R2022-156 2022-07-11RESOLUTION NO. R2022-156
A Resolution of the City Council of the City of Pearland, Texas, ratifying
expenditures with Change Healthcare Technology Enabled Services, LLC., for
fees associated with participation in the Texas Ambulance Supplemental
Payment Program, in the amount of $99,564.06.
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PEARLAND, TEXAS:
Section 1. That the City Council hereby ratifies expenditures, in the amount of
$99,564.06 for fees associated with participation in the Texas Ambulance Supplemental Payment
Program.
PASSED, APPROVED and ADOPTED this the 11th day of July, A.D., 2022.
________________________________
J.KEVIN COLE
MAYOR
ATTEST:
________________________________
LESLIE CRITTENDEN
CITY SECRETARY
APPROVED AS TO FORM:
________________________________
DARRIN M. COKER
CITY ATTORNEY
DocuSign Envelope ID: 487FA7C9-ADBF-4C7F-94A5-3EEC3B24F525
rrsztmnnnuAMCKPDP119217045213039094F‘,3026927445.3343032241,1
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Change Healthcare Technology Enabled
Serv1ces,LLC
PO BOX 742526
ATLANTA,GA 30374-2526
BILL TO:
Aim:Daniel Baum
Pearland Fire Department
2703 Veterans Dr
Pearland TX 77584
INVOICE 7004020700
Invoice Dale """0
Date Due 1
M10/0112021 10/3112021 _I
Customq§_Numhg;___V_Amount Due_:#__I
1175711 99,564.00 USD I
SaIes Org/Sales OHIEEIBIII Type.2030/2030/‘/BPS
For biI|ing quesIions,pIease contact:
For change of address requests,nreaseemail
TES1nvoiciI1g@cha11geh9a|thcare cum
SI11p-to:Pearland Fire uapamnenz
Location:PEARLAND TX 77504
Sh1p-(o,—parXy:11_712
Item No Mat Iescription
PO Number NO Po PROVIDED
Contract No‘K316725074!)Service Per1od'09/D1/21 -09/30/21
Recurring Fees
000010 74045131 PEMT Billing 2020-2021
Chan e HealthcareTechnology
Enab ed Services,LLC
PO BOX 742526
ATLANTA.GA 30374-2526
I"IIIIIIIIIIII‘|II|I||I'III!IIl'IIIIIIIII'I|'|II'I|IIII"IIII'IIATTNDANIELBAUIVIPEARL/\ND FIRE DEPARTMENT2703VETERANSDRPEARL/\ND,TX 775844410nnaaaaum‘
SIIbm(aI for Fearland Fire Department/FEARLAND TXH175712 ,
""""""""HIQLEASERETURN THIS PORTIONIIIIIIITHVOUR1515/'I1IIIé}i'T
7''Unit Amount"Net Amount TaxAvnagnt”
2,212,534.700 0.0450 99,564.06 000
EA
99,564.06 0 00
INVOICE 7004020700
TBTI
99,504.09
95,564.06
____A_@bu>tal Tax Total
_
Amount Due
99,564.06 0.00
‘
99,504.00
Customer Number Date Due
W“
Currency
10/3112021
REMIT TO:Change HealthcarePOBox742526ATLANTA.GA 30374-2526USA