualified reservist distribution and your prior Health FSA reimbursements for the Plan Year. Tax Treatment of a Qualified Reservist Distribution. If you receive a qualified reservist distribution, it will be included in your gross Income and will be reported as wages on your Form W -2 for the year in which it is paid to you. If you have any questions on this Summary or the amendment to your Plan, contact your Plan Administrator: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979) 361 -4181 y.1 ')(1,� z D Amendment Number 2 to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Allowing Election Changes for Additional HIPAA Special Enrollment Events Pursuant to section 133 Amendment and Termination under General Provisions of the Plan, the Employer hereby amends the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN as follows effective for Plan Year beginning March 1, 1987: The Plan Is hereby amended by allowing election changes for additional HIPAA special enrollment events under Article X Irrevocability of Elections; Exceptions, Section 10.3 Change in Status the with the following language: Loss of Coverage Under Other Group Health Coverage. A Participant may prospectively change his or her election to add group health coverage for the Participant or his or her Spouse or Dependent, if such individual(s) loses coverage under any group health coverage sponsored by a governmental or educational institution, including (but not limited to) the following: a state children's health Insurance program (SCHIP) under Title XXI of the Social Security Act; a medical care program of an Indian Tribal government (as defined in Code Section 7701(a)(40)), the Indian Health Service, or a tribal organization; a state health benefits risk pool; or a foreign government group health plan, subject to the terms and limitations of the applicable Benefit Package Option(s). Additional HIPAA Special Enrollment Events. Notwithstanding any other provision of the Plan to the contrary, effective May 1, 2011, if a Participant or his or her Dependent is entitled to special enrollment rights under a group health plan (other than an excepted benefit) as required by HIPAA under either of the following circumstances, then the Participant may revoke a prior election for group health plan coverage and make a new election, provided that the election change corresponds with such HIPAA special enrollment rights: The Participant's or Dependent's coverage under a Medicaid plan or under a state children's health insurance program is terminated as a result of loss of eligibility for such coverage and the Participant requests coverage under the group health plan not later than 60 days after the date of termination of such coverage. The Participant or Dependent becomes eligible for a state premium assistance subsidy from a Medicaid plan or through a stale children's health insurance program with respect to coverage under the group health plan and the Participant requests coverage under the group health plan not later than 60 days after the date the Participant or Dependent Is determined to be eligible for such assistance. An election change under this provision must be requested within 60 days after the termination of Medicaid or state child health plan coverage or the determination of eligibility for a state premium assistance subsidy, as applicable. Election changes made pursuant to this provision shall be effective for the balance of the Period of Coverage following the change of election unless a subsequent event allows for a further election change and shall be effective on a prospective basis only (i.e., election changes will become effective no earlier than the first day of the next calendar month following the date that the election change was filed, but, as determined by the Plan Administrator, election changes may become effective later to the extent that the coverage in the applicable Benefit Package Option commences later). IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing amendment to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN has caused this Amendment to be executed in its name and on Its behalf, on this day of BRAZOS COUNTY By: r I �r BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Summary of Material Modifications To: Participants of BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN From: BRAZOS COUNTY Date: May 1, 2011 This summary of material modifications supplements the summary plan description (SPD) of the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN (the Plan). Please attach this document to your SPD for future reference. Additional Special Enrollment Rights (Applies to Medical Insurance Benefits, but not to Health FSA orDCAP Benefits). On May 1, 2011, BRAZOS COUNTY amended the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN (the Plan) as described below: The Plan's provision regarding election changes during the Plan Year have been amended to allow you to change an election under the Plan when enrollment for Medical Insurance Benefits occurs outside the Open Enrollment Period due to one of the following special enrollment rights: Coverage for you or your Dependent under a Medicaid plan or under a state children's health Insurance program is terminated as a result of loss of eligibility for such coverage and you request coverage under the Medical Insurance Plan not later than 60 days after the date of termination of such coverage. You or your Dependent become eligible for a stale premium assistance subsidy from a Medicaid plan or through a slate children's health insurance program with respect to coverage under the Medical Insurance Plan and you request coverage under the Medical insurance Plan not later than 60 days after the date you or your Dependent are determined to be eligible for such assistance. When one of the foregoing special enrollment rights applies to your Medical Insurance Benefits, you may change your election under the Plan to correspond with the special enrollment right. In order to change your election, you must inform the Plan Administrator and complete a new Election Form/Salary Reduction Agreement within 60 days after the termination of Medicaid or state children's health Insurance program coverage or the determination of eligibility for a state premium assistance subsidy, as applicable. If you have questions, please contact BRAZOS COUNTY at (979) 361 -4181 or at BRAZOS COUNTY, 200 S. Texas Ave, Ste 206, BRYAN, TX 77803. ERISA Information: Plan Sponsor: BRAZOS COUNTY Plan Number: 501 Sponsor's EIN: 74- 6000433 Plan Year. 2011 Plan Name: BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Vnl 1(14"% P$ 2�` ✓`� Amendment Number 3 to BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Document Michelle's Law Amendment Section 1. General Rules 1.1. Adoption and Purpose. The purpose of this Amendment is to amend certain provisions of the Plan. 1.2. Precedence. The requirements of this Amendment will take precedence over any inconsistent provisions of the Plan, including any previous amendments adopted by the Employer, Where appropriate, the term "Plan" shall mean the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN. 1.3. Effective Date. Effective Date. This Amendment shall be effective for Plan year beginning after October 9, 2009. Section 2. Coverage of Dependent Students Under Article II (Definitions) "Dependent" has been amended as follows: "Dependent" means any Individual who is a tax dependent of the Participant as defined in Code section 152. The following exceptions apply: For purposes of the Cafeteria Plan Document, a dependent is defined under code section 152, without reference to subsections b(1), b(2) and d(1 XB) or IRS Rev. Proc. 2008 -48 which would (regarding certain children of divorced or separated parents who receive more than half of their support for the calendar year from one or both parents and are in the custody of one or both parents for more than half of the calendar year) treat a child as a dependent of both parents. However, the Cafeteria Plan will provide benefits in accordance with any OMCSO, even if the child does not otherwise meet the definition of "Dependent ". For purposes of a group health plan, for plan years beginning after October 9, 2009, this Plan will incorporate all the requirements under Michelle's Law (P.L. 110 -381). This law prohibits a group health plan from terminating a dependent college student's health coverage on the basis of the child taking a medically necessary leave of absence from a postsecondary educational institution or changing to a part-time status. IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing amendment to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN has caused this Amendment to be executed in its name and on its behalf, on this day of 20_ BRAZOS COUNTY By: r W.41 'I BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN SUMMARY OF MATERIAL MODIFICATIONS To: Participants of BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN From: BRAZOS COUNTY Date: May 1, 2011 This is a summary of a recent Amendment to your Plan that is effective on May 1, 2011. The Plan has been amended to comply with Michelle's Law. In general, the law states that a Dependent will not cease being a dependent because of a "Medically Necessary Leave of Absence ". A "Medically Necessary Leave of Absence" means a leave of absence (or any other change In enrollment) for such child from a postsecondary educational institution, that — (1) commences while such child is suffering from a serious illness or injury (as certified by a physician); (2) is medically necessary (as certified by a physician); and (3) causes such child to lose student status for purposes of coverage under the terms of the plan or coverage. The Plan shall not terminate coverage of such child under the Plan due to a "Medically Necessary Leave of Absence" before the date that is the earlier of— (A) the date that is one year after the first day of the "Medically Necessary Leave of Absence "; or (B) the date on which such coverage would otherwise terminate under the terms of the Plan. Dependent Child Described. —A dependent child described in this paragraph is, with respect to a group health plan or health insurance coverage offered In connection with the Plan, a Beneficiary under the Plan who — (A) is a dependent child, under the terms of the Plan or coverage, of a Participant or Beneficiary under the Plan or coverage; and (B) was enrolled in the Plan or coverage, on the basis of being a student at a post- secondary educational Institution before the first day of the "Medically Necessary leave of Absence ". Please file this "Summary of Material Modifications" with your Summary Plan Description (the booklet that explains your Plan). If you would like to see the full text of the changes, you may Inspect the Plan Document or receive a copy of the changes as explained in the "ERISA Rights" section of your Summary Plan Description. If you have any questions on this Summary or the amendments to your Plan, contact your Plan Administrator: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979) 361 -4181 r 1 r-. Amendment Number 4 to BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Document GINA Amendment Section 1. General Rules 1.1. Adoption and Purpose. The purpose of this Amendment is to amend the'HIPAA Provisions for Health FSA' of the Plan. 1.2. Precedence. The requirements of this Amendment will take precedence over any inconsistent provisions of the Plan, including any previous amendments adopted by the Employer. Where appropriate, the term "Plan" shall mean the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN. 1.3. Effective Date. This Amendment shall be effective for Plan year beginning after October 9, 2009 Section 9.8 This Plan shall comply with all the provisions Included within the Genetic Information Nondiscrimination Act of 2008 (GINA). Pursuant to GINA, an employer may not: 1) Use generic testing Information for Increasing premium or contribution amounts. 2) Offer premium reductions or other economic rewards for participating in a health risk assessment. 3) Request or require an individual or family member to undergo a genetic test. 4) Collect genetic information at any time for underwriting purposes. 5) Breach the required confidentiality of any genetic Information. 6) Discriminate against employees with respect to compensation, terms, conditions, or privileges of employment on the basis of genetic information. IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing amendment to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN has caused this Amendment to be executed in Its name and on Its behalf, on this day of 20_ BRAZOS COUNTY By: Vol. 205 Pg. � BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN SUMMARY OF MATERIAL MODIFICATIONS To: Participants of BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN From: BRAZOS COUNTY Date: May 1, 2011 This is a summary of a recent Amendment to your Plan that is effective on May 1, 2011. The Plan has been amended to comply with the Genetic Information Nondiscrimination Act of 2008 (GINA). In general, the law states that: 1. Generic testing Information cannot be used to increasing premium or contribution amounts. 2. Prohibits an employer from offering premium reductions or other economic rewards for participating in a health risk assessment. 3. Prohibits an employer from requesting or requiring an individual or family member to undergo a genetic test. 4. Prohibits an employer from collecting genetic information at any time for underwriting purposes. Please file this "Summary of Material Modifications" with your Summary Plan Description (the booklet that explains your Plan). If you would like to see the full text of the changes, you may inspect the Plan Document or receive a copy of the changes as explained in the "ERISA Rights" section of your Summary Plan Description. If you have any questions on this Summary or the amendments to your Plan, contact your Plan Administrator: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979) 361 -4181 Vol. 205 Pg. ,'IJ7 Amendment Number 5 to BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Document Tax Treatment of Health Coverage for Children Under Age 27 Amendment On May 1, 2011, BRAZOS COUNTY amended the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN as described below to reflect certain provisions of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA) relating to the tax exclusion for medical care reimbursement of adult children and IRS Notice 2010.38. Section 1. General Rules 1.1. Adoption and Purpose. The purpose of this Amendment is to amend the definition of'Dependent'to include children up to age 26 under Code Sections 105(b) and 106 of the Plan. 1.2. Precedence. The requirements of this Amendment will take precedence over any inconsistent provisions of the Plan, including any previous amendments adopted by the Employer. Where appropriate, the term "Plan" shall mean the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN. Plan Provisions Effective March 30, 2010, the definition of "Dependent" in Article II of the Plan shall be amended to read as follows: "Dependent" means: for purposes of accident or health coverage (lo the extent funded under the Premium Payment Component, and for purposes of the Health FSA Component), (1) a dependent as defined as in Code section 152, determined without regard to subsections (b)(1), (b)(2), and (d)(1)(8) thereof, (2) any child (as defined in Code section of the Participant who as of the end of the taxable year has not attained age 27, and (3) any child of the Participant to whom IRS Rev. Proc. 2008 -48 applies (regarding certain children of divorced or separated parents who receive more than half of their support for the calendar year from one or both parents and are in the custody of one or both parents for more than half of the calendar year); and (b) for purposes of the DCAP Component, a Qualifying Individual. Notwithstanding the foregoing, the Health FSA Component will provide benefits in accordance with the applicable requirements of any QMCSO, even If the child does not meet the definition of "Dependent." For purposes of the new income exclusions under Code sections 105(b) and 106, the term "child" includes adult children under the age of 27 that is the employee's son, daughter, stepson, stepdaughter, legally adopted individual (or an individual placed with the employee for adoption), and eligible foster child. Under Notice 2010.38. such a child does not have to satisfy the age limits, residency, support and other tests described in Section 152 of the Code in order to be considered an employee's child for purposes of these new income exclusions. Notwithstanding any provision of the Plan to the contrary, a Participant may make a new election for Health FSA coverage under the Plan during the 30-day period beginning May 1, 2011, that is on account of and corresponds with his or her child (as defined in Code §152(f)(1)) becoming newly eligible for coverage (or, eligible for coverage beyond the date on which coverage would otherwise have been lost) as a result of the foregoing amendment to the definition of "Dependent" in Article II of the Plan. Requests for such election changes shall In all other respects be subject to the Plan's terms and conditions regarding election changes: IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing amendment to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN has caused this Amendment to be executed in its name and on its behalf, on this day of 20_ BRAZOS COUNTY By: Vol. 205 Pg. ,;-, &// BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN SUMMARY OF MATERIAL MODIFICATIONS To: Participants of BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN From: BRAZOS COUNTY This is a summary of a recent Amendment to your Plan that is effective on May 1, 2011. Change in Health FSA Benefits for Children Under Age 27. As a result of a change to the Internal Revenue Code that was part of federal health care reform, if you are a participant in the Health FSA, you can now be reimbursed for otherwise- eligible Medical Care Expenses incurred by a child through December 31 of the calendaryear in which the child turns age 26, regardless of the child's residency, employment, financial dependence, student status, marital status, or status as a tax dependent. The change applies to expenses that are Incurred on or after March 30, 2010 by your son, daughter, stepchild, legally adopted child, or eligible foster child. (Otherwise- reimbursable Medical Care Expenses Incurred by a child before that date will also qualify for reimbursement if the child was your tax dependent for health coverage purposes when the expenses were incurred.) If you have a child whose Medical Care Expenses became eligible for reimbursement from the Health FSA as a result of this change to the Code, you may request a mid -year Increase in your health FSA salary reduction contributions that Is consistent with the change during the 30 -day period beginning May 1, 2011. To do so, you must inform the Plan Administrator and complete a new Election Form /Salary Reduction Agreement. If your child's Medical Care Expenses were already eligible for reimbursement from the Health FSA before the change to the Code, your child will remain eligible through the and of 2010 and you may not request an increase in your health FSA salary reduction contributions as a result of the change. Change in Medical Insurance Benefits for Children Under Age 27. As a result of the change to the Code discussed above, if you have a child who is under age 27 as of the end of the calendar year and is currently receiving Medical Insurance coverage, income will not be imputed for the coverage beginning March 30, 2010. Please file this "Summary of Materlal Modifications" with your Summary Plan Description (the booklet that explains your Plan). If you would like to see the full text of the changes, you may Inspect the Plan Document or receive a copy of the changes as explained in the "ERISA Rights" section of your Summary Plan Description. If you have any questions on this Summary or the amendments to your Plan, contact your Plan Administrator: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979) 361 -4181 Vol. 205 Pg. 244 Amendment Number 6 to BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Document Limitation on Reimbursement of Over- the - Counter Medicines Amendment On January 1, 2011, BRAZOS COUNTY amended the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN as described below to reflect certain provisions of the Patient Protection and Affordable Care Act (PPACA) relating to the tax exclusion for medical care reimbursement of over - the - counter medicines. Section 1. General Rules 1.1. Adoption and Purpose. The purpose of this Amendment is to amend the definition of qualified medical expenses, for purposes of reimbursements from the Plan. 1.2. Precedence. The requirements of this Amendment will take precedence over any inconsistent provisions of the Plan, including any previous amendments adopted by the Employer. Where appropriate, the term "Plan" shall mean the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN. 1.9. Effective Date. This Amendment shall be effective for Plan year beginning on or after December 31, 2010. Plan Provlsions This Plan shall comply with the provisions included in the Patient Protection and Affordable Care Act in which the cost incurred for a medicine or drug will be treated as a qualified medical expense for purposes of reimbursement through a health flexible spending arrangement (health FSA) only If the medicine is a prescribed drug or is insulin. Article II - Definitions Reimbursements for medicine restricted to prescribed drugs and insulin. For purposes of Code sections 105 and 100, reimbursement for expenses incurred for a medicine or a drug shall be treated as a reimbursement for medical expenses only if such medicine or drug is a prescribed drug (determined without regard to whether such drug is available without a prescription) or is insulin. "Qualified Medical Expenses" shall include amounts paid for medicine or a drug only if such medicine or drug is a prescribed drug (determined without regard to whether such drug is available without a prescription) or is insulin. IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing amendment to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN has caused this Amendment to be executed in its name and on its behalf, on this day of 20_ f:7:�r�i�3eZe19�j17 By: Vol. 205 Pg. _02-3 / BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN SUMMARY OF MATERIAL MODIFICATIONS To: Participants of BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN From: BRAZOS COUNTY This is a summary of a recent Amendment to your Plan that is effective on January 1, 2011. The Plan has been amended to comply with the Patient Protection and Affordable Care Act (PPACA) which allows reimbursement for "prescribed" medicines, drugs or insulin. The health care reform law allows the Plan to reimburse expenses incurred for medicines or drugs only if the medicine or drug is a prescribed drug—determined without regard to whether the medicine or drug is available without a prescription —or is insulin. Therefore, expenses incurred on or after January 1, 2011 for over - the - counter medicines or drugs (other than Insulin) generally will be reimbursable by the Plan only if those medicines or drugs were prescribed. Additionally, debit cards will no longer be allowed to purchase OTC drugs or medicines. The employee must use a different forth of payment for these items and submit the receipt and a copy of the prescription to the plan administrator for reimbursement. Please file this "Summary of Material Modifications" with your Summary Plan Description (the booklet that explains your Plan). If you would like to see the full text of the changes, you may Inspect the Plan Document or receive a copy of the changes as explained in the "ERISA Rights" section of your Summary Plan Description. If you have any questions on this Summary or the amendments to your Plan, contact your Plan Administrator: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979) 361 -4181 Vol. 205 Pg. 24V Amendment Number 7 to BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Document Effective January 1, 2013, the BRAZOS COUNTY hereby amends the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN (the Plan) in compliance with the Health Care Reform Law (PPACA) that imposes a $2,500 limit on annual salary reduction contributions to health FSAs. This Amendment shall be effective for plan years beginning on or after January 1, 2013, and shall apply notwithstanding any other statements in the Plan, the summary plan description (SPD), or any other documents. The Plan is hereby amended by replacing the 'Maximum Dollar Limits' provision under section 7.5 'Maximum Benefits for Health FSA' with the following language: Maximum Annual Salary Reduction Contributions Limit. The maximum annual salary reduction contributions that a Participant may elect to receive under this Plan in the form of reimbursements for Medical Care Expenses incurred in any Period of Coverage under the General- Purpose Health FSA shall be $2,500, subject to Section 7.7(c). IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing amendment to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN has caused this Amendment to be executed in its name and on Its behalf, on this day of 20_ BRAZOS COUNTY By: Vol. 205 Pg. "2_d__6_ BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN SUMMARY OF MATERIAL MODIFICATIONS To: Participants of BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN From: BRAZOS COUNTY Date: April 30, 2013 On January 1, 2013, the BRAZOS COUNTY amended the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN (the Plan) in compliance with the Health Care Reform Law (PPACA) which imposes a $2,500 limit on annual salary reduction contributions to health FSAs, effective for plan years beginning on or after January 1, 2013. The Plan has been amended to replace the section 'What are the maximum Health FSA Benefits that I may elect? under Article VII — Health FSA to reflect the new statutory maximum reimbursement limit of $2,500 per plan year. • What are the maximum Health FSA Benefits that I may elect? You may choose any amount of Medical Care Expenses reimbursement that you desire under the Health FSA, subject to the maximum annual salary reduction contributions limit of $2,500 under the General- Purpose Health FSA per plan year. You will be required to pay the annual Health FSA contribution equal to the coverage level that you have chosen. If you have any questions on this Summary or the amendment to your Plan, contact your Plan Administrator BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979)361.4181 Vol. 205 Pg. z- L� Amendment Number 8 to BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN Document Pursuant to section 13.3 Amendment and Termination of the Plan, on January 1, 2013, the Employer amended the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN by replacing Article XI 'Appeals Procedure' in Its entirety with the following language: 11.1 Procedure If Benefits Are Denied Under This Plan If a claim for reimbursement or benefit under this Plan Is wholly or partially denied, such claim shall be administered in accordance with the procedure set forth below and in the summary plan description of this Plan. The Appeals Committee, separate and distinct from the individual(s) that adjudicate the claims, shah act on behalf of the Plan Administrator with respect to appeals. An external review process shall be provided as legally required and as further set forth below. Claims Under the Health FSA or DCAP Components. If (a) a claim for reimbursement under the Health FSA or DCAP Components of the Cafeteria Plan is wholly or partially denied, or (b) Participant is denied a benefit under the Plan due to an Issue germane to said coverage under the Plan, then the procedure described below will apply. If a claim is denied in whole or in part. Participant will be notified in writing by the Plan Administrator within 30 days after the date the Plan Administrator received the claim. (This time period may be extended for an additional 15 days for matters beyond the control of the Plan Administrator, including in cases where a claim Is Incomplete. The Plan Administrator will provide written notice of any extension, including the reasons for the extension and the date by which a decision by the Plan Administrator is expected to be made. Where a claim Is incomplete, the extension notice will also specifically describe the required Information, will allow the Participant 45 days from receipt of the notice in which to provide the specified information and will have the effect of suspending the time for a decision on the claim until the specified information is provided.) Notification of a denied claim will include - a statement of the specific reason(s) for the denial; - reference(s) to the specific Plan provislon(s) on which the denial is based; - a description of any additional material or information necessary for Participant to validate the claim and an explanation of why such material or Information is necessary; - appropriate information on the steps to be taken if Participant wishes to appeal the Plan Administrator's decision, including their right to submit written comments and have them considered, their right to review (upon request and at no charge) relevant documents and other information, and their right to file suit under ERISA (where applicable) with respect to any adverse determination after appeal of their claim. Appeals If a claim is denied in whole or in part, then the Participant (or authorized representative) may request review upon written application to the Appeals Committee. The appeal must be made In writing within 180 days after Participant's receipt of the notice that the claim was denied. If Participant does not appeal on time, Participant will lose the right to appeal the denial and the right to file suit in court. Participant's written appeal should state the reasons that they feel their claim should not have been denied. It should include any additional facts and /or documents that they feel support their claim. Participant will have the opportunity to ask additional questions and make written comments, and Participant may review (upon request and at no charge) documents and other information relevant to their appeal. Participant will not be allowed to take legal action against the Plan, the Employer, the Administrator, or any other entity to whom admintstrative or claims processing functions have been delegated unless they exhaust the Internal appeal rights. A Participant does not have to pursue external review in order to.preserve the right to file a lawsuit; however, a Participant may be unable to take further legal action if they pursue an external appeal because the external appeal process results in a binding determination. Decision on Review of Internal Appeal Vol. 205 Pg. G % Participant's internal appeal will be reviewed and decided by the Appeals Committee within a reasonable time not later than 60 days after the Appeals Committee receives Participant's request for review. The Appeals Committee may, in its discretion, hold a hearing on the denied claim. Any medical expert consulted in connection with their internal appeal will be different from and not subordinate to any expert consulted in connection with the Initial claim denial. The Identity of a medical expert consulted in connection with the internal appeal will be provided. If the decision on review affirms the initial denial of the claim, Participant will be furnished with a notice of adverse benefit determination on review setting forth: - a statement of the specific reason(s) for the decision on review; - reference(s) to the specific Plan provision(s) on which the decision is based; - a statement of Participant's right to review (upon request and at no charge) relevant documents and other information; - if an 'internal rule, guldeline, protocol, or other similar criterion" is relied on in making the decision on review, then a description of the specific rule, guideline, protocol, or other similar criterion or a statement that such a rule, guideline, protocol, or other similar criterion was relied on and that a copy of such rule, guideline, protocol, or other criterion will be provided free of charge to Participant upon request; and - a statement of Participant's right to bring an external appeal or a civil action under ERISA Section 502(a) (where applicable). Participant may have the right to an external review of the Administrator's denial of the Internal appeal of the Health FSA claim unless the Benefit denial was based on the Participant's (or their Spouse's or Dependent's) failure to meet the Plan's eligibility requirements. Requirements for an External Appeal Participant may request an external appeal by completing the forth provided by the Administrator which must include the following Information: Participant's name, address, daytime telephone number and email address; and A brief description of why the Participant disagrees with the decision, along with any additional information, such as a physician's letter, bills, medical records, or other documents to support their claim. Deadline for filing an External Appeal Participant's external appeal must be filed with the external reviewer within four (4) months of the date the Participant was served with the Administrator's response to their internal appeal request. If Participant does not file an external appeal within this 4 -month period, the Participant shall lose the right to appeal. For example, if Participant received the internal appeal decision on January 3, 2012, they must appeal the decision by May 3, 2012 (or, If that is not a business day, the next business day thereafter). The plan must complete a preliminary review within five (5) business days upon receipt of the external review request to determine if the claimant was covered under the plan, the claimant provided all of the necessary information to process the external review and that the claimant has exhausted the internal appeals process. The plan must provide the claimant written notice of its preliminary review determination within one (1) business day after completing Its review. If the request is complete, but not eligible for external review, the notice must state the reasons for the Ineligibility and provide EBSA contact information. If the request is incomplete, the notice must describe the information or materials needed to complete the request. The plan must permit the claimant to "perfect" (i.e., complete) the extemal review request within the four -month filing period or, if later, 48 hours after receipt of the notice. Decision on Review of External Appeal The plan must assign an accredited Independent Review Organizatlon (IRO) to perform the external review. The external reviewer must notify you and the Administrator of its decision on your external appeal within 45 days after its receipt of your request for external review. The external reviewer's decision is binding upon the parties unless other State or Federal law remedies are available. Such remedies may or may not exist. Therefore, unless another legal right exists under your claim, use of the external review process may terminate your right to bring a lawsuit on your claim. Vol. 205 Pg. 9 6k Duty of Beneficiary/Third Party Recoveries Any Beneficiary under the Plan that receives a payment, whether by lawsuit, settlement, or otherwise, from third parties for costs associated with sickness or injury resulting from the acts or omissions of another person or party must reimburse the Plan to the extent the Beneficiary has received payments from the Plan for such sickness or injury. The Plan has a first lien upon any such recovery. Any recovery by the Plan Administrator from such payments is subject to a deduction for reasonable attorney fees and court costs Incurred by the Beneficiaries in securing the third -party payments, and shall be prorated, to reflect that portion of the total recovery reimbursed to the Plan Administrator for the benefits it had paid from the Plan. However, the Plan's share of the recovery will not be reduced because the Beneficiary has not received the full damages claimed, unless the Plan Administrator agrees in writing to such a reduction. The Plan further requires covered Beneficiaries promptly advise the Plan Administrator of third -parry claims and to execute any assignments, liens, or other documents the Plan Administrator requests. The Plan may withhold Benefits until such documents are received. Subrogation /Acts of Third Parties The Plan Administrator, on behalf of the Plan, has the right to recover any payments made to Beneficiaries, whether by lawsuit, settlement, or otherwise, by third parties for costs associated with sickness or injury resulting from the acts or omissions of another person or party. The Plan has a first lien upon any such recovery. Any recovery by the Plan Administrator from such payments is subject to a deduction for reasonable attorney fees and court costs incurred by the Beneficiaries in securing the thlyd -party payments, and shall be prorated, to reflect that portion of the total recovery reimbursed to the Plan Administrator for the benefits it had paid from the Plan. However, the Plan's share of the recovery will not be reduced because the Beneficiary has not received the full damages claimed, unless the Plan Administrator agrees in writing to such a reduction. 11.2 Claims Procedures for Medical Insurance Benefits Claims and reimbursement for Medical Insurance Benefits shall be administered in accordance with the claims procedures for the Medical Insurance Benefits, as set forth by the provider. IN WITNESS WHEREOF, and as conclusive evidence of the adoption of the foregoing amendment to the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN has caused this Amendment to be executed in Its name and on its behalf, on this day of 20_ BRAZOS COUNTY By: Vol. 205 ft. �' e y BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN SUMMARY OF MATERIAL MODIFICATIONS To: Participants of BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN From: BRAZOS COUNTY Date: April 30, 2013 BRAZOS COUNTY amended the BRAZOS COUNTY FLEXIBLE BENEFIT CAFETERIA PLAN (the Plan) as described below, effective for Plan Years beginning on or after January 1, 2011. The Plan has been amended to replace Article XI 'Appeals Procedure' In its entirety to include the External Review Process for the Health FSA Component of the Plan. What happens if my claim for benefits Is denied? Premium Insurance Benefits The applicable insurance company will decide your claim in accordance with its claims procedures. If your claim is denied, you may appeal to the insurance company for a review of the denied claim. If you don't appeal on time, you will lose your right to file suit in a state or federal court, as you will not have exhausted your internal administrative appeal rights (which generally is a prerequisite to bringing a suit In state or federal court). Note that under certain circumstances, you may also have the right to obtain external review (review outside of the plan). For more information about how to file a claim and for details regarding the medical insurance company's claims procedures, consult the claims procedure applicable under that plan or policy, as described in the plan document or summary plan description for the Medical Insurance Plan. Claims Under the Cafeteria Plan If (a) a claim for reimbursement under the Health FSA or DCAP Components of the Cafeteria Plan is wholly or partially denied, or (b) you are denied a benefit under the Cafeteria Plan (such as the ability to pay for Premium Insurance, Health FSA, or DCAP Benefits on a pre-tax basis) due to an issue germane to your coverage under the Cafeteria Plan (for example, a determination of a Change in Status; a "significant" change in contributions charged; or eligibility and participation matters under the Cafeteria Plan document), then the claims procedure described below will apply. If your claim is denied In whole or in part, you will be notified in writing by the Plan Administrator within 30 days after the date the Plan Administrator received your claim. (This time period may be extended for an additional 15 days for matters beyond the control of the Plan Administrator, including in cases where a claim is incomplete. The Plan Administrator will provide written notice of any extension, including the reasons for the extension and the date by which a decision by the Plan Administrator Is expected to be made. Where a claim is incomplete, the extension notice will also specifically describe the required information, will allow yoO 45 days from receipt of the notice in which to provide the specified information and will have the effect of suspending the time for a decision on your claim until the specified information is provided.) Notification of a denied claim will set out: - a statement of the specific reason(s) for the denial; - the specific Plan provision on which the denial is based; - a description of any additional material or information necessary for you to validate the claim and an explanation of why such material or information is necessary; - appropriate information on the steps to be taken if you wish to appeal the Plan Administrator's decision, including your right to submit written comments and have them considered, your right to review (upon request and at no charge) relevant documents and other information, and your right to file suit under ERISA (where applicable) with respect to any adverse determination after appeal of your claim. Appeals If your claim is denied in whole or part, then you (or your authorized representative) have the right to an internal appeal and, if applicable, an external review to an independent review organization. You may request review upon Vol. 205 Pg. X,70 written application to the "Appeals Committee" for an internal review You will not be allowed to take legal action against the Plan, the Employer, the Administrator, or any other entity, to whom administrative or claims processing functions have been delegated unless you exhaust your internal appeal rights. But you do not have to pursue external review in order to preserve your right to file a lawsuit. In fact, as explained later in this summary, you may be unable to take further legal action if you pursue an external appeal because the external appeal process results in a binding determination. Requirements for an Internal Appeal Your internal appeal must be in writing, must be provided to the Administrator, and must include the following information: - Your name and address; - The fact that you are disputing a denial of a claim or the Administrator's act or omission; - The date of the notice that the Administrator informed you of the denied claim; and - The resson(s), In clear and concise terms, for disputing the denial of the claim or the Administrator's act or omission. You should also include any documentation that you have not already provided to the Administrator Deadline for Filing an Internal Appeal Your Internal appeal must be delivered to the Administrator within 180 days after receiving the denial notice or the Administrator's act or omission. If you do not file your internal appeal within this 180 day period, you lose your right to appeal. Your internal appeal will be heard and decided by the Committee. Decision on Revlew of Internal Appeal Anytime before the Internal appeal deadline, you may submit copies of all relevant documents, records, written comments, testimony, and other information to the Committee. The Cafeteria Plan is required to provide you with reasonable access to and copies of all documents, records, and other information related to the claim. When reviewing your internal appeal, the Administrator will take Into account all relevant documents, records, comments, and other Information that you have provided with regard to the claim, regardless of whether or not such information was submitted or considered in the initial determination. If the Administrator receives new or additional evidence that It considered, relied upon, or generated in connection with the claim, other than evidence that you have provided to it, you will be provided with this information and given a reasonable opportunity to respond to the evidence before the due date for the Administrator's notice of final internal adverse benefit determination. Similarly, If the Administrator identifies a new or additional reason for denying your claim, that new or additional reason will be disclosed to you and you will be given a reasonable opportunity to respond to that new rationale before the due date for the Administrator's notice of final internal adverse benefit determination. Your appeal will be reviewed and decided by the Committee or other entity designated in the Plan in a reasonable time not later than 60 days after the Committee receives your request for review. The Committee may, in its discretion, hold a hearing on the denied claim. Any medical expert consulted in connection with your appeal will be different from and not subordinate to any expert consulted in connection with the initial claim If your internal appeal is denied, the notice that you receive from the Committee will include the following information: - Information about your claim, including the date of service, health care provider, claim amount, and any diagnosis and treatment code and their corresponding meanings, to the extent such information is available; The specific reason for the denial upon review; -A reference to the specific Plan provision(s) on which the denial is based; - Any denial code (and its corresponding meaning) that was used in denying the claim; - A statement providing that you are required to receive, upon request and free of charge, reasonable access Vol. 205 Pg. ,7, 7/ to and copies of all documents, records, and other information relevant to your claim for benefits; • If an internal rule, guideline, protocol, or similar criterion was relied upon in making the review determination, either the specific rule, guideline, or protocol, or a statement that such a rule, guideline, protocol, or similar criterion was relied upon in making the review determination and that a copy of such rule, guideline, protocol, or similar criterion will be provided to you free of charge upon request; and - A statement of your right to bring an external appeal or a civil action under ERISA §502(a), where applicable. You have the right to an external review of the Administrator's denial of your Internal appeal unless the Benefit denial was based on your (or your Spouse's or Dependent's) failure to meet the Plan's eligibility requirements. Requirements for an External Appeal You may request an external appeal by completing the form provided to you by the Administrator which must Include the following information: Your name, address, daytime telephone number and email address; and - A brief description of why you disagree with the decision, along with any additional information, such as a physician's letter, bills, medical records, or other documents to support your claim. Return the Request for External Review and your denial notice as instructed on the form. You should also include any documentation that you have not already provided to the Administrator Deadline for filing an External Appeal Your external appeal must be filed with the external reviewer within four (4) months of the date you were served with the Administrator's response to your internal appeal request. If you do not file your appeal within this 4 -month period, you lose your right to appeal. For example, if you received the internal appeal decision on January 3, 2012, you must appeal the decision by May 3, 2012 (or, if that Is not a business day, the next business day thereafter). The plan must complete a preliminary review within five (5) business days upon receipt of your external review request to determine if you were covered under the plan, you provided all of the necessary information to process the external review and that you have exhausted the internal appeals process. The plan must provide you with a written notice of its preliminary review determination within one (1) business day after completing its review. If your request is complete, but not eligible for external review, the notice must state the reasons for the ineligibility and provide you with the Employee Benefits Security Administration (EBSA) contact information. If your request is incomplete, the notice must describe the information or materials needed to complete the request. The plan must permit you to "perfect" (i.e., complete) the external review request within the four -month filing period or, if later, 48 hours after receipt of the notice. Decision on Review of External Appeal The plan must assign an accredited Independent Review Organization to perform the external review. The external reviewer must notify you and the Administrator of its decision on your external appeal within 45 days after its receipt of your request for external review. The external reviewer's decision is binding upon the parties unless other State or Federal law remedies are available. Such remedies may or may not exist. Therefore, unless another legal right exists under your claim, use of the external review process may terminate your right to bring a lawsuit on your claim. If you have any questions on this Summary or the amendments to your Plan, contact your Plan Administrator: BRAZOS COUNTY 200 S. Texas Ave, Ste 206 BRYAN, TX 77803 (979) 361 -4181 Vol. 205 Pa. 7�- Brazos County Job Description Last Updated: September 2012 f i Class Number j 832 Pay Group: 09 FLSA Status: Non Exempt 1 0/0 112 01 3 Ternp[MR..sw 110WIY2012 Temporary --- �MT ' Title: Attendant, Building & Grounds (11040 Depart- m ent Ex posi tio n Complex -- ----- - - - --- - - - - --- -- . -- -- Reports To: ev ent Coordinators & All Managers - EEOC Category: Service If Maintenance Temporary osition End 09/30/2014 Employee Oat ate: FY/ VN Signature, ----------- ------ --------- General Sumrrury: -- ---------- ---------- Airkinnins and monitors daily operational responsibilities including janitorial duties, responsibilities and maintenance of the Brazos County Expositiort Complex including seeing -up, cleaning and tearing-down events Essential Duties: --- -------- - ---------- --- ---- ---- --- --- • operaiisligh-t to moderate equipment such as fira6iors with implements, forklft and skid steer loaders: Sets up/team down rodeo equipment. ilonse stalls, cattle ties, panels and pens; Sets up/tears down meeting and event rooms, including stages, dance floors, tables, chairs and equipment and assists with the soundielectrical system setup and/of tear down: Cleans meeting and event rooms, including sweeping, vacuuming and taking out trash: Cleans restroomm, including using commercial chemicals to remove stainsiodors and keeps them free of litter; buffs and scrubs floors as needed and instructed. Keeps all floors dusted, mopped, and vacuumed: Changes light bulbs and distributes supplies as necessary; Assists in painting and other maintenance projects as necessary; Operates a vacuum cleaner and hand cleaning materials, supplies and equipment; Cleans I windows, doors, floors, water fountains, and furniture; Empties and cleans waste receptacles and properly disposes of trash; Assists visitors in a polite manner during events at the Exposition Complex; Keeps janitorial and storage areas clean and organized: Must be willing to work various hours as needed including some nights, weekends, holidays, etc.: Communicates with Exposition Complex administrative assistant/secretary regarding janitorial supply inventory: Assists as necessary in inventory control including equipment and consumables Iassigned. , ----- - ss AN as (�) -------------------- -- -- Given: -66F High school graduation or be equivalent; or any equivalent provides the required knowledge, skills and abilities. one year ... ...... ........ ------------ ion experience Thal - inE Sir ii-her light to 1�WeFiii equipment ii preferred. - -------------------- -- - : -- - --.- - 11 - --.- ...... --------- ----- - I - - - - Cerificates Licenses, Reglgqdons u--- ---- - --------------- Pref-e-r-red: - --- ---------- — — --- ---------- ------- ---- ..... I.- - ---- -- ------- -------- -- - Vol. 205 Pg. -g 21 ------------- - ----- . ............. - -.. - .._.. - - - -- -- _ ... -- -- - -_ ............. - ............ Physical Demands .. - ._._ ..- ------- ---- -- --- - --- -- - ------ --- -- - - - - - --- - - - -- - ...... - Typical: The physical demands described hero are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations maybe made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit; use hand to finger, handle. or to feel; reach with hands and arms; bend and kneel; and talk and hear. The employee frequently is required to stand and walk. The employee must I frequently lift and/or move objects weighing up to 100 pounds, such as begs of mulch and rocks. Specific vision abilities required for this job include close vision, distance vision, and the ability to adjust focus. _ .. ............. .. .... .. ..... ... .. .. .. ......._....- ........- _._..._.. _..._._.__. ....... __. _ ... _... _... _. - .....__.., Knowledge, Skills, & Abili ; _ ..__ ._. _ - ..._.__ _ - -_ _- . _ - ..-. --__ " Typlc.l: Safe operellen of custodial and maintenance equipment, including the safe use of commercial cleaning I ! chemicals. Ability to follow oral and written instructions; ability to loam the proper use of farftorial equipment I and supplies; ability to make minor repairs; ability to communicate and work effectively with co-workers; ability to perform physical and strenuous work; and an ability to understand and follow Brazos County safety policies. j I 111=34175-11111711i Typical: ' The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable I individuals with disabilities to perform the essential functions. The noise level in the work environment is I frequently loud. The employee is constantly required to work closely with others as a part of a team to perform multiple tasks simultaneously, and switch from one task to another. The employee is frequently required to I work under time pressures and meet deadlines. The employee may be exposed to extreme weather iI conditions. tA'�OVE 711A /1 Duane Peters Date County Judge Vol. 205 Pg. r' INTER - GOVERNMENTAL AGREEMENT IGA 881 -14 between the Federal Bureau of Prisons U.S. Department of Justice 320 First Street, NW Washington, D.C. and Brazos County Jail 1835 Sandy Point Road Bryan, Texas Pursuant to relevant authority contained in federal and state laws, including authority contained in 18 United States Code (U.S.C.) § 4002, this Inter - Governmental Agreement (IGA or Agreement) is entered into between the United States Department of Justice, Federal Bureau of Prisons (BOP) and Brazos County Jail (Brazos County), Bryan, Texas. The parties hereby agree as follows: 1. PURPOSE /SCOPE: (A) This Agreement is intended to establish responsibilities of the parties and procedures for Brazos County to provide secure custody, housing, safekeeping, subsistence, and care for one or more federally adjudicated female inmates, hereinafter referred to as BOP inmates. (B) Nothing contained in this Agreement shall be construed to abrogate, impair, alter, or amend any other agreement or contract now in effect between the parties relating to any other subject. (C) Third Party Contracts. Brazos County shall not enter into any contract for overall management and operation of the Brazos County facilities housing BOP inmates without providing thirty (30) days written notice to BOP of the intent to contract or modify said contracts. SOP shall not be liable for any claim Page 1 of 12 IGA B81 -14 Vol. 205 Pg. ,275 2. arising under said contracts including modifications thereto. (A) Brazos County shall: 1. Provide secure custody, housing, safekeeping, subsistence, and care for one or more BOP inmates under the terms of this Agreement, subject to the availability of suitable space, at the Brazos County Jail, 1835 Sandy Point Road, Bryan, Texas, 77807, in accordance with the attached, statements of work, titled "Contract Detention Services (Jail),, dated November 2013. 2. Allow the BOP to designate BOP inmates, to the Brazos County facility listed above. 3. Advise BOP Residential Reentry Manager (RRM) of a rejected placement within forty -eight (48) hours after referral and allow BOP RRM seventy -two (72) hours to re- assign BOP inmate. 4. Provide BOP RRM with progress reports, as outlined in the Sow, for each BOP inmate placed. 5. Submit all requests for medical, disciplinary, or security transfer(s) of a BOP inmate to BOP RRM. 6. Submit to BOP RRM all invoices requesting reimbursement by the tenth of each month following the month the service was provided. 7. At all times, allow BOP access to the Brazos County facility housing BOP inmates, and all records pertaining to this agreement, including financial records, as BOP may require. 8. Notify BOP of any incident which would likely result in litigation or alleged criminal activity by a BOP inmate. 9. Comply with the Freedom of Information Act, 5 U.S.C. § 552, and the Privacy Act, 5 U.S.C. § 552a, regarding the release of inmate records. Page 2 of 12 Vol. 205 Pg. 47 4 IGA 881 -14 10. Brazos County shall collect Deoxyribonucleic Acid /DNA samples as per the SOW. 11. Brazos County shall comply with the P.L. 108 -79, Prison Rape Elimination Act of 2003 (PREA) as per the SOW. PREA seeks to eliminate sexual assaults and sexual misconduct of offenders in correctional facilities to include all community based facilities. BOP Administration must maintain a zero - tolerance for sexual abuse, specific policy that addresses PREA compliance will be maintained by Brazos County. Facility must be in full compliance with PREA standards that apply to Adult Prisons and Jails. Compliance with standards will be measured during contract monitoring of facilities. PREA coordinator must be designated in writing and submitted to BOP at the time of the contract proposal. In accordance with provisions of PREA, Brazos County must be audited by a certified PREA compliance auditor at no cost to BOP. Copies of all audit material will be provided to BOP. (B) BOP RRM shall: 1. Forward to the Brazos County copies of pre - sentence report(s) and information to accomplish placement and follow -up on administrative requirements. 2, visit the Brazos County facility to meet and speak with all BOP inmates and ensure that BOP inmates have the name, address, and telephone number(s) of BOP RRM. 3. Certify the Brazos County's invoice(s) for payment and forward the invoice(s) to BOP Regional Department for payment. 4. Advise each BOP inmate of appropriate procedures to follow in raising concerns about BOP issues. Page 3 of 12 IGA 881 -14 Vol. 205 Pg. 2;7,7 3. PERIOD OF PERFORMANCE: This Agreement shall become effective September 1, 2014, and remain in effect for a period not to exceed three (3) years, until August 30, 2017, in accordance with 18 U.S.C. § 4002. Any provisions which require performance after the expiration or termination shall remain in force notwithstanding the expiration or termination of this IGA. 4. MODIFICATION: This Agreement, or any of its specific provisions, may be revised or modified by signatory concurrence of the undersigned parties, or their respective official successors. If any provisions of this IGA become invalid or unenforceable, the remaining provisions shall remain in force and unaffected to the extent permitted by law and regulation. 5. TERMINATION: This Agreement shall expire on August 30, 2017 or be terminated by either party upon one hundred eighty (180) days advanced written notice to the other party, or sooner by signatory concurrence of both parties. Within one hundred eighty (180) days after giving unilateral termination notice to Brazos County, or receiving unilateral termination notice from Brazos County, BOP shall retake custody of all BOP inmate(s) transferred to the Brazos County under this Agreement. Brazos County agrees to consult with BOP at least ninety (90) days prior to any termination action(s) to allow BOP sufficient time to prepare for loss and replacement of services. 6. CONTRACTING OFFICER'S REPRESENTATIVE (COR): La Tanya Robinson, Residential Reentry Manager (RRM) or her successor, is hereby designated as COR for this Agreement. This designation does not include authority to sign contractual documents, or to otherwise commit to or issue changes which could affect the price, costs, or monetary terms and conditions of this Agreement. The COR is authorized to resolve technical direction /redirection of work, in writing, signed by both parties. Page 4 of 12 IGA 881 -14 Vol. 205 Pg. 7 . PAYNEW RATE: (A) In consideration for Brazos County performance under the Terms and Conditions of this Agreement, BOP shall make payment to Brazos County for each BOP inmate accepted and housed by Brazos County. Payment will be made at a rate equal to the appropriate cost per - inmate, per -day for Brazos County based upon the established daily per diem rates which are allowable and allocable in accordance with the Department of Management and Budget Circular A -87, "Cost Principles for State, Local, and Indian Tribal Governments," as revised and amended. The rate for Brazos County is the per diem rate for the support of one inmate per day and shall include the day of arrival but not the day of departure. Brazos County shall charge BOP for only those costs which are directly related to the housing and detention of BOP inmates. (B) UNALLOWABLE COSTS include, but are not limited to: 1. Salaries of elected officials. 2. Salaries of employees not directly engaged in the housing and detention of BOP inmates. 3. Indirect costs in which a percentage of all local government costs are pro -rated and applied to individual departments. 4. Inmate services which are not provided to, or cannot be used by, BOP inmates. 5. Operating costs of facilities not utilized by BOP inmates. (C) The current rate is: $69.00 per inmate, per day for housing BOP inmates at the Brazos County facility. The estimated maximum number of BOP inmates per day to be housed under Detention services is S. The estimated amount is $604,992.00. A separate line item is for Guard /Transportation service at $30.00 per hour for 300 hours during the three year period at an estimated value of $9,000.00. The estimated total value of this Agreement is not to exceed: $613,992.00. Page 5 of 12 Vol. 205 Pg. (D) Nothing contained herein shall be construed to obligate the Federal Bureau of Prisons to any expenditure or obligation of funds in excess of, or in advance of, appropriations in accordance with the Anti- Deficiency Act, 31 U.S.C. 3 1341. 8. BILLING PROCEDURE: (A) Invoices - Invoices shall itemize each BOP inmate by name, register number, dates of stay, appropriate inmate -day rate, facility, and shall contain a remittance address. Billing shall be based upon the actual number of inmate - days) used. The invoices shall be based upon the established daily per diem rate for Brazos County which is allowable and allocable in accordance with the Department of Management and Budget Circular A -87, ^Cost Principles for State, Local, and Indian Tribal Governments," as revised and amended. Invoices for medical care should reference BOP inmate's name, register number and date of service. (B) Invoice Submission - Brazos County shall submit complete [as described in 8(A) above] invoices to BOP at the following address: Federal Bureau of Prisons Regional Residential Reentry Office 727 East Cesar E. Chavez Blvd, Room B -138 San Antonio, Texas 78206 (C) Payment 1. BOP shall make payments to Brazos County upon receipt of a complete [as described in 8(A) above] invoice. All payments shall be accomplished through Electronic Funds Transfer (EFT). 2. The Prompt Payment Act, 31 U.S.C. § 3902, shall apply. 3. Payments made under this agreement shall be charged to BOP accounting code - FP0900D1 YREGDOC number - NDW20089. Page 6 of 12 Vol. 205 PQ. Z YO IGA 881 -14 9. PRICE REDETERMINATION: This is a fixed unit -price Agreement. The inmate -day rate is as stated in section 7(C) above. Price redetermination shall, if allowable, be adjusted upward or downward as follows: (A) General - The prices for services performed prior to the first effective date of price redetermination shall remain fixed. (B) Performance Periods - For the purpose of price redetermination, the performance of this Agreement is divided into one -year periods. The first period shall extend from the effective date of the Agreement forward for twelve (12) months. All succeeding periods shall begin on the anniversary date of the preceding period. (C) Supporting Data - Not more than sixty (60) calendar days, nor less than thirty (30) calendar days, before the end of each performance period, Brazos County shall, if the price /costs change, submit to BOP: Proposed prices for services which may be performed in the next succeeding period under this Agreement, together with: (a) A breakdown of the estimated costs of such services on forms supplied by BOP; (b) Sufficient data to support the accuracy and reliability of such estimates; and, (c) An explanation of any differences between such estimates and the prices for the same services in the current performance period. (D) Redetermination by Modification - All negotiated price redeterminations shall be evidenced by a Modification to this Agreement signed by Brazos County and BOP. The Modification(s) shall set forth the redetermined prices and services to be performed during the next period in accordance with the provisions above, including section 4. Page 7 of 12 Vol. 205 Pa. AV IGA 881 -14 10. DELIVERY OF SOP INMATE: Upon receipt of written approval from Brazos County, BOP, at its own expense, shall deliver BOP inmate(s) to be transferred to location(s) agreed upon by both parties. 11. TRANSFER COSTS: Personal property in excess of the release amount authorized by BOP shall be mailed to BOP inmate's residence prior to transfer. Brazos County will not be responsible for these mailing costs. All other costs incident to the transfer of a BOP inmate, as well as transportation costs related to the release of a BOP inmate, shall be the responsibility of BOP. 12. MEDICAL SERVICES: Medical Services shall be provided in accordance with the Sow. 13. OVERPAYMENT /UNDERPAYMENT: If BOP has overpaid Brazos County, all such overpaid amounts shall be deducted from the monthly billing following discovery and confirmation. 14. COLLECTION FROM SOP INMATES: Any subsistence monies collected from a BOP inmate, including medical co- payments, shall be deducted from the monthly billing and verified by a copy of the receipt attached with Brazos County invoice, unless disposition of the monies is otherwise specified. 15. TRANSFER: Prior to transfer, BOP will request permission from Brazos County to transfer a BOP inmate to the care and custody of the Brazos County. A separate application shall be submitted for each BOP inmate proposed for transfer. Page 8 of 12 IGA 861 -14 Vol. 205 Pg. 90U- Each application for transfer shall include the following: (A) Copies of all documents which relate to BOP inmate's case history, physical, and clinical record(s); (B) Copies of all judicial and administrative rulings and orders relating to the inmate and the sentence(s) imposed, including confinement. 16. DISCIPLINE: Discipline shall be handled in accordance with the SOW. 17. ESCAPE: Escape shall be handled in accordance with the SOW. 18. DEATH OF A HOP INMATE: In the event of the death of a BOP inmate, Brazos County shall: (1) immediately notify BOP of the death; (2) furnish information as requested by BOP; and (3) follow instructions given by BOP with regard to the disposition of the body. The body shall NOT be released except upon written order of BOP. All expenses relative to the necessary preparation and disposition of the body, as well as the duty to notify the nearest relative of the deceased inmate, will be the responsibility of BOP. The provisions of this paragraph shall govern only the contractual relationship between BOP and Brazos County and shall not affect the responsibility of relatives or other persons for the disposition of the deceased and for expenses connected therewith. 19. INTER- INSTITUTIONAL TRANSFERS: Brazos County may NOT relocate a BOP inmate from one Brazos County facility under its control to another without prior written permission of BOP. BOP inmates causing safety and /or security concerns may be transferred immediately, followed by written notification to BOP. Page 9 of 12 Vol. 205 Pg. IGA 881 -14 20. RETAKING OF BOP INMATE UPON RELEASE: 21. upon the lawful termination of a BOP inmate's commitment, BOP shall accept delivery of BOP inmate at BOP's expense. However, by agreement between the parties and BOP inmate, BOP inmate may be discharged, conditionally or otherwise, at a mutually agreed upon location. All notices, reports, redirection of work, and correspondence to the respective parties to this Agreement shall be sent to the following: Brazos County: Duane Peters, County Judge Brazos County 200 South Texas Avenue Bryan, Texas 77801 Phone: (979) 361 -4104 Christopher C. Kirk, Sheriff Brazos County 1700 West State Highway 21 Bryan, Texas 77803 Phone: (979) 361 -4992 Bureau of Prisons: Federal Bureau of Prisons Construction Contracting Section 320 First St., NW, 500 -6 Washington, D.C. 20534 Phone: (202) 307 -0954 Fax: (202) 616 -6055 22. LIABILITY /INDEMNITY: (A) Each party to this Agreement shall be responsible for any liability arising from its own conduct. Neither party agrees to insure, defend, or indemnify the other. (B) Brazos County and BOP do not waive sovereign immunity by entering into this Agreement, and specifically retain immunity and all defenses available to them as Page 10 of 12 V01.205 Pg. IGA 881 -14 .2�5� 23 sovereigns pursuant to all federal, state and tribal laws. (B) Each party shall cooperate with the other party in the investigation and resolution of administrative actions and /or litigation arising from conduct related to the responsibilities and /or procedures addressed herein. AGENCY INTERFACE / DISPUTES: (A) The parties agree that, in the event of a dispute between the parties, the parties will use their best efforts to resolve the dispute in an informal fashion through consultation and communication, or other forms of non - binding alternative dispute resolution mutually acceptable to the parties. (B) Should questions arise and need further clarification, BOP and Brazos County establish the following direct lines of communication to ensure timely responses to inquiries. The following persons /positions are the primary points of contact for the named subject areas: (1) Agreement Administration: (Correspondence, modifications, notices). Brazos County: Duane Peters, County Judge Brazos County 200 South Texas Avenue Bryan, Texas 77801 Phone: (979) 361 -4104 Bureau of Prisons: Federal Bureau of Prisons Construction Contracting Section 320 First St., NW, 500 -6 Washington, D.C. 20534 Phone: (202) 307 -0954 Fax: (202) 616 -6055 (2) Technical Requirements: (Applications, direction of work, rulings). Page 11 of 12 IGA 881 -14 Vol. 205 Pg. ,;', b Brazos County: Wayne Dicky Brazos County Jail Administrator 1835 Sandy Point Road Bryan, Texas 77807 Phone: (979) 361 -4996 Bureau of Prisons: La Tanya Robinson, RRM Federal Bureau of Prisons Regional Residential Reentry Office 727 East Cesar E. Chavez Blvd, Rm 8 -138 San Antonio, Texas '18206 Phone: (210) 472 -6220 IN WITNESS WHEREOF, Lhe undersigned, duly - authorized officers have subscribed their names on behalf of Brazos County and Federal Bureau of Prisons: Brazos County U.S. Department of Justice Federal Bureau of Prisons County Judge Procurement Executive Date Christopher 01. Ktrk Sheriff O D .20 Date n Lc Page 12 of 12 Vol. 205 Pg. sZX TGA 981 -14 MEMORANDUM OF UNDERSTANDING Psychological Evaluations of Applicants for Detention Officer and Deputy Sheriff Positions and Other Employees This Memorandum of Understanding (hereinafter referred to as "MOU") is made this 1" day of October 2014 by and between Texas A &M University—a member of the Texas A &M University System, an agency of the State of Texas on behalf of its Department of Psychology (hereinafter referred to as "TAMU ") —and the Brazos County Office of the Sheriff (hereinafter referred to as "BCSO "). WHEREAS, TAMU offers a clinical psychology doctoral program; and WHEREAS, BCSO seeks to evaluate potential candidates for employment, and potential candidates for promotion; and WHEREAS, it is deemed in the best interest of both parties that said governments do enter into a mutually satisfactory agreement and share in the educational process; NOW THEREFORE, based on the mutual promises set forth herein, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto, intending to be legally bound, have agreed as follows: TAMU RESPONSIBILITES: (1) TAMU shall assign a liaison to BCSO for purposes of (a) correspondence regarding billing and scheduling appointments, Angela Morehead, Lead Office Associate, TAMU Psychology Clinic, Department of Psychology, Texas A &M University, 4235 TAMU, College Station, TX 77843 -4235 (979) 845 -8017 clinic @tamu.edu and (b) for MOU management, Robert Heffer, Ph.D., Director TAMU Psychology Clinic, Department of Psychology, 4235 TAMU, College Station, TX 77843 -4235 (979) 845 -8017 clinic@tamu.edu. (2) TAMU shall furnish psychological evaluations, in accordance with regulations set forth in the Texas Commission on Law Enforcement (TCOLE), for peace officer, jailer, and communications officer applications and other employees as referred by BCSO. (a) Each evaluation will include (1) a thorough clinical interview (2) an appropriate global measure of personality/psycho social functioning, and (3) additional specific measure(s) of behavioral style or cognitive functioning as indicated by other evaluation measures or referral questions posed by BCSO. (3) TAMU shall schedule evaluations within 10 working days after receiving written or phone request from BCSO to conduct such evaluations. (4) TAMU agrees to provide verbal feedback to BCSO and make available, for mailing or I of 5 C:$Usersiadd 231'W ppDamlLocaAMlcrosofAglindmvslT emporary Internet FileslContenl .OullookWH88LGRPOra_os Sher L3 Eval_ MOU _FY14.1 i_July 29_needs stgs doer Vol. 205 Pg. o247 personal pick -up, the TCOLE L -3 (LICENSEE PSYCHOLOGICAL AND EMOTIONAL HEALTH DECLARATION) form within 3 working days of completion of the testing. (5) TAMU shall make available the psychological evaluation report generated on persons served under this Agreement for mailing to, or personal pick -up by, BCSO within 14 working days after the scheduled evaluation. (6) TAMU agrees to discuss via phone or email with BCSO situations that alter these scheduling - testing -report expectations as soon as either party becomes aware of the need to change expectations for a given referral. (7) TAMU agrees that payment will be based on the timely submission of evaluation reports as stated above. (8) TAMU shall provide BCSO an invoice by the 10`h of each month for services rendered during the previous month. (9) TAMU shall accept, as full compensation, the sum of $260,00 per psychological evaluation. (10) TAMU shall accept, as full compensation, the sum of $120.00 per psychological re- evaluation. (11) TAMU shall provide BCSO, if requested, a copy of current professional credentials of all individuals involved with the evaluations, professional liability insurance for psychological or behavioral health services applicable under this Agreement and all policies established by the TAMU Psychology Clinic. (12) TAMU students and faculty supervisors appointed by TAMU shall comply with policies established by the TAMU Psychology Clinic regarding code of ethics, confidentiality, and other issues relevant to provision of consultative clinical services. BCSO RESPONSIBILITIES: (1) BCSO shall assign a liaison to, TAMU for purposes of communication, Jody Aranda, Deputy Sheriff, Recruiter, Brazos County Office of the Sheriff, 1700 Highway 21 West, Bryan, Texas, (979) 361 -4948, jaranda@co.brazos.tx.us. (2) BCSO shall provide TAMU a written request for evaluation. (3) BCSO shall provide TAMU with a completed Release of Information signed by each person being evaluated prior to the scheduled evaluation. 2of5 i C:'U serskadsl23lWppDa talLowP,blicrosgRlLYirdw Temporary Internet FileslConreni .0utlook"8LGRPlaro- or Sheri L3 Eva! aM0U FY14 -1S July 29_ needs sigs.docx Vol. 205 Pg. ,Z �� (4) BCSO agrees to discuss via phone or email with TAMU situations that alter the scheduling- testing -report timeline expectations, as stated in the TAMU RESPONSIBILITIES section above, as soon as either party becomes aware of the need to change expectations for a given referral. (5) BCSO shall pay, as full compensation, the sum $260.00 per psychological evaluation. BCSO shall provide payment upon timely submission of evaluation reports as agreed to above. (6) BCSO shall pay as full compensation, the sum of $120.0 0 per psychological re- evaluation. BCSO shall provide payment upon timely submission of evaluation reports as agreed to above. (7) BCSO shall pay TAMU for services in full within 30 days after satisfactory receipt of services and billing unless otherwise specified or mutually agreed upon before orders are placed. BCSO will not be liable for payment of invoices received six (6) months after order completion. Invoices must be submitted by TAMU to Laura Cook, Administrative Secretary, Brazos County Office of the Sheriff, 1835 Sandy Point Road, Bryan, TX 77807; (979) 361 -4997; (cook @co.brazos.tx.us; (979) 361-4833 — Fax. NOTICE: Except for procedures under Alternative Dispute Resolution below, any required notice or contact under this MOU shall be made to: Brazos County Office of the Sheriff: Sheriff Christopher C. Kirk with copies to or Wayne Dicky, Jail Administrator Brazos County Office of the Sheriff 1700 Highway 21 West Bryan, TX 77803 -1300 (979) 361 -4900 TAMU: TAMU Psychology Clinic Department of Psychology Texas A &M University 2435 TAMU College Station, Texas 77843 -2435 Judge Duane Peters Brazos County Commissioners Court Brazos County Administration Building 200 South Texas Avenue Bryan, TX 77803 (979) 361 -4102 employer's I.D. #: 74- 6000531 profession/ occupation: psychologist Phone: (979) 845-8017 Fax: (979) 845 -5191 INDEMNIFICATION: Subject to the limitations as to damages in the Texas Tort Claims Act and without waiving its governmental immunity, Each party agrees to hold harmless each other, its governing board, officers, agents and employees for any liability, loss, damages, claims or 3 of 5 C:IUsersladsl237L9ppOata4 eatAlicrosoJNWindmvslTemporary Inwne+ Files iContent. OadooklRH88LORP IBrcl_or Skeri -L3 Eva! bf0U_FYIJ -IS July29 needs sigs.dorx Vol. 205 Pg. � causes of action caused or asserted to have been caused directly or indirectly by any other party to this Agreement, or any of its officers, agents or employees, or as the result of its performance, or any of its officers, agents or employees, of this MOU. CONSENT TO SUIT: By entering into this Agreement neither party gives its consent to suit. ALTERNATE DISPUTE RESOLUTION (1) To the extent Chapter 2260, GOVERNMENT CODE, as it may be amended from time to time ( "Chapter 2260), is applicable to this Agreement and is not preempted by other applicable law, BCSO and TAMU must use the dispute resolution process provided in Chapter 2260 of the Texas Government Code to attempt to resolve a dispute arising under this Agreement and is a required prerequisite to suit in accordance with Chapter 107, Texas Civil Practices and Remedies Code. BCSO must submit written notice of a claim of breach of contract to the University Contracts Officer, TAMU. TERM OF AGREEMENT: for no more than twelve (12) months, endine September 30, 2015. This MOU may be terminated on behalf of either party in the agreement, by providing the other party with thirty (30) days written notice. Any BCSO candidates scheduled for evaluations, at time of cancellation will be allowed to complete their evaluation, provided that the cancellation was requested by TAMU. In the event this agreement is canceled, TAMU will be paid only for the evaluations completed, provided the required evaluation reports are presented to BCSO within three weeks of the cancellation of this Agreement. INDEPENDENT CONTRACTOR STATUS: This MOU shall not be construed as creating an employer /employee relationship between TAMU, including any of its officers, agents and employees, and BCSO and does not constitute a joint venture. PROVISIONS: If any provision or provisions of the MOU shall be held to be invalid, illegal or unenforceable, the validity, legality and enforceability of the remaining provisions shall not in any way be affected or impaired thereby. GOVERNING LAW: The terms and conditions of the MOU and performance hereunder shall be construed in accordance with the laws of the State of Texas. Venue shall be in a court of competent jurisdiction in Brazos County, Texas. OTHER DIRECT COSTS: The BCSO will only pay the amount per completed evaluation or re- evaluation as specified in the preceding "RESPONSIBILITIES" sections. The number of evaluations will vary over the months in which this contract is in effect. The cost of each evaluation or re-evaluation includes other direct costs which will be used by TAMU for supplies; photo - reproduction; books; journals; training recordings; software; equipment; professional dues; travel expenses; educational development; salaries, fringe, tuition and fee costs; and other directly related costs. This MOU constitutes a fixed -cost contract. 4of5 C: IUsersl adsl2321AppDul alLowAMicrosojtiWindmeslTemporarylntermi FileslContent .OurlookkRH88LGRPIOr wSherifj_L3 EVal_MOU FY /4- 15_July29_needrsigsdaci Vol. 205 Pg. 02 9a AUTHORITY TO CONTRACT: Each party has the full power and authority to enter into and perform this MOU, and the persons signing below on behalf of each party have been properly authorized and empowered to enter into this MOU. The persons executing this MOU hereby represent that they have authorization to sign on behalf of their respective entities. BRAZOS COUNTY OFFICE OF THE SHERIFF i By: Christopher C. Kirlr he&T Brazos County Office of the Sheriff lE COURT Duane Peters, Judge Brazos County Commissioners Court TEXAS A &M UNIVERISTY 02 Dean K. Endler, Executive Director Contract Administration Date: 08 o sot Date: D Date: 5 of 5 C: IUsersWdsl232UppDaralLoca RMicrmoJAWimlowslTcmporary Internet FileslCmienr .OutlookINH88LGRP�aracm Sherdf __L3 Eval MO6' FY14 -13 July2i needssigs.d= Vol. 205 Pg. —z—V COMMISSIONER COURT MINUTES OF AUGUST 12, 2014 ARE CONTINUED IN VOLUME 206 PAGE 1 Vol. 205 Pg. �L �-2 COMMISSIONER COURT MINUTES OF AUGUST 12, 2014 ARE CONTINUED FROM VOLUME 205 Vol. 206 Pg. STATE OF TEXAS COUNTY OF HAYS 1 CONTRACT AND AGREEMENT FOR SECURE LONG -TERM AND SHORT -TERM RESIDENTIAL SERVICE OF JUVENILE OFFENDERS This Contract and Agreement is made and entered into by and between HAYS COUNTY JUVENILE BOARD, hereinafter referred to as the Service Provider, and the CountyofBRAZOS, hereinafter referred to as the placing County, acting by and through its duly authorized representative, as indicated by their signatures below, to be effective from and after the I" day of September, 2014, through the 31" day of August, 2015 pursuant to its provisions. WITNESSETH; Whereas, Hays County Juvenile Center has been duly inspected and certified as being suitable for the treatment and detention of children: and, Whereas, the placing County, in order to carry out and conduct its juvenile program in accordance with the Texas Juvenile Court Act (Texas Family Code) has need of the use of detention facilities to house and maintain children of juvenile age, referred for an act of delinquency or an act indicating a need for supervision, during pre-trial and pre- dispositional status or in the post - dispositional treatment prescribed by the Court; and Whereas, Service Provider desires to make the facility available to the placing County for such use and purposes and the Service Provider desires to contract for the use of said facility; NOW, THEREFORE, the parties agree as follows: I. TERMINATION The term ofthis contract shall be for a period of twelve (12) months from the effective date; however if either party hereto feels in its judgment that the contract cannot be successfully continued, and desires to terminate the contract, then the party so desiring to terminate may do so by notifying the other parry in writing, by certified mail or personal delivery to its principal office, of its intention to terminate the contract thirty (30) calendar days from the date of Notice of Termination is received by the other party. At 12:00 o'clock midnight thirty (30) calendardays thereafter, this contract shall terminate, become null and void and be of no further force of effort. Such termination shall not affect or diminish the placing County's responsibility for payment of any amounts due and owing at the time of termination of the contract. After receipt of notice of termination, the placing County shall remove all children placed in the facility on or before the termination date. Vol. 206 Pg. II. COMPENSATION, BILLING, AND PAYMENT The placing County agrees to pay Service Provider the sum of 5100.00 per day for each space utilized in Detention services. The placing County agrees to pay Service Provider the sum of $105.00 per day for each space utilized in the Boot Camp (B /C) /General Offender programs. The placing County agrees to pay Service Provider the sum of 1$ 40.00 per day for each space utilized in the Juvenile Intensive Treatment Program (JITP), Mental Health Program (MH) and the Sex Offender Residential Treatment program (SORT). The daily cost being based on the projected actual cost of care for children in the facility. Payment shall be made monthly in accordance with Texas Government Code, Chapter 2251, Payment for Goods and Services. The Service Provider may at its discretion, or upon recommendation of the Hays County Auditor's Office, impose interest on payments that become overdue in accordance with §2251.025, Texas Government Code. In addition to the rate agreed upon between the two parties, the placing County shall either make arrangements to pay, or reimburse the Service Provider for expenditures made, for medical care and dental care for children placed if: (1) the medical care or dental care is not covered by Medicaid or the funding source, and (2) the expenditures are approved by the placing County in writing prior to the expenditures being incurred. If emergency examination, treatment and /or hospitalization outside the facility is required for a child placed in the facility, the Administrator of the facility is authorized to secure such examination, treatment or hospitalization at the expense of the County. The County agrees to indemnify and hold harmless Service Provider, their representatives, agents and employees from any and all liability for charges for reasonable and necessary medical treatment, examination, and /or hospitalization. The Administrator, or designee, shall notify the appropriate County and parent/guardian of such an emergency within twenty -four (24) hours of its occurrence. III. PLACEMENT OBJECTIVE Service Provider agrees to provide a space, if available, at the time that the placing County requests the space. Service Provider will provide a copy of the visitation/phone contact schedule with this contract and the placing County shall provide a copy to a resident's parent/guardian /legal custodian. Service Provider will provide room and board, twenty -four hour per day, seven day a week supervision; routine medical examination and treatment within the facility (emergency examination, treatment, or hospitalization outside the facility with prior written approval of the placing County, if feasible); TEA approved educational programming; recreation facilities; and counselingto each child placed within the facility. The objective of the placement with the Service Provider is to protect the well -being of the child, and in long -term to enhance the child's functional abilities in a residential care setting and achieve the goals of the child's Individual Treatment Plan and Child/Family Case Plan. -2- V01 -2o6 Pg. IV. ADMISSION AND DISCHARGE Prior to transporting a child to the facility for short term - placement, the official authorizing the placement shall call the facility to insure that space is available. Placement of children from any County may be denied if space limitations require. Children referred for long -term placement shall complete the referral process for acceptance prior to placement. Each child placed in the facility shall be placed therein under proper order of the Juvenile Court, and the Administrator shall be furnished a copy of said order and will arrive with appropriate pre- and post- adjudication paperwork as stipulated by Texas Juvenile Justice Department standards. Each child placed therein shall be required to follow the rules and regulations of conduct as fixed and determined by the Administrator and staff of the facility. If a child is accepted by the facility from any County and such child thereafter is found to be, in the sole judgment of the Administrator, mentally unfit, dangerous, or unmanageable or whose mental or physical condition would or might endanger the other occupants of the facility, then the Administrator shall notify the placing County of such conditions. Such child shall be immediately removed from the facility. It will be the responsibility of the placing County to provide for the transportation for the removal of the child. The Service Provider must provide at least (10) calendar days notice before discharging a child except when the child is a danger to self or others. Service Provider agrees that the facility will accept any child qualified hereunder, without regard to such child's religion, race, creed, color, sex, or national origin. It is further understood and agreed by the parties hereto that children placed in the facility may be granted furloughs with parents, guardians, custodians, or other responsible adults only with prior written approval of the placing County or appropriate Juvenile Court. It is further understood and agreed by the parties hereto that children placed in the care ofthe facility shall not be discharged there from without: (a) Receipt of the Order signed by the Judges havingjuvenile jurisdiction of the placing County, duly certified by the clerk of said Court, or (b) Prior written authorization of the Juvenile Probation Department who originally detained the child. It is further understood and agreed by the parties hereto that children placed in pre - adjudication care in the facility shall be removed therefrom by the appropriate authorities from the placing County, or its agents, servants or employees at the expiration of the period authorized by the Court Order issued by the Judge of the appropriate Juvenile Court unless a new Order has been -3- Vol. 206 Pg. issued authorizing the continued detention, and a copy of such Order has been delivered to the detention facility, or unless a waiver of a detention hearing has been executed and a signed copy of the waiver delivered to the facility. It is further understood and agreed by the parties hereto that nothing in this contract shall be construed to permit the placing County, its agents, servants, or employees in any way to manage, control, direct or instruct Service Provider, its servants or employees in any manner respecting of their work, duties or function pertaining to the maintenance and operation of the facility. However, it is also understood that the Juvenile Court of the placing County shall control the conditions and terms of detention supervision as to a particular child pursuant to Texas Family Code Section 51.12. V. SERVICES TO BE PROVIDED The Service Provider shall provide the following services to each child placed bythe placing County to the extent that such services are permitted within the Service Provider's standards and consistent with the child's Individual Treatment Plan: • Basic residential child care services, including food and snacks, room, clothing, personal hygiene items, haircuts, local transportation & school supplies. • Educational and vocational activities. • Recreational activities. • Special treatment services, including behavior management, diagnostic services, psychological counseling, and psychiatric consultation. • Medically necessary health services. • Other services described in this Contract. The Service Provider shall provide all services in a manner which safeguards the health, welfare, and safety of the children to the maximum extent possible, and in the least restrictive setting possible. Residential care shall be provided by professional staffthat posses the required qualifications for performing designated job functions. The Service Provider shall verify and disclose, or cause its employees and volunteers to verify and disclose, criminal history and any current criminal indictment for an offense against the person, an offense against the family, an offense involving public indecency under the Texas Penal Code as amended, or an offense under the Texas Controlled Substances Act, Chapter 481 of the Texas Health and Safety Code or comparable provisions in another state. This verification and disclosure shall be required for all staff having direct contact with the placing County children. VI. INDIVIDUAL TREATMENT PLAN Each child placed in long -term shall have a written Individualized Treatment Plan (ITP) developed in concert with the child and mutually agreed upon by the Service Provider staff, any -4- psychologist and/or psychiatrist working with the child, as applicable, and/or appropriate placing county personnel within thirty (30) days of placement. The ITP shall complement the Child/Family Case Plan supplied by the placing County. The ITP shall be reviewed jointly by all parties at intervals specified by Texas Juvenile Justice Department standards, to assess the child's progress with modifications of the ITP being made when indicated. Either the Service Provider or the placing County may request a review at any time. The ITP may contain, but not be limited to the following: the reasons why the placement will benefit the child; specify behavioral goals and objectives being sought for the child; state how the goals and objectives are to be achieved during the child's placement with the Service Provider; and state how the parent(s), guardian(s), and where possible, grandparents(s) or other extended family members will be involved in the ITP to assist in preventing or controlling the child's alleged delinquent behavior or alleged conduct indicating a need for supervision as defined in the Texas Family Code. The Service Provider shall provide the placing County with a written report of the child's progress toward or achievement of goal's /objectives contained in the ITP on a monthly basis. These reports are to include, but not be limited to, the following information: (a) Behavior in program. (b) Progress in treatment. (c) Progress in school. (d) Peer and staff relationships. (e) Family relationships. (t) Aftercare goals. VII. PERFORMANCE MEASURES Goals The Individual Treatment Plan for each child shall contain specific behavior goals and services that are appropriate to the child and that enable the child to develop to his/her fullest potential. This development will be through provision of a safe, drug -free environment in which counseling services are utilized as tools for educational, emotional and behavioral catharsis. Outputs The Service Provider shall provide the placing information which outlines the services provided to clients are not limited to: -5- County, within ten (10) working days, . These output measures may include, but • Average length of stay of children in each program. • Average daily population of children in each program. • Average number of counseling hours provided each child daily, weekly or monthly. • Average number of educational hours provided each child daily, weekly or monthly. • Specific types of milieu implemented by the Service Provider. Measurable Outcomes The Service Provider agrees to furnish the placing County the annual indicators which express the effectiveness of the Service Provider in providing public benefit. Evaluation of the contract by the placing County may be performed by using the following outcome measures: • 80% of youth successfully completing the program. • 80% of youth report improved family communication/functioning while in placement. • 80% of youth will demonstrate progress in a majority of goals outlined in the ITP and encompassing the nine domains of the Child/Family Case Plan. • 85 % of youth will cam at least A educational credits in core subject(s). Sanctions If the Service Provider fails to achieve the defined goals, outputs, and outcomes, set out by the placing County or if the Service Provider fails to comply with the terms of this contract, the placing County may, at its discretion, take any one or more of the following sanctions: • Cease placement of children at the facility. • Remove children previously placed by the County. • Require the Service Provider to take specific corrective actions in order to comply with the terms and conditions of the contract. • Suspend the contract in part or in whole until such time as the Service Provider is in compliance with all of the terms of the contract. • Terminate the contract. • Exercise any other rights or remedies which may be available to the County, at law or in equity. VIII. RECORDS AND RECORDS RETENTION Service Provider will keep a record of all services provided to the placing County under this agreement and provide all information, records, papers, reports, and other documents regarding any aspect of the services furnished as may be requested by the placing County. Service Provider will make these records and all other materials which relate in any way to the services provided, available for inspection, audit, and examination by the County, the Comptroller General of the United State, M2 the U.S. Department of Justice, the Texas Juvenile Justice Department, and the State of Texas and/or their duly authorized representatives. Service Provider will maintain the records (as referenced above) for three (3) years after the final payment, or until any audit of the program, has been made and all questions arising therefrom have been resolved, whichever is later. This Agreement shall be construed under and in accordance with the laws of the State of Texas. Service Provider will provide certification of eligibility to receive State funds as required by Texas Family Code Section 231.006. Service Provider shall adhere to all applicable state and federal laws and regulations pertinent to the Service Provider's provision of services to the placing County. IX. EXAMINATION AND ACCESS TO FACILITY The placing County reserves the right to perform periodic on -site monitoring of the Service Provider's compliance with the terms of this Contract, and the adequacy and timeliness of the Service Provider's performance under this Contract. The Service Provider shall establish a method to ensure the confidentiality of records and other information relating to the child according to applicable federal and state law, rules and regulations, and applicable professional ethical standards. This provision shall not limit the placing County's right of access to the child's case records or other information relating to children served under this Contract. X. INDEMNITY, HOLD HARMLESS, AND CLAIMS The Service Provider shall indemnify, save and hold harmless the placing County, its officers, agents, and employees from all suits, actions, losses, damages, claims, or liability of any character, type, or description, including without limiting the generality of the foregoing all expenses of litigation, court costs, and attorney's fees for injury or of the foregoing all expenses of litigation, court costs, and attorney's fees for injury or death to any person, or injury to property, received or sustained by any person or persons or property, arising outof, or occasioned by, directly or indirectly, the acts of omissions of the Service Provider, its agents, servants, employees, consultants. or invitees, in the execution or performance of this Contract. In the event that any claim, suit, or other action is made or brought by any person, firm, corporation, or other entity against the Service Provider or County, the Service Provider shall give written notice to the placing County of any such claim, demand, suit or other action within three (3) working days after being notified of such claim, demand, suit or other action of the threat thereof. 7- Vol. 206 Pg. `� XI. INSURANCE The Service Provider shall have, and shall require all subcontractors providing services under this Contract to have insurance throughout the term of this agreement covering, among other matters that the placing County shall desire, any and all damages and/or claims that might arise out of the placement of county children. Such insurance shall include, but not be limited to, breach of confidentiality. XII. COMPLIANCE WITH LAWS, REGULATIONS AND STANDARDS The Service Provider shall comply with all federal, state, county, and city laws, rules, ordinances, regulations and standards applicable to the provision of services described herein and the performance of all obligations undertaken pursuant to this Contract. The Service Provider shall not discriminate against any employee or applicant for employment based on race, color, religion, sex (gender), national origin, age or handicapping condition. The Service Provider will take affirmative action to ensure that applicants are employed, and that the employees are treated during employment without regard to their race, religion, color, sex, national origin, age or handicapping condition. The Service Provider shall comply with minimum standards as put forth by the Texas Juvenile Justice Department at all times. The Service Provider shall ensure that suspected or alleged cases of child abuse, neglect or exploitation are immediately reported to the placing County and to the appropriate authorities as required by law and in conformity with the procedures detailed in Chapter 261 ofthe Texas Family Code. The Service Provider shall ensure that its employees are properly trained in the reporting requirements and procedures of Chapter 261 of the Texas Family Code. XIII. ACKNOWLEDGEMENTS AND ASSURANCES The Service Provider acknowledges and agrees that the placing County is under no obligation to place any child or children with the Service Provider and this Contract shall not be so construed. The Service Provider acknowledges and agrees that the placing County may, at its discretion, remove any child placed pursuant to this Contract, at any time. The placing County will notify Service Provider in a timely manner prior to the removal of a child except in instances where in the placing County's judgment such notification may result in risk to the child's health, 'safety "or welfare. The parties acknowledge and agree that the Service Provider is under no obligation to accept a child who is deemed by Service Provider to be inappropriate for placement with the Service Provider. -g- I rim r Under Section 23 1.006 of the Texas Family Code, the Service Provider certifies that they are eligible to receive state funds and acknowledges that this contract may be terminated and payment may be withheld if this certification is inaccurate. The Service Provider agrees to account separately for the receipt and expenditures of state funds received from the placing County. The Service Provider shall adopt specified accounting, reporting, and auditing requirements applicable to any state funds paid to the Service Provider under this contract. XIV. LAW AND VENUE In any legal action arising under this contract, the laws of Texas shall apply and venue shall be in Hays County. XV. MISCELLANEOUS PROVISIONS Fee Assessment Clients or their families shall not be assessed fees for services by the Service Provider unless arrangements are specified by the Court. This does not preclude reasonable attempts to seek voluntary contribution from families of the placing Counties clients for donations of clothing, personal articles, and funds to assist in supporting a youth's rehabilitation. Officials Not To Benefit No officer, member or employee of Hays County and no member of its governing body, and no other public officials of the governing body of the locality or localities in which the project is situated or being carried out who exercise any functions or responsibilities in the review or approval of the undertaking or carrying out of the project, shall participate in any personal or pecuniary interest, direct or indirect, in this contract or the proceeds thereof. XVI. PRISON RAPE ELIMINATION ACT OF 2003 The Service Provider has a zero tolerance towards all forms of sexual abuse and sexual harassment in accordance with the provisions of the Prison Rape Elimination Act of 2003 that provides for administrative and/or criminal disciplinary sanctions. The Service Provider shall adopt policies and comply with the Prison Rape Elimination Act of 2003 (28 CFR § 1 15) standards and shall permitthe placing County to monitor its facility and records as necessary to ensure thatthe Service Provider is complying with said standards. Under the provisions of the Prison Rape Elimination Act of 2003, the Service Provider shall provide to the placing County all incident - based aggregate date reports for every allegation of sexual abuse or sexual harassment and all such data that may be requested by the Department of Justice from the previous calendar year no later than June 30 ( §115.387 (f)) and the data necessary to answer all questions from the most recent version of the iE Vol. 206 Pg. /o Survey of Sexual Violence. The Sery ice Provider shall report to the placing county in writing within 15 days any positive findings by a court or governmental agency that the Service Provider has violated a relevant federal statute or rule. THIS CONTRACT AND AGREEMENT is made by and between the parties hereof, it being the declared intention of the parties hereto that the above and foregoing contract is a contract providing for the care of children who have allegedly committed an act of delinquency or an act indicating a need for supervision and payment for such care by the placing County for such children placed in the facility by the Judge of the placing County having juvenile jurisdiction. This Contract is in lieu of all previous contracts or agreements by and between Service Provider and the placing County for these purposes. Said previous contract to terminate, become null and void, and be of no further force or effect of the date this contract become effective. Executed this the _ day of shall be considered an original copy for all purposes. HAYS COUNTY Linda Rodriguez Chairman, Hays County Juvenile Board Hays County Justice Center, Room 177 20_ each copy here BRAZOS C UNT C MISSION ERS COURT u Duane Peters, County Judge Brett Littlejohn Administrator, Hays County Juvenile Center 2250 Clovis Barker Rd. San Marcos, Texas 78666 a U1 Vol. 206 D�g. —Z-Z Brazos Countv 200 S. Texas Ave., Ste. 332 Bryan, TX 77803 Phone: 979-3614102 Fax: 979-3614503 Douglas Vance, Ph.D. Executive Director Brazos County Juvenile Services 1904 Hwy 21 W Bryan, Texas 77803 TEXAS ASSOCIATION OF COUNTIES RISK MANAGEMENT POOL GENERAL LIABILITY COVERAGE DOCUMENT DECLARATIONS These Declarations form part of the General Liability Coverage Document between the Texas Association of Counties' Risk Management Pool and the Named Member shown in item B, below. Item A. COVERAGE DOCUMENT NO.: GL 1050 2013 11 15 Item B. NAMEDMEMBER: Hays County ADDRESS: 111 E Saul Antonio St 9300 San Marcos, TX 78666 -5534 Itnn C. COVERAGE PERIOD: From November 15, 2013 to November 15, 2014 'Data under this item are 12:01 AM United Staho Cvnlrai Tme Item D. LIMIT'S OF LIABILITY. BASIC: Bodily injury Liability Each Person: $100,000 Each Occurrence: $300,000 Property Damage Liability Each Occurrence: $100,000 Damage to Premises Rented to the Named Member $ 50,000 Personal and Advertising Injury Liability Per Person $100,000 Per Offense /Aggregate $300,000 Employee Benefits Liability $100,000 Medical Payment Per Person $ 5,000 Itern E. DEDUCTIBLE: $10,000 Item F. Contribution: General Liability Coverage Form $33,493 TOTAL ANNUAL CONTRIBUTION: $33,493 ltnn G. NOTICE OF ACCIDENT.. Notice of an accident orclaim (including service of process) is to be delivered immediately to the Pool via the Texas Association of Counties Claim Department at: Texas Association of Counties Attm Claims Department P.O. Box 2131 Austin, Texas 78768 Fax (512) 615.8942 (Immediately, in addition to any fax transmission, tratutnit the notice of maim and related documents by U.S. Mail or other delivery service to the above address.) Item H NAMED MEMBER'S DESIGNATED Risk Management Pool Coordinator: Ms. Dee Dee Baen Item 1. FORMS AND ENDORSEMENTS The forms and endorsements comprising this General Liability Coverage Document at issuance are: TAC/GL (1113); GLIEBL (01108); GUNUCL 'Ota ((OsOi 1088); TAC- GL/DED (01/08) T . Js [ .nom This agreement is issued by � , as authorized representative of the Pool on October 31, 2013 at Austin, TX TACCVDEC (01113) Board Approved 11!18/12 Page: 1 of 7 Vol. 206 Pg. YAS ASSOCIATION OF COUNTk , RISK MANAGEMENT POOL LAW ENFORCEMENT PROFESSIONAL LIABILITY COVERAGE DECLARATIONS These Declarations form part of Coverage Document Number: LE 1050 2013 04 02 Item 1. NAMED MEMBER: Hays County 2. ADDRESS: 111 E San Antonio 5t 0300 San Marcos, TX 78666.5534 Item B. 1. COVERAGE DOCUMENT PERIOD: From April 02, 2013 to April 02.2014* 2. BASIC COVERAGE RETROACTIVE DATE: April 02, 2001 Included Coverages: Retro Date: Criminal and Malicious Acts and Omissions April 02, 2001 Punitive Damages April 02, 2001 Elected Coverages: Retro Date: District Judge April 02, 2006 *Dates under this Item are 12:01 A.M. United States Central Standard Time. Item C. LIMITS OFLIABILITY. For the sum of DAMAGES arising out of each CLAIM first made during the COVERAGE DOCUMENT PERIOD: 52,000,oco AGGREGATE: 82, 000, 000 Item D. DEDUCTIBLE: (a) per claim For the sum of DAMAGES and CLAIMS EXPENSES arising out of each CLAIM first made during the COVERAGE DOCUMENT PERIOD: 525,000 Item E. CONTRIBUTION: $133,455 item F. COVERED LAW ENFORCEMENT DEPARTMENTS OR AGENCIES OR OTHER AGENCIES: Flays County Sheriffs Office e Hays County Constables' Offices e Hays County Employees of the District Attorney's Office e Hays County Attorney's Office Hays County Juvenile Probation Department Hays County Juvenile Center e Hays County Fire Marshal Item G. NOTICE OF CLAIM (including service of process, if any) is to be delivered immediately to the POOL via the Texas Association of Counties Claims Department: Texas Association of Counties Attention: CLAIMS R 0. Box 2131 Austin, Texas 78768 FAX Number: 512.615 -8942 (Immediately, in addition to any fax transmission, transmit by U. S. mail or other delivery service the notice of claim and related documents to the above address. TAC -LEMEC (01/08) Board Approved 08129/07 Vol. 206 Pg. 13 Page 1 of 2 rAS ASSOCIATION OF COUNT,' RISK MANAGEMENT POOL LAW ENFORCEMENT PROFESSIONAL LIABILITY COVERAGE DECLARATIONS CONTINUED Item H. MEMBER'S DESIGNATED POOL COORDINATOR: Ms. Dee Dee Baen, Pool Coodinator Item f. FORMS AND ENDORSEMENTS: Form Numbers or Designations of Endorsements attached at issuance TAC LE (11/10) ; CLEL /C &M (06/08); CLEL/PDEA (01 /08); CLEL/DI (09/09) This agreement is issued by 1�? _ as authorized representative of the Pool on April 10, 2013 at Austin, TX TACLElDEC (01109) Board Approved 009/07 Vol. 206 Pg. / Z/ Page: 2 of 2 t ERAS ASSOCIATION OF COUNTi1s RISK MANAGEMENT POOL AUTO LIABILITY COVERAGE DOCUMENT DECLARATIONS These-Pedarations form -part of- the- Auto-L-iabii ity Coverage - Document between -the- Texas- fismriatiwmf-CCounties`Risic Management Poo) and the Named Member shown in Item 8, below. Item A. COVERAGE DOCUMENT NO.: AL 1050 2013 11 15 Item B. NAMEDMEMBER: Address: Item C. COVERAGE PERIOD: Item D. LIMITSOFLIABILI7Y BASIC: Auto Liability Coverage Bodily Injury Ilability: Each Person: Each Accident Property Damage Liability Each Accident: Uninsured/Underinsured Motorists Item E. DEDUCTIBLE: Item F. Contribution: Auto Liability Coverage Form Non -Owned and Hired Coverage Limited Mexico Coverage Supplementary Death Benefit Uninsured/Underinsured Motorist Personal Injury Protection Official Use of POV TOTAL ANNUAL CONTRIBUTION Item G. NOTICE OF ACCIDENT Hays County 111 E San Antonio St s3o0 San Marcos, TX 78666 -5534 Frnm November 15, 2013 to November 15, :014 Dan, under this item are 12:01 AM United Slates Cenlnl Time $100,000 $300,000 $100,000 Per Endorsement iir) $64,825 $73 Included Included $6,546 Included $0 $71,444 Notice of an accident or claim (ncluding service of process) is to be delivered immediately to the Pool via the Texas Association of Counties Claim Department at: Texas Association of Counties Am: Claims Department P.O. Box. 2131 Austin, Texas 78768 Fax: (512)615.8942 (Immediately, in addition to any fax transmission, transmit the notice of claim and related documents by U.S. Mail or other delivery service to the above address.) Item H. NAMED MEMBER'S DESIGNATED POOL COORDINATOR: Ms. Dee Dee Baen Item 1. FORMS AND ENDORSEMENTS The forms and endorsements comprising this Auto Liability Coverage Document at issuance are: TAC /AL (09112); AL /SDB (01108); ALWfEX (01108); AL/NUCL (01108); AUPW (11/12); ALUM (01/08) This agreement is issued by 100el- of >t , as authorized representative of the Pool on October 31, 2013 at Austin, TX TAC•A LOW (09112) Board Approved 06/07/12 Vol. 206 Pg. / Brazos County Purchasing Departmen &I if,, nit 7.011 200 SOUTH TEXAS AVE SUITE 352 BRYAN, TX 77 03 PHONE (979) 361 -4290 FAX (979) 361-4293 $$i \ %.' " .< : w I July 18, 2014 Cleveland Asphalt Products, Inc Phone: 1- 800 -334 -0177 P.O. Box 1449 Fax: Shepherd, TX 77371 Email: ccmcapco@msn.com Attn: Clayton Moore Re., Renewal of Contract for Asphalt, Oils and Emulsions Products— 2014 -83R previously known as 1014 -12 Brazos County appreciates the quality work your company has provided and would like to exercise the renewal Option forAsphah's. Oils and Emulsions Products - 1014 -83R previously known as 1014 -12 All terms, conditions, and pricing shall remain the same. This renewal will be for one year and will start December 1, 2014 through November 30, 2015. The renewal of this contract will be as follows: Cleveland Asphalt: Sections 1, 2, 3, 5, 6 and 7 Ergon: Section 4 To accept the renewal option, please fill out the information and sign below. Return the signed documents by email to talvarado@bmzoscountytx.gov or fax to (979) 361 -4293. Please then submit the original signed documents and an updated Certificate of Insurance by mail to the address listed above. Please return acceptance as soon as possible. If you have any questions, I may be reached at (979) 3614294. Contact Name: Clayton Moore Telephone: 800- 334 -0177 E -Mail: ccmcapco @msn.com Fax: 936 - 628 -6602 CLEVELAND ASPHALT PRODUCTS, INC Authorized Signature B ZO COUNT Duane Peters, County Judge Vol. 206 Pg. /6 7/31/14 Date VAN- Date sae op rF. t r h r OF Brazos County Purchasing Department F1F'.- 200 SOUTH TEXAS AVE SUITE 352 BRYAN, TX 77503 AUU 0 4 2014 PHONE (979) 3614290 FAX(979)361-4293 July 18, 2014 Ergon Asphalt & Emulsions, Inc. Phone: 512 -469 -9292 11612 RM 2244, Building 1, Suite 250 Fax: Austin, TX 78738 Email: Kamn.sellers@aergon.com Beth.roe@ergon.com Attn: David Stroud Re: Renewal of Contract joy Asphalt, Oils and Emulsions Products - 1014 -83R previously known as 2014 -12 Brazos County appreciates the quality work your company has provided and would like to exercise the renewal option for Asphalt, Oils and Emulsions Products- 2014 -83R previously known as 2014 -12 All terms, conditions, and pricing shall remain the same. This renewal will be for one year and will start December I, 2014 through November 30, 2015. This renewal will renew as follows: Cleveland Asphalt: Sections 1, 2, 3, 5, 6 and 7 Ergon: Section 4 To accept the renewal option, please fill out the information and sign below. Return the signed documents by email to talvarado@bmzoscoun*u.gov or fax to (979) 361 -4293. Please then submit the original signed documents and an updated Certificate of Insurance by mail to the address listed above. Please return acceptance as soon as possible. If you have any questions, I may be reached at (979) 361 -4294. Contact Name:_ DAVID STROUD Telephone: (512) 469 -9292 E -Mail: david.stroud @ergon.com OR Fax: (512) 469 -0391 beth.roe @ergon.com ERGON ASPHALT & EMf,11.Si9IV9,'&C Authorized Signat - R. M. McKEMIE VICE PRESIDENT BRAI CO _ Duane Peter, County Judge Vol. 206 Pg. / 7 AUGUST 1, 2014 Date Vol. 206 Pg. / ca co N a o_ `t v C N R = .. 4 CL Q t a °6 V! m Q A V uJ � C t c E z 0 a Z W 0 U W r_ O c CL 0 6I; ��pp CD ��mmpp Y O. M A ti C Ln QQ�. ^' r n H A Oi ,10.+4 w O� C » w �fiY°a , 1q a o� C $ a ,e 10 C C of � LM w w m ` a m N in o CR _ c d. z! w w �► (ten a� 0 a LO O- a °o s .O M ` N 0 t. Q c H J � CL u) c- o �� oo d e m c o c R Z N C ��cc = tM o W _N N_ t6 CY CQ7 C7 UQ' C7 Ca7 Ce e o o e o o g g S = 'Q � � N c s jB s o 0 o a �= R `m t .0 � Q m o W W o u C t] p e. 0= W v :3 E� W c r m t C A d 44z O O G W CL a U, m E ayr�� W ui -C N y N N Q Q V v� O' ce k o N V U = V G E U W Of 0 Vol. 206 Pg. / ca co N a o_ `t v C N R = .. 4 CL Q t a °6 V! m Q A V uJ � C t c E z 0 a Z W 0 U W r_ O c CL 0 6I; AGREEMENT FOR ENCLOSURE SYSTEM CONSTRUCTION, BRAZOS COUNTY FACILITY BUILDINGS, BRYAN TEXAS TCPN 132203 -TX -1940 BRAZOS COUNTY, TEXAS RoofConnect -MRI Roof Contract Page 1 Vol. 206 Pg. I TABLE OF ARTICLES 1. General Provisions 2. Owner 3. Contractor 4. Administration of the Contract 5. Subcontractors 6. Changes in the Work 7. Time 8. Payments and Completion 9. Protection of Persons and Property 10. Insurance and Bonds 11. Uncovering and Correction of Work 12. Miscellaneous Provisions 13. Termination or Suspension of the Contract 14. Access to the Work 15. Standards 16. Prohibition Against Personal Interest in the Contract 17. Prevailing Wage Rates 18. Authority to Contract RoofConnect -MRI Roof Contract Vol. 206 Pg. --6 Page 2 1.1.3 THE WORK: The term "Work" means the construction and services required by the Scope of Work section of the Project Manual and subsequent addendums and amendments, whether completed or partially completed, and includes all other labor, materials, equipment and services provided or to be provided by the Contractor to fulfill the Contractor's obligations. The Work may constitute the whole or a part of the Project. Although not indicated, 'Work" includes providing supplementary or miscellaneous items, appurtenances and devices incidental to or necessary for a sound, secure, complete and functional installation. 1.1.4 THE PROJECT: The Project is the repair of the roof systems and support systems of the Brazos County Administration Building, Brazos County Juvenile Probation Building and the building known as the Lilly Building in Brazos County, Texas as specified in the Contract Documents. The Project may include construction by the Owner or by separate contractors. 1.1.5 THE PLANS: The Plans are the graphic and pictorial portions of the Contract Documents, wherever located and whenever issued, showing the design, location and dimensions of the Work, generally including plans, elevations, sections, details, schedules and diagrams. 1.1.6 THE SPECIFICATIONS: The Specifications are that portion of the Contract Documents consisting of the written requirements for materials, equipment, construction systems, standards and workmanship for the Work, and performance of related services. 1.1.7 GENERAL DEFINITIONS: Construction industry technical terms not defined in the Contract Documents shall have the meanings given as listed in the latest edition of the AIA "Glossary of Construction Industry Terms." Those not specifically defined at either place shall have the meanings commonly attributed to them by the particular trade involved. 1 Provide: shall be understood to mean: "Furnishing of all labor, materials, equipment, transportation and services referred to and installation of the materials, equipment and other items referred to, all in compliance with the requirement of the Contract Documents and applicable Federal, State and local laws and ordinances as well as requirements of Federal, State and local authorities having jurisdiction at the site of the Work." .2 Required: shall be understood to refer to the requirements of the Contract Documents unless its use in a sentence clearly implies a different interpretation. .3 Where "as shown," "as indicated," "as noted," and similar terms are used, it shall be understood that reference to the Contract Drawings is made, unless their use in a sentence clearly implies a different interpretation. .4 Where the terms "Plans" or "Drawings" are used, they shall be understood to include drawings, details and schedules as applicable. RoofConnect -MRI Roof Contract Page 4 Vol. 206 Pg. 1-/ THIS ENCLOSURE SYSTEM CONSTRUCTION, BRAZOS COUNTY FACILITY BUILDINGS, BRYAN TEXAS AGREEMENT ( "Agreement "), is made and entered into this day of August, 2014, by and between BRAZOS COUNTY, (hereinafter referred to as ( "COUNTY'), 200 South Texas Ave., Suite 352, Bryan, Texas 77803 and ROOFCONNECT and MARTON ROOFING INDUSTRIES, LTD. (hereinafter collectively referred to as "CONTRACTOR "). Contractor agrees to repair various building roof systems in Brazos County, Texas in return for the payment of THREE HUNDRED FOURTEEN THOUSAND ONE HUNDRED SIXTY -ONE and no /1.00 Dollars ($314,161.00) — included within this amount is a contingency amount of FORTY -THREE THOUSAND and no /1.00 DOLLARS ($43,000.00). This Agreement is a unit price contract. In consideration of the mutual covenants hereinafter set forth, the County and Contractor agree as follows: ARTICLE 1 GENERAL PROVISIONS 1.1. BASIC DEFINITIONS 1.1.1 THE COMPLETE CONTRACT DOCUMENTS: The complete Contract Documents ( "Contract Documents ") consist of this Agreement between Owner and Contractor (hereinafter the "Agreement ") and: A. Brazos County Bid Number 2014 -44 B. Project Manual — Bid Issue, May, 2014 C. Addendum #2 — Memorandum, Dated June 20, 2014 D. Addendum #3 — Memorandum, Dated July 14, 2014 E. Architectural Drawings — Dated May 28, 2014 F. Minimum Prevailing Wage Rate — Dated January 6, 2012 G. TCPN Proposal Number: 132203 -TX -1940. A Modification is: (1) a written amendment to the Agreement signed by both parties or (2) a Change Order. Unless specifically enumerated in the Agreement, the Contract Documents do not include other documents such as bidding requirements (advertisement or invitation to bid, Instructions to Bidders, sample forms or portions of addenda relating to bidding requirements). The Contract Documents shall prevail in case of an inconsistency with subsequent versions made through manipulatible electronic operations involving computers. 1.1.2. SUMMARY OF THE CONTRACT PRICE: Contractor's Unit Price Schedule indicated a best and final offer of THREE HUNDRED FOURTEEN THOUSAND ONE HUNDRED SIXTY -ONE and no /1.00 Dollars ($314,161.00) — included within this amount is a contingency amount of FORTY -THREE THOUSAND and no /1.00 DOLLARS ($43,000.00). RoofConnecUMRI Roof Contract Vol. 206 Pg. 2X Page 3 .5 Construction Time: the number of calendar days required to perform the work calculated from the date of signing of this Agreement until Substantial Completion. .6 Day: A calendar day beginning and ending at 12:00 midnight. .7 Equal; approved equal; Engineer approved; acceptable; approved; satisfactory; required; directed; instructed: Such terms and related phrases shall relate to the opinions and interpretations of the Contract Documents by the Engineer, unless otherwise stated, and shall be limited in authority and responsibility as defined under this Agreement and the contract between the Engineer and Owner. .8 Date of Final Completion: The date when Engineer and Owner find all the work of the Contract documents acceptable and the Contract fully performed. .9 Occurrence: Is defined as follows for purpose of insurance — An event which occurs during the policy period, or a continuous or repeated exposure to conditions which result, during the policy period in bodily injury, sickness or disease, or injury to or destruction of property, excluding injuries or deaths of one or more persons or organizations, including the loss of use thereof, resulting from a common cause or from exposure to substantially the same general condition existing at or emanating from each location shall be deemed to result from one occurrence. 10 Not —In— Contract (N.I.C.): Work not included in this Contract. 11 And /or: Shall mean both "and" and "or" and shall be enforceable by Owner when read in either manner. 12 General Contractor: Same as Contractor. .13 Material Man; Material Supplier: Anyone that supplies material only and does not perform any labor at the site of the work. .14 Timely Change: A change in the work that can be arranged before the particular item of work has required the expenditure of any non- recoverable costs by the Contractor and/or subcontractors. .15 Late Change: A change in the work that cannot be performed before the particular item of work that requires the expenditure of some non- recoverable cost after shop drawings, samples and /or schedules related to the change have been reviewed and found acceptable. .16 Prompt: Promptly and similar terms shall be held to refer to a time period of not more than forty -eight (48) hours. .17 Addendum: A change to the Construction Documents (General Documents, Specifications and Drawings) issued prior to the execution of RoofConnect•MRI Roof Contract Page S Vol. 206 Piz. 023 the Agreement. 18 Agreement/Contract: Agreement/Contract means the same and are used interchangeably throughout this document. This Agreement/Contract is the signed agreement between Owner and Contractor for the performance of the Work. .19 Critical Path: The project's tasks that will cause the project end date to be delayed if they are delayed. The word "critical" does not imply how important a task is; a task is critical solely because it must occur as scheduled for the project to finish on time. 20 Furnish: Unless specifically limited in context, the word "furnish" and any derivatives thereof mean: deliver indicated items, materials, equipment, apparatus, appurtenances and all items necessary for a complete and proper installation to Project site and stored in secure locations. .21 Install: "Install" and any derivatives thereof mean; incorporated indicated items, materials, equipment, apparatus, appurtenances and all items necessary for the Work including all necessary labor, materials and connections to perform a properly and complete installation ready for operation of use, including but not limited to unpacking and assembly, if necessary. .22 The Contractor Shall: In the interest of conciseness; sentences, statements and clauses may be verb phrases with expressed verbs such as "furnish," "install," "provide," "construct," "erect," "comply," "apply," "submit," etc. Any such sentences, statements and clauses are to be interpreted to include the applicable form of the phrase "the Contract shall" preceding the expressed verb, with the requirements described interpreted as mandatory elements of the Contract. .23 Evaluation: "Evaluation" and any derivative thereof, as used in reference to Engineer mean; to become generally familiar with the progress and quality of the portion of Work completed to determine in general if it is being performed in a manner indicating that the Work when completed may be occupied or utilized by the Owner for its intended use. Such evaluations shall be based on what is plainly visible at the construction site during periodic visits to the Project, and without the removal of material or other Work that is in place. .24 Inspect: "Inspect" and any derivative thereof, as used in reference to the Engineer shall mean; Type of evaluation that a reasonably prudent Engineer, in the exercise of ordinary care, would make to determine if the Work is in general accordance with the Contract Documents; they are not "inspections" as would necessarily disclose a defect. .25 See: In the interest of conciseness, references to specification sections and details are preceded by the word "see." Any such references are to be interpreted to include applicable form of phrase "...and comply with." RoofConnect -MRI Roof Contract Page 6 Vol. 206 Pg. 1.2 CORRELATION AND INTENT OF THE CONTRACT DOCUMENTS 1.2.1. The intent of the Contract Documents is to include all items necessary for the proper execution and completion of the Work by the Contractor. The Contract Documents are complementary and what is required by one shall be as binding as K required by all; performance by the Contractor shall be required only to the extent consistent with the Contract Documents and reasonably inferable from them. 1.2.2. Organization of the Specifications into divisions, sections and articles, and arrangement of Drawings shall not control the Contractor in dividing the Work among Subcontractors or in establishing the extent of Work to be performed, nor limit the scope of work performed by any trade or by any Sub - contractor or supplier. 1.2.3. Unless otherwise stated in the Contract Documents, words which have well — known technical or construction industry meanings are used in the Contract Documents in accordance with such recognized meanings. 1.2.4 Precedence of the Contract Documents: The most recently issued Document takes precedence over previous issues of the same Document. The order of precedence is as follows with the highest authority listed as "A." A. Agreement S. Brazos County Bid Number 2014 -44 C. Project Manual — Bid Issue, May, 2014 D. Addendum #2 — Memorandum, Dated June 20, 2014 E. Addendum #3 — Memorandum, Dated July 14, 2014 F. Architectural Drawings — Dated May 28, 2014 G. TCPN Proposal Number: 132203 -TX -1940 H. Minimum Prevailing Wage Rate — Dated January 6, 2012 1.2.5 Current Editions: When any work is governed by reference to standard, codes, manufacturer's instructions or other reference documents, the latest issue in effect on the original issue date of the Construction Documents shall apply whether or not the proper edition is noted. 1.2.6 Enumeration of Items: Lists of "work included," "work excluded" and "description of the work" and similar groupings are not intended to enumerate each and every item of work or appurtenance required therein, but shall be used in conjunction with all other portions of the Contract Documents to establish the requirements for completion of the Work or any portions thereof. 1.2.7 Reference Guarantees: When reference standards are made a part of the requirements, the warranties and guarantees they contain shall apply, except for the portions that are less stringent than those required by the Contract Documents or imply or state exclusions, limitations or waivers that are inconsistent with the requirements of the Contract Documents. 1.3 CAPITALIZATION RoofConnect -MRI Roof Contract Vol. 206 Pg. Page 7 1.3.1 Terms capitalized in these General Conditions include those which are: (1) specifically defined; (2) the titles of numbered articles and identified references to Paragraphs, Subparagraphs and Clauses in the document, or (3) the titles of other documents published by the American Institute of Engineers. 1.4 INTERPRETATION 1.4.1 In the interest of brevity the Contract Documents frequently omit modifying words such as "all" and "any' and articles such as "the" and "an," but the fact that a modifier or an article is absent from one statement and appears in another is not intended to affect the interpretation of either statement. 1.5 EXECUTION OF CONTRACT DOCUMENTS 1.5.1 The Contract Documents shall be enumerated on attachment(s) to the Agreement and attachments(s) shall be signed by the Owner and Contractor as provided in the Agreement. 1.5.2 Execution of the Contract by the Contractor is a representation that the Contractor has visited the site, become familiar with local conditions under which the work is to be performed and correlated personal observations with requirements of the Contract Documents. Contractor shall verify the location of all easements established by the Plans before beginning the project. ARTICLE 2 OWNER 2.1 DEFINITION 2.1.1 The Owner is Brazos County, Texas. The term "Owner" means the Owner or the Owner's authorized representative. The Owner's representative is Gary Arnold, Director of Planning and Traffic, or such other person as may from time to time be so designated by the Brazos County Commissioners Court to act on behalf of Owner. 2.1.2 The Owner upon reasonable written request shall furnish to the Contractor in writing information which is necessary and relevant for the Contractor to evaluate, give notice of or enforce mechanic's lien rights. Such information shall include a correct statement of the record legal title to the property on which the Project is located, usually referred to as the site, and the Owner's interest therein at the time of execution of the Agreement and within five (5) days after any change, information of such change in title, recorded or unrecorded. 2.2 INFORMATION AND SERVICES REQUIRED OF THE OWNER 2.2.1 Information or services required of the Owner by the Contract Documents shall be furnished by the Owner with reasonable promptness and complete and accurate to the best of the Owner's information and belief. Any other information or services relevant to the Contractor's performance of the Work under the Owner's control shall be furnished by the Owner after receipt from the Contractor of a written request for RoofConnect -MRI Roof Contract Page 8 Vol. 206 Pg. -G such information or services. 2.3 OWNER'S RIGHT TO STOP THE WORK 2.3.1 If the Contractor fails to correct Work which is not in accordance with the requirements of the Contract Documents as required by Paragraph 11.1 or fails, more than once, to carry out Work in accordance with the Contract Documents, the Owner by written order may order the Contractor to stop the Work, or any portion thereof, until the cause for such order has been eliminated; however, the right of the Owner to stop the Work shall not give rise to a duty on the part of the Owner to exercise this right for the benefit of the Contractor or any other person or entity. Owner does not waive the right to stop the work in any future situation if Owner waives this right in any one situation. 2.4 OWNER'S RIGHT TO CARRY OUT THE WORK 2.4.1 If the Contractor defaults or neglects to carry out the Work, or any portion thereof, in accordance with the Contract Documents or fails to complete, within the time period stipulated, any items of work scheduled (punch listed) to be done subsequent to the Date of Substantial Completion or fails to complete or correct any items of work disclosed subsequent to the Date of Substantial Completion and fails within a seven day period after receipt of written notice from Owner to commence and continue correction of such default or neglect with diligence and promptness, the Owner may, without prejudice to other remedies the Owner may have, correct such deficiencies. In such case, an appropriate Change Order shall be issued deducting from payments then, or thereafter, due the Contractor the cost of correcting such deficiencies. 2.4.2 Contractor and Surety are responsible for all costs for completing the Work including cost in excess of original Contract Sum. Owner does not forfeit right to recover damages from Contractor or Surety for failure to complete Contract by taking over the Work or by declaring Contract in default. Maintenance of the Work remains Contractor's and Surety's responsibility as provided for in Performance Bond and guarantee of Contractor. 2.4.3 The Owner reserves the right to: .1 observe the work, at any time, whenever it is in preparation or progress; .2 make emergency repairs to the work during the guarantee period, to prevent further damages and the Contractor shall pay for such repairs when necessitated by defects in the Contractor's work; .3 make changes to the work. 2.4.4 The Owner shall not be required to accept from the Contractor (unless specifically agreed upon): .1 Partial Substantial Completion; .2 Substantial Completion when it occurs prior to the expiration of the Construction Time. ARTICLE 3 CONTRACTOR RoofConnect -MRI Roof Contract Page 9 Vol. 206 Pg. -� 7 RKr C34k114 :7c11 3.1.1 The Contractor is the person or entity identified as such in the Agreement and is referred to throughout the Contract Documents as if singular in number. The term "Contractor" means the Contractor or the Contractor's authorized representative. 3.1.2 The Contractor shall perform the Work in accordance with the Contract Documents. 3.1.3 The Contractor shall not be relieved of obligations to perform the Work in accordance with the Contract`Documents either by activities or duties of the Engineer in the Engineer's administration of the Contract, or by tests, inspections or approvals required or performed by persons or entities other than the Contractor. 3.2 SUPERVISION AND CONSTRUCTION PROCEDURES 3.2.1 The Contractor shall supervise and direct the Work, using the Contractor's best skill and attention. The Contractor shall be solely responsible for and have control over construction means, methods, techniques, sequences and procedures and for coordinating all portions of the Work under the Contract, unless the Contract Documents give other specific instructions concerning these matters. If the Contract Documents give specific instructions concerning construction means, methods, techniques, sequences or procedures, the Contractor shall review, substantiate, and comply with current industry execution standards and manufacturer's current execution instructions and evaluate the jobsite safety thereof and, except as stated below, shall be fully and solely responsible for the jobsite safety of such means, methods, techniques, sequences or procedures. 3.2.2 The Contractor shall be responsible to the Owner for acts and omissions of the Contractor's employees, Subcontractors and their agents and employees, and other persons performing portions of the Work under a contract with the Contractor. 3.2.3 The Contractor shall be responsible for inspection of portions of Work already performed under this Contract to determine that such portions are in proper condition to receive subsequent Work. 3.2.4 Contractor is solely responsible for coordination of scope of Work for its own forces, and of Subcontractors and suppliers, and to complete all Work, whether performed by the Contractor or a Subcontractor. 3.2.5 The Contractor shall provide a full -time Project Superintendent with a minimum of five years of similar construction experience. Superintendent shall be approved by Owner and permanently assigned to project until full completion of project. 3.3 LABOR AND MATERIALS 3.3.1 In addition to the .products warranties cited in the Project Manual, the Contractor shall provide and pay for labor, materials, equipment, tools, construction equipment and machinery, water, heat, utilities, transportation and other facilities and RoofConnect -MRI Roof Contract Page 10 Vol. 206 Pg. 29 services necessary for proper execution and completion of the Work, whether temporary or permanent, and whether or not incorporated or to be incorporated in the Work. 3.3.2 The Contractor may make substitutions only if allowed by Contract Documents and with the consent of the Owner, after evaluation by the Engineer and in accordance with a Change Order, or by Owner's approval of a Substitution Request. 3.3.3 The Contractor shall enforce strict discipline and good order among the Contractor's employees and other persons carrying out the Contract. The Contractor shall not permit employment of unfit persons or persons not skilled in tasks assigned to them. 3.4 WARRANTY 3.4.1 The Contractor warrants to the Owner that all materials and equipment furnished under this Contract will be of good quality and new unless otherwise specified and that all Work will be provided in accordance with the requirements of the Contract Documents and will be of good quality, free of faults and defects. All Work not conforming to the requirements of the Contract Documents, including substitutions or changes made by the Contractor or any subcontractor, material supplier or equipment supplier that have not been specifically identified (PRIOR to Contract award) by means of a Letter of Notice to Architect and properly accepted and authorized by Architect, shall be considered defective and not in agreement with the requirements of the Contract Documents, and shall be promptly corrected in accordance with the requirements of Article 1,1 of this Agreement and amendments thereto as set forth in Supplementary Conditions or Modifications. This warranty is not limited by the provisions of Paragraph 11.1. 3.4.2 Immediately prior to Date of Substantial Completion, Contractor shall execute and deliver to Owner, a written warranty in approved form, stating that all materials and equipment provided and all work performed are in accordance with the requirements of the Contract Documents and authorized modifications and additions thereto; and further stating that Contractor guarantees, should any condition arise or be disclosed during the time of Contract warranty, which conditions are due to incomplete, or improper or defective materials, or due to incomplete or improper or defective workmanship or arrangement, such condition; together with all work affected in correcting such condition, shall be (upon written notice from Owner) promptly and satisfactorily corrected by Contractor at no additional cost to Owner. Contractor shall be fully responsible for the prompt, satisfactory completion of all warranty work whether performed by his own or subcontract personnel. 3.4.3 Work Covered by Warranty: Contractor's warranty shall cover all work under the Contract, whether or not any portion or trade has been assigned or sub —let. In the event any portion of the Work is performed by an assignee or subcontractor, Contractor shall obtain from such assignee and/or subcontractor a written warranty to Contractor and Owner covering their respective portion of the Work for the period required. Contractor shall deliver them, together with his own warranty, to Owner prior to final payment. Assigns' and subcontractors' warranties shall expressly provide that the same shall be enforceable directly by Owner, if he so elects, and shall run concurrently RoofConnect -MRI Roof Contract Page 11 Vol. 206 Piz. with Contractor's warranty. Warranty shall be secured by Contractor's Performance Bond as directed by Owner. 3.4.4 Time of Warranty: Contractor's warranty shall be for a period of one (1) year from Date of Substantial Completion of the Work. Should a warranty required under any Section of the Specifications or of this Contract be for a period of more than one year, Contractor's and subcontractor's warranty, with respect to such work, shall be for such longer period. Warranty for work done subsequent to Date of Substantial Completion shall be for a period of one year from date of Final Completion or such longer period, if so specified. 3.4.5 Partial Occupancy: Should Owner occupy a portion of the Work before the date of Substantial Completion, the warranty period for that portion so occupied shall begin on the date of such occupancy as agreed in writing with Owner. 3.4.6 Objectionable Process: Where any material, process, or method or operation or application procedure is required, which in the opinion of the Contractor, would render the finished work unsuitable for the required warranty, then, before a bid is submitted, such unsuitable material, process, or application method shall be objected to in writing to Engineer, stating reasons therefore and recommending other alternate materials or methods so that the Work, when completed, will be suitable for the required warranty. In the event the Contractor's recommendations are approved, the work shall be installed in accordance therewith, and all changes In cost resulting there from shall be included in the Contract bid amount. 3.4.7 Under the requirements of this Paragraph 3.4, Contractor shall be responsible for: 1 Damages to the building contents and /or building utilities or services when damages result from use of faulty materials or negligent workmanship. .2 Warranting modifications will give satisfactory results. .3 Warranting substitutions will be equal or superior to the specified item or method unless he specifically lists shortcomings in his request for making substitution. .4 Obtaining and enforcing all subcontract warranties with particular attention being directed to enforcement of warranty work by mechanical, electrical and plumbing subcontractors. 3.5 TAXES 3.5.1 Although Owner is a tax - exempt unit of local government, the Contractor shall pay all sales, consumer, use and similar taxes for the Work or portions thereof provided by the Contractor which may not be within Owners exemption that are legally enacted when Contractor's bids were received or negotiations between Owner and Contractor were concluded, whether or not yet effective or merely scheduled to go into effect. 3.5.2 Contractor requires all Subcontractors, Sub - subcontractors and suppliers to bill Contractor for all sales and use taxes on all materials and equipment incorporated into Project as clearly discernible separate item to facilitate Contractor's keeping tax as separate item of expense on records. Furnish this information to Owner to enable RoofConnect -MRI Roof Contract Page 12 Vol. 206 Pa. F0 Owner to meet state reporting requirements 3.6 PERMITS, FEES AND NOTICES 3.6.1 Unless otherwise provided in the Contract Documents, the Contractor shall secure and pay for the permits and governmental fees, licenses and inspections necessary for proper execution and completion of the Work which are customarily secured after execution of the Contract and which are legally required when bids are received or negotiations concluded. 3.6.1.1 Owner shall secure and pay for health and environmental impact fees, and impact fees, and zoning regulation fees and permits. The Contractor shall secure and pay for sewer connection fees and all other permits and governmental fees, licenses and inspections necessary for proper execution of and completion of Work which are customarily secured after execution of Contract and which are legally required when bids are received or Contract is executed. 3.6.2 The Contractor shall comply with and give notices required by applicable laws, statutes, ordinances, codes, rules, regulations and lawful orders of public authorities bearing on performance of the Work. 3.6.3 It is not the Contractor's responsibility to ascertain that the Contract Documents are in accordance with applicable laws, statutes, ordinances, building codes, and rules and regulations, unless they bear upon construction means, methods, techniques or safety and health precautions. However, if the Contractor observes that portions of the Contract Documents are at variance therewith, the Contractor shall promptly notify the Owner in writing and necessary changes shall be accomplished by appropriate Modification. 3.6.4 If the Contractor performs Work, knowing it to be contrary to laws, statutes, ordinances, building codes, and rules and regulations without such notice to the Owner, the Contractor shall assume full responsibility for such Work and shall bear all the costs attributable for any and all repairs required for conformance, including but not limited to, any penalties, fines or other damages realized.. 3.7 SUPERINTENDENT 3.7.1 The Contractor shall employ a competent superintendent with a minimum of five years of similar construction experience and necessary assistants who shall be in attendance at the Project site during performance of the Work. The Superintendent shall represent the Contractor, and communications given to the superintendent shall be as binding as if given to the Contractor. 3.7.2 The Contractor, as soon as practicable after award of the Contract, shall furnish in writing to the Owner the name and qualifications of a proposed superintendent. The Owner or Engineer may reply within fourteen (14) days to the Contractor in writing stating: (1) whether the Owner has reasonable objection to the proposed superintendent, or (2) that the Owner requires additional time to review. Failure of the Owner to reply within the fourteen (14) day period shall constitute notice of no reasonable objection. RoofConnect -MR1 Roof Contract Page 13 Vol. 206 Pg. 31 3.7.3 The Contractor shall not employ a proposed superintendent to whom the Owner has made reasonable and timely objection. The Contractor shall not change the superintendent without the Owner's consent, which shall not unreasonably be withheld or delayed. 3.8 CONTRACTOR'S CONSTRUCTION SCHEDULES 3.8.1 The Contractor, promptly (within 7 days) after notification of contract award, shall prepare and submit for the Owner's information a Contractor's construction schedule for the Work. The schedule shall not exceed time limits current under the Contract Documents, shall be revised at appropriate intervals as required by the conditions of the Work and Project whichever is less, shall be related to the entire Project to the extent required by the Contract Documents and shall provide for expeditious and practicable execution of the Work. 3.8.2 The Contractor shall perform the Work in general accordance with the most recent schedules submitted to the Owner. 3.8.3 Owner shall not be bound by any early completion deadline submitted in any schedule. 3.9 USE OF SITE 3.9.1 The Contractor shall confine operations at the site to areas permitted by applicable laws, statutes, ordinances, policies, codes, rules and regulations, and lawful orders of public authorities and the Contract Documents and shall not unreasonably encumber the site with materials or equipment. 3.9.2 Contractor shall assume full responsibility for protection and safekeeping of materials stored on premises. 3.9.3 Contractor shall provide all necessary precautions to protect public, visitors and tenants from activities of Contractor or his agents on project. 3.10 CUTTING AND PATCHING 3.10.1 The Contractor shall be responsible for cutting, fitting or patching required to complete the Work or to make its parts fit together properly. 3.10.2 The Contractor shall not damage or endanger a portion of the Work, or fully or partially completed construction, by the Owner, or separate contractors by cutting, patching or otherwise altering such construction, or by excavation. The Contractor shall not cut or otherwise alter such construction by the Owner, or a separate contractor, except with written consent of the Owner and of such separate contractor; such consent shall not be unreasonably withheld. The Contractor shall not unreasonably withhold from the Owner, or a separate contractor, the Contractor's consent to cutting or otherwise altering the Work. 3.11 CLEANING UP RoofConnect -MRI Roof Contract Page 14 Vol. 206 ft. �� 3.11.1 The Contractor shall keep the premises and surrounding area free from accumulation of waste materials or rubbish caused by operations under the Contract. At completion of the Work the Contractor shall remove from and about the Project waste materials, rubbish, the Contractor's tools, construction equipment, machinery and surplus materials. 3.11.2 If the contractor fails to clean up as provided in the Contract Documents after reasonable notice from Owner of such failure, the Owner may do so and the cost thereof shall be charged to the Contractor. 3.12 ACCESS TO WORK 3.12.1 The Contractor shall provide governmental authorities who lawfully request access to the work, the Owner and Engineer proper facilities and equipment for access to the Work in preparation and progress wherever located. 3.13 ROYALTIES AND PATENTS 3.13.1 The Contractor shall pay all royalties and license fees. The Contractor shall defend suits or claims for infringement of patent rights and shall hold the Owner harmless from loss (including but not limited to attorney's fees, court cost, and other cost of defense), on account thereof, but shall not be responsible for such defense or loss when a particular design, process or product of a particular manufacturer or manufacturers is required by the Contract Documents. However, if the Contractor has reason to believe that the required design, process or product is an infringement of a copyright, trademark, trade name, or similar property right or interest, or a patent, the Contractor shall be responsible for such loss unless such information is promptly furnished to the Owner. 3.14 INDEMNIFICATION 3.14.1 TO THE FULLEST EXTENT PERMITTED BY LAW, THE CONTRACTOR SHALL INDEMNIFY, DEFEND AND HOLD HARMLESS THE OWNER, ITS ELECTED OFFICIALS, APPOINTED OFFICIALS, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS AND REPRESENTATIVES, ENGINEER, ENGINEER'S CONSULTANTS (COLLECTIVELY REFERRED TO AS THE "INDEMNITEES' ) FROM AND AGAINST ANY AND ALL CLAIMS, LIABILITIES, DAMAGES, LOSSES, COSTS, AND EXPENSES, INCLUDING, BUT NOT LIMITED TO, ATTORNEY'S FEES, ARISING OUT OF, RESULTING FROM, OR OCCURRING IN CONNECTION WITH THE PERFORMANCE OF THE WORK PROVIDED THAT SUCH CLAIM, LIABILITY, DAMAGES, LOSS, COSTS OR EXPENSE IS ATTRIBUTABLE TO BODILY INJURY, SICKNESS, DISEASE, OR DEATH OR TO INJURY TO, OR DESTRUCTION OF, TANGIBLE PROPERTY (OTHER THAN THE WORK ITSELF), INCLUDING THE LOSS OF USE THEREOF IN ANY WAY OCCURRING, INCIDENT TO, ARISING OUT OF OR IN CONNECTION WITH: (A) A BREACH OF THE WARRANTIES PROVIDED BY THE CONTRACTOR; (B) THE WORK PERFORMED OR TO BE PERFORMED BY THE CONTRACTOR, ITS CONTRACTORS, SUB - CONTRACTORS, SUB- SUB - CONTRACTORS, AND SUPPLIERS, AND THEIR EMPLOYEES AND AGENTS; (C) ANY NEGLIGENT Page 15 Vol. 206 Pg. j ACTION AND /OR OMISSION OF THE INDEMNITEES RELATED IN ANY WAY TO THE PROJECT WHETHER THE INDEMNITEES ARE NEGLIGENT IN WHOLE OR IN PART, AND EVEN WHEN THE LOSS IS CAUSED BY THE SOLE FAULT OR NEGLIGENCE (INCLUDING ACTS OR OMISSIONS THAT ARE CHARACTERIZED AS NEGLIGENCE PER SE, NEGLIGENCE PREMISED ON STRICT LIABILITY, OR ANY OTHER TYPE OF NEGLIGENCE) OF THE INDEMNITEES; OR (D) ANY FINES, PENALTIES, DAMAGES (INCLUDING PUNITIVE), LIABILITIES, COSTS AND EXPENSES IN CONNECTION WITH: (1) A VIOLATION OF ANY LAW, STATUTE, RULE, ORDINANCE, CODE OR OTHER REQUIREMENT OF PUBLIC AUTHORITIES; (2) MEANS, METHODS, PROCEDURES OR SEQUENCES OF EXECUTION OR PERFORMANCE OF THE WORK, AND (3) FAILURE TO SECURE AND PAY FOR PERMITS, FEES, APPROVALS, LICENSES AND INSPECTIONS FOR WHICH THE CONTRACTOR IS RESPONSIBLE UNDER THE CONTRACT DOCUMENTS. THE CONTRACTOR'S INDEMNITY OBLIGATION HEREIN SHALL NOT BE CONSTRUED TO NEGATE, ABRIDGE OR REDUCE OTHER RIGHTS OR OBLIGATIONS OF INDEMNITY THAT WOULD OTHERWISE EXIST AS TO A PARTY OR PERSON. THE SCOPE AND EXTENT OF THIS INDEMNITY SHALL NOT BE LIMITED BY THE AVAILABILITY OF COVERAGE UNDER THE CONTRACTOR'S INSURANCE AND SHALL NOT LIMIT INDEMNITEES' OTHER LEGAL REMEDIES AGAINST CONTRACTOR OR ANY OTHER PERSON OR ENTITY. THIS INDEMNIFICATION PROVISION SHALL SURVIVE TERMINATION OF THE CONTRACT. 3.14.2 In claims against any person or entity indemnified under Paragraph 3.14 by an employee of the Contractor, a Subcontractor, Sub - Sub - contractor, anyone directly or indirectly employed by them or anyone for whose acts they may be liable, the indemnification obligation under Paragraph 3.14 shall not be limited by a limitation on amount or type of damages, compensation or benefits payable by or for the Contractor or a Subcontractor under workers' or workmen's compensation acts, disability benefit acts or other employee benefit acts. 3.14.3 Contractor shall furnish written warranties using the form directed by Owner or Engineer. 3.14.4 Contractor shall secure required inspection certificates and transmit them to Engineer and Owner. ARTICLE 4 ADMINISTRATION OF THE CONTRACT 4.1 SCHEDULE OF WORK (at a maximum, in calendar days) Day 0: Approval of this Agreement by the Brazos County Commissioners Court No Later than Day 3: Notice to Proceed is delivered to Contractor No Later than Day 24: Contractor attains Substantial Completion No Later than Day 30: Contractor attains Final Completion 4.1.1 Waiver of Claims: Final Payment. The making of final payment shall constitute a waiver of Claims by the Owner except those arising from: Roofconnect -MRI Roof Contract Page 16 Vol. 206 Pg. ; < .1 liens, Claims, security interests or encumbrances arising out of the Contract and unsettled; .2 failure of the Work to comply with the requirements of the Contract Documents; or .3 terms of special warranties required by the Contract Documents. 4.1.2 Claims for Additional Time 4.1.2.1 If the Contractor wishes to make Claim for an increase in the Contract Time, written notice as provided herein shall be given. The Contractor's Claim shall demonstrate that the task is on the critical path and identify the new completion date. In the case of a continuing delay, only one Claim is necessary. 4.1.2.2 If adverse weather conditions are the basis for a Claim for additional time, such Claim shall be documented by the agreement between Owner's representative and Contractor's representative that a rain or mud day occurred. Such agreement shall not be unreasonably withheld by either party; however, both parties understand and agree that the final allowance for any delay based upon adverse weather conditions shall be at the discretion of the Brazos County Commissioners Court. 4.1.2.3 Claims for increase in Contract Time shall set forth in detail the circumstances that form the basis of the Claim, date upon which each cause of delay began to affect progress of Work, date upon which each cause of delay ceased to affect progress of Work and the number of days' increase in Contract Time claimed as a consequence of each such cause of delay. Contractor shall provide such supporting documentation as Owner or Engineer may require including, where appropriate, a revised construction schedule indicating all activities affected by circumstances forming the basis of the Claim. 4.1.2.4 Contractor shall not be entitled to a separate increase in Contract Time for each one of the number of causes of delay which may have concurrent or interrelated effects on progress of Work or for concurrent delays due to fault of Contractor. 4.1.3 Injury or Damage to Person or Property. If either party to the Contract suffers injury or damage to person or property because of an act or omission of the other parry, of any of the other party's employees or agents, or of others for whose acts such party is legally liable, written notice of such injury or damage, whether or not insured, shall be given to the other party within a reasonable time not exceeding twenty -one (21) days after first observance. The notice shall provide sufficient detail to enable the other party to investigate and evaluate the matter. 4.1.3.1 If unit prices stated in the Contract Documents, or subsequently agreed upon, and if quantities originally contemplated in the Plans are materially changed in a proposed Change Order or Construction Change Directive, so that application of such unit prices to quantities of Work proposed will cause substantial inequity to the Owner or Contractor, the applicable unit prices shall be equitably adjusted. For purposes of this provision, "Materially' shall mean a change in quantity of at least twenty -five percent (25 %) and a change in price of at least ten thousand dollars ($10,000.00). RoofConnect -MRI Roof Contract Vol. 206 Pg. Page 17 4.1.3.2 Owner reserves the right to audit the Contractor's costs and bid documents, regarding the Project, if Contractor files a claim against Owner. 4.1.3.3 Contractor, not owner, shall handle any disputes which may arise between subcontractor and owner. ARTICLE 5 SUBCONTRACTORS 5.1 DEFINITIONS 5.1.1 A Subcontractor is a person or entity who has a direct contract with the Contractor to perform a portion of the Work at the site. The term "Subcontractor" is referred to throughout the Contract Documents as if singular in number and means a Subcontractor or an authorized representative of the Subcontractor. The term "Subcontractor" does not include a separate contractor or subcontractors of a separate contractor. 5.1.2 A Sub — subcontractor is a person or entity who has a direct or indirect contract with a Subcontractor to perform a portion of the Work at the site. The term "Sub — subcontractor" is referred to throughout the Contract Documents as if singular in number and means a Sub — subcontractor or an authorized representative of the Sub — subcontractor. 5.2 AWARD OF SUBCONTRACTS AND OTHER CONTRACTS FOR PORTIONS OF THE WORK 5.2.1 Unless otherwise stated in the Contract Documents or the bidding requirements, the Contractor, upon award of the Contract, shall furnish in writing to the Owner the names of persons or entities (including those who are to furnish materials or equipment fabricated to a special design) proposed for each principal portion of the work. The Owner will promptly reply to the Contractor in writing stating whether or not the Owner has reasonable objection to any such proposed person or entity. Failure of the Owner to reply promptly shall constitute notice of no reasonable objection. 5.2.2 The Contractor shall not contract with a proposed person or entity to which the Owner has made reasonable and timely objection. The Contractor shall not be required to contract with anyone to whom the Contractor has made reasonable objection. 5.2.3 If the Owner has reasonable objection to a person or entity proposed by the Contractor, the Contractor shall propose another to whom the Owner has no reasonable objection. The Contract Sum shall be increased or decreased by the difference in cost occasioned by such change and an appropriate Change Order shall be issued. However, no increase in the Contract Sum shall be allowed for such change unless the Contractor has acted promptly and responsively in submitting names as required. 5.2.4 The Contractor shall not change a Subcontractor, person or entity previously RoofConnect -MRI Roof Contract Page 18 Vol. 206 Pg. 3 4 selected, if the Owner makes reasonable objection to such change. Acceptance of the substitute Subcontractor after previous acceptance of a Subcontractor for any portion of the work shall not constitute reason for an increase in the Contract amount. 5.2.5 Contractor is fully responsible for acts and omissions of Subcontractors, and persons either, directly or indirectly, employed by them or under their control, as Contractor is for their own employees. 5.2.6 Nothing in Contract Documents creates any contractual relationship between any Subcontractor or Sub - subcontractor, or other tiers, and Owner. ARTICLE 6 CHANGES IN THE WORK 6.1 CHANGES 6.1.1 Changes in the Work may be accomplished after execution of the Contract and without invalidating the Contract, by Change Order, subject to the limitations stated in this Article 6 and elsewhere in the Contract Documents. 6.1.2 A Change Order shall be based upon agreement among the Owner and Contractor. 6.1.3 Changes in the Work shall be performed under applicable provisions of the Contract Documents and the Contractor shall proceed promptly, unless otherwise provided in the Change Order. 6.1.4 If unit prices are stated in the Contract Documents, or subsequently agreed upon, and if quantities originally contemplated are so changed in a proposed Change Order that application of such unit prices to quantities of Work proposed will cause substantial inequity to the Owner or Contractor, the applicable unit prices shall be equitably adjusted. 6.2 CHANGE ORDERS 6.2.1 A Change Order is a written instrument prepared by Owner and Contractor, stating their agreement upon all of the following: .1 a change in the Work; .2 the amount of the adjustment in the Contract Sum, if any, and .3 the extent of the adjustment in the Contract Time, if any. 6.2.2 Methods used in determining adjustments to the Contract Sum may include those listed in 7.1 DEFINITIONS RoofConnect•MRI Roof Contract ARTICLE 7 TIME Vol. 206 Pg. Page 19 7.1.1 The Contractor shall achieve Substantial Completion of the Work not later than twenty -four (24) days from the date of commencement, subject to adjustments of the time for completion as provided in this Agreement. 7.1.2 The date of commencement of the Work shall be effective upon the issuance of written notice to proceed from the Owner. 7.1.3 The term "day" as used in the contract documents shall mean calendar day. 7.1.4 The term "critical path" as used in the Contract Documents shall mean the project's tasks that will cause the project end date to be delayed if they are delayed. The word "critical" does not imply how important a task is; a task is critical solely because it must occur as scheduled for the project to finish on time. 7.1.5 The term "free slack time" as used in the Contract Documents shall mean the amount of time a task can be delayed without delaying another task. 7.1.6 The term "total slack time" as used in the Contract Documents shall mean the amount of time a task can be delayed without delaying the finish date of the project. 7.2 PROGRESS AND COMPLETION 7.2.1 Time limits stated in this Agreement are of the essence of the contract. By executing the Agreement, the Contractor confirms that the Contract Time is a reasonable period for performing the Work. 7.2.2 The Contractor shall not, except by agreement or instruction of the Owner in writing, prematurely commence operations on the site or elsewhere or store materials or equipment on site prior to the effective date of insurance required by Article 10 to be furnished by the Contractor and Owner. The date of commencement of the Work shall not be changed by the effective date of such insurance. Unless the date of commencement is established by the Contract Documents and a notice to proceed given by the Owner, the Contractor shall notify the Owner in writing not less than five (5) days or other agreed period before commencing the Work to permit the timely filing of mortgages, mechanic's liens and other security interests. 7.2.3 The Contractor shall proceed expeditiously with adequate forces and shall achieve Substantial Completion within the Contract Time. 7.2.4 Contractor and their Subcontractors shall complete and coordinate Work in accordance with established schedule. 7.2.5 Contractor is responsible for expediting Work, identifying potential conflicts and coordination problems, and proposing measures to avoid such problems 7.2.6 Whenever it becomes apparent that any activity completion date may not be met, unless delay is related to an approved extension of time, Contractor shall take some or all of following actions and submit supplementary schedule indicating effect of action on progress and completion of Work, all without additional costs to Owner; RoofConnect -MRI Roof Contract Page 20 Vol. 206 Pg. 3� .1 increase number of working hours per shift, shifts per working days, working days per week, or amount of construction equipment, or any combination of foregoing which will substantially eliminate backlog of Work, and put Project back on schedule, and /or, .2 increase construction manpower in such quantity as will substantially eliminate backlog of Work, and put Project back on schedule, and /or, .3 reschedule activities to achieve maximum practical concurrency of accomplishment of activities, and put Project back on schedule. 7.2.7 If Contractor fails to take any of actions indicated in subparagraph 7.2.6 within three (3) days after receiving written notice, Owner may take action to attempt to put Project back on schedule, and deduct cost of such actions from money due or to become due Contractor, or shall be grounds for determination by Owner that Contractor is not prosecuting Work with such diligence as will insure completion within Contract Time. Upon such determination, Owner may terminate Contractor's right to proceed with Work, or any separable part thereof, in accordance with provisions of Article 13, 7.2.8 Contractor shall bear cost of any services made necessary by delays in completion of Work due to actions or inactions of Contractor or any Subcontractors. Contractor shall promptly pay any such cost upon demand by Owner. At Owner's option, these costs may be deducted from any amounts otherwise due Contractor. 7.3 DELAYS AND EXTENSION OF TIME 7.3.1 Except as otherwise provided in the Contract Documents, if the Contractor is delayed at any time in the commencement or progress of the Work by an act or neglect of the Owner, or of an employee of either, or of a separate Contractor employed by the Owner, or by changes ordered in the Work, or by labor disputes, fire, adverse weather conditions, unusual delay in deliveries, unavoidable casualties or other causes beyond the Contractor's control, or by delay authorized by the Owner, or by other causes which the Owner determines may justify delay, then the Contract Time shall be extended by Change Order for such reasonable time as the Owner, and Contractor may determine. 7.3.2 There will be no delay claims by Contractor if the Contractor finishes the Project early or timely, even if owner delays the work. 7.3.3 If Contract Time is extended pursuant to paragraph 7.3 for no more than fourteen (14) days, such extension shall be the exclusive remedy of Contractor and said Contractor shall not be entitled to recover damages from Owner or Engineer. ARTICLE 8 PAYMENTS AND COMPLETION 8.1 SUBSTANTIAL COMPLETION 8.1.1 Substantial Completion is the stage in the progress of the Work when the Work is complete in accordance with the Contract Documents so the Owner can occupy or utilize the Work for its intended use. RoofConnect -MRI Roof Contract Page 21 Vol. 206 Pg. 8.1.2 Unless otherwise provided in the Contract Documents, when the Contractor considers that the Work, or a portion thereof which the Owner agrees to accept separately, is substantially complete, the Contractor shall thoroughly inspect the Work and prepare and submit to Owner a comprehensive list of items to be completed or corrected, Contractor's Notice of Substantial Completion, and a written request for Owner's review of the Work. The Contractor shall proceed promptly to complete and correct items on the list. Failure to include an item on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents. Upon approval of Substantial Completion by Brazos County, Contractor has six (6) days to reach Final Completion of the Work. If the Contractor does not achieve Final Completion within six (6) days after Substantial Completion, Contractor shall be subject to additional Liquidated Damages as set forth under paragraph 8.3.2 herein. 8.1.3 Unless otherwise provided in the Contract Documents, after receipt of the Contractor's Notice of Substantial Completion and the Contractor's list, the Owner will make inspections to determine whether the Work or designated portion thereof is substantially complete. If the Owner's inspections disclose any item, whether or not included on the Contractor's list, which is not in accordance with the requirements of the Contract Documents, the Contractor shall, before issuance of the Certificate of Substantial Completion, complete or correct such item upon notification by the Owner. In such case, the Contractor shall then submit another Contractors Notice of Substantial Completion and a request for another inspection by the Owner to determine Substantial Completion. 8.1.4 When the Work is substantially complete, the Owner will prepare a Certificate of Substantial Completion which shall establish the date of Substantial Completion, shall establish responsibilities of the Owner and Contractor for security, maintenance, heat, utilities, damage to the Work and insurance, and shall fix the time within which the Contractor shall finish all items on the list accompanying the Certificate. Warranties required by the Contract Documents shall commence on the date of Substantial Completion of the Work or designated portion thereof unless otherwise provided in the Certificate of Substantial Completion. The Certificate of Substantial Completion shall be submitted to the Contractor for their written acceptance or responsibilities assigned to them in such Certificate. 8.2 FINAL COMPLETION AND FINAL PAYMENT 8.2.1 Unless otherwise provided in the Contract Documents, the Contractor shall inspect the Work to determine that it is sufficiently complete in accordance with the Contract Documents and the Contract is fully performed. Upon receipt of Contractors Notice of Final Completion written notice certifying that the Work is sufficiently complete in accordance with the Contract Documents, that the Contract is fully performed, that the Work is ready for final inspection and acceptance and upon receipt of a final Application for Payment, the Owner will in a reasonable time, make such inspection and when the Owner finds the Work acceptable under the Contract Documents and the Contract sufficiently performed will promptly issue a final Certificate for Payment. The Owner's final Certificate for Payment will constitute a further representation that conditions listed in Subparagraph 8.2.2 as precedent to the RoofConnect -MRi Roof Contract Page 22 Vol. 206 Pg. -140 Contractors being entitled to final payment have been fulfilled. However, 95% of the contract amount will be due and payable to Contractor as noted in said final Certificate, with the remaining 5% retainage due and payable to the Contractor within thirty (30) days after acceptance of the Work by the Owner. 8.2.2 Unless otherwise provided in the Contract Documents, neither final payment nor any remaining retained percentage shall become due until the Contractor submits to the Owner: (1) an affidavit that payrolls, bills for materials and equipment and other indebtedness connected with the Work for which the Owner or the Owners property might be responsible or encumbered (less amounts withheld by Owner) have been paid or otherwise satisfied; (2) a certificate evidencing that insurance required by the Contract Document to remain in force after final payment is currently in effect and will not be canceled or allowed to expire until at least thirty (30) days' prior written notice has been given to the Owner; (3) a written statement that the Contractor knows of no substantial reason that the insurance will not be renewable to cover the period required by the Contract Documents; (4) consent of surety, if any, to final payment, and (5) if required by the Owner, other data establishing payment or satisfaction of obligations, such as receipts, releases and waivers of liens, claims, security interests or encumbrances arising out of the Contract, to the extent and in such form as may be designated by the Owner, for Owner's review and approval. If a Subcontractor refuses to furnish a release or waiver required by the Owner, the Contractor may furnish a bond satisfactory to the Owner to indemnify the Owner against such lien. If such lien remains unsatisfied after payments are made, the Contractor shall refund to the Owner all money that the Owner may be compelled to pay in discharging such lien, including all costs and reasonable attorney's fees. 8.2.3 If, after Substantial Completion of the Work, Final Completion thereof is materially delayed through no fault of the Contractor or by issuance of Change Orders affecting final completion, the Owner shall, upon application by the Contractor and certification by the Owner and without terminating the Contract, make payment of the balance due for that portion of the Work fully completed and accepted. If the remaining balance for Work not fully completed or corrected is less than retainage stipulated in the Contract Documents and if bonds have been furnished the written consent of surety to payment of the balance due for that portion of the Work fully completed and accepted shall by submitted by the Contractor prior to certification of such payment. Such payment shall be made under terms and conditions governing final payment, except that it shall not constitute a waiver of claims. 8.2.3.1 Final payment constituting entire unpaid balance of Contract Amount will be paid by Owner to Contractor within thirty (30) days after final Certificate for Payment has been issued by Owner. 8.2.4 The making of final payment shall constitute a waiver of Claims by the Owner except those arising from: .1 liens, Claims, security interests or encumbrances arising out of the Contract and unsettled; .2 failure of the Work to comply with the requirements of the Contract Documents; .3 terms of special warranties required by the Contract Documents, or RoofConnect -MRI Roof Contract Vol. 206 Pg. -/-/ Page 23 .4 non - conforming, faulty or defective Work appearing at or after final payment. 8.2.5 Acceptance of final payment by the Contractor, a Subcontractor or material supplier shall constitute a waiver of claims by that payee except those previously made in writing and identified by that payee as unsettled at the time of final Application for Payment. 8.3 LIQUIDATED DAMAGES 8.3.1 Owner will suffer financial loss if the Project is not Substantially Complete on the date set forth in the Contract. Contractor and Contractor's Surety shall be liable for and shall pay Owner stipulated and fixed sums, hereinafter agreed to as liquidated damages, for each calendar day of delay after the date established for Substantial Completion until the Work is Substantially Complete: Two Hundred Fifty dollars ($250.00). It is understood that said sum shall be considered as liquidated damages and shall not be considered as a penalty against the Contractor 8.3.2 If thirty (30) days after Substantial Completion of the Work the Contractor is unable to achieve Final Completion of the Project as determined by Brazos County, Brazos County will suffer further loss. Contractor and Contractor's Surety shall be liable for and shall pay Owner stipulated and fixed sums, hereinafter agreed to as liquidated damages, for each additional calendar day of delay past thirty (30) days after Substantial Completion until Final Completion is achieved: Five Hundred Dollars ($500.00). It is understood that said sum shall be considered as liquidated damages and shall not be considered as a penalty against the Contractor. ARTICLE 9 PROTECTION OF PERSONS AND PROPERTY 9.1 SAFETY AND HEALTH PRECAUTIONS AND PROGRAMS 9.1.1 The Contractor shall be responsible for initiating, maintaining and supervising all safety and health precautions and programs in connection with the performance of the Contract. This requirement applies continuously and is not limited to normal Working hours. 9.2 SAFETY OF PERSONS AND PROPERTY 9.2.1 The Contractor shall at all times conduct all operations under this Agreement in a manner to avoid the risk of bodily injury or risk of damage to the following: .1 employees on the Work and other persons who may be affected thereby, to include but not limited to the Owner and Engineer and their consultants and employees; .2 the Work and materials and equipment to be incorporated therein, whether in storage on or off the site, under care, custody or control of the Contractor or the Contractor's Subcontractors or Sub — subcontractors; and .3 other property at the site or adjacent thereto, such as trees, shrubs, lawns RoofConnect -MRI Roof Contract Page 24 Vol. 206 Pg. walks, pavements, roadways, structures and utilities not designated for removal, relocation or replacement in the course of construction. 9.2.2 The Contractor shall comply with and give notices required by applicable laws, statutes, ordinances, codes, standards, rules, regulations, policies and lawful orders of public authorities (including reference standards issued under the Occupation Safety Act and the Occupancy Safety and Health Administration) bearing on safety and health of persons or property or their protection from damage, injury or loss. 9.2.3 The Contractor shall erect and maintain, as required by existing conditions and performance of the Contract, reasonable safeguards for safety and protection, including posting danger signs and other warnings against hazards, promulgating safety regulations and notifying owners and users of adjacent sites and utilities. 9.2.4 When use or storage of hazardous materials or equipment or unusual methods are necessary for execution of the Work, such as driving or removal of piles, wrecking, demolition, excavation or other similar potentially dangerous work is necessary, the Contractor shall exercise utmost care and carry on such activities under supervision of properly qualified personnel, and shall give Owner reasonable advance notice. Contractor is fully responsible for any and all damages, claims, and for the defense of all actions against Owner and Engineer, and their consultants and employees resulting from the prosecution of such work. 9.2.4.1 Use or storage of explosives is prohibited. 9.2.5 The Contractor shall promptly remedy damage and loss (other than damage or loss insured under property insurance required by the Contract Documents) to property referred to in Paragraphs 9.2.1.2 and 9.2.1.3 caused in whole or in part by the Contractor, a Subcontractor, a Sub — subcontractor, or anyone directly or indirectly employed by any of them or by anyone for whose acts they may be liable and for which the Contractor is responsible under Paragraphs 9.2.1.2 and 9.2.1.3, except damage or loss attributable to acts or omissions of the Owner or anyone directly or indirectly employed by either of it, or by anyone for whose acts either of them may be liable and not attributable to the fault or negligence of the Contractor. The foregoing obligations of the Contractor are in addition to the Contractor's obligations under other provisions of this Agreement. 9.2.6 The Contractor shall designate a responsible, properly trained and qualified member or members of the Contractor's organization at the site whose duties shall be the prevention of accidents, damage to property and to supervise and train personnel in the use of dangerous and hazardous equipment, materials and substances necessary for the execution of the Work. This person shall be the Contractor's superintendent unless otherwise designated by the Contractor in writing to the Owner. 9.2.7 The Contractor shall not permit any part of the construction or site, including new construction or existing facilities to be loaded with weights that will exceed design loads or so as to endanger safety of persons or property or cause damage or create an unsafe condition. 9.2.8 Contractor shall give notice in writing at least forty -eight (48) hours or RoofConnect -MRI Roof Contract Page 25 Vol. 206 Pg. 4,5 longer if required by affected parties before beginning work, to all persons having interests on or near site, Public Utility Companies, owners of property having structures or improvements in proximity to site of the Work, agencies, authorities, inspectors, or those otherwise in charge of property, streets, water pipes, gas pipes, sewer pipes, telephone cables, electric cables, railroads or otherwise who may be affected by Contractor's operation, in order that they may remove any obstruction for which they are responsible and have representative on site to see that their property is properly protected. Such notice does not relieve Contractor of responsibility for any damages, claims, and defense of all actions against Owner resulting from performance of such Work in connection with or arising out of Contract. 9.2.9Temporary items such as, but not limited to: scaffolding, staging, lifting and hoisting devices, shoring, excavation, barricades, and safety and construction procedures necessary in completion of Project shall be the responsibility of the Contractor and its Subcontractors and shall comply with all applicable codes and regulations. It shall not be responsibility of Owner or its representatives to determine if Contractor, Subcontractors or their representatives are in compliance with the aforementioned regulations. 9.2.10The Contractor shall comply with all Federal Occupational Safety and Health Administration Hazard Communications Act (HAZCOM) requirements, including properly maintaining Materials Safety Data Sheets (MSDS) at the Project site. The Contractor shall ensure that all MSDS are compiled in a single location at the Project site, and are available to the regulating agencies. The Contractor shall indemnify and hold harmless the Owner for their respective failure to comply with this provision. 9.2.11 The Contractor shall be responsible for any fines, penalties or charges by any regulatory body by reason of any violation of safety or health regulations. Contractor shall also be responsible for reimbursement of any OSHA fines incurred by the Owner for Project site safety conditions created or controlled by the Contractor that result in the Owner receiving a citation under the OSHA multi - employer citation provision. 9.2.12 The Contractor shall notify Owner's personnel upon arrival to the Project site of any known safety or health hazards at the Project and the precautions they should take. 9.2.13 The Contractor shall provide safety and health equipment (excluding boots) for the Owner to protect them from safety and health risks during the performance of their services during the construction of the Project. 9.3 HAZARDOUS MATERIALS OR SUBSTANCES 9.3.1 The Contractor is responsible for compliance with any requirements included in the Contract Documents regarding hazardous materials. If the Contractor encounters a hazardous material or substance not addressed in the Contract Documents and if reasonable precautions will be inadequate to prevent foreseeable bodily injury or death to persons resulting from a hazardous material or substance, including but not limited to, asbestos or polychlorinated biphenyl (PCB) encountered on the site by the RoofConnect -MRI Roof Contract Page 26 Vol. 206 Pg. 4_// Contractor, the Contractor shall, upon recognizing the condition, immediately stop Work in the affected area and report the condition to the Owner in writing. 9.3.1.1 The term "hazardous materials or substance" also includes, but is not limited to, asbestos, asbestos products, polychlorinated biphenyl (PCB), radon gas, industrial waste, acids, lead, alkaline, irritants, contaminants or other pollutants, excluding mild chemicals used in the cleaning of finished building materials. 9.3.2 Upon receipt of the Contractor's written notice, the Owner shall obtain the services of a licensed laboratory to verify the presence or absence of the material or substance reported by the Contractor and in the event such material or substance is found to be present, to cause it to be rendered harmless. Unless otherwise required by the Contract Documents, the Owner shall furnish in writing to the Contractor the names and qualifications of persons or entities who are to perform tests verifying the presence or absence of such material or substance or who are to perform the task of removal or safe containment of such material or substance. The Contractor will promptly reply to the Owner in writing stating whether or not either has reasonable objection to the persons or entities proposed by the Owner. If the Contractor has an objection to a person or entity proposed by the Owner, the Owner shall propose another to whom the Contractor has no reasonable objection. When the material or substance has been rendered harmless, Work in the affected area shall resume upon written agreement of the Owner and Contractor. By Change Order the Contract Time shall be extended appropriately and the Contract Sum shall be increased in the amount of the Contractor's reasonable additional costs of shut -down, delay and start-up. 9.3.3 The Owner shall not be responsible under Paragraph 9.3 for hazardous materials and substances brought to the Project site by the Contractor unless such materials or substances were required by the Contract Documents and the Contractor so notified the Owner. The Contractor shall notify the Owner prior to bringing any hazardous material or substance onto the Project site. 9.4 EM 9.4.1 In an emergency affecting safety or health of persons or property, the Contractor shall act, at the Contractor's discretion, to prevent threatened damage, injury or loss. Additional compensation or extension of time claimed by the Contractor on account of an emergency shall be determined as provided in other sections of this Agreement. 9.4.2 The Contractor shall promptly report in writing to Owner all accidents arising out of, or in connection with, the performance of the Work, whether on or off the site, which caused death, personal injury or property damage, giving full details and statements of any witnesses. In addition, if death, serious personal injuries or serious property damages are caused, the accident shall be reported immediately by telephone or messenger to Owner. ARTICLE 10 INSURANCE AND BONDS 10.1 CONTRACTOR'S LIABILITY INSURANCE RoofConnect -MRI Roof Contract Page 27 Vol. 206 Pg. �S 10.1.1 The Contractor shall purchase from and maintain in a company or companies lawfully authorized to do business in the State of Texas such insurance as will protect the Contractor from claims set forth below which may arise out of, or result from, the Contractor's operations under the Contract and for which the Contractor may by legally liable, whether such operations be by Contractor or by a Subcontractor or by anyone directly, or indirectly, employed by any of them, or by anyone for whose acts any of them may be liable: .1 claims under workers' or workmen's compensation, disability benefit and other similar employee benefit acts which are applicable to the Work to be performed; .2 claims for damages because of bodily injury, occupational sickness or disease, or death of the Contractor's employees; .3 claims for damages because of bodily injury, sickness, disease or death of any person other than the Contractor's employees or persons or entities excluded by statute from requirements of Subparagraph 10.1.1.1, but required by Contract Documents to provide insurance required by that Subparagraph; .4 claims for damages insured by usual personal injury liability coverage which are sustained by: (1) by a person as a result of an offense directly or indirectly related to employment of such person by the Contractor; or (2) by another person; .5 claims for damages, other than to the Work itself, because of injury to or destruction of tangible property, including loss of use resulting there from; .6 claims for damages because of bodily injury, death of a person or property damage arising out of ownership, maintenance or use of a motor vehicle; .7 claims for bodily injury or property damage arising out of completed operations; .8 claims involving contractual liability insurance applicable to the Contractor's obligations. .9 Liability Insurance shall include all major divisions of coverage and be on a comprehensive basis including: (1) Premises Operations (including X, C and U coverages as applicable). (2) Independent Contractors' Protective. (3) Products and Completed Operations. (4) Personal Injury Liability with Employment Exclusion deleted. (5) Contractual, including specified provision for Contractor's obligations. (6) Owned, non -owned and hired motor vehicles. (7) Broad Form Property Damage including Completed Operations. .10 If General Liability coverages are provided by a Commercial General Liability Policy on a claims -made basis, the policy date or Retroactive Date shall predate the Contract; the termination date of the policy or applicable extended reporting period shall be no earlier than the termination date of coverages required to be maintained after final payment. 10.1.2 The insurance required by Subparagraph 10.1.1 shall be written for not less than the limits of liability specified in the Bid documents or as required by law, RoofConnect -MRI Roof Contract Page 28 Vol. 206 Pg. whichever coverage is greater. Coverage shall be written on an occurrence basis and shall be maintained without interruption from date of commencement of the Work until date of final payment and termination of any coverage required to be maintained after final payment. 10.1.2.1 The insurance required by Subparagraph 10.1.1 shall be written for not less than the following limits, or greater if required by law: 1. Workers' Compensation: (a) State: Texas Statutory (b) Applicable Federal (e.g., Longshoremen harbor work, Work at or outside U.S. Boundaries): Statutory: Not Applicable (c) Maritime: Not Applicable (d) Employer's Liability: $ 1,000,000 each accident $ 1,000,000 disease, policy limit $ 1,000,000 disease, each employee (e) Benefits required by union labor contracts: As Applicable 2. Comprehensive or Commercial General Liability (including Premises - Operations; Independent Contractors' Protective: Products and Completed Operations; Broad Form Property Damage): (a) Bodily Injury: $ 1,000,000 each occurrence $ 1,000,000 aggregate (b) Property Damage: $ 1,000,000 each occurrence $ 1,000,000 aggregate (c) Products and Completed Operations Insurance to be maintained for a minimum period of five 5 years) after final payment: (d) Property Damage Liability Insurance shall include coverage for the following hazards: 1) X (Explosion). 2) C (Collapse). 3) U (Underground). (e) Broad Form Property Coverage shall include Completed Operations. 3. Contractual Liability: (a) Bodily Injury: $ 1,000,000 each occurrence (b) Property Damage: $ 1,000,000 each occurrence $ 2,000,000 aggregate 4. Personal Injury with Employment Exclusion deleted: $ 1,000,000 aggregate 5. If the General Liability coverages are provided by a Commercial Liability policy, the: (a) General Aggregate shall be not less than $ 2,000,000 and it shall apply, in total, to this Project only. (b) Fire Damage Limit shall be not less than $ 100,000 on any one Fire. (c) Medical Expense Limit shall be not less than $ 10,000 on any one person. RoofConnect -MRI Roof Contract Page 29 Vol. 206 Pg. 7 6. Umbrella Excess Liability: $ 2,000,000 over primary insurance $ 10,000 retention for self- insured hazards each occurrence 7. Business Auto Liability (including owned, non -owned and hired vehicles): (a) Bodily Injury: $ 500,000 each person $ 1,000,000 each accident (b) Property Damage: $ 500,000 each occurrence Note: The State of Texas has a no fault automobile insurance requirement. Contractor shall be certain coverage is provided which conforms to any specific stipulation in the law. 10.1.3 Certificates of Insurance and Policies acceptable to the Owner shall be filed with the Owner prior to commencement of the Work. These Certificates and the insurance policies and the Policies required by this Paragraph 10.1 shall contain a provision that coverage afforded under the policies will not be canceled, or allowed to expire, until at least thirty (30) days prior written notice has been given to the Owner. If any of the foregoing insurance coverage are required to remain in force after final payment and are reasonably available, an additional certificate evidencing continuation of such coverage shall be submitted with the final Application for Payment. Information concerning reduction of coverage shall be furnished by the Contractor with reasonable promptness in accordance with the Contractor's information and belief. Not later than ten (10) days from award of bid, Contractor shall deliver to the Owner, copies of the insurance certificate in accordance with the above requirements naming Owner as additional insured. 10.2 OWNER'S LIABILITY INSURANCE 10.2.1 The Owner reserves the right to be self insured for any and all insurance of any kind, type, or nature required by the Contract Documents. 10.3 PROPERTY INSURANCE 10.3.1 The Contractor shall purchase and maintain, and furnish evidence of, Builder's Risk Insurance. At a minimum, the policy limits of such insurance shall be equal in face amount to the full Contract Amount. At the option of the Owner or if called for elsewhere in the Contract Documents, the Contractor shall furnish evidence of such insurance with limits up to the full value of the Project under construction. Such insurance shall include the interest of the Owner, its employees and agents, and of the Contractor, its employees and agents, and of all Subcontractor, Sub - subcontractors and their employees and agents. 10.4 PERFORMANCE BOND AND PAYMENT BOND 10.4.1 Not later than ten (10) days from and after the date on which the award of the bid is made by the Owner, Contractor shall execute, as Principal, bonds joined in by a Surety Company of the Contractor's choice, generally referred to as a "Performance Bond" and a " Payment Bond," each in a penal sum equal to 100% of the Contract RoofConnect -MRI Roof Contract Page 30 Vol. 206 Pg. -17/y Sum. The Bonds shall be on the form provided by Owner and shall be compatible with provisions of goveming authorities. Contractor shall file bonds with the Owner. 10.4.2 Surety Company executing bonds shall be acceptable to Owner and shall be authorized to do business in the State of Texas. 10.4.3 Surety Company shall list the address and phone number of the home office of its' principal place of business. Surety shall also provide the name, address and phone number of the local Agent issuing the bonds. 10AAContractor shall require attorney -in -fact who executes required bonds on behalf of surety to affix thereto a certified and current copy of power of attorney. 10.4.5 Contractor shall deliver required bonds to Owner not later than three (3) days following the date the Agreement is entered into, or if Work is to be commenced prior thereto in response to a letter of intent, Contractor shall, prior to commencement of Work, submit evidence satisfactory to Owner that such bonds will be furnished. 10.4.6 Upon the request of any person or entity appearing to be a potential beneficiary of bonds covering payment of obligations arising under the Contract, the Contractor shall promptly furnish a copy of the bonds or shall permit a copy to be made. 10.4.7 Contractor shall keep surety informed of progress of Work and where necessary, obtain surety's consent to, or waiver of: (1) notice of changes in the Work; (2) request for reduction or release of retention; (3) request for final payment; and (4) any other information required by surety. ARTICLE 11 CORRECTION OF WORK 11.1 CORRECTION OF WORK 11.1.1 BEFORE OR AFTER SUBSTANTIAL COMPLETION 11.1.1.1 The Contractor shall promptly correct Work rejected by Owner or governing authority or failing to conform to the requirements of the Contract Documents, whether observed before, or after, Substantial Completion and whether or not fabricated, installed or completed. The Contractor shall bear costs of correcting such rejected Work, including additional testing and inspections made necessary thereby. 11.1.2 AFTER SUBSTANTIAL COMPLETION 11.1.2.1 In addition to the Contractor's obligation under Paragraph 3, if, within one (1) year after the date of Substantial Completion of the Work, or designated portion thereof, or after the date for commencement of warranties, or by terms of an applicable special warranty required by the Contract Document, any of the Work is found to be not in accordance with the requirements of the Contract Documents, the Contractor shall correct it promptly after receipt of written notice from the Owner to do so unless the RoofConnect -MRI Roof Contract Page 31 Vol. 206 Pg. �y Owner has previously given the Contractor a written acceptance of such condition. This period of one (1) year shall be extended with respect to portions of Work first performed after Substantial Completion by the period of time between Substantial Completion and the actual performance of the Wont. This obligation under this paragraph 11.1.2 shall survive acceptance of the Work under the Contract and termination of the Contract. The Owner shall give such notice promptly after discovery of the condition. 11.1.2.2 The one (1) year period for correction of Work shall be extended with respect to portions of Work first performed after Substantial Completion by the period of time between Substantial Completion and the actual completion of that portion of the Work. 11.1.2.3 The one (1) year period for correction of Work shall not be extended by corrective Work performed by the Contractor pursuant to this Paragraph 11.1. 11.1.3 The Contractor shall remove from the site portions of the Work which are not in accordance with the requirements of the Contract Documents and are neither corrected by the Contractor nor accepted by the Owner. 11.1.4The Contractor shall bear the cost of correcting destroyed, or damaged, construction, whether completed or partially completed, of the Owner or separate contractors caused by the Contractor's correction or removal of Work which is not in accordance with the requirements of the Contract Documents. 11.1.5 Nothing contained in this Paragraph 11.1 shall be construed to establish a period of limitation with respect to other obligations the Contractor has under the Contract Documents. Establishment of the one (1) year period for correction of Work as described in Subparagraph 11.1.2 relates only to the specific obligation of the Contractor to correct the Work and has no relationship to the time within which the obligation to comply with the Contract Documents may be sought to be enforced, nor to the time within which proceedings may be commenced to establish the Contractor's liability with respect to the Contractor's obligations other than specifically to correct the Work. 11.2 ACCEPTANCE OF NONCONFORMING WORK 11.2.1 If the Owner prefers to accept Work which is not in accordance with the requirements of the Contract Documents, the Owner may do so instead of requiring its removal and correction, in which case the Contract Sum will be reduced as appropriate and equitable. Contractor shall bear all direct, indirect and consequential costs attributable to Owner's evaluation of and determination to accept such defective or nonconforming Work. Such adjustment shall be effected whether or not final payment has been made. If any such acceptance occurs prior to final payment, Owner shall be entitled to an appropriate decrease in the Contract Sum. If the acceptance occurs after final payment, an appropriate amount will be paid by the Contractor to the Owner. ARTICLE 12 MISCELLANEOUS PROVISIONS RoodConnect•MRI Roof Contract Page 32 Vol. 206 Pg. J -25 12.1 GOVERNING LAW: The Contract shall be governed by the laws of the State of Texas. 12.2 SUCCESSORS AND ASSIGNS 12.2.1 The Owner and Contractor respectively bind themselves, their partners, successors, assigns and legal representatives to the other party hereto and to partners, successors, assigns and legal representatives of such other party in respect to covenants, agreements and obligations contained in the Contract Documents. Neither party to the Contract shall assign the Contract as a whole without written consent of the other. If either party attempts to make such an assignment without such consent, that party shall nevertheless remain legally responsible for all obligations under the Contract. 12.2.2 Contractor shall not assign any monies due or to become due hereunder without written consent of Owner and of Contractor's Surety. The Contractor shall file a copy of such consent of Surety, together with copy of assignment with Owner. In case Contractor assigns all or any part of any monies due or to become due under this Contract, instrument of assignment must contain a clause substantially to effect that it is agreed that right of assignees in and to any monies due or to become due to Contractor shall be subject to prior liens and claims of all persons, firms and corporations for services rendered; for payment of all laborers and mechanics for labor performed; for payment for all materials and equipment furnished and payment for all materials and equipment used or rented in performance of the Work called for in Contract; and for payment of any liens, claims, or amounts due to governments or any of their funds. 12.3 WRITTEN NOTICE: Written notice shall be deemed to have been duly served if delivered in person to the individual or a member of the firm or entity or to an officer of the corporation for which it was intended, or if delivered or sent by registered or certified mail or by courier service providing proof of delivery to the last business address known to the party giving notice. 12.4 RIGHTS AND REMEDIES 12.4.1 Duties and obligations imposed by the Contract Documents and rights and remedies available there under shall be in addition to and not a limitation of duties, obligations, rights and remedies otherwise imposed or available by law. 12.4.2 No action or failure to act by the Owner or Contractor shall constitute a waiver of a right or duty afforded them under the Contract, nor shall such action or failure to act constitute approval of or acquiescence in a breach there under, except as may be specifically agreed in writing, 12.5 TESTS AND INSPECTIONS 12.5.1 Tests, inspections and approvals of portions of the Work required by the Contract Documents, Owner, or by laws, ordinances, rules, regulations or orders of public authorities having jurisdiction shall be made at an appropriate time. Unless otherwise provided, the Contractor shall make arrangements for such tests, inspections RoofConnect -MR[ Roof Contract Page 33 Vol. 206 Pg. I and approvals with an independent testing laboratory or entity acceptable to the Owner, or with the appropriate public authority, and shall bear all related costs of re- tests, re- inspections and approvals following the failure of any test. Otherwise, the Owner shall bear costs of tests, Inspections or approvals. The Contractor shall give the testing agency, Project inspector (if any), and public authorities. 12.5.2 If the Owner, Project inspector (if any), or public authorities having jurisdiction determine that portions of the Work require additional testing, inspection or approval not included under Subparagraph 12.5.1, the Project inspector (if any) will, upon written authorization from the Owner, instruct the Contractor to make arrangements for such additional testing, inspection or approval by an entity acceptable to the Owner, and the Contractor shall give timely notice to the testing agency, project inspector (if any), governing agency of when and where tests and inspections are to be made so they may observe such procedures. The Owner shall bear such costs except as provided in Subparagraph 12.5.3. 12.5.3 If procedures for testing, inspection or approval under Subparagraphs 12.5.1 and 12.5.2 reveal failure of the portions of the Work to comply with requirements established by the Contract Documents, laws, statutes, ordinances, codes, rules or regulations, all costs made necessary by such failure including those of repeated procedures and compensation for additional engineering or architectural services and expenses shall be at the Contractor's expense. 12.5.4 Required certificates of testing, inspection or approval shall, unless otherwise required by the Contract Documents, be secured by the Contractor and promptly delivered to the Engineer and Project inspector (if any). 12.5.5 If the Owner or Project inspector (if any), is to observe tests, inspections or approvals required by the Contract Documents, they will do so promptly and where practicable, at the normal place of testing. 12.5.6 Test or inspections conducted pursuant to the Contract Documents shall be made promptly to avoid unreasonable delay in the Work. 12.6 INTEREST 12.6.1 Payments due and unpaid under the Contract Documents shall bear interest from the date payment is due at the legal rate prevailing for public entities under the laws of the State of Texas. 12.7 COMMENCEMENT OF STATUTORY LIMITATION PERIOD 12.7.1 As between the Owner and Contractor: .1 Before Substantial Completion. Before Substantial Completion, any applicable statute of limitations shall commence to run and any alleged cause of action shall be deemed to have accrued in any and all events not later than such date of Substantial Completion; .2 Between Substantial Completion and Final Certificate for Payment. As to acts or failures to acts occurring subsequent to the relevant date of Substantial Completion and prior to Issuance of the final Certificate for RoofConnect -MRI Roof Contract Page 34 Vol. 206 Pg. _5�1_ Payment, any applicable statute of limitations shall commence to run and any alleged cause of action shall be deemed to have accrued in any and all events not later than the date of issuance of the final Certificate for Payment; and .3 After Final Certificate for Payment. As to acts or failures to act occurring after the relevant date of issuance of the final Certificate for Payment, any applicable statute of limitations shall commence to run and any alleged cause of action shall be deemed to have accrued in any and all events not later than the date of any act or failure to act by the Contractor pursuant to any warranty provided under Paragraph 3.5, the date of any correction of the Work or failure to correct he Work by the Contractor under paragraph 11.1, or the date of actual commission of any other act or failure to perform any duty or obligation by the Contractor or Owner, whichever occurs last. 12.8 EQUAL OPPORTUNITY 12.8.1 Contractor shall maintain policies of employment as follows: .1 Contractor and Contractor's Subcontractors shall not discriminate against any employee or applicant for employment because of race, religion, color, sex or national origin. Contractor shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, religion, color, sex or national origin. Such action shall include, but not be limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth policies of nondiscrimination. .2 Contractor and Contractors Subcontractors shall, in all solicitations or advertisements for employees placed by them or on their behalf, state that all qualified applicants will receive consideration for employment without regard to race, religion, color, sex or national origin. 12.9 NON - DISCRIMINATION 12.9.11n performance of Work, Contractor and Subcontractors agree not to discriminate against any employee or applicant for employment because of age, race, religion, color, handicap, sex, physical condition, developmental disability, sexual orientation or national origin. This provision shall include, but not be limited to the following; employment, upgrading, demotion, promotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeships, ARTICLE 13 TERMINATION OR SUSPENSION OF THE CONTRACT 13.1 TERMINATION BY THE CONTRACTOR RoofConnect -MRI Roof Contract Page 35 Vol. 206 Pg. 3 13.1.1 The Contractor may terminate the Contract if the work is stopped for a period of thirty (30) days through no act or fault of the Contractor or a Subcontractor, Sub — subcontractor or their agents or employees or any other persons performing portions of the Work under the Contract with the Contractor, for any of the following reasons: .1 issuance of an order of a court or other public authority having jurisdiction; .2 an act of government, such as a declaration of national emergency, making material unavailable; .3 because the Owner has not made payment on a Certificate for Payment within the time stated in the Contract Documents; or .4 if repeated suspensions, delays or interruptions by the Owner as described in Paragraph 13.3 constitute in the aggregate more than 100 percent of the total number of days scheduled for completion, or one hundred twenty (120) days in any three hundred sixty -five (365) day period, whichever is less. 13.1.2 If one of the above reasons exists, the Contractor may, upon seven (7) additional days written notice to the Owner and Engineer, terminate the Contract and recover from the Owner payment for Work executed and for proven loss with respect to materials, equipment, tools and construction equipment and machinery, including reasonable overhead, profit and damages. 13.1.3 If the Work is stopped for a period of sixty (60) days through no act or fault of the Contractor or a Subcontractor or their agents, employees or any other persons performing portions of the Work under the Contract with the Contractor because the Owner has persistently failed to fulfill the Owner's obligations under the Contract Documents with respect to matters important to the progress of the Work, the Contractor may, upon seven (7) additional days written notice to the Owner and the Engineer, terminate the Contract and recover from the Owner as provided in Subparagraph 13.1.2. 13.2 TERMINATION BY THE OWNER FOR CAUSE 13.2.1 The Owner may terminate the Contract if the Contractor: .1 persistently or repeatedly refuses or fails to supply enough properly skilled workers or proper materials; .2 fails to make prompt payment to Subcontractors for materials or labor in accordance with the respective agreement between the Contractor and the Subcontractors; .3 persistently disregards laws, ordinances, or rules, regulations or orders of a public authority having jurisdiction; or .4 otherwise is guilty of substantial breach of a provision of the Contract Documents. 13.2.2 When any of the above reasons exist and the Owner believes that sufficient cause exists to justify such action, the Owner may, without prejudice to any other rights or remedies of the Owner and after giving the Contractor and the Contractor's surety seven (7) days written notice, terminate employment of the Contractor and may, subject to any prior rights of the surety: RoofConnect -MRI Roof Contract Page 36 Vol. 206 Pg. 5 .1 take possession of the site and of all materials, equipment, tools, construction equipment and machinery thereon owned by the Contractor, .2 accept assignment of subcontracts; and .3 finish the Work by whatever reasonable method the Owner may deem expedient. 13.2.3 When the Owner terminates the Contract for one of the reasons stated in Subparagraph 13.2.1, the Contractor shall not be entitled to receive further payment until the Work is finished. 13.2.4 If the unpaid balance of the Contract Sum exceeds costs of finishing the Work, including compensation for the Engineer's services and expenses made necessary thereby, such excess shall be paid to the Contractor. If such costs exceed the unpaid balance, the Contractor shall pay the difference to the Owner. This obligation for payment shall survive termination of the Contract. 13.3 SUSPENSION BY OWNER FOR CONVENIENCE 13.3.1 The Owner may, without cause, order the Contractor in writing to suspend, delay or interrupt the Work in whole or in part for such period of time as the Owner may determine. 13.3.2 The Contract Sum and Contract Time shall be adjusted for increases in the cost and time caused by suspension, delay or interruption as described in Subparagraph 13.3.1. Adjustment of the Contract Sum shall include profit. No adjustment shall be made to the extent: .1 that performance is, was or would have been so suspended, delayed or interrupted by another cause for which the Contractor is responsible; or .2 that an equitable adjustment is made or denied under another provision of the Contract. 13.4 TERMINATION BY THE OWNER FOR CONVENIENCE 13.4.1 The Owner may, at any time, terminate the Contract for the Owner's convenience and without cause. 13.4.2 Upon receipt of written notice from the Owner of such termination for the Owner's convenience, the Contractor shall: .1 cease operations as directed by the Owner in the notice; .2 take actions necessary, or that the Owner may direct, for the protection and preservation of the Work; and .3 except for Work directed to be performed prior to the effective date of termination stated in the notice, terminate all existing subcontracts and purchase orders and enter into no further subcontracts and purchase orders. 13.4.3 In case of such termination for the Owner's convenience, the Contractor shall be entitled to receive payment for Work executed and costs incurred by reason of such termination, along with reasonable overhead and profit on the Work not executed. RoofConnect -MRI Roof Contract Page 37 Vol. 206 Pg. S'Sr ARTICLE 14 ACCESS TO THE WORK 14.1 The Owner, and their authorized representatives, shall have access at all times to the work for inspection wherever it is in preparation or progress and the Contractor shall provide proper facilities for such access and inspection. ARTICLE 15 STANDARDS 15.1 Any material specified by reference to the number, symbol or title of a specific standard, such as a Commercial Standard, a Federal specification, a trade association standard or other similar standard, shall comply with the requirements in the latest revision thereof and any amendment or supplement thereto in effect on the date of these Specifications, except as limited to type, class or grade, or modified in such reference. 15.2 The Standards referred to, except as modified in the Specifications, shall have full force and effect as though printed in the Specifications. These Standards are not furnished to bidders for the reason that the manufacturers and trade involved are assumed to be familiar with their requirements. The Engineer will furnish, upon request, information as to how copies of the standards referred to may be obtained. 15.3 It is not the intent of the Specifications to limit materials to the product of any particular manufacturer. Where definite materials, equipment and /or fixtures have been specified by name, manufacturer or catalog number, it has been done to set a definite standard and a reference for comparison of quality, application, physical conformity and other characteristics. It is not the intention to discriminate against, or prevent, any dealer, jobber or manufacturer from furnishing materials, equipment and fixtures which meet or exceed the characteristics of the specified items. ARTICLE 16 PROHIBITION AGAINST PERSONAL INTEREST IN CONTRACTS 16.1 No officer or employee of Brazos County, Texas, shall have a financial interest, direct or indirect, in this Agreement or shall be financially interested, directly or indirectly, in the sale of any materials, supplies or services, except on behalf of the County as an officer or employee. Any willful violation of this Article shall constitute malfeasance in office and any officer or employee guilty thereof shall be subject to removal from his office or position. Any violation of this Article with the knowledge, express or implied, of the Contractor or Subcontractors shall render this Agreement voidable by Brazos County. ARTICLE 17 PREVAILING-WAGE RATES 17.1 PREVAILING WAGE RATE DETERMINATION RoofConnect -MRI Roof Contract Vol. 206 Pg. ✓Z Page 38 c17-1.1 2268, ities, counties,r independent ®school districts and Ti other political subdivisions Gthat engage In construction projects using public funds to Include prevailing wage rates In the project bid documents and the construction contract, 1 AUTHORITY TO CONTRACT The County Judge Is authorized to execute this Agreement upon the Commis8loners Court's approval of the Agreement as set forth In the minutes of the Court's August ' , 2014, meeting. This Agreement is entered Into In as of the day and year first written above and Is executed In at least three (3) original copies of which one (1) is to be delivered to each of the Contredore and the remalnder to the Owner, OWNER: BRAZOS COUNTY, TEXAS B s County Judge Deta� 200 South Texas Ave., Suite 332 BrazoB, Texas 77603 CONTRACTOR: Morton Roofing Industries, Ltd. kw�� �l R. C. Biba. Vice President Date 6207 Ashbrook Dr. Houston, TX 77081 CONTRACTOR: RoofConnect Logistics, Inc. Jeremy Hfll, . DI of Operations ate P.O. Box g08, 44 Grant 66 Sheridan, AR 72150 RoofConnett•MRI Roof Conrmct X39 Vol. 20 6 Pg. S `' EXHIBIT "A" RoofConnect -MR1 Roof Contract Page 40 Vol. 206 Pg. ff EXHIBIT "B" RoofConnect -MRI Roof Contract Page 41 Vol. 206 Pg. z RoofConnect -MRI Roof Contract EXHIBIT "C" Vol. 206 Pg. ZD Page 42 EXHIBIT "D" RoofConnect -MRI Roof Contract Page 43 Vol. 206 Pg. �/ RoofConnect -MR) Roof Contract EXHIBIT "E" Vol. 206 Pg. 6 ,� Page 44 EXHIBIT "F" RoofConnect -MRI Roof Contract Page 45 Vol. 206 Pg. 63 W RoofConnecta NATIONAL ROOFING SERVICES July 16, 2014 Wm. Charles Wendt Purchasing Agent Brazos County 200 S. Texas Ave., Ste. 352 Bryan, TX 77803 979 - 3614292 Office Via email: cwendt @brazoscountytx.gov Dear Charles, Thank you for allowing RoofConnect and Marton Roofing Industries to provide you with a proposal for our roofing services. We are the most experienced roofing service organization in the country. We have years of experience managing multiple properties through a single point of contact. With our dedicated staff of roofing professionals, Brazos County is in good hands with RoofConnect and Marton Roofing Industries. The contract that is being used for this proposal is a TCPN contract, R132203, was awarded by a lead public agency, Region 4 Education Service Center, using a competitive solicitation process consistent with applicable procurement laws and regulations. The contract allows Brazos County to leverage national buying power (37,000 Member Agencies nationwide) ensuring a quality end product at competitive prices while streamlining the process, thus saving time and money. Marton Roofing Industries is a RoofConnect Member Owner and is included in our TCPN contract and thus has the ability to represent this contract and will be able to submit the proposal, provide Insurance or any bonding requirements, permits and ultimately enter Into contract individually or jointly with RoofConnect and Brazos County. Through the RoofConnect TCPN Contract, Brazos County will receive the compliance and auditing power of TCPN to ensure that what the County is receiving is compliant with the TCPN contract. The attached Total Base Bid from the Brazos County Form is tied to contracted line -item pricing via a TCPN Certified Proposal 1132203 -TX -1940) that will allow TCPN to track projects from beginning to end. We will provide the actual TCPN Certified Line Item Proposal to you once you have determined that the County wants to enter Into contract with us. That certified line -item proposal will not exceed the amount listed in this submhtal. This Certified Proposal Number is a benefit to Brazos County by providing assurance of compliance, tracking and accountability, therefore providing you peace of mind. If you have any questions feel free to contact me. We look forward to the opportunity of working with your team on this project while building a long term partnership that will prolong the life of your roofs, ultimately saving money for Brazos County. Regards,l� David Adams RoofConnect 949.614.6342 cc: Marton Roofing Industries, Joe Morgan Vol. 206 Pg. 6 el th Roof Connect, NATIONAL ROOFING SERVICES VJe PU[Ch oQ�oo � TCPN P��ed P�D—a`NJ��o Proposal p: 132203 -TX -1940 Dear Valued TCPN Member /User: Thank you for your Consideration in accessing and potentially using a TCPN- awarded contract. As you are aware, we take each and every awarded vendor through a very transparent and competitive process. Nonetheless, we continue to look for methods to better serve our customers. We have Implemented a new proposal registration program to provide consistency and faster service for our members. The process will require Facility Contract holders to register and receive a Certified TCPN Proposal Number that must be prominently displayed on proposal($) that you receive. This new system will track Facility transactions from the initial proposal stage to the completion of each project. TCPN has assembled an experienced Facilities Management Team that stands ready and willing to assist Its vendors In providing quality services to your organization. We support and encourage you to call our TCPN Team to verify the TCPN Certified Proposal Number (CPN) and ask further questions. Failure to receive the TCPN Certified Proposal Number can result in potential delays to your services. Please see our webslte at www.lcpn.org to contact our team members In serving your needs. Thank you for your potential business and remember to only accept proposals with a TCPN Certified Proposal Number. Sincerely, The TCPN Facilities Management Team Vol. 206 Pg. eJ partnership, the name and address of each member must be given, and the proposal must be signed by an official or duly authorized agent. 3. The Contractor must submit an original and six (6) copies of the proposal to Brazos County. 4. The complete proposal should include the following: a. Completed and signed RFP. b. Conlraclor's Qualification Statement (AIA Document A -305 or equal) c. Bid bond, certified check or cashier's check lire 5% of the total bid amount S. By signing the certification below, the vendor verifies that all plans and specifications have been reviewed and are considered in the pricing attached. R. List of Subcontractors: Trade Vendor Name I._ 2. 3. 4. 5. S. Pricing Alternate Price Table: Alternate Roof No. Ma Item scope: Quantity: I Old Amount (Numbers): Old Amount IMlorda):: Justice of the Peace Buildin No. B Install new Roof 16 "ems. 16 1 Page Vol. 206 Pg. C 6 Allowance Price Table: Aliowan Robe Nem 9oeas: Ousrift: Bid Amount (Numbers): Bid Amount (Words):: e No. At Price Arm; Auditorium Administration Building Repair of three Auditorium Administration Bulldin existing roof drains INA I and associated Repair - Base Scope No. 1 C piping- ft 000 Includes 20 batten NA Unit Price Table: Unit Roof Item Smile: Ousnaiy: Bid Amount (Numbers) Bid Amount (Words):: Price Arm; I No. Auditorium Administration Bulldin Batten Seem Cover Repair - Base Scope Includes 20 batten cover Unit Price includes each batten cover greater than base amount on a 1 batten pO No. 1 B per unit once. cover. Existing Expansion Joint replacement - Base Scope includes replacement of 133 LF of expansion joint demo and installation. Unit Price includes replacement of expansion joint greeter then base amount on a per linear fool of expansion joint unit oe No. 2 C rice. 1 L. Ft. This Space Intentionally Left Blank Vol. 206 Pg. 171Pagc Unit Roof Rem Scope: Ouantny: Bid Amount (Numbers): Bid Amount (Words):: Price Area: No. Juvenile Justice Center Building Existing replacement of metal roofing fasteners - Base Scope includes replacement of 406 fasteners. Unit Price includes replacement of Metal Roof fasteners greater 5 than base amount on fastener a per five fasteners in s per / G S'+ 11..i�e.r trCllQ•• -� No.3 C unit rice. unit. •�� Replacement of vertical well assembly _ sealant joint - Be" Scope Ipcllides replacemee of 250 LF. Unit Price includes replacement of sealant JOIN greater then base amount on a per , 00 (cur 1� + \�°r•� No. 4 linear foot unit price. L. Ft. ` c Replacement of exterior wall assembly horizontal sealant joint to concrete foundation - Base Scope Includes replacement of 240 LF. Unit Price includes replacement of sealant joint greater than base amount on a per I ' Cd l �t�c' +I •F+ No.5 linear foot unit rice, L. Ft. A. Total of Unit Prices Numbers Jilr- AA. Total of Unit Prices Words I.�I B. Total Alternate No. 1 (Numbers) B.1. Total Alternate No. 1 Words Twa 7�+wa....l J'+sK Fiu•..:v� L%'1� a ^ o_ C. Total Base Bid (Numbers)-7 or ^%or p00 C. t. Total Bess Bid (Words) 18jPagr Vol. 206 Pg. D. Continnency Allowance $43,000 E. Total Pricing A +B +C +D (Numbers)A D O F. TotalPncin E (Words)r ���nr -�1 ��d' `^'7�»•.��� Time A. From award of contract and receipt of purchase order, work can begin in how many da s? D Days B, Time to substantial completion c-Q O Days C. Time from substantial completion to final completion Days D. Additional time required for Alternate No.I D Days T. Proposal Evaluation Waiver 191 P I . Vol. 206 Pg. /� By submitting a proposal or response, each Proposer/offeror indicated below agrees to waive any claim it has or may have against Brazos County (the Owner), Architect, Engineers, Consultants and their respective Commissioners, directors, employees, or agents arising out of or in connection with (1) the administration, evaluation, or recommendation of any proposal or response Of any requirement under the Request for Qualification or related documents; (3) the rejection of any proposal or response or any pan ol'any proposal or response; and /or (4) the award of a Contract. if any. The Proposer further agrees the Owner reserves the right to waive any requirements under the proposal documents or the Contract Documents, with regards to acceptance or rejection of any proposals, and recommendation or award of the contract. Note: The Statement of Affirmation Must be Notarized. STATEMENT OF AFFIRMATION "The undersigned attirms that he /she is duly authorized to execute this waiver by the person(s) or busiine�ss entity making the proposal. limt'sName: f 1 / 1A2 ;. -z 0Z :3:; % �r.a� +G'�o►. Address: oo7 a-00�ro,i 71` %-70% Proposer's Namc:_ Position/Title:.. Proposer*s r � � to J this��1 L day of tlw11 in the year ,&i/ Notary PublicIJ (2W1� My Commission expires U. ADDENDA 201Papc Vol. 206 Pe. _70 The undersigned acknowledges receipt of the following addenda issued during the time of Bidding and includes the several changes therein in this Proposal. No. ( No. 0) No. Date Date V. CERTIFICATION OF PROPOSAL The undersigned affirms that they are duly authorized to execute this contract, that this bid has not been prepared in collusion with any other Contractor. and that the contents of this hid have not been communicated to any other Contractor prior to the official opening. Signed By: Typed Name: Company Name: Title: Phonc No. Mailing Address: 6d 0% 4- s ",-o k fga.+" —ne -7-2aw I P.O. Box or Street City State Zip Employer Identification Number: %6 OfY S 2-13 CORPORATE SEAL IF SUBMITTED BY A CORPORATION END OF RFP NO. 2014 -44 By signing below, Brazos County agrees tl t this RFP 2 ill be a dad to the vendor whose name appears above and oth riles ogre o the ! n conditions contained herein. By: Brazos County Commissioner's Court U Attest: Brazos Count) Vol. 206 Pg. %/ 211 P,y,c BRAZOS COUNTY COMMISSIONERS' COURT ACTION FORM DEPARTMENT: Road & Bridge MEETING DATE: August 12, 2014 SUBJECT: Utility Permit — ETC Texas Pipeline, Ltd Consider and take action on the ETC Texas Pipeline utility permit to construct road bore under Rock Prairie Road. Project will lay 16" pipeline for transportation of natural gas. Site is located in Precinct 2. SUBMITTED BY: �Anu� J Salvato Right of Way Agent APPROVED BY: This request is LYAPPROVED / DENIED 0 by Commissioners' Court Duane Peters, County Judge DATE: 01 i a 11 `f' Vol. 206 Pg. �/%Z z TO: THE COUNTY ENGINEER OF BRAZOS COUNTY, TEXAS Comes now ETG elA W B . [company namej, hereinafter referred to as "Company" a (st fe] Corporation, with authority to transact business in Texas, acting by and through its duly authorized representative, and hereby petitions the County Engineer for the right to lay, construct, maintain, repair and /or operate equipment under, over, across and/or along certain County Roads as shown on drawings and diagrams attached hereto and said location described as follows: I.7 Ro Name Block Number Length of Crossing I TYPE OF CONSTRUCTION (CHECK ONE Bor d Jac d Drivcn Cased Facility to Parallel County Road Within Riga -Of- -Way CONSTRUCTION TYPE ��p DiameterQ_ Wall'I'hickness High Pressure Underground ❑ Low Pressure Underground p p Pipeline (60 psi or greater Pipeline (60 psi operating Material Specification % operating pressure) pressure) Minimum Yield Strength 1ROL - Maximum Operation Pressure The location and description of the proposed installation and appurtenances must be fully shown on the attached detailed drawings. The Company shall commence actual constructiof�> rk in good faith within 60 days from the date of said permit and shall complete said construction /work within rrll working days. (COMPANY MUST FILL IN). If such construction is not begun by the 60" day, Company will be required to apply for anew Penn it. Company declares that prior to filing this application, it has ascertained the location of all existing utilities, both aerial and underground, and the filing of this application is prima facie evidence that the proposed installation will not conflict with any existing utility. A copy of this permit shall be kept at the job site any time work is being performed. It is expressly stipulated that this Permit is a license for permissive use only and that the placing of facilities upon public property pursuant to this permit shall not operate to create or vest any property right in said holder. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the County's right, title and-interest in the land to be entered upon and used by the holder and the holder will at all times assume risk of and indemnify, defend and save harmless Brazos County from and against any and all loss, damages, cost or expense arising in any manner on account of the exercise or attempted exercise by said holder of the aforesaid rights and privileges. Any deviation from these specifications must be approved by Brazos County Engineer's Office or its designated representative. Vol. 206 ft. 73 Approval of Comity Engineer's Office may take as long as two weeks after complete application is received Applicant agrees to comply with all rules of the County Commissioners and the County . Engineer in construction of said installation attached hereto as BRAZOS COUNTY DESIGN STANDARDS AND SAFETY PRECAUTION REQUIREMENTS FOR WORK CONDUCTED IN BRAZOS COUNTY RIGHTS OF WAY and incorporated herein for reference. in the event Company fails to obtal a permit prior to the installation or does not Install utilities in compliance with installation requirements set forth herein llie. depth, location, etc), Company assumes aii financial responsibility for drrntages and/or destruction of lines, cables, etc, based upon lis failure to comply with Brazos County requirements. Applicant agrees that f Brazos Como, demonstrates a violation of lite terms of this policy, Applicant stipulates that requisites for injunctive relief exist and that Brazos Comity is entitled to relief enjoining any conduct by applicant which Is contrary to the policies. This penult is a revocable perndL Brazos County reserves the right to revoke this permit at any time, in the sole discretion of Brazos County, for interests of public health, safety or welfare, or for failure to repair any damages upon demand, or for tiny other reason deemed sr f cienl by Brazos County. In the event Company falls to comply mhh any or all of the requirements as set forth herein, the County may take such action as it deems appropriate to compel compliance. The County Engineer further retains lire right to revoke this Permll by verbal noty7catlon to the Applicant/Company. Failure to obtain this permit andlor notify the County Engineer's Office within 24 hours of beginning construction shall constitute grounds for Job shutdown. By signing below, I certify that i am authorized to represent the Company listed below, and that the Company agrees to the conditions/provisions included in this permit. Vol. 206 Pg. 7' L Ic. ct" PIPELINE UTILITY APPROVAL Brazos County offers no objection., to the _proposed location of the utility in the County right of way as shown by accompanying drawings and notice dated Oi3 0 7' ol#)q except as noted below: (Month/Day/Year) EXCEPTIONS: �VoNFL SWUMM Vol. 206 Pg. 13 QW0S COUNTY, TEXAS ROBERT MATTHEWS SURVEY, A -36 3 PATRICIA A. HOWARD a� �'/ �/ 4 p % / h yry PIPELINE MARKER EA. SIDE w /C.P. TEST LEAD BOTH SIDES 210' i 200' i 190' GPI REV. JOY I DATE 1 I NJP 02/14 12 1 J01 104/14 13. 1 JPF 108/14 J /71.* LAT: 30'34'03.31" / /LONG: - 96'11'50.76" 32' 32' xlU p YO O W U z wI 0 wix� °d dl w O i ox N M 0 N ox O I O I O 01 O 1 4 10' MIN. 10' MIN. i'T it 16'0.0. N 0375' PIPE SPECIFICATIONS: MX. OPER. PRESSURE: 1200 PSIG MW. TEST PRESSURE: M�PSIG MIN. YIELD SIRENGIH: 2437 PSI CARKR PIPE: 16'U. X 0375 N.T. X52 PROPOSED PIPELINE 0 PEACH CREEK LOOP PROPOSED 16' PIPELINE ROCK PRAIRIE ROAD ROAD PERMIT BRAZOS COUNTY, TEXAS Vol. if/ r- BZ- 020.010 E.E. ALLEN, JR. REVOCABLE TRUST (AGREEMENT NUMBER 2 DATED AUGUST 24, 2010) PROPOSED PIPELINE PLAN SCALE 1' - 20' N.G. PROFILE HORIZ 1' - 20' VERT. 1' - 20' 210' 200' 190' SHEET 3 OF 3 SWOS COUNTY TEXAS ROBERT MATTHEWS SURVEY, A -36 PLAN SCALE 1" - 20' SHEET 2 OF 3 ACCT.- CCT NO. PIPE SPECIFICATIONS- PEACH CREEK LOOP AFE NO. 45102665 NM- CPER. PRESSURE 12M PSIG PROPOSED 16' PIPELINE , REV. BY DATE MIN. TEST PRESSURE: �—PSIG ROCK PRAIRIE ROAD MIN. YIELD STRENGTH: 21.77 Psi QM)ER PIPE: 16' DA X OM W.L, X52 ROAD PERMIT BRAZOS COUNTY, TEXAS o,l-V ° A "u$ZM � \� � ( � ' � }� \ � :� � - � ~ ��� ��2���� A � w ?2 < \� 2\ � \� � ( � ' � }� \ .� /( � ~ ��� ���� A 16" Peach Creek Loop { Rock Prairie Road, Brazos County Road Crossing Permit 4/7/14 Barlow's Formula Tmin = wall thickness required ( inches) D = Outside diameter of pipe (inches) P = Internal. Design Pressure (psi) S = Yield strength of pipe (psi) F =Design actor E = Seam Joint Factor (Normally 1) T = Temperature Factor (Normally 1) t = DxP /(2xSxFxExT) per 192.105 D =16 in P =1200 psig S = 52000 psig F = 0.5 (Class 111) E =1 (ERW API 5L per 192.113). T =1 (temperature < 250 deg per 192.115) t =.370 in design wall thickness required (t min) t actual is 0.375 in t actual > t min Vol. 206 Pg. % 1 I BRAZOS COUNTY ROADWAY SAFETY AND ROAD PRESERVATION STANDARDS FOR WORK CONDUCTED IN BRAZOS COUNTY RIGHTS OF WAY A. General Requirements 1. Adequate drainage shall be maintained in ditches at all times. 2. Permittee will use best management practices ( "BMP ") (EPA and TCEQ both provide lists of examples of BMPs) to minimize erosion and sedimentation resulting from the proposed installation. 3. The permittee shall take precautions to avoid damage to property. All County Right of Way and property shall be restored to its original condition, as far as practical, in the opinion of the County Engineer or appointed representative. 4. The construction and maintenance of such utility shall not interfere with the property or rights of a prior occupant. 5. Permittee shall not interfere with other utilities located in the right of way. In the event damages occur, permittee will be liable to the County or other utilities running through the right of way. 6. County Engineer shall determine whether or not permittee's plans "shall inconvenience the public. If it is detennined that inconvenience to the public exists, then the County Engineer will decide whether such project will be allowed or if an alternative exists so as not to inconvenience the public. B. Safety Requlremeals I. Proper traffic control measures must be put in place prior to beginning work and remain in place during tine duration of the job. All traffic control measures must follow the Texas Manual of Uniform Traffic Control Devices (TMUTCD). See Traffic Control Requirements below. 2. During construction, all safety regulations of the Texas Department of Transportation shall be observed. 3. Permittee must take such precautions and measures, including placing and displaying safety devices, as may be necessary, in order to safely conduct the public through the project area. Company shall provide Flagmen, signs, signals or devices necessary to provide complete safety to the public. 4. Adequate provisions must be made to cause minimum inconveniences to traffic and adjacent property owners. 5. No cable, conduit and/or pole line shall be laid, constructed, maintained and /or repaired so as to constitute a danger or hazard of any kind to persons or vehicles using such road. Any poles placed in the Right of Way for future installation shall be placed at the back of the Right of Way. Exceptions may be approved by the County Engineer, C. Traffic Control Plan 1. A traffic control plan, pursuant to the TMUTCD or Engineered Traffic Control Plan trust be provided for the following: a. Any construction (i.e. pit, excavation, hole) left open over night, requires sixcific nighttime traffic control measures pursuant to the TMUTCD; b. if consniwtion is within ten (10) feet of the roadway; or c. Any work performed in the road right-of-way; 2, Plan must be attached to the permit and kept at the job site any time work is being performed. 3. Plan must set forth the time of completion for the job. Vol. 206 Pg. F6 D. Design Standards 1. All overhead installations shall conform to clearance standards of the Texas Department of Transportation and the pole be placed in the designated area for power specified as set forth in the Texas Utilities Code, Section 181.045. 2. All pole installation (including lighting) shall be placed at the backside of the Right of Way to ensure safety to the public. Any pole placed in violation of this requirement will be required to be moved to the appropriate location at the company's expense. Exceptions may be approved by the County Engineer. 3. All underground installations shall (these are minimum depths — utility may place deeper): a. be placed at a minimum depth of forty -eight (48) inches below the top of the pavement; b. be at least thirty-six (36) inches below ditch flow line when installation is within the area measured from top of bank to top of bank; c, be at least forty -eight (48) inches below ditch flow line if low pressure gas or petroleum lines, For high pressure gas and petroleum lines, see High Pressure Pipelines requirements listed below; d. not be closer than ten (10) feet from the edge of pavement. Exceptions may apply in rights of way of less than 60'. 4. Water Lines: All water lines must be a minimum 36- inches below the ditch flow line and cased. Waterlines shall be cased if crossing under the roadway. 5. Utilities in all new developments that have 60 feet or greater of right of way shall be installed within designated locations based upon the type of utility. The locations shall be as follows: (measured from back of right -of -may). Power -0 -2 feet, nominally I' Phone— 2 -4 feet, nominally 3' Gas -4 -6 feet, nominally 5' Cable — 6 -8 feet, nominally 7' 6. Utilities with less than 60 feet right -of -way in all new developments shall install the utility in a similar manner as referenced in No. 3 above, however, the County Engineer or its designated representative will provide final approval of each utility location. 7. The length of any trench to be opened in advance of the pipe, conduit or ducts may not be longer than 400' if left open over night or unattended. Crossings under a county road shall: a. be bored or jacked, ABSOLUTELY NO OPEN CUTS WITHIN COUNTY ROAD PAVEMENT; b. be pressure grouted for the full length of the crossing if the annular space between pipe and casing and soil exceeds one (1) inch. Brazos County must be given 24 hours notice of pressure grouting operations and have the opportunity to have an inspector on site to observe pressure grouting operations; C. TxDOT Standard Specification Item 476 shall be followed for all boring, jacking, tunneling and joints. 9. Dore Pits a. no pits shall remain open longer than 2 days; b. all pits shall have proper traffic control measures in place. See Traffic Control Plan listed above. C. pits shall NOT be located within ten (10) feet from the edge of pavement without prior approval from the County Engineer or his representative; d. when pits are to remain open for more than 8 hours, due diligence will be used in protecting the spoil pile to prevent drainage problems; C. based upon soil conditions, the County Engineer or his representative may require shoring to protect pavement integrity; f. based upon soil conditions, the County Engineer or his representative may require pits be placed further from the edge of road. Vol. 206 Pg. 91 10. Any installation within ten (10) feet of edge of pavement shall meet the following: a. location must be approved by the County Engineer or his representative b. backftlled with cement stabilized material. c. based upon soil conditions, the County Engineer or his representative may require shoring to protect pavement integrity. d. All excess water and mud shall be removed from the trench prior to backfilling. Any backfill placed during a rainy period or at other times where excess water cannot be prevented from entering the trench will be considered TEMPORARY and shall be replaced with PERMANENT cement stabilized material as soon as weather permits; e. All disturbed base and pavement materials shall be removed and restored to the satisfaction of the County Engineer or his representatives. f No side or lateral tamping to fill voids under the base and pavement materials is allowed. 11. Company must be careful to not jeopardize the slope or integrity of the shoulder of the road. Tit the event Company damages the slope, shoulder or any other portion of the right -of -way, Company will be responsible for repairing the damage and replacing the right -of -way to the condilion it was prior to commencing construction. 12. Operation of construction and /or maintenance equipment on the traveled surface of any improved County road will not be permitted, except in an instance whereby the laying, construction, maintenance and/or repair of cables, conduits and /or pole lines cannot be accomplished by any other method and in this event all such equipment shall he of the rubber tire variety. Appropriate traffte control shall be provided meeting TMUTCD requirements. 13. In the event said construction and/or maintenance and /or repair requires Company to remove, cut orjeopardize any section of the road (asphalt, cement, road base, etc), Company will be required to provide a performance bond or letter of credit securing necessary repairs. Said bond amount will be determined by the County Engineer. 14. The applicant shall submit a letter of "No Objection" from the Army Corps of Engineers for all designated wetlands and environmentally sensitive lands. E. Emergency work 1. In the event Company is required to perform emergency services, that requires excavation in a County Right of Way, and unable to notify the County Engineer prior to conducting emergency repairs, Company shall notify County Engineer within 24 hours of beginning construction /repairs. This will allow the County Engineer's Office an opportunity to inspect the site to ensure the integrity of the County Right of Way and traffic safety controls used. F. Repairs to evisring frreiliries 1. Maintenance and/or repair to existing cables, conduits, and /or pole lines which require disturbance of the soil, shall not be performed until plans describing such maintenance and/or repair have been approved by the County Engineer or its designated representative and a permit has been obtained. C. Relocation of wifi les: 1. When and if the County Engineer determines that it is necessary for the construction, repair, improvement, alteration or relocation of all or any portion of said road, any or all poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be removed from said road, or reset or relocated thereon, as required by the County Engineer within a reasonable time as determined by the County Engineer and Utility Company, and at the expense of the Utility Company. Vol. 206 Pg. Y�,)- H. High Pressure Pipelines I. All utility Pennits for high pressure pipelines (generally 60 PSI or grealet), whether pertaining to controlled access or non- controlled'access installations, should contain the following additional information in the description of the permit. - diameter -wall thickness - material specification - minimum yield strength - maximum operation pressure of the pipeline 2. With the exception of the maximum operation pressure of the pipeline, this information is to be supplied for both the carrier pipe and the casing. 3. Assurance must also be given that the installation material and design meet the minimum Federal Safety Standards for Liquid and Gas Pipe Lines. Assurance must be provided on company letterhead and signed by an authorized representative of the company. 4. Petroleum Pipelines: Depth Tyne of Pipeline (below deepest ditch erade) Special Requirements Encased Pipe Less than 10' Must be covered with concrete pad at least 36 "deep Encased Pipe Greater than 10' No concrete pad required Non -Cased Pipe Less than 10' Must be covered with concrete pad at least 48" deep Non -Cased Pipe Greater than 10' No concrete pad required The Concrete pad shall be minimum of 3" thick and width shall be pipe diameter plus 18" minimum. 5. Under no circumstances will a pipeline be installed parallel to a County Road within the Right -of- Way. Transmission lines have been determined to be petroleum pipelines (which includes natural gas lines) and shall not be parallel to a County Road. 6. Natural Gas Distribution is a line that serves the final customer. Vol. 206 Pg. �>' g� (' I s1i l { �� icy =�{alPjl yEi d jr L JI $ bit , � { #j j fl� i i 1� s► °:���Sisk All f - • -•-•- '�-- -- «nb- .�:.Twri ----•---•-------•---- � a® ail ��� i S O Y N i fi iF rlkt• §bIS Y+YS d c��l SA�t$SR sB _ �b8bb�b� �IS,a r4Q �VP�S C 1• IM: 3.^. 33R. -. g� (' I s1i l { �� icy =�{alPjl yEi d jr L JI $ bit , � { #j j fl� i i 1� s► °:���Sisk All f 1*1. .1. C� •MI..xR a _ -- fF- - - -»,� C' F gg If F £ ' �: AL:. i:!„' �, 1• T• iiiwlrii 'r'•Adi'.i+�::w'•7.- :.T...0 :�i:iffi�12w i.:1. ^.ii .rr.n »�e Vol. 206 Pg. 9 �/ W U = N C W O W � u K Y w O a J O 0 8 s� n �^ N N u Y K O 'i O J a N S o � N yJ cC� 2 O H V m a�N aY O 3 - • -•-•- '�-- -- «nb- .�:.Twri ----•---•-------•---- � a® ail ��� i S O Y N i K. _ r4Q 1*1. .1. C� •MI..xR a _ -- fF- - - -»,� C' F gg If F £ ' �: AL:. i:!„' �, 1• T• iiiwlrii 'r'•Adi'.i+�::w'•7.- :.T...0 :�i:iffi�12w i.:1. ^.ii .rr.n »�e Vol. 206 Pg. 9 �/ W U = N C W O W � u K Y w O a J O 0 8 s� n �^ N N u Y K O 'i O J a N S o � N yJ cC� 2 O H V m a�N aY O 3 - • -•-•- '�-- -- «nb- .�:.Twri ----•---•-------•---- � a® ail ��� 1*1. .1. C� •MI..xR a _ -- fF- - - -»,� C' F gg If F £ ' �: AL:. i:!„' �, 1• T• iiiwlrii 'r'•Adi'.i+�::w'•7.- :.T...0 :�i:iffi�12w i.:1. ^.ii .rr.n »�e Vol. 206 Pg. 9 �/ W U = N C W O W � u K Y w O a J O 0 8 s� n �^ N N u Y K O 'i O J a N S o � N yJ cC� 2 O H V m a�N aY O 3 BRAZOS COUNTY COMMISSIONERS' COURT ACTION FORM DEPARTMENT: Road & Bridge MEETING DATE: August 12, 2014 SUBJECT: Utility Permit — ETC Texas Pipeline, Ltd Consider and take action on the ETC Texas Pipeline utility permit to construct road bore under Weedon Loop. Project will lay 16" pipeline for transportation of natural gas. Site is located in Precinct 2. SUBMITTED BY: Jo h. Salvato Right of Way Agent This request is APPROVED BY: ❑ by Commissioners' Court Duane Peters, County Judge Vol. 206 Pg. zz TO: THE COUNTY ErNGINEER OF BBRRJAZOS COUNTY, TEXAS Comes now Fir l PI il�l�•1� LTD [company name], hereinafter referred to as "Company" a _ [slate Corporation, with authority to transact business in Texas, acting by and through its duly authorized representative, and hereby petitions the County Engineer for the right to lay, construct, maintain, repair and /or operate equipment under, over, across and/or along certain County Roads as shown on drawings and diagrams attached hereto and said location described as follows: Facility to Cross Road Road Name & Block Number Length of Crossing TYPE OF CONSTRUCTION CHECK ONE BV Jacked Driven Cased MOM Ma7112M CONSTRUCTION TYPE II ,, Diameier vl J Wall'Mickness ® High Pressure Underground ❑ Low Pressure Underground t , Pipeline (60 psi or greater Pipeline (60 psi operating Material Specificationl6[/12 operating pressure) pressure) Minimum Yield Suengtb 'Z"71 LUI Maximum Operation Pressure The location and description of the proposed installation and appurtenances must be fully shown on the attached detailed drawings. The Company shall commence actual construction( vAk in good faith within 60 days from the date of said permit and shall complete said construction /work within working days. (COMPANY MUST FILL IN). If such construction is not begun by the 60d' day, Company will be required to apply for a new permit. Company declares that prior to filing this application, it has ascertained the location of all existing utilities, both aerial and underground, and the filing of this application is prima facie evidence that the proposed installation will not conflict with any existing utility. A copy of this permit shall be kept at the job site any time work is being perfomied. It is expressly stipulated that this Permit is a license for permissive use only and that the placing of facilities upon public property pursuant to this permit shall not operate to create or vest any property right in said holder. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the County's right, title and interest in the land to be entered upon and used by the holder and the holder yvill. at all times assume risk of and indemnify, defend and save harmless Brazos County from and against any and all loss, damages, cost or expense arising in any manner on account of the exercise or attempted exercise by said holder of the aforesaid rights and privileges. Any deviation from these specifications must be approved by Brazos County Engineer's Office or its designated representative. Vol. 206 Pg. �h Approval of County Engineer's Office may take as long as two weeks afler complete application is received. Applicant agrees to comply with all rules of the County Commissioners and the County Engineer in construction of said installation attached hereto as BRAZOS COUNTY DESIGN STANDARDS AND SAFETY PRECAUTION REQUIREMENTS FOR WORK CONDUCTED iN BRAZOS COUNTY RIGHTS OF WAY and incorporated herein for reference. In the event Company fails to obtain a perinit prior to the installation or does not install utilities is compliance uvith installation requirentenrs sel forth herein (I.e. depth, location, etc), Company assumes all financial responsibility for danmges and/or destruction of limes, cables, etc. based upon iu failure to comply with Brazos County requirements. Applicant agrees that if Brazos County demonstrates a violation of the terms of this policy, Applicant stipulates that requisires for injinactive relief exist and that Brazos Comity is entitled to relief enjoining any conduct by applicant which is contrary to lite policies. This permll is a revocable permit. Brazos Cooly reserves the right to revoke this perntil tit any time, in the sole discretion of Brazos County, for interests of public health, safely or welfare, or for failure to repair any dnnmges upon denand, or for any other reason deemed sufficient by Brazos County. In the event Compmty falls to comply with any or «l1 of the requirements as sea forth herein, lire County nay take such action as it deenis appropriate to compel compliance. The County Engineer further retains the right to revoke this Permit by verbal notification to lire ApplicanUConnparry. Failure to obtain this permit and/or notify lite County Engineer's Office within 24 hours of beginning construction shall constitute growids for Job shutdown. By signing below, I certify that i am authorized to represent the Company listed below, and that the Company agrees to the conditions /provisions included in this permit. 1 ' 11 "11411. Vol. 206 Pg. ��% M PIPELINE UTILITY APPROVAL Brazos County offers „no objection to the proposed location of the utility in the County right of way as shown by accompanying drawings and notice dated O$' 07 - .91p1 q except as noted below: (Month/Day/Year) EXCEPTIONS: Nonr6 Braz ounty Engineer Vol. 206 Pg. S79 ENERGY TRANSFER June 12, 2014 ETC Texas Pipeline, Ltd . Post Orrice Box 2000 Giddings, Texas 79942 979142.5702 Brazos County Commissioners Court The Honorable Duane Peters, Brazos County Judge The Honorable Lloyd Wasserman, Brazos County Commissioner, Precinct 1 The Honorable Sammy Catalena, Brazos County Commissioner, Precinct 2 The Honorable Kenny Mallard, Brazos County Commissioner, Precinct 3 The Honorable Irma Cauley, Brazos County Commissioner, Precinct 4 VARIANCE REQUEST REGARDING DEPTH FOR NATURAL GAS PIPELINE, WEEDON LOOP, BRAZOS COUNTY, TEXAS ETC Texas Pipeline, Ltd., CETC ") is in the process of locating and constructing a proposed pipeline, in Brazos County, Texas and has prepared an APPLICATION FOR PIPELINE UTILITY PERMIT DESIGNATING PLACEMENT OF UTILITY IN COUNTY RIGHT OF WAY for review and approval, to the Brazos County Road and Bridge Department. ETC hereby requests a variance of the cover required at the proposed Idcadon of the pipeline crossing on Weedon Loop (see attached Plan /Profile prepared by Hatch Mott MacDonald). The proposed pipeline crosses the county road at a location with extreme surface elevations. Additional excavation at the proposed crossing has the potential to create an occupational safety hazard or issue for the pipeline boring contractors. R pectf ly /Submitted dr i arles Moody Senior Constructio Man ETC Texas Pipeline, Ltd. Energy Transfer Vol. 206 Pg. k 1r i BRAZOS COUNTY. TEXAS BZ- 002.000 4F 2 �/ CORPORATION 4 �1 f" f S co/ N g/ 78'f LAT: 3939'07.89" JAMES SIMPSON / /LONG: – 96'12'04.51" SURVEY, A -208 f / / I / I-=— 29' 41 I g J �I O W PIPELINE MARK SIDE w /C.P. TI LEAD BOTH SIC 250' 230' 210' NO. JPF D. WICKSON SURVEY, A -235 SZ- 004.000 RON RUST INVESTMENTS, LP PROPOSED PIPELINE PLAN SCALE: 1" = 20' PROFILE SCALE: HORIZ i" a 20' VERT. 1' - 20' BORE (70' LENGTH) 16- O.D. X 0.375' W.T., 5MZ ERW FIE WITH ARO COATING PIPE SPECIFICATIONS: 665 MAX. OPER. PRESSURE 1200 PSIG DATE MIN. TEST PRESSURE ��PSIG WIN. YIELD STRENGT : 2437 PSI 3/14 OMER PIPE 16' O.D. X OA6 IT, X57 PEACH CREEK EXTENSION PROPOSED 16' PIPELINE WEEDON LOOP ROAD PERMIT BRAZOS COUNTY, TEXAS 250' 230' 210' SHEET 3 OF 3 „� �.. ��' �, `'L�: 1 (�: r ,., �� 1: E' i � i,. � � � ° • ,. [n ift�' � a� � � w f w { pKe � j `r> > t.• l _ r �`��� nn r p � 1 r a � �:. � + 1' Z � / ,�. ryl. J `4> � 1 1 � f � 1 I > � t� �� � � � l' i { e 1 (�: r ,., �� 1: E' � � � ° • ,. [n <a 1 ,� `, j A f •J��, - ..���- � -.. 3`.:`F _ r �`��� nn r p � r a � �:. � fl t:• ,�. ryl. � i -�, J)�t 1M I f .. �� l' I - 1! ivIl fiy 1 t.T.`�� ., � i!; _. t1.. .. ...... 1;.. 11, 111-17 Xr -JA CK I bZf t MMMM. rbiffyr-T-A 16" Peach Creels Loop Weedon Loop, Brazos County Road Crossing Permit 6/25/2014 Barlow's Formula Tmin - wall thickness required ( inches) D = Outside diameter of pipe (inches) P = Internal Design Pressure (psi) S = Yield strength of pipe (psi) F = Design actor E = Seam Joint Factor (Normally 1) T = Temperature Factor (Normally 1) t = DxP /(2xSxFxExT) per 192.105 D =16 in P =1200 psig S = 52000 psig F = 0.5 (Class 111) E =1 (ER W API 5L per 192.113) T =1 (temperature < 250 deg per 192.115) t = .37in design wall thickness required (t min) t actual is 0.375 in t actual > t min Vol. 206 Pg. 93 BRAZOS COUNTY ROADWAY SAFETY AND ROAD PRESERVATION STANDARDS FOR WORK CONDUCTED IN BRAZOS COUNTY RIGHTS OF WAY A. General Requirements I. Adequate drainage shall be maintained in ditches at all times. 2, Permittee will use best management practices ( "BMP ") (EPA and TCEQ both provide lists of examples of BMPs) to minimize erosion and sedimentation resulting from the proposed installation. 3. The permittee shall take precautions to avoid damage to property. All County Right of Way and property shall be restored to its original condition, as far as practical, in the opinion of the County Engineer or appointed representative. 4. The construction and maintenance of such utility shall not interfere with the property or rights of a prior occupant. 5. Permittee shall not interfere with other utilities located in the right of way. In the event damages occur, permittee will be liable to the County or other utilities running through the right of way, 6. County Engineer shall determine whether or not permittee's plans shall inconvenience the public. If it is determined that inconvenience to the public exists, then the County Engineer will decide whether such project will be allowed or if an alternative exists so as not to inconvenience the public. B. Safety Requirements 1. Proper traffic control measures must be put in place prior to beginning work and remain in place during the duration of the job. All traffic control measures must follow the Texas Manual of Uniform Traffic Control Devices ( TMUTCD). See Traffic Control Requirements below. 2. During construction, all safety regulations of the Texas Department of Transportation shall be observed. 3. Permittee must take such precautions and measures, including placing and displaying safety devices, as may be necessary, in order to safely conduct the public through the project area. Company shall provide flagmen, signs, signals or devices necessary to provide complete safety to the public. 4. Adequate provisions must be made to cause minimum inconveniences to traffic and adjacent property owners. S. No cable, conduit and/or pole line shall be laid, constructed, maintained and /or repaired so as to constitute a danger or hazard of any kind to persons or vehicles using such road. Any poles placed in the Right of Way for future installation shall be placed at the back of the Right of Way, Exceptions may be approved by the County Engineer. C. Truffle Control Plan I. A traffic control plan, pursuant to the TMUTCD or Engineered Traffic Control Plan must be provided for the following: A. Any construction (i.e. pit, excavation, hole) left open over night, requires specific nighttime traffic control measures pursuant to the TMUTCD; b. If construction is within ten (10) feel of the roadway; or c. Any work performed in the road right -of -way; 2. Plan must be attached to the permit and kept at the job site any time work is being performed. 3. Plan must set forth the time of completion for the job. Vol. 206 Pg. %� D. Design Standards 1. All overhead installations shall conform to clearance standards of the Texas Department of Transportation and the pole be placed in the designated area for power specified as set forth in the Terris Utilities Code, Section 181.045. 2. All pole installation (including lighting) shall be placed at the backside of the Right of Way to ensure safety to the public. Any pole placed in violation of this requirement will be required to be moved to the appropriate location at the company's expense. Exceptions may be approved by the County Engineer. 3. All underground installations shall (these are minimum depths— utility may place deeper): a. be placed at a minimum depth of forty-eight (48) inches below the top of the pavement; b. be at least thirty -six (36) inches below ditch flow line when installation is within the area measured from top of bank to top of bank; c. be at least forty - eight (48) inches below ditch flow line if low pressure gas or petroleum lines. For high pressure gas and petroleum lines, see High Pressure Pipelines requirements listed below; d. not be closer than ten (10) feet from the edge of pavement. Exceptions may apply in rights of way of less than 60'. 4. Water Lines: All water lines must be a minimum 36- inches below the ditch flow line and cased. Waterlines shall be cased if crossing under the roadway. S. Utilities in all new developments that have 60 feet or greater of right of way shall be installed within designated locations based upon the type of utility. The locations shall be as follows: (measured from back of right -of -way). Power— 0.2 feet, nominally 1' Phone— 2 -4 feet, nominally 3' Gas — 4 -6 feet, nominally S' Cable — 6-8 feet, nominally 7' 6. Utilities with less than 60 feet right -of -way in all new developments shall install the utility in a similar manner as referenced in No. 3 above, however, the County Engineer or its designated representative will provide final approval of each utility location. 7. The length of any trench to be opened in advance of the pipe, conduit or ducts may not be longer than 400' if left open over night or unattended. H. Crossings under a county road shall: a. be bored orjacked. ABSOLUTELY NO OPEN CUTS WITHIN COUNTY ROAD PAVEMENT; b. be pressure grouted for the full length of the crossing !f the annular space between pipe and casing and soil exceeds one (1) inch. Brazos County must be given 24 homy notice of pressure grouting operations and have the opportunity to have an inspector on site to observe pressure grouting operations; C. TxDOT Standard Specification Item 476 shall be followed for all boring, jacking, tunneling and joints. 9. Bore Pits a. no pits shall remain open longer than 2 days; b, all pits shall have proper traffic control measures in place. See Traffic Control Plan listed above. C. pits shall NOT be located within ten (10) feet from the edge of pavement without prior approval from the County Engineer or his representative; d. when pits are to remain open for more than 8 hours, due diligence will be used in protecting the spoil pile to prevent drainage problems; e. based upon soil conditions, die County Engineer or his representative may require shoring to protect pavement integrity; f. based upon soil conditions, the County Engineer or his representative may require pits be placed further from the edge of road. Vol. 206 Pg. 9-') 10. Any installation within ten (10) feet of edge of pavement shall meet the following: a. location must be approved by the County Engineer or his representative b. backfilled with cement stabilized material. c. based upon soil conditions, the County Engineer or his representative may require shoring to protect pavement integrity. d. All excess water and mud shall be removed from the trench prior to backfilling. Any backfill placed during a rainy period or at other times where excess water cannot be prevented from entering the trench will be considered TEMPORARY and shall be replaced with PERMANENT cement stabilized material as soon as weather permits; e. All disturbed base and pavement materials shall be removed and restored to the satisfaction of the County Engineer or his representatives. f No side or lateral tamping to rill voids under the base and pavement materials is allowed. 11. Company must be careful to not jeopardize the slope or integrity of the shoulder of the road. In the event Company damages the slope, shoulder or any other portion of the right -of -way, Company will be responsible for repairing the damage and replacing the right -of -way to the condition it was prior to commencing construction. 12. Operation of construction and /or maintenance equipment on the traveled surface of any improved County road will not be permitted, except in an instance whereby the laying, cmrstrucdon, maintenance and/or repair of cables, conduits and /or pole lines cannot be accomplished by any other method and in this event all such equipment shall be of the rubber tire variety. Appropriate traffic control shall be provided meeting TMUTCD requirements. 13. In the event said construction and /or maintenance and /or repair requires Company to remove, cut orjeopardize any section of the road (asphalt, cement, road base, etc), Company will be required to provide a performance bond or letter of credit securing necessary repairs. Said bond amount will be determined by the County Engineer. 14. The applicant shall submit a letter of "No Objection" from the Arty Corps of Engineers for all designated wetlands and environmentally sensitive lands. E. Emergency work I. In the event Company is required to perform emergency services, that requires excavation in a County Right of Way, and unable to notify the County Engineer prior to conducting emergency repairs, Company shall notify County Engineer within 24 hours of beginning construction/repairs. This will allow the County Engineer's Office an opportunity to inspect the site to ensure the integrity of the County Right of Way and traffic safety controls used. R Repairs to e.isting jocillNes I. Maintenance and/or repair to existing cables, conduits, and /or pole lines which require disturbance of the soil, shall not be performed until plans describing such maintenance and/or repair have been approved by the County Engineer or its designated representative and a permit has been obtained. C. Relocallon of rrtllitles. I. When and if the County Engineer determines that it is necessary for the construction, repair, improvement, alteration or relocation of all or any portion of said road, any or all poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be removed from said road, or reset or relocated thereon, as required by the County Engineer within a reasonable time as determined by the County Engineer and Utility Company, and at the expense of the Utility Company. Vol. 206 Pg. �11K N. Nigh Pressure Pipelines 1. All utility Permits for high pressure pipelines (generally 60 PSI or greater), whether pertaining to controlled access or non-conti�olled access installations, should contain the following additional information in the description of the penn is - diameter -wall thickness - material specification - minimum yield strength - maximum operation pressure of the pipeline 2. With the exception of the maximum operation pressure of the pipeline, this information is to be supplied for both the carrier pipe and the casing. 3. Assurance must also be given that the installation material and design meet the minimum Federal Safety Standards for Liquid and Gas Pipe Lines. Assurance must be provided on company letterhead and signed by an authorized representative of the company. 4. Petroleum Pipelines: Depth Type of Pipeline (below deepest ditch ¢rade) Special Requirements Encased Pipe Less than 10' Must be covered with concrete pad at least 36 "deep Encased Pipe Greater than 10' No concrete pad required Non -Cased Pipe Less than 10' Must be covered with concrete pad at least 48" deep Non -Cased Pipe Greater than 10' No concrete pad required The Concrete pad shall be minimum of 3" thick and width shall be pipe diameter plus 18" minimum. 5. Under no circumstances will a pipeline be installed parallel to a County Road within the Right -of- Way. 'transmission lines have been determined to be petroleum pipelines (which includes natural gas lines) and shall not be parallel to a Cotmty Road. 6. Natural Gas Distribution is a line that serves the final customer. Vol. 206 Pg. y% }} fit IA { 5 ®e@�}vA..}by3L {!ti win lift L� 0 te a 83 �y� • ��' w.K. -a A/ } N it a � � O nbi +MINYt .& a a _ tiet{ ±iLlpSi k3 $bt_b_ kh kbk F ��lie �AAR si "E 1• RN$.S SS2 }} fit IA { 5 ®e@�}vA..}by3L {!ti win lift L� 0 te a 83 �y� • ��' w.K. -a A/ } N it a � � O ' �iJL.^. i./: L' �'.{«: Cii. ZJ/": fi' r..�B6i'o."�'SW"7/�.S"n"}.."�•t w°/ :1.'YET »/+mw» Vol. 206 Pg. 91f' K w 0 ���JJJJ g U Z K F U+ o> 3 O A �8 Z 2 Q ZNZ yN O U Y� K D+ _ 8 1/1 � O G - W F ff CL N . +MINYt a a _ � F ' �iJL.^. i./: L' �'.{«: Cii. ZJ/": fi' r..�B6i'o."�'SW"7/�.S"n"}.."�•t w°/ :1.'YET »/+mw» Vol. 206 Pg. 91f' K w 0 ���JJJJ g U Z K F U+ o> 3 O A �8 Z 2 Q ZNZ yN O U Y� K D+ _ 8 1/1 � O G - W F ff CL N a a ' �iJL.^. i./: L' �'.{«: Cii. ZJ/": fi' r..�B6i'o."�'SW"7/�.S"n"}.."�•t w°/ :1.'YET »/+mw» Vol. 206 Pg. 91f' K w 0 ���JJJJ g U Z K F U+ o> 3 O A �8 Z 2 Q ZNZ yN O U Y� K D+ _ 8 1/1 � O G - W F ff CL N z6 BRAZOS COUNTY, TEXAS BUDGET AMENDMENT(S) FOR THE 2013 -2014 BUDGET YEAR NO. 13/14 43.1— 43.5 On this the 12th day of August 2014 at a regular meeting of the Commissioners' Court, the following members were present: A. Duane Peters, County Judge, Presiding B. Lloyd Wassermann, Commissioner, Precinct 1 C. Sammy Catalena, Commissioner, Precinct 2 D. Kenny Mallard, Commissioner, Precinct 3 E. Irma Cauley, Commissioner, Precinct 4 F. Karen McQueen, County Clerk The following proceedings were held: THAT WHEREAS, on 12th day of August 2014 the Court heard and approved a budget amendment for the 2013 -2014 budget year for Brazos County, Texas; and WHEREAS, expenditure is necessary due to the necessity to meet unusual and unforeseen conditions which could not be reasonably included in the original budget adopted 10 September 2013, the following amendment(s) to the original budget are hereby authorized, as described on the attached page(s). ADOPTED AND APPROVED this the 12th day of August 2014. THE COMMISSIONERS COURT OF BRAZOS COUNTY, TEXAS. By: Duane Peters, County Judge Original: County Clerk's Office and Attached to the original budget Copies: County Auditor County Treasurer County Budget Officer Commissioners' Court Minutes Vol. 206 Pg. 1`7f BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 13114.43.1 and expenditures to match what revenue that was received for FY 14. When preparing FY 14 budget, the total amount should have 1.000. not $62,500. Vol. 206 Pg. IeO BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 13114 - 43.2 8/12/2014 (�����■ Vol. 206 Pg. /d/ BRAZOS COUNTY, TEXAS BUDGETAMENDMENTS No. 13114 - 43.3 811212014 Vol. 206 Pg. /�Z BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 13114 - 43.4 811212014 ACCOUNT NAME Vehicle Maintenance �- Reallocation of funds to cover for expenses for remainder of FY 14. -_ -- Vol. 206 Pg. 141_? BRAZOS COUNTY, TEXAS BUDGET AMENDMENTS No. 13114.43.5 8/1212014 Network Maintenance Computer Hardware Vol. 206 Pg. Z6S PERSONNEL CHANGE OF STATUS REQUESTS Commissioner Court Date: August 12, 2014 Department Submitting Information: Human Resources Purpose of Submissions: Consider and Take Action on Change Requests Department Submitting Employee Request Action Requested Request(s) Applies To County Clerk Baker, Debbie Reinstated District Attorney Thomas, Raymond Retirement Expo Complex Cooks, William Resignation Gardner, Keri New Hire Facilities Bustamante- Vasquez, Grisel Resignation Juvenile Dempsey, Penny New Hire Rodriguez, Anjela New Hire Road and Bridge Daniels, Stephen Retirement Thomas, Charles New Hire S.O. -Admin Anderson, Lyndsay New Hire S.O. — Jail Cruz, Dora No Show Donaldson, Dillon New Hire Felix- Rodriguez, Monica Transfer w /in Dept Murray, Sylvia Resignation Approved In Commissloners' Court: Auciust 122 4: County Judge's or Commissioner's Signature: (This Copy to be attached to minutes) Vol. 206 P2.16-5 6-5 ZI