HomeMy WebLinkAbout11-14-22 City Council Meeting Packet
CITY COUNCIL MEETING
Mayor
Amáda Márquez Simula
Councilmembers
John Murzyn, Jr.
Connie Buesgens
Nick Novitsky
Kt Jacobs
City Manager
Kelli Bourgeois
City Hall—Council Chambers, 590 40th Ave NE
Monday, November 14, 2022
6:00 PM
AMENDED AGENDA
AGENDA AMENDED ON 11/14/22 TO ADD ITEM 12 AND
SUPPORTING DOCUMENTS
ATTENDANCE INFORMATION FOR THE PUBLIC
Members of the public who wish to attend may do so in-person, by calling 1-312-626-6799
and entering meeting ID 816 0077 4087and passcode or by Zoom at
https://us02web.zoom.us/j/81600774087. For questions please call the Administration Department at
763-706-3610.
CALL TO ORDER/ROLL CALL
MISSION STATEMENT
Our mission is to provide the highest quality public services. Services will be provided in a fair, respectful
and professional manner that effectively addresses changing citizen and community needs in a fiscally -
responsible and customer-friendly manner.
PLEDGE OF ALLEGIANCE
APPROVAL OF AGENDA
(The Council, upon majority vote of its members, may make additions and deletions to the agenda.
These may be items submitted after the agenda preparation deadline.)
PROCLAMATIONS, PRESENTATIONS, RECOGNITION, ANNOUNCEMENTS, GUESTS
CONSENT AGENDA
(These items are considered to be routine by the City Council and will be enacted as part of the Consent
Agenda by one motion. Items removed from consent agenda approval will be taken up as the next
order of business.)
MOTION: Move to approve the Consent Agenda as presented.
1. Approve October 24, 2022 City Council Meeting Minutes.
MOTION: Move to approve the September 26, 2022 City Council meeting minutes.
2. Accept October 5, 2022 Library Board Minutes.
MOTION: Move to Accept the Library Board Minutes from October 5, 2022.
3. Approve September 7, 2022 Planning Commission Meeting Minutes.
MOTION: Move to approve the September 7, 2022 Planning Commission M eeting Minutes.
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City Council Meeting Page 2
4. Approve September 26, 2022 Special EDA Meeting Minutes.
MOTION: Move to approve the Special EDA Meeting Minutes of September 26, 2022.
5. Adopt Resolution 2022-99, Updating Income Limit for Senior Citizen Utility Rates.
MOTION: Move to waive the reading of Resolution 2022-99, there being ample copies
available to the public.
MOTION: Move to adopt Resolution 2022-99, being a resolution updating the income limit
for senior citizen utility rates.
6. Adopt Resolution 2022-100 submitting a list of eligible nominees to Anoka County for the
Open Manager position on the Rice Creek Watershed District Board of Managers.
MOTION: Move to waive the reading of Resolution 2022-100 there being ample copies
available to the public.
MOTION: Move to adopt Resolution 2022-100 being a Resolution Submitting a List of
Eligible Nominees to Anoka County for the Open Manager Position on the Rice Creek
Watershed District Board of Managers.
7. Adopt Resolution 2022-103 Accepting the Feasibility Report for 53rd Avenue Turnabout
Construction and Ordering the Public Improvement Hearing, City Project No. 2007.
MOTION: Move to waive the reading of Resolution 2022-103, there being ample copies
available for the public.
MOTION: Move to adopt Resolution 2022-103, being a Resolution accepting the Feasibility
Report for 53rd Avenue Turnabout Construction, Project 2007, and ordering the Public
Improvement Hearing beginning at 6:15 p.m. on February 21, 2023.
8. Adopt Resolution 2022-104 Accepting the Feasibility Report and Ordering the Public
Improvement Hearing for 53rd Avenue Trail, Sidewalk, and Partial Street Reconstruction
and Ordering the Public Improvement Hearing, City Project No. 2305.
MOTION: Move to waive the reading of Resolution 2022-104, there being ample copies
available for the public.
MOTION: Move to adopt Resolution 2022-104, being a Resolution accepting the Feasibility
Report for 53rd Avenue Trail, Sidewalk, and Partial Street Reconstruction, Project 230 5,
and ordering the Public Improvement Hearing beginning at 6:00 p.m. on February 21, 2023.
9. Refuse Dumpster Services Contract with Walters Recycling & Refuse.
MOTION: Move to approve a refuse dumpster service contract with Walters Recycling &
Refuse; and authorize the Mayor and City Manager to enter into a contract for the same.
10. Approve Change Order for Contract for Painting of Public Safety Building.
MOTION: Move to authorize the Police Department to enter into an agreement with
Allen’s Perfect Painting to repair and paint walls not previously budgeted for in the
carpeting project completed earlier this year. The change order amount to be $28 ,155,
with monies to come from the Police Department’s regular budget.
11. Adopt Resolution 2022-102, Transfer of Funds to the Fire Department 2022 Budget.
MOTION: Move to waive the reading of Resolution No. 2022-102, there being ample copies
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to the public.
MOTION: Move to adopt Resolution 2022-102, being a resolution amending the 2022 Fire
Department budget.
12. Approve the 2023 Contract with Medica for Employee Health Insurance.
MOTION: Move to approve Medica as the City’s health insurance provider for 2023 and
authorize the City Manager to sign the contract.
13. Rental Occupancy Licenses for Approval.
MOTION: Move to approve the items listed for rental housing license applications for
November 14, 2022, in that they have met the requirements of the Property Maintenance
Code.
14. Review of Bills.
MOTION: Move that in accordance with Minnesota Statute 412.271, subd. 8 the City
Council has reviewed the enclosed list to claims paid by check and by electronic funds
transfer in the amount of $2,658,291.65.
PUBLIC HEARINGS
15. Approve Resolution 2022-101, Emergency Abatement for Hazardous Situation at 4201
7th Street NE.
MOTION: Move to close the public hearing and to waive the reading of Resolution 2022 -
101, there being ample copies available to the public.
MOTION: Move to adopt Resolution Number 2022-101, being a resolution of the City
Council of the City of Columbia Heights declaring the property listed a nuisance and
approving the emergency abatement, and any subsequent abatements, of the hazardous
situation located at 4201 7th St NE.
ITEMS FOR CONSIDERATION
16. Resolution 2022-98, Conditional Use Permit to Allow Accessory Outdoor Storage at 660
39th Avenue NE.
MOTION: Move to waive the reading of Resolution 2022-98, there being ample copies
available to the public.
MOTION: Move to approve Resolution 2022-98, a resolution approving a Conditional Use
Permit for Accessory Outdoor Storage within the I-2, General Industrial District in the City
of Columbia Heights, Minnesota.
17. Approve Resolution 2022-105 Early Redemption of Taxable G.O. Housing Improvement
Area Bonds, Series 2008A.
MOTION: Move to waive the reading of Resolution 2022-105, there being ample copies
available to the public.
MOTION: Move to adopt Resolution 2022-105, being a resolution calling for redemption of
Taxable General Obligation Housing Improvement Area Bonds, Series 2008A.
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City of Columbia Heights AGENDA November 14, 2022
City Council Meeting Page 4
18. Approve Resolution 2022-106 Appropriating $600,000 of Existing Fund Balance for Use in
the 2022 Budgets of the Governmental Operating Funds.
MOTION: Move to waive the reading of Resolution 2022-106, there being ample copies
available to the public.
MOTION: Move to adopt Resolution 2022-105, being a resolution appropriating $600,000
of existing fund balance for use in the 2022 budgets of the governmental operating funds.
Ordinances and Resolutions
Bid Considerations
New Business and Reports
CITY COUNCIL AND ADMINISTRATIVE REPORTS
Report of the City Council
Report of the City Manager
COMMUNITY FORUM
At this time, individuals may address the City Council in a respectful manner. Individuals
should address their comments to the City Council as a whole, not individual members. Speakers that
are inperson are requested to come to the podium. All speakers need to state their name and
connection to Columbia Heights, and limit their comments to five (5) minutes. All speakers are also
asked to fill out this information as well as their address on a form for the Council Secretary's record.
Those in attendance virtually should send this information in the chat function to the moderator and
make sure to turn on their video and audio when they address the Council. The City Council will listen
to brief remarks, ask clarifying questions, and if needed, request staff to follow up or direct the matter
to be added to an upcoming agenda. Generally, the City Council will not take official action on items
raised at the Community Forum at the meeting on which they are raised.
ADJOURNMENT
Auxiliary aids or other accommodations for individuals with disabilities are available upon request when the request is
made at least 72 hours in advance. Please contact Administration at 763-706-3610 to make arrangements.
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CITY COUNCIL MEETING
Mayor
Amáda Márquez Simula
Councilmembers
John Murzyn, Jr.
Connie Buesgens
Nick Novitsky
Kt Jacobs
City Manager
Kelli Bourgeois
City Hall—Council Chambers, 590 40th Ave NE
Monday, October 24, 2022
6:00 PM
MINUTES
The following are the minutes for the Meeting of the City Council held at 6:00 pm on Monday,
October 24, 2022, in the City Council Chambers, City Hall, 590 40th Avenue NE, Columbia Heights,
Minnesota.
CALL TO ORDER/ROLL CALL
Mayor Márquez Simula called the meeting to order at 6:00 pm.
Present: Mayor Márquez Simula; Councilmember Buesgens; Councilmember Jacobs; Councilmember
Murzyn, Jr.; Councilmember Novitsky
Also Present: Kelli Bourgeois, City Manager; Kevin Hansen, Public Works Director; Jim Hoeft, City
Attorney; Sara Ion, City Clerk; Erik Johnston, Police Captain; Charlie Thompson, Fire Chief; Jack
Isrealson, Youth Commissioner; Mary Kunesh, State Senator; Renee Dougherty, Library Director; Eliza
Pope, Youth Librarian; Paul Edner, City Resident; Mark Veronicas, City Resident; Aza Donnelly, City
Resident; K Meyers, City Resident
MISSION STATEMENT
Our mission is to provide the highest quality public services. Services will be provided in a fair, respectful
and professional manner that effectively addresses changing citizen and community needs in a fiscally-
responsible and customer-friendly manner.
PLEDGE OF ALLEGIANCE
APPROVAL OF AGENDA
Motion by Councilmember Novitsky, seconded by Councilmember Murzyn Jr., to approve the Agenda as
presented. All Ayes, Motion Carried 5-0.
PROCLAMATIONS, PRESENTATIONS, RECOGNITION, ANNOUNCEMENTS, GUESTS
A. Todd Estrem Day Proclamation
Mayor Márquez Simula proclaimed October 19, 2022, as “Todd Estrem Day” and read the
City’s proclamation.
B. Native American Heritage Month Proclamation
Youth Commissioner Isrealson read the City’s proclamation for “Native American Heritage
Month” for November 2022.
Senator Kunesh accepted the proclamation and stated she is a proud decent of the
Standing Rock Lakota Nation. She said on behalf on the diverse number of members of
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Indigenous people across the community and state, she accepts the proclamation and
thanked the Council for the recognition of the indigenous people and the land they walk
on.
C. Introduction of Eliza Pope, Youth Librarian
Library Director Dougherty introduced Youth Librarian Pope. She stated that Pope earned
her Master of Library and Information Science at the University of Alabama; she brings
work experience from Tuscaloosa and Saint Louis public libraries. Dougherty added that
most recently she was a Teen Specialist and the manager at the Createch Lab at the Saint
Paul Public Library.
Youth Librarian Pope said she has enjoyed getting to know the families and youth within
the City. She updated the Council on the summer reading program that happened, and said
that they had 302 youth register and they read a combined 1,889 hours. She stated that
the “Volun-teen” program returned, they had 16 volunteers and they volunteered 95 hours
in total. Pope said they hosted a variety of art programs with their 21 st Century grant,
which encouraged youth to learn new skills with new mediums. The library also hosted a
screen-printing class which was led by resident and MCAD Professor Natasha Pestich.
D. Citizens Justice Academy Update
Police Captain Johnston said the idea of the Citizens Justice Academy began in July of this
year and is going to be a broader overview of the criminal justice system from beginning to
end. He said that it is five sessions and free to attend on Thursday nights beginning
November 3, 2022; a meal will be provided. He stated that interested participants can sign
up by contact Officer Monberg or calling the police department directly.
CONSENT AGENDA
Motion by Councilmember Murzyn Jr., seconded by Councilmember Buesgens, to approve the Consent
Agenda as presented. All Ayes, Motion Carried 5-0.
1. Approve October 3, 2022 City Council Work Session Meeting Minutes
MOTION: Move to approve the October 3, 2022 City Council Work Session meeting
minutes.
2. Approve October 10, 2022 City Council Meeting Minutes
MOTION: Move to approve the October 10, 2022 City Council meeting minutes.
3. Railroad Agreement for 37th Avenue Reconstruction Project
MOTION: Move to approve an agreement with Soo Line Railroad (CP Rail) for right of entry
and a construction agreement for the reconstruction of 37th Avenue; and authorize the
Director of Public Works to sign the agreements.
4. Adopt Resolution 2022-97, Accepting the Feasibility Report for 37th Avenue and 37th
Place Street Reconstruction and Multi-use Trail and Ordering the Public Improvement
Hearing, City Project Nos. 2110 and 2306
MOTION: Move to waive the reading of Resolution 2022-97, there being ample copies
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available to the public.
MOTION: Move to adopt Resolution 2022-97, being a resolution accepting the Feasibility
Report for 2023 Street Reconstruction – 37th Avenue and 37th Place, City Project Nos.
2110 and 2306, and ordering the Public Improvement Hearing beginning at 6:00 p.m. on
January 10, 2023.
5. License Agenda
MOTION: Move to approve the items as listed on the business license agenda for October
24, 2022 as presented.
6. Rental Occupancy Licenses for Approval
MOTION: Move to approve the items listed for rental housing license applications for
October 24, 2022, in that they have met the requirements of the Property Maintenance
Code.
7. Review of Bills
MOTION: Move that in accordance with Minnesota Statute 412.271, subd. 8 the City
Council has reviewed the enclosed list to claims paid by check and by electronic funds
transfer in the amount of $1,282,813.33.
PUBLIC HEARINGS
ITEMS FOR CONSIDERATION
8. Refuse Service Contract with Walters/Haul Star
Director Hansen reported that the current refuse hauling contract ends December 31,
2022. Although a two-year extension is provided in the contract, Staff notified the current
hauler, Waste Management, that a new RFP will be issued early in 2022. The first step was
to review and update the Solid Waste Operating Policy (SWOP), as it is the primary
document that provides policy guidance for creating service vendor RFPs to perform the
work as directed. The SWOP was reviewed and approved by the Council in February 2022.
Director Hansen stated that an RFP was prepared by Staff for trash, recycling, yard waste,
organics, and bulk services for the City. The RFP was prepared so vendors could respond to
a single service or any one of the services for the city. Two vendors provided responses to
the RFP: Waste Management and Walters Recycling & Refuse. Over the past year Waste
Management has failed to perform the contract standards for trash collection, as well as
other services, causing delays in service almost weekly. Staff asked Walters Recycling &
Refuse to attend the June 27, 2022, Council meeting to review their proposal, provide
company information, and be available for any qu estions from the Council. The Council
then directed Staff to prepare a contract with Walters.
Director Hansen said that on July 28, 2022, Walters informed the City Manager and Staff
that they were withdrawing their proposal due to worker shortages and ina bility to hire
drivers. Staff then contacted other vendors, including Waste Management and Republic for
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providing City refuse services. Both contractors indicated interest in providing services to
the City, but were specific in that they would not pick up in alleys.
Director Hansen explained that due to ongoing service issues with Waste Management,
Staff was able to find other contractors to perform other refuse services such as yard waste
(Better Futures), bulky materials (College Hunks), and compost cart s (Haul Star). In our
review of the work by Haul Star, they were providing a high level of service using rear load
trucks, which are necessary to service our alleys. Staff inquired if Haul Star had an interest
in or would consider providing trash and recycling service in our alleys, as the alleys require
rear load packer trucks.
Director Hansen said that on September 30, 2022, a proposal from Walters and Haul Star
was received. They are proposing to team up on providing services to the community. Haul
Star will provide services to properties collected in the alleys and Walters will provide
services to all other areas. This is for trash and recycling only. Staff has prepared a contract
for the Walters and Haul Star team, which has been reviewed by the City Attorney and
Walters and is included. The contract is for a 4-year term, with a 1-year extension option.
The pricing sheet was provided to the Council at the meeting; Director Hansen mentioned
that prices in total, were going up by 24% and tipping fees increase for waste are about
34%. Staff is reviewing a contract for dumpster services and that will be presented to the
Council at a future meeting. Additionally, the phased replacement of City carts will be
presented at a future Council meeting for consideration.
Staff recommends approving the contract with Walters Recycling & Refuse/Haul Star
Sanitation for providing trash and recycling services to the City.
Councilmember Buesgens thanked Director Hansen and his Staff for their work on this
issue.
Director Hansen recognized Public Works Refuse Coordinator Jesse Davies for his work.
Councilmember Jacobs stated she was thankful that Walters came back with a proposal.
Councilmember Murzyn Jr. thanked Director Hansen and Refuse Coordinator Davies for
their work and that there will be a reliable hauler.
Mayor Márquez Simula said that she has heard from the community about the issue
throughout the last three months but there was also concern about what would happen
come January 1, 2023. She thanked Director Hansen and Refuse Coordinator Davies.
Motion by Councilmember Murzyn. Jr., seconded by Councilmember Buesgens, to approve a
refuse service contract with Walters/Haul Star; and authorize the Mayor and City Manager
to enter into a contract for the same. All Ayes, Motion Carried 5-0.
9. Amend 2022 Budget for $2,300,000 and Award Related Purchase Agreement(s) to
MacQueen Equipment Through the Houston-Galveston Area Council (HGAC) Consortium
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Pricing Contract, for One Impel Pumper and One Impel 110’ Platform Bid # 989 & 990
Fire Chief Thompson reported that during the October 3, 2022, Council work session, Chief
Thompson gave his budget presentation followed by a detailed capital equipment purchase
presentation. The capital equipment presentation provided details on past equipment
purchases and the current needs for replacement. Chief Thompson shared NFPA 1901
Annex D for replacement guidelines as outlined in the 2018 Staffing study.
Chief Thompson explained that the discussion focused on two pieces of apparatus needing
replacement. The aerial has failed several times in the past two years; it has failed
completely at two fire scenes and had to be towed back to the fire station. This truck will
reach its recommended replacement time in 2024. The current third out engine was also
mentioned. It is a 1995 general safety pumper, and it has already exceeded the
recommended replacement date. Cost savings was a second major cause for action
presented to the Council for consideration. The replacement cost for these trucks has risen
around 28% in just under two years. Effective November 1, 2022, the price will increase
another 6.5%. This increase alone will raise the purchase price of both trucks $167,000.00.
The third consideration for replacement is that it now takes t hree times longer to build
these trucks than in the past; current timeline is 30 to 34 months.
Chief Thompson stated that after reviewing this information with the Council, Chief
Thompson and Director Klobier were given very specific direction. The Council wanted the
2022 budget amended to include the purchase of both pieces of apparatus in 2022 versus
2023. The Council directed the Chief Thompson and Director Klobier to present the
required documents necessary to approve these trucks at the October 24, 2022, Council
meeting.
Chief Thompson and Director Klobier prepared several documents for the Council to
approve at the Council meeting. These include a resolution amending the 2022 budget and
the Council letter detailing the agreement with MacQueen Emergency group through an
agreement with the Houston-Galveston Area Council (HGAC) at Consortium Pricing for one
Impel Pumper at a total cost of $828,574.00 and one Impel 110’ Platform at a cost of
$1,436,255.00 for a total purchase price of $2,264,829.00.
Director Klobier made note that this item was proposed for the 2023 budget so therefore it
would be pulled from that budget and added to the 2022 budget with this action.
Motion by Councilmember Jacobs, seconded by Councilmember Novitsky, to waive the
reading of Resolution 2022-96, there being ample copies available to the public. All Ayes,
Motion Carried 5-0.
Motion by Councilmember Jacobs, seconded by Councilmember Murzyn Jr., to adopt
Resolution No. 2022-96 amending the 2022 budget to appropriate $2,300,000 from the
fund balance of Government Equipment Fund 431 and authorize the city manager to enter
into the related vehicle purchase agreement(s) with MacQueen Emergency Group unde r a
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cooperative purchasing contract with the Houston-Galveston Area Council (HGAC.) All Ayes,
Motion Carried 5-0.
CITY COUNCIL AND ADMINISTRATIVE REPORTS
Report of the City Council
Mayor Márquez Simula said that she set up a display about Poland at the library for Polish Heritage
Month; she attended the Booster dinner with other Councilmembers; attended the Youth Commission
meeting; she continues to make an art piece with the MWMO; toured the personal care facility open
house; she taught a class on Día de los Muertos with HeightsNext at the library. She volunteered with
the Every Meal program at Valleyview School; she attended the fire department open house; spoke at
a Minnesota Healthcare Forum at the library; and attended the ribbon cutting at the high school for
the gym that the Boosters purchased for them.
Councilmember Novitsky said he attended the Booster dinner and thanked the Boosters for donating
the gym floors. He said the Adopt-a-Highway was held a few weeks ago and he thanked everyone who
helped for the event or donated hygiene items.
Councilmember Murzyn Jr. said the fire department open house was well attended; he attended the
Booster banquet; attended Todd Estrem’s 60th birthday and that a lot of people attended in support;
he said the shredding event did alright. He added that the Lions Club was having their Halloween Bash
Saturday, October 29, 2022, which opens at 6:30 pm; City Nights will be playing and there will be a
costume contest with cash prizes.
Councilmember Buesgens stated she attended the Minnesota Climate Adaption Partnership monthly
webinar; she thanked Public Works for adding more ADA corners to the intersections in the City; she
thanked the high school for joining the effort in recycling plastic bags and wraps; she attended the
Boosters’ awards dinner; attended the high school ribbon cutting ceremony; attended the fire
department open house; attended Tom Estrem’s birthday party; and attended the open house for the
personal care senior living.
Councilmember Jacobs said she attended Tom Estrem's celebration; attended the fire house open
house; attended the open house for the personal care facility; participated in the Adopt -a-Highway;
and she said that the Trunk-or-Treat will be held that weekend. She made a statement regarding the
last three months and the impact to all involved; she said that “the time has come and it is her intent
to return her focus to the tasks and responsibilities that over 4,200 voters elected her to.” She said that
the mayor previously stated that they may not all agree with each other, but it should not prevent
them from fulfilling their roles on the Council. She asked that with that in mind, that the efforts of the
Council be received appropriately on behalf of the residents and not disregarded because of personal
prejudice toward her.
Report of the City Manager
Manager Bourgeois said that Trunk-or-Treat will be held October 29, 2022, from 1:00 pm-4:00 pm at
Huset Park East and listed all the activities that will take place. She said that the pet costume contest
will be sponsored by Healing Hearts Rescue and the winn er will receive an exam from Pet Central and
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Puppet Wagon will have shows in the afternoon. She said that November 1, 2022, is the deadline for
the art submissions for the City wall calendar; the City is looking for art from residents or of City
landmarks, events, or performers or photos of an artistic nature. Submissions can be emailed to
photos@columbiaheights.gov, there is a maximum of three submissions and more information can be
found at www.columbiaheights.gov/photos.
COMMUNITY FORUM
Mayor Márquez Simula opened the community forum.
Paul Edner, City Resident, spoke regarding the new City Hall and apartments construction impact ing
the roads. He said he was concerned that taxpayers may need to pay for resurfacing due to d amage to
the roads during construction. He also expressed concern about the new parking and said that typically
families have more than one vehicle and with guests additional parking will be needed; he doesn’t
believe there will be enough parking, especially during the winter season when parking restrictions are
in place.
Mark Veronicas, City Resident, said he was also concerned about the roads near the new construction.
He stated he previously spoke to someone in Public Works and that they were going to tar further up
on Peters Place NE and Gould Avenue NE but they still stopped in the same spot. He added that they
were also going to put up a “no parking” sign at the bottom of his alleyway so the garbage trucks could
get in and out. He expressed concerns about what the end result may be because neither of these
things happened, and he said that the entrances near the Heights Theater, Dairy Queen, and the
church isn’t where the old ones were. Veronicas said that there hasn’t been enough communication
about the changes and some of the changes don’t make sense. He also made comments regarding if
residents will be having a special assessment in the future for the roads.
Aza Donnelly, City Resident, thanked the mayor and the Council for their professionalism throughout
the last three months while the investigation took place and said it impacted both the Council and
those within the City. She said that although the censure took place, residents are distressed that there
is someone sitting on the Council who has treated members of the community with some distain, and
they are waiting for her to resign so they can put this behind them. Donnelly stated that it is “not over”
until Councilmember Jacobs resigns.
K Meyers, City Resident, stated that she is just learning about what happened with Councilmember
Jacobs from the newspapers and she said that in respect to all of the Councilmember , to “grow up”.
She said that she is tired of the political climate, where it is all about them; she said it’s time to move
on and no one is perfect, we’ve all made mistakes or said things that we regret.
ADJOURNMENT
Motion by Murzyn Jr., seconded by Councilmember Buesgens, to adjourn. All Ayes, Motion Carried 5-0.
Meeting adjourned at 6:54 pm.
Respectfully Submitted,
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______________________________________
Sara Ion, City Clerk/Council Secretary
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COLUMBIA HEIGHTS PUBLIC LIBRARY
3939 Central Ave NE, Columbia Heights, MN 55421
BOARD OF TRUSTEES: MEETING MINUTES
Wednesday, October 5th, 2022
Approved
11/2/2022
ATTENDANCE INFORMATION FOR THE PUBLIC
Members of the public who wished to attend could do so in-person, by calling 1-312-626-6799 and entering meeting ID 862 5221 5747 and passcode 039390, or by
Zoom at https://us02web.zoom.us/j/86252215747 at the scheduled meeting time. For questions, please call the library at 763-706-3690.
The meeting was called to order in the Library Community Room by Teresa Eisenbise at 5:30pm.
Members physically present: Teresa Eisenbise; Chris Polley; Rachelle Waldon; Carrie Mesrobian; Nick Novitsky (Council
Liaison). Members remotely present: N/A. Members Absent: Gerri Moeller. Also present: Renee Dougherty (Library
Director); Nick Olberding (Recording Secretary). Public physically/remotely present: N/A.
1. The Minutes of the September 7, 2022, Board Meeting were moved and unanimously approved.
2. Review Operating Budget: 75% into the year and 72% of the budget encumbered.
a. Utility Services (43800): In 2022 and future years, this new line will show expenditures for budget
estimates shown in lines 43820 for water and 43850 for sewer for 2022.
b. E-Books (42183): $5,658 over budget (includes e-audiobooks and e-magazines). CHPL contracts with
Anoka County Library for access to ebooks rather than purchasing collection items. ACL bills for this
access based on patron usage patterns and actual collection expenditures from the previous year,
approximately 4.14%. Collection expenditures and patron usage of electronic materials has grown over
the last three years. Checkouts of electronic materials account for 19% of Columbia Heights circulation
with 81% coming from checkout of physical items.
Community Forum: Opportunity for public input; no correspondence, and no public in attendance at this meeting.
Old Business: N/A
New Business:
3. Examination of Community Room Use: Dougherty provided the Board with data on use in 2021 and 2022. The
room was not available for public rental until September 2021. Renee said that she has fielded roughly 30 calls
for Community Room use in 2022 but doesn’t know why there have only been a handful of reservations. Reasons
could include rental fees, lack of availability, policy restrictions on charging admission fees, storing equipment, or
having food or alcohol.
a. The Board expressed their aversion to charging a fee to local community groups especially book clubs and
other literacy-based groups that share the Library’s mission.
b. The Board observed that several groups already use the room for free (Northeast Business Council, CHPL
Foundation).
c. Neither Councilmember Novitsky nor the Board was particularly comfortable with groups using the room
while the building is closed, which is allowed under current policy.
d. Novitsky explained that the City Council has made an exception in the cost of library room rental which is
significantly lower than rates for rooms at Murzyn Hall and park shelters.
e. Novitsky conveyed that the Park and Rec Commission in partnership with the CH Athletic Boosters, grants
fee waivers or scholarship funds to cover the rental costs at Murzyn Hall. Applications are reviewed by
the Parks and Rec Commission at regular meetings, allowing them to assess waiving rental fees on a case-
by-case basis. Novitsky suggested the Board could investigate a similar process with the CHPL Foundation
providing funding.
f. The Board will continue discussion at future meetings.
13
Item 2.
4. Strategic Planning: The Board discussed the previous idea of preparing a presentation template for promoting
the Library and its services to various types of groups (e.g. school districts, non-profits, community groups, PTA,
etc). This would help guide any one of them to advocate and promote the library when the opportunity arises.
Dougherty will gather information to help put this presentation together, starting with a PowerPoint used for
building tours. Novitsky mentioned that Will Rottler has lists and contact info for local community groups
nonprofits, and churches.
5. Director’s Update: Operational reports, general updates, event reminders, and items from the floor.
a. August Operational Report
b. Board commented positively on increasing visits, circulation, and computer usage.
c. The Board expressed regret that Library staff has had to deal with multiple drunk and/or disorderly
patrons verbally harassing them, which also required police calls. The Board is very appreciative of the
staff for enduring this and being patient with the public and are concerned with staff mental health.
d. Library Programs:
i. Doug Ohman’s next Minnesota From the Road presentation is November 5th.
ii. The Library hosted a Careerforce resume workshop, but registered people did not attend.
Another workshop will be offered October 18th at 1pm. Polley would have promoted to seniors at
the high school, but it is during the school day.
iii. Mental Health Awareness Workshop is Monday, October 10th.
There being no further business, a motion to adjourn was made and seconded at 6:42 pm and the meeting was
adjourned.
Respectfully submitted,
Nicholas P. Olberding
Recording Secretary, CHPL Board of Trustees
14
Item 2.
PLANNING COMMISSION
City Hall—Council Chambers, 590 40th Ave NE
Wednesday, September 07, 2022
6:00 PM
MINUTES
CALL TO ORDER/ROLL CALL
The meeting was called to order at 6:00 pm by Chair Sahnow.
Commissioners present: Laurel Deneen, Stan Hoium, Tom Kaiser,Mike Novitsky, Eric Sahnow,Mark
Vargas, Clara Wolfe,Council Liaison John Murzyn,Jr.
Also Present:Aaron Chirpich,Community Development Director;Bob Kirmis,Planning
Consultant;Alicia Howe,Administrative Assistant;Mary Rooney,City Resident;John Martin,City
Resident;DeWayne Morrell,City Resident
APPROVE MINUTES
1.Approve August 3, 2022 Planning Commission Meeting Minutes
Motion by Hoium,seconded by Novitsky, to approve the Planning Commission Meeting
Minutes of August 3, 2022.All ayes. MOTION PASSED.
PUBLIC HEARINGS
2.Minor Subdivision (Lot Line Adjustment) 4221 and 4217 Reservoir Boulevard NE
Introduction:Chirpich stated that Michael Hamman has requested approval of a Minor
Subdivision, per City Code Section 9.104 (k), for abutting parcels of land located at 4217
and 4221 Reservoir Boulevard NE.
The subject sites, both occupied by single family homes, are zoned R-1, Single Family
Residential and are surrounded by similarly zoned properties.
The applicant, the owner of the 4221 parcel, has reached agreement with the neighboring
property owner to the south to shift the shared side lot between the two lots such that a
“pie-shaped” area of land measuring 3,430 square feet is size will be conveyed to the north
property. Basically, the minor subdivision calls for the shared rear yard corner monument
(between the two properties) to be shifted to the south a distance 40 feet.
To be noted is that lot configurations along the west side of Reservoir Boulevard NE are
characterized by side lot lines which run diagonally from the street right-of-way line (as
opposed to more typical side lines which are perpendicular to streets). These side lot line
conditions tend to create triangular-shaped side yards which oftentimes result in widely
varied side yard structure setbacks and limited side yard usability. The proposed land
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City of Columbia Heights MINUTES September 07, 2022
Planning Commission Page 2
conveyance will result in a new, more centrally located shared side lot line between the
two homes.
Lot Requirements.In consideration of the minor subdivision application, a determination
should be made that the newly created lots meet the minimum lot area and width
requirements of the applicable R-1 zoning district. According to Section 9.109.C of the
Zoning Ordinance,lots within R-1 Districts must have a minimum lot area of 8,400 square
feet and a minimum width of 70 feet.
Presently, the north parcel (4221 Reservoir Boulevard) measures 16,107 square feet in size
and has a width of 100 feet. As a result of the proposed lot line adjustment, the parcel
would be increased to 19,317 square feet in size and increased in width to 106 feet.
Presently, the south parcel (4217 Reservoir Boulevard NE), measures 16,035 square feet in
size and likewise has a width of 100 feet. As a result of the proposed lot line adjustment,
the parcel would be decreased to 12,825 square feet in size and decreased in width to 94
feet.
Both proposed lots meet the minimum area and lot width requirements of the R-1 District.
Setbacks.The proposed lot line adjustment will result in a change to side yard structure
setbacks. According to Section 9.109.C of the Zoning Ordinance, lots within R-1 Districts
must maintain side yard setbacks of not less than 7 feet.
As a result of the proposed lot line adjustment, the structure setback on the north parcel
(Lot 5) will be increased in from 9 feet to 23 feet while the side yard setback on the south
parcel (Lot 6) will be reduced from 28 feet to 22 feet. Both proposed lots meet the
minimum setback requirements of the R-1 District.
Findings of Fact.Section 9.104 (K) of the Zoning Code outlines specific conditions in order
for the City Council to approve a minor subdivision. They are as follows:
1.The proposed subdivision of land will not result in more than three lots.
Staff Comments:The proposed subdivision will result in two conforming lots.
2.The proposed subdivision of land does not involve the vacation of existing easements.
Staff Comments:No vacation of existing easements will occur as a result of the minor
subdivision.
3.All lots to be created by the proposed subdivision conform to lot area and width
requirements established for the zoning district in which the property is located.
Staff Comments:Both newly created lots will conform to the lot width and lot area
requirements of the applicable R-1 zoning designation.
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City of Columbia Heights MINUTES September 07, 2022
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4.The proposed subdivision does not require the dedication of public rights-of-way for
the purpose of gaining access to the property.
Staff Comments:The proposed subdivision does not require the dedication of public
rights-of-way for the purpose of gaining access to the property.
5.The property has not previously been divided through the minor subdivision provisions
of this article.
Staff Comments:The subject property has not previously been subdivided via a minor
subdivision process.
6.The proposed subdivision does not hinder the conveyance of land.
Staff Comments:The proposed subdivision will not hinder the conveyance of land.
7.The proposed subdivision does not hinder the making of assessments or the keeping of
records related to assessments.
Staff Comments:The proposed subdivision is not expected to hinder the making of
assessments or the keeping of records related to assessments.
8.The proposed subdivision meets all the design standards specified in Section 9.115.
Staff Comments:As a condition of minor subdivision approval, all applicable design
standards of Section 9.115 of the Zoning ordinance must be satisfied.
Recommendation:Staff review finds that the proposed Minor Subdivision (lot line
adjustment) application meets the requirements of the Zoning Ordinance. As a result,
Staff recommends that the Planning Commission recommend approval of the proposed
Minor Subdivision for the properties located at 4221 and 4217 Reservoir Boulevard NE
(Lots 5 and 6, Block 11, Auditor’s Subdivision of Walton’s Second Addition) subject to
certain conditions.
Chirpich added that one resident submitted a concern, which was in the packet, relating to
if the buildable area be diminished if there was redevelopment. He stated that the lot
would still be buildable with a variety of modern floor plans.
Vargas asked about the survey and if it was required to have a survey versus a survey plan.
Chirpich stated that a certificate of survey is what is required for the application.
Vargas further stated that he believed other details that should be documented are not on
the survey and asked if the survey was a complete notarized survey. Chirpich asked Vargas
if he believed if there was any reason why the County would not accept this as a legal
survey.Vargas commented on the lot certificate and said that the new lot corner needs to
be a stamped rebar corner cap.
Hoium clarified the applicant’s request and asked if the City had any objections. Chirpich
stated the City does not.
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City of Columbia Heights MINUTES September 07, 2022
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Sahnow asked if the applicant mentioned why they are moving the lot line. Chirpich stated
they did not, but that the applicant was the owner of both properties originally, and he
sold the one lot where the triangle is proposed to be acquired.
Chirpich asked Mary Rooney, representative for the applicant, if she knew of the intent of
the lot line adjustment.Rooney said she did not know why the owner wanted to move the
lot line, that he wanted to “square up” the property and acquire a little more land; he
originally wanted to fix up the other property but sold it to an investor.
Hoium asked if the moratorium on single-family rentals existed. Chirpich stated that there
currently is one in place but as far as the City is aware, the intent is to rehabilitate the
property and resell.
Sahnow stated he believed the request is straightforward.
Hoium asked if it needs to be approved by the Council. Chirpich said that it does need their
approval and the County also needs to approve it.
Vargas made additional comments regarding the survey and the City having specific
requirements for the survey received. Chirpich stated that Staff does not have the
knowledge that Vargas has regarding the survey and expects the County will use their
expertise and let the City know if it doesn’t meet the requirements.
Chirpich said that there could be a condition of a numbered cap and rebar added to
approval.
Further conversation ensued regarding the expertise of the surveyor and survey itself.
Sahnow opened the public hearing.
John Martin, 4248 Reservoir Boulevard, stated he has lived on this road for 32 years and
that these lots are platted correctly currently. He said that he believed the one lot to the
south,the house will be torn down based upon the condition.He further added that there
was another in the past that was torn down and an investor built a new home that fits into
the neighborhood. Martin said this proposal gives an advantage one owner but does not
give an advantage to the other owner,or the City to do this lot line adjustment.He stated
he didn’t believe the lot line adjustment should be approved.
Mary Rooney, 588 Lomaniki Lane,agreed with some of the comments Martin made
regarding the sale of the property. She said it could be a tear down but that’s not
supported by the market right now and that the investor was aware the owner of the other
property wanted to require the additional piece of the lot. Rooney stated that it’s a small
lot and there isn’t room to build a larger home on the lot, but they could put up a fence.
She said the only person it would matter to is the new owner and there is still plenty of
room in the back lot that will exist.
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Item 3.
City of Columbia Heights MINUTES September 07, 2022
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DeWayne Morrell, 4212 Reservoir Boulevard,stated that he has lived across from 4217
Reservoir Boulevard for 70 years. He said that if a larger home was built on the existing lot,
it would be a benefit to the City to have a comparable lot to the others.Morrell said
moving the lot line doesn’t “square up” the lot line, it only does to one corner of the lot
line. He stated that the property, 4221 Reservoir Boulevard, is the owner’s secondary
home.He asked the Commission how long the new lot line is versus the current one.
Vargas provided the measurements of the existing line and the new proposed line from the
survey.
Morrell said he went on Anoka County’s online mapping site and there was a discrepancy
between the GIS date on that site and the survey.
Vargas said the County’s GIS record is a close estimate, it’s not the actual measurements.
Further conversation ensued about the discrepancies of the measurements.
Sahnow asked for clarification on his opposition due to the discrepancy.
Morrell stated that the adjusted property may be smaller than the commission thinks.
Vargas asked if the impervious area had been looked at by the City. Chirpich said this
district does not have an impervious surface maximum,rather it requires building coverage
ratio, and this proposal is compliant with that.
Chirpich stated that the minimum lot requirement is 8,400 square feet; the certificate
survey states it is 12,825 square feet and setbacks are 7 feet. He said this lot conforms with
the lot requirements of the district.
Morrell suggested the City look at how the driveway is arranged with the north lot line at
4221 Reservoir Boulevard,and said if it was “squared up” it wouldn’t fit, so it is parallel
with the south boundary. He stated he was opposed to the lot line adjustment being
approved.
Rooney said in an ideal world, someone would buy the house and tear it down, but no one
wanted to buy it, including the City. She added that the investor that bought it is willing to
fix it up and revamp it.
Morrell stated that the neighborhood as a whole is attractive to potential buyers and
several have driven by the property, but once they see the house, they are not interested.
Chirpich said that the sale of the property has not taken place yet because of the lot line
adjustment pending, but the sale of the home in the future would take place once
renovated according to the current owner.
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Item 3.
City of Columbia Heights MINUTES September 07, 2022
Planning Commission Page 6
Vargas commented about the vote by the commission and said the rules say that this
should be approved, but listening to residents’comments, they are asking the commission
to essentially break the rules,and asked Staff for their advice.
Chirpich said that the commission is often going to be put in this position, where the City
Code and views of others are in misalignment. He said that the commission is required to
look at the requirements of the City Code for the lot line adjustment. Although staff agrees
with some of the concerns about the future use of the house that is in poor condition,
these concerns are not relevant to the decision at hand. Chirpich said that the Council
ultimately has the final decision,but staff take the position that there is no reason to not
recommend approval of the adjustment.
Morrell made some comments regarding not considering the public’s concerns in the
approval.Sahnow stated that Morrell could address his concerns with staff afterwards if he
would like to.
Hoium said he didn’t see why if the two property owners want to move the line, that they
would deny it, and he believes this is progress of an investor revamping the property.
Deneen said that their role as the commission is to see if it meets the City Code and it does.
The commission agreed to add the condition of a numbered cap and rebar after the lot line
adjustment has been made.
Motion by Hoium, seconded by Wolfe,to waive the reading of draft Resolution 2022-78, there being
ample copies available to the public.All ayes. MOTION PASSED.
Motion by Hoium, seconded by Novitsky,that the Planning Commission recommends that the City
Council approve draft Resolution 2022-78, approving a Minor Subdivision (lot line adjustment) for the
properties located at 4221 and 4217 Reservoir Boulevard NE (Lots 5 and 6, Block 11, Auditor’s
Subdivision of Walton’s Second Addition), within the City of Columbia Heights, Minnesota, subject to
certain conditions stated in the resolution.All ayes. MOTION PASSED.
OTHER BUSINESS
Chirpich stated that there will be no Planning Commission meeting for October 2022 since the City has
not received any applications for this deadline.
Chirpich said that the engagement phase for the Rainbow site redevelopment will be moving forward
in late 2022,with approval by the Planning Commission in early 2023.
Sahnow asked about the progress on City Hall.Chirpich stated the registration of the title and the
condo plat with the County has delayed the closing.He said that transfer of title should happen in the
next couple weeks,with construction to start in October and Staff moving in in the spring.
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Item 3.
City of Columbia Heights MINUTES September 07, 2022
Planning Commission Page 7
ADJOURNMENT
Motion by Vargas, seconded by Wolfe, to adjourn the meeting at 7:00 pm. All ayes. MOTION PASSED.
Respectfully submitted,
_______________________________
Alicia Howe, Administrative Assistant
21
Item 3.
SPECIAL ECONOMIC DEVELOPMENT
AUTHORITY MEETING
City Hall—Council Chambers, 590 40th Ave NE
Monday, September 26, 2022
5:00 PM
MINUTES
The special meeting was called to order at 5:00 pm by Chair Szurek.
CALL TO ORDER/ROLL CALL
Members Present: Gerry Herringer, Kt Jacobs, Amáda Márquez Simula (arrived at 5:06 pm), John
Murzyn Jr., Nick Novitsky, Marlaine Szurek
Members Absent: Connie Buesgens
Staff Present: Kelli Bourgeois, City Manager; Aaron Chirpich, Community Development Director; Joseph
Kloiber, Finance Director; Sara Ion, City Clerk; Mitchell Forney, Community Development Coordinator;
Alicia Howe, Administrative Assistant
PLEDGE OF ALLEGIANCE
CONSENT AGENDA
1. Approve the minutes of the regular EDA Meeting of September 6, 2022
2. Approve financial reports and payment of bills of August 2022 – Resolution No. 2022-17
Herringer questioned the bills regarding the three developer payments. Chirpich stated the payments
are biannual payments to various developers throughout the City that have TIF contracts.
Herringer asked about the fourth developer payment. Chirpich stated that it was a similar payment
and then gave the name of each development related to each payment.
Motion by Murzyn Jr, seconded by Márquez Simula, to approve the Consent Agenda as presented. All
ayes of present. MOTION PASSED.
RESOLUTION NO. 2022-17
A RESOLUTION OF THE ECONOMIC DEVELOPMENT AUTHORITY OF COLUMBIA HEIGHTS, MINNESOTA,
APPROVING THE FINANCIAL STATEMENTS FOR THE MONTH OF AUGUST 2022 AND THE PAYMENT OF
THE BILLS FOR THE MONTH OF AUGUST 2022.
WHEREAS, the Columbia Heights Economic Development Authority (the “EDA”) is required by
Minnesota Statutes Section 469.096, Subd. 9, to prepare a detailed financial statement which shows all
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Item 4.
City of Columbia Heights MINUTES September 26, 2022
Special Economic Development Authority Meeting Page 2
receipts and disbursements, their nature, the money on hand, the purposes to which the money on
hand is to be applied, the EDA's credits and assets and its outstanding liabilities; and
WHEREAS, said Statute also requires the EDA to examine the statement and treasurer's vouchers or
bills and if correct, to approve them by resolution and enter the resolution in its records; and
WHEREAS, the financial statements for the month of August 2022 have been reviewed by the EDA
Commission; and
WHEREAS, the EDA has examined the financial statements and finds them to be acceptable as to both
form and accuracy; and
WHEREAS, the EDA Commission has other means to verify the intent of Section 469.096, Subd . 9,
including but not limited to Comprehensive Annual Financial Reports, Annual City approved Budgets,
Audits and similar documentation; and
WHEREAS, financials statements are held by the City’s Finance Department in a method outlined by
the State of Minnesota’s Records Retention Schedule,
NOW, THEREFORE BE IT RESOLVED by the Board of Commissioners of the Columbia Heights Economic
Development Authority that it has examined the referenced financial statements including the check
history, and they are found to be correct, as to form and content; and
BE IT FURTHER RESOLVED the financial statements are acknowledged and received and the check
history as presented in writing is approved for payment out of proper funds; and
BE IT FURTHER RESOLVED this resolution is made a part of the permanent records of the Columbia
Heights Economic Development Authority.
ORDER OF ECONOMIC DEVELOPMENT AUTHORITY
Passed this 26th day of September, 2022
Offered by:
Seconded by:
Roll Call:
President
Attest:
Secretary
BUSINESS ITEMS
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Item 4.
City of Columbia Heights MINUTES September 26, 2022
Special Economic Development Authority Meeting Page 3
3. Adoption of the 2023 Budget and Authorization of the EDA and HRA Levies
Chirpich reported that in late August, the proposed budget for the 2023 fiscal year was distributed
to the Council. Before the Council completes their final review of the proposed budget, the
Columbia Heights Economic Development Authority (the “EDA”) and the Housing and
Redevelopment Authority in and for the City of Columbia Heights (the “HRA”) are required to adopt
fund budgets for Fund 204: EDA Administration and Fund 408: EDA Redevelopment Projects; and to
authorize their respective 2022 tax levies, payable in 2023.
The EDA effectively has two separate tax levies after the Council granted the EDA certain HRA
powers in 1996. One tax levy is administered by the City under Minnesota Statutes, Section 469.107
on behalf of the EDA (the “EDA Levy”) and the other is a special benefit tax levy administered by the
EDA under Minnesota Statutes, Section 469.033 on behalf of the HRA (the “HRA Levy”). The
proposed fund budgets reflect total levy amounts that are within the statutory limits. For 2023, the
EDA Levy would capture $297,100 from the City’s estimated market land value; whereas the HRA
Levy would net $310,000. When combined, both levies result in total net revenue of $607,100.
The proposed 2023 fund budgets are dedicated to maintaining existing projects and initiatives, as
well as allocating funds for programs that reflect the priorities of the EDA, such as the Commercial
Revitalization Project, the Façade Improvement Grant Program, and the Fire Suppression Grand
Program. It is worth noting that the proposed 2023 budget for Fund 204 includes a 19% levy
increase, which represents an increase of $47,200 from 2022. This increase is primarily driven by
regular COLA increases and salary adjustments for the Community Development Director, and
Community Development Coordinator that resulted from the compensation study that was
completed this year. More detail regarding revenue and expenses was provided in the summary
budgets in the packet.
The following overview was provided:
Fund: 204 – EDA Administration -- Revenue $297,100, Expense $297,100
Fund: 408 – Redevelopment Projects -- Revenue $310,000, Expense $310,000
Total Revenue $607,100 and Total Expenses $607,100
Herringer asked about the levy for $310,000 in 2022. Chirpich stated that the levy was higher than
the budget so there was a surplus in 2022.
Motion by Márquez Simula, seconded by Jacobs, to waive the reading of Resolution 2022-18, there
being ample copies available to the public. All ayes of present. MOTION PASSED.
Motion by Márquez Simula, seconded by Novitsky, to adopt Resolution 2022-18, a resolution of the
Columbia Heights Economic Development Authority, adopting a budget for the fiscal year of 2023
and setting the 2022 tax levy, payable in 2023. All ayes of present. MOTION PASSED.
RESOLUTION NO. 2022-18
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Item 4.
City of Columbia Heights MINUTES September 26, 2022
Special Economic Development Authority Meeting Page 4
A RESOLUTION OF THE COLUMBIA HEIGHTS ECONOMIC DEVELOPMENT AUTHORITY, ADOPTING A
BUDGET FOR THE FISCAL YEAR OF 2023 AND SETTING THE 2022 TAX LEVY, PAYABLE IN 2023 .
BE IT RESOLVED, by the Columbia Heights Economic Development Authority (the “EDA”) as follows:
WHEREAS, the City of Columbia Heights (the “City”) established the EDA by an enabling resolution
adopted on January 8, 1996, pursuant to Minnesota Statutes 469.090 to 469.1081 (the “EDA Act”);
and
WHEREAS, the City Council of the City has given to the EDA the responsibility for all development
and redevelopment projects and programs; and
WHEREAS, under Section 469.107 of the EDA Act, the City is authorized to levy a tax for t he benefit
of the EDA on its area of operation for the purposes authorized under the EDA Act, subject to the
approval of the City Council;
NOW, THEREFORE BE IT RESOLVED, by the Board of Commissioners of the Columbia Heights
Economic Development Authority, that the EDA adopts and requests the City Council’s approval of
its budget in the amount of $297,100 for 2023; and
BE IT FURTHER RESOLVED, that the EDA adopts and requests the City Council’s approval of an EDA
tax levy under Section 469.107 of the EDA Act, in the amount of $297,100 for taxes payable in 2023;
and
BE IT FURTHER RESOLVED, that the Executive Director is instructed to transmit a copy of this
resolution to the City Manager, Finance Director, and City Clerk of the City of Columbia Heights,
Minnesota.
ORDER OF ECONOMIC DEVELOPMENT AUTHORITY
Passed this 26th day of September, 2022
Offered by:
Seconded by:
Roll Call:
President
Attest:
Secretary
Motion by Márquez Simula, seconded by Murzyn Jr., to waive the reading of Resolution 2022-19,
there being ample copies available to the public. All ayes of present. MOTION PASSED.
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Item 4.
City of Columbia Heights MINUTES September 26, 2022
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Motion by Novitsky, seconded by Jacobs, to adopt Resolution 2022-19, a resolution of the Columbia
Heights Economic Development Authority, adopting a budget for the fiscal year of 2023 and
authorizing a special benefit tax levy, payable in 2023. All ayes of present. MOTION PASSED.
RESOLUTION NO. 2022-19
A RESOLUTION OF THE COLUMBIA HEIGHTS ECONOMIC DEVELOPMENT AUTHORITY, ADOPTING A
BUDGET FOR THE FISCAL YEAR OF 2023 AND AUTHORIZING A SPECIAL BENEFIT TAX LEVY, PAYABLE
IN 2023.
BE IT RESOLVED, by the Columbia Heights Economic Development Authority (the “EDA”) as follows:
WHEREAS, the City of Columbia Heights (the “City”) established the EDA by an enabling resolution
adopted on January 8, 1996, pursuant to Minnesota Statutes 469.090 to 469.108 1 (the “EDA Act”);
and
WHEREAS, the City Council granted the EDA all powers and duties of a housing and redevelopment
authority by an enabling resolution and ordinance adopted on October 22, 2001, pursuant to
Minnesota Statutes 469.001 to 469.047 (the "HRA Act"), except certain powers that are allocated to
the Housing and Redevelopment Authority in and for the City of Columbia Heights (the “HRA”); and
WHEREAS, under Section 469.033 of the HRA Act, the EDA is authorized to levy a special benefit tax,
in an amount not to exceed .0185 percent of the City’s estimated market value (the “HRA Levy”);
and
WHEREAS, by separate resolution, the EDA has before it for consideration a copy of the EDA budget
for the fiscal year of 2023, and the proposed amount of the HRA Levy, payable in 2023, is based on
said budget;
NOW, THEREFORE BE IT RESOLVED, by the Board of Commissioners of the Columbia Heights
Economic Development Authority, that the EDA hereby adopts an HRA Levy payable in 2023 of
$310,000 under Section 469.033 of the HRA Act; and
BE IT FURTHER RESOLVED, that the Board of Commissioners of the Columbia Heights Economic
Development Authority hereby directs staff to take such actions necessary to file with the City and
certify with the County of Anoka County, the HRA Levy in the amount of $310,000 for taxes payable
in 2023 under Section 469.033 of the HRA Act.
ORDER OF ECONOMIC DEVELOPMENT AUTHORITY
Passed this 26th day of September, 2022
Offered by:
Seconded by:
Roll Call:
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Item 4.
City of Columbia Heights MINUTES September 26, 2022
Special Economic Development Authority Meeting Page 6
President
Attest:
Secretary
4. Adopt Resolution 2022-20, Authorizing Certain 2022 Inter-Fund Transfers
Director Chirpich stated that at the September 12, 2022, meeting, the Council approved certain
interfund transfers. Two of those transfers involve Funds of the Economic Development Authority,
and those transfers therefore also require approval by the Authority.
1. To transfer the $3,331,655 of assets received by EDA Redevelopment Fund 408 from the sale of
3989 Central Avenue; to the City for use within the new city hall project in Governmental Buildings
Fund 411 as follows: noncash value of office condominium shell to be constructed $2,115,600; cash
deposited to city hall construction escrow account at closing $421,748; cash deposited with EDA at
closing, in excess of EDA land cost $394,307.
2. To transfer $150,000 of surplus operating fund balance from EDA Administration Fund 204 to the
Governmental Equipment Fund 431. This combines with $1,850,000 of surplus separately
transferred from various City operating funds to the Governmental Equipment Fund 431, to provide
a total $2 million to extend the number of years for which Governmental Equipme nt Fund 431 is
sustainable. This is a funding mechanism the City and EDA use periodically to provide funding for
various capital purposes. The need to do this $2 million transfer is described in the narrative to City
Manager’s 2023 proposed budget. Staff notes that balance in the Governmental Equipment Fund
431 is available to all governmental functions of the EDA and City for capital equipment purchases.
This $150,000 transfer from EDA Fund 204 will still leave the remaining fund balance in EDA Fund
204, well above the established working capital target of 45% of next year’s budget for that fund .
Motion by Novitsky, seconded by Jacobs, to waive the reading of Resolution 2022-20, there being
ample copies available to the public. All ayes of present. MOTION PASSED.
Motion by Novitsky, seconded by Murzyn Jr., to adopt Resolution 2022-20, transferring $3,331,655
to the Governmental Buildings Fund 411 from EDA Redevelopment Fund 408, and transferring
$150,000 from EDA Administration Fund 204 to the Governmental Equipment Fund 431. All ayes of
present. MOTION PASSED.
RESOLUTION NO. 2022-20
A RESOLUTION OF THE ECONOMIC DEVELOPMENT AUTHORITY OF COLUMBIA HEIGHTS,
MINNESOTA, APPROVING THE TRANSFER OF $3,331,655 FROM EDA REDEVELOPMENT FUND 408
TO THE GOVERNMENTAL BUILDINGS FUND 411, AND APPROVING THE TRANSFER OF $150,000
FROM EDA ADMINISTRATION FUND 204 TO GOVERNMENTAL EQUIPMENT FUND 431.
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City of Columbia Heights MINUTES September 26, 2022
Special Economic Development Authority Meeting Page 7
WHEREAS, the Economic Development Authority of Columbia Heights, Minnesota (the Authority)
carried out a redevelopment project at 3989 Central Avenue NE for multiple public purposes
including securing a site for a new city hall; and
WHEREAS, this project resulted in the Authority receiving certain assets totaling $3,331,655 over
the Authority’s cost in this project; and
WHEREAS, not intending to own the new city hall or any of its related assets, the Authority elects to
transfer these assets to the City for construction of the new city hall; and
WHEREAS, the Minnesota Office of the State Auditor has established a fund balance guideline for
local governments to generally apply to operating funds of the local government, because retaining
more fund balance that necessary for operations is a burden on taxpayers; and
WHEREAS, the operating fund of the Authority currently has fund balance above this threshold; and
WHEREAS, best financial practices include pairing the one-time source of such available fund
balance with appropriate one-time uses, such as purchases of capital equipment through the
Governmental Equipment Fund 431.
NOW, THEREFORE BE IT RESOLVED that, after appropriate examination and due consideration, the
Authority
1. Approves the transfer of $3,331,655 from EDA Redevelopment Fund 408 to the Governmental
Buildings Fund 411.
2. Approves the transfer of $150,000 from EDA Administration Fund 204 to Governmental
Equipment Fund 431.
ORDER OF ECONOMIC DEVELOPMENT AUTHORITY
Passed this 26th day of September, 2022
Offered by:
Seconded by:
Roll Call:
President
Attest:
Secretary
OTHER BUSINESS
Chirpich thanked the commissioners for convening that evening for the special EDA meeting. He stated
that there would be no regular EDA meeting in October 2022.
28
Item 4.
City of Columbia Heights MINUTES September 26, 2022
Special Economic Development Authority Meeting Page 8
Szurek asked about the “Rainbow Site”. Chirpich said there wasn’t an update and that they continue to
work with grocery partners for the site.
Chirpich stated that the Ratio Apartments obtained a temporary certificate of occupancy; there are still
some “punch list” items that remain on the exterior of the building. He further said that the Council
and commissioners will be invited for a tour of the building once it is complete.
Herringer asked about the number of potential tenants. Chirpich did not have an exact number, but
stated that it was difficult to do virtual tours when the building was not finished, so now that it is
finished, they should have more interest; they will update the commission on the leasing in the futur e.
ADJOURNMENT
Motion by Jacobs, seconded by Márquez Simula, to adjourn the meeting at 5:17 pm. All ayes. MOTION
PASSED.
Respectfully submitted,
_______________________________
Alicia Howe, Administrative Assistant
29
Item 4.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT AGENDA
MEETING DATE NOVEMBER 14, 2022
ITEM: Consideration of Resolution 2022-99, Updating Income Limit for Senior Citizen Utility Rates.
DEPARTMENT: Finance BY/DATE: Jackie Zillmer, November 1, 2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength _Excellent Housing/Neighborhoods
X Equity and Affordability X Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
For many years, the City Council has annually updated the income eligibility limit for reduced senior citizen
utility rates. Currently, the income limit for reduced senior citizen rates is set at $41,800. Attached is a
resolution raising the income limit, beginning in 2023, to $45,300 for reduced senior citizen rates.
The formula the City has used for this limit is the maximum current year (2023) Social Security benefit for an
individual at full retirement age, plus 4%, rounded to the next even $100 increment. This limit is then
compared to applicants’ prior year (2022) income. This formula is intended to allow for a modest amount of
income beyond the maximum Social Security benefit possible. The maximum Social Security benefit for an
individual at full retirement age for 2023 is $43,524.
The City Council can set any formula or amount for income eligibility. If the City establishes the income
eligibility guideline at a higher level, more people will qualify. As more people qualify for reduced rates, the
rates for non-qualifying people will have to be raised to ensure adequate revenue in the utility fund. For many
years, the number of seniors receiving the reduced rate has remained relatively constant at approximately 120
residents.
STAFF RECOMMENDATION:
It is staff’s recommendation that we maintain the current formula and increase the senior citizen utility rate to
$45,300.
RECOMMENDED MOTIONS:
MOTION: Move to waive the reading of Resolution 2022-99, there being ample copies available to the public.
MOTION: Move to adopt Resolution 2022-99, being a resolution updating the income limit for senior citizen
utility rates.
ATTACHMENT:
Resolution 2022-99
30
Item 5.
RESOLUTION NO. 2022-99
A resolution of the City Council for the City of Columbia Heights, Minnesota, establishing eligibility standards
for senior citizen utility rates.
Now, therefore, in accordance with all ordinances and regulations of the City of Columbia Heights, the City
Council of the City of Columbia Heights makes the following:
ORDER OF COUNCIL
WHEREAS, the City Council has previously established eligibility standards for senior citizen rates for refuse
service, sewage disposal and water supply; and
WHERAS, it has been the City’s practice to maintain uniform eligibility standards whenever possible:
NOW, THEREFORE, BE IT RESOLVED by the City of Columbia Heights as follows:
That anyone over 62 years of age with a maximum household income of $45,300 will be eligible for
reduced rates.
BE IT FURTHER RESOLVED that the above eligibility standard is effective January 1, 2023.
Passed this _________ day of ______________________, 2022
Offered by:
Seconded by:
Roll Call:
Amáda Márquez Simula, Mayor
Attest:
Sara Ion, City Clerk/Council Secretary
31
Item 5.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT
MEETING DATE NOVEMBER 14, 2022
ITEM: Adoption of Resolution 2022-100 submitting a list of eligible nominees to Anoka County for the
Open Manager position on the Rice Creek Watershed District Board of Managers.
DEPARTMENT: Administration BY/DATE: Kelli Bourgeois, 11/9/22
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength _Excellent Housing/Neighborhoods
_Equity and Affordability X Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
The Council received a letter from Anoka County Administration outlining the process for appointing members
to the Rice Creek Watershed District. Although the County makes the final appointment, they are to do so
from a list of nominees submitted by the towns and municipalities within the District. There has been recent
disagreement between the local municipalities and the County on how appointments are made, and the State
Supreme Court has recently found in favor of the municipalities.
Columbia Heights has been asked to contribute to a joint resolution supporting a list of District Nominees that
will be submitted to the Anoka County Board for consideration and appointment. The deadline for submittal
of this joint resolution is November 18th.
The list of nominees is:
Jan Kreminski – Circle Pines
Jess Robertson – Blaine
Scott Robinson – Lino Lakes
Heidi Ferris – Fridley
Staff recommends partnering on the joint resolution supporting the nominees that are listed.
RECOMMENDED MOTION(S):
MOTION: Move to waive the reading of Resolution 2022-100 there being ample copies available to the
public.
MOTION: Move to adopt Resolution 2022-100 being a Resolution Submitting a List of Eligible Nominees to
Anoka County for the Open Manager Position on the Rice Creek Watershed District Board of Managers.
ATTACHMENT(S):
September 26th Anoka County Letter including the Public Notice of Vacancy and Map
Resolution 2022-100
Two Star Tribune Articles Regarding the State Supreme Court Decision
32
Item 6.
RESOLUTION NO. 2022-100
A Resolution of the City Council for the City of Columbia Heights, Minnesota, Submitting a List of Eligible
Nominees to Anoka County for the Open Manager Position on the Rice Creek Watershed District Board of
Managers.
WHEREAS, the city received notice of an opening on the Rice Creek Watershed District Board of Managers;
and
WHEREAS, the county notified the city they can submit a list of Nominations to the Anoka County Board of
Commissioners per Minnesota Statue 103D.311; and
WHEREAS, the Cities of Blaine, Centerville, Circle Pines, Columbia Heights, Fridley, Lino Lakes, Lexington and
Spring Lake Park wish to have representation on the Rice Creek Watershed District; and
WHEREAS, the nominees are from Blaine, Circle Pines, Fridley and Lino Lakes; and
WHEREAS, the city of Columbia Heights supports the nominees from the Jointly Submitted List from ONLY the
Cities of Blaine, Centerville, Circle Pines, Columbia Heights, Fridley, Lino Lakes, Lexington and Spring Lake Park .
NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of Columbia Heights, Minnesota does
hereby submit a list of names for consideration by the Anoka County Board of Commissioners per Minnesota
Statue 103D.311 at least 60 days before the expiration of the term of the board managers’ term who expires.
Passed this 14th day of November, 2022.
Offered by:
Seconded by:
Roll Call:
Mayor Amáda Márquez Simula
Sara Ion, City Clerk
33
Item 6.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT
MEETING DATE NOVEMBER 14, 2022
ITEM:
Adopt Resolution 2022-103 Accepting the Feasibility Report for 53rd Avenue Turnabout
Construction and Ordering the Public Improvement Hearing, City Project No. 2007
DEPARTMENT: Public Works
BY/DATE: Kevin Hansen/Sulmaan Khan
November 7, 2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength _Excellent Housing/Neighborhoods
_Equity and Affordability X_Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND: Staff has developed preliminary plans and prepared the Feasibility Report for the 53 rd Avenue
Trail, Sidewalk, Partial Street Reconstruction, and Turnabout Construction from Main Street in Fridley to
Central Avenue.
ANALYSIS /CONCLUSIONS:
Attached is the Feasibility Report that details the scope of work for Turnabout Construction on 53rd Avenue.
Particular issues are summarized below:
1. Safety Issues
53rd Avenue from 1,100 feet west of Central Avenue to Central Avenue provides access to several businesses
and commercial establishments including Target, Petco, Dollar Tree, Pawn America, Medtronic, various banks,
Discount Tire, AT&T, nail salons, and other various restaura nts. This creates high traffic volumes and several
conflict points because of the various access points within the area. In order to reduce the number of conflict
points, a turnabout will be constructed where the roadway is at its widest point.
2. Utilities Replacement
Utilities have been reviewed on 53rd Avenue. Staff utilized structure inspections, televising, history of water
main breaks, age of water main and services, leakage testing (independent testing), and previous engineering
reports in determining utility recommendations.
Only minor adjustments to water main, sanitary sewer, and storm sewer utility work is proposed.
3. Assessment Methodology
Street Rehabilitation in Phase 1, Zones 1, 2 and 3 all followed the previous assessment policies for each area.
Under the 1999 Alley Construction Program and in subsequent zones, a “unit” assessment methodology was
employed rather than using a “front foot” rate basis. The area of Columbia Heights west of Central Avenue is
essentially a block type development pattern with streets and avenues. The existing assessment policy for
this area would involve “street” assessments and “avenue” assessments. The “street” frontage (typical front
of property or where driveway access is) would pay a particular rat e for the full frontage for that type of
34
Item 7.
City of Columbia Heights - Council Letter Page 2
treatment (mill and overlay or full reconstruction, for example) used on that street. That same parcel would
pay a reduced rate for the avenue for the full frontage.
4. Scope of Work
The cost sharing policy provides a 70/30 cost share for partial street reconstruction.
5. Financing:
Turnabout Construction 53rd Avenue
The estimated construction costs are as follows:
Street construction: $1,300,000
Utilities: $ **
The costs and associated funding for utility work (**) will be further developed during the final design. Project
funding including assessments will also be further developed during the final design.
6. Past Assessments:
There are no prior city assessments within the project limits of the 53 rd Avenue turnabout project.
7. Concurrent Projects
Partial street reconstruction on 53rd Avenue as well as the turnabout construction on 53 rd Avenue will be
done concurrently with each other.
8. Utility Issues
Aside from minor adjustments, no major utility work is being proposed within Columbia Heights on the
south side of 53rd Avenue. The City of Fridley will be completing reconstruction, remove/replace, or
adjustments of specific sections of watermain and storm systems on the north side of 53rd Avenue.
9. Meeting Dates
Staff has established the following meeting dates:
Resident Informational: TBD*
Public Hearing: February 21, 2023
STAFF RECOMMENDATION:
A public improvement hearing will need to be held for MSAS streets following completion and acceptance of
the feasibility report.
RECOMMENDED MOTION(S):
MOTION: Move to waive the reading of Resolution 2022-103, there being ample copies available for the
public.
MOTION: Move to adopt Resolution 2022-103, being a Resolution accepting the Feasibility Report for 53rd
Avenue Turnabout Construction, Project 2007, and ordering the Public Improvement Hearing beginning at
6:15 p.m. on February 21, 2023.
ATTACHMENT(S): Resolution 2022-103
35
Item 7.
RESOLUTION NO. 2022-103
A resolution of the City Council for the City of Columbia Heights, Minnesota,
WHEREAS, the City Council is proposing to construct a turnabout on 53rd Avenue which has not been rehabilitated
under the street program, and
WHEREAS, pursuant to Resolution No. 2022-86, a report has been prepared by the City Engineer with reference to
the Program, and the following street(s):
53rd Avenue from 1,100 Feet West of Central Avenue to Central Avenue
WHEREAS, the report provides information regarding whether the proposed project is feasible, necessary and cost-
effective, and
Said report is hereby received by the City Council of Columbia Heights on November 14, 2022.
Now, therefore, in accordance with the foregoing, and all ordinances and regulations of the City of Columbia
Heights, the City Council of the City of Columbia Heights makes the following:
FINDINGS OF FACT
1. The Council will consider the improvement of such streets in accordance with the report and the
assessment of abutting or benefited property for all or a portion of the cost of the improvement pursuant
to Minnesota Statutes, Chapter 429 at an estimated total cost of the improvement of $1,300,000 for 53rd
Avenue turnabout construction.
2. A public hearing shall be held on such proposed improvement on the 21st day of February, 2023, in the City
Council Chambers at 590 40th Avenue N.E. at 6:15 P.M. and the City Clerk shall give mailed and published
notice of such hearing and improvement as required by law.
ORDER OF COUNCIL
Passed this 14th day of November, 2022
Offered by:
Seconded by:
Roll Call:
Amáda Márquez Simula, Mayor
Attest:
Sara Ion, City Clerk/Council Secretary
36
Item 7.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT
MEETING DATE NOVEMBER 14, 2022
ITEM:
Adopt Resolution 2022-104 Accepting the Feasibility Report and Ordering the Public
Improvement Hearing for 53rd Avenue Trail, Sidewalk, and Partial Street Reconstruction and
Ordering the Public Improvement Hearing, City Project No. 2305
DEPARTMENT: Public Works
BY/DATE: Kevin Hansen/Sulmaan Khan
November 7, 2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength _Excellent Housing/Neighborhoods
_Equity and Affordability X_Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND: Staff has developed preliminary plans and prepared the Feasibility Report for the 53rd Avenue
Trail, Sidewalk, and Partial Street Reconstruction, and Turnabout Construction from Main Street in Fridley to
Central Avenue.
ANALYSIS /CONCLUSIONS:
Attached is the Feasibility Report that details the scope of work for Partial Street Reconstruction on 53rd Avenue.
Particular issues are summarized below:
1. Rehabilitation Strategies
Three treatment strategies are utilized in the street rehabilitation program: mill and overlay, partial
reconstruction, and full reconstruction. For 53rd Avenue, partial reconstruction is proposed for the section
identified on the attached area map.
Staff utilizes three methods in evaluating the condition of the street and determining appropriate treatment:
1. Present physical structure (cross-section): 53rd Avenue has been excavated down to the sub-base
material and the individual street segment cross-sections are catalogued.
2. Non-destructive strength determination and condition rating: Braun Intertec, a ge o-technical
engineering consultant, conducted tests on all streets at 50-foot intervals with a dropping weight
deflection test. From this test, the strength of the road segment is determined. Braun Intertec also
develops their own pavement conditions index.
3. Overall Condition Index (OCI): Staff also reviews each street segment by measuring the type and quantity
of each type of cracking in the pavement. This information, along with other factors, such as drainage
and physical structure is used to determine an “overall condition index”. An OCI of 70 or greater suggests
a surface treatment is the appropriate treatment. An OCI between 69 and 55 reflects that the
bituminous pavement is showing signs of significant deterioration and a mill and overlay is required to
strengthen the pavement. An OCI of less than 55 suggests the best course of action is to reconstruct the
street, typically because both the pavement and the base under the pavement are failing. The need for
full or partial reconstruction depends on the condition of the curb and gutter. The results are then used 37
Item 8.
City of Columbia Heights - Council Letter Page 2
to determine the appropriate treatment to maximize the life of the street.
2. Utilities Replacement
Utilities have been reviewed on 53rd Avenue. Staff utilized structure inspections, televising, history of water
main breaks, age of water main and services, leakage testing (independent testing), and previous engineering
reports in determining utility recommendations.
A watermain replacement is proposed on 53rd Avenue between 5th Street and 6th Street. Aside from this, only
minor adjustments to water main, sanitary sewer, and storm sewer utility work is proposed.
3. Assessment Methodology
Street Rehabilitation in Phase 1, Zones 1, 2 and 3 all followed the previous assessment policies for each area.
Under the 1999 Alley Construction Program and in subsequent zones, a “unit” assessment methodology was
employed rather than using a “front foot” rate basis. The area of Columbia Heights west of Central Avenue i s
essentially a block type development pattern with streets and avenues. The existing assessment policy for
this area would involve “street” assessments and “avenue” assessments. The “street” frontage (typical front
of property or where driveway access is) would pay a particular rate for the full frontage for that type of
treatment (mill and overlay or full reconstruction, for example) used on that street. That same parcel would
pay a reduced rate for the avenue for the full frontage.
4. Scope of Work
The cost sharing policy provides a 70/30 cost share for partial street reconstruction.
5. Financing: Partial Street Reconstruction 53rd Avenue
The estimated construction costs are as follows:
Partial street reconstruction (includes Fridley share): $ 2,575,500
Columbia Heights share of total cost: $ 875,500
Utilities: $ 245,650
Project funding including assessments will be further developed during the final design.
6. Past Assessments:
The information provided below lists assessment areas for previous street rehabilitation projects.
2020 Zone 4B and 5 Project: Partial Reconstruction
Assessment term: 10 years (2021-2030)
Residents on 4th Street and on 5th Street from 52nd Avenue to 53rd Avenue were assessed a residential street
assessment rate as part of this project.
7. Concurrent Projects
Partial street reconstruction on 53rd Avenue as well as the turnabout construction on 53 rd Avenue will be
done concurrently with each other.
8. Utility Issues
Watermain replacement on 53rd Avenue is proposed to be done between 5th Street and 6th Street. Aside
38
Item 8.
City of Columbia Heights - Council Letter Page 3
from other minor adjustments, no major utility work is being proposed within Columbia Heights on the
south side of 53rd Avenue. The City of Fridley will be completing reconstruction, remove/replace, or
adjustments of specific sections of watermain and storm systems on the north side of 53rd Avenue.
9. Meeting Dates
Staff has established the following meeting dates:
Resident Informational: TBD*
Public Hearing: February 21, 2023
STAFF RECOMMENDATION:
A public improvement hearing will need to be held for MSAS streets following completion and acceptance of
the feasibility report.
RECOMMENDED MOTION(S):
MOTION: Move to waive the reading of Resolution 2022-104, there being ample copies available for the
public.
MOTION: Move to adopt Resolution 2022-104, being a Resolution accepting the Feasibility Report for 53rd
Avenue Trail, Sidewalk, and Partial Street Reconstruction, Project 2305, and ordering the Public
Improvement Hearing beginning at 6:00 p.m. on February 21, 2023.
ATTACHMENT(S): Resolution 2022-104
Area Map
39
Item 8.
RESOLUTION NO. 2022-104
A resolution of the City Council for the City of Columbia Heights, Minnesota,
WHEREAS, the City Council is proposing to partially reconstruct 53rd Avenue which has not been rehabilitated under
the street program, and
WHEREAS, pursuant to Resolution No. 2022-87, a report has been prepared by the City Engineer with reference to
the Program, and the following street(s):
53rd Avenue from Main Street in Fridley to 1,100 Feet West of Central Avenue
WHEREAS, the report provides information regarding whether the proposed project is feasible, necessary and cost-
effective, and
Said report is hereby received by the City Council of Columbia Heights on November 14, 2022.
Now, therefore, in accordance with the foregoing, and all ordinances and regulations of the City of Columbia
Heights, the City Council of the City of Columbia Heights makes the following:
FINDINGS OF FACT
1. The Council will consider the improvement of such streets in accordance with the report and the
assessment of abutting or benefited property for all or a portion of the cost of the improvement pursuant
to Minnesota Statutes, Chapter 429 at an estimated total cost of the improvement of $2,575,500 for 53rd
Avenue partial street reconstruction.
2. A public hearing shall be held on such proposed improvement on the 21st day of February, 2023, in the City
Council Chambers at 590 40th Avenue N.E. at 6:00 P.M. and the City Clerk shall give mailed and published
notice of such hearing and improvement as required by law.
ORDER OF COUNCIL
Passed this 14th day of November, 2022
Offered by:
Seconded by:
Roll Call:
Amáda Márquez Simula, Mayor
Attest:
Sara Ion, City Clerk/Council Secretary
40
Item 8.
53RD AVE
MAIN ST
51ST AVE
49TH AVE
50TH AVE
CENTRAL AVE
3RD ST
2 1/2 ST
JEFFE
RS
ON S
T
2ND ST
7TH ST
6TH ST
5TH ST
4TH ST
MONROE ST
SULLIVAN
D
R
PANORAMA AVE
HUGHE
S
AVE
HORIZON DR
CLEA
RV
IEWST
UNIV
E
RSITY
AV
E
ROMA
N
RD
CAPITOL ST
WA
SHIN
GTON ST
JACKS
ON S
T
47TH AVE
46TH AVE
52ND AVE
48TH AVE
S U L L IVANWA
Y
PA RKS
IDE
LN
GIBRALTAR RD
MADISON ST
46 1/2 AV E
47 1/2 AV E
PILOT AVE
50 1/2 AV E
49 1/2 AV E Partial Street Reconstruction with Multiuse Trail (CH), Sidewalk (Fridley), and Turnabout
LEGEND
®CITY OF COLUMBIA H EIGH TSGIS / ENGINEERING DEPT
Map Date: Map Auth or:No vem ber 202 2K You ng
MSA STREETRECONSTRUC TION
Mun icipa l State Aid Street R econstru ctio n
53rd Ave nue NEMain St NE (Fridle y) toCentral Ave nue
PROPOSED 2023CONSTRUCTION
City ofColumbia Heights
41
Item 8.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT
MEETING DATE NOVEMBER 14, 2022
ITEM: Refuse Dumpster Services Contract with Walters Recycling & Refuse
DEPARTMENT: Public Works
BY/DATE: Jesse Davies, Kevin Hansen/
November 8, 2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength _Excellent Housing/Neighborhoods
X_Equity and Affordability _Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND: The current refuse hauling contract ends December 31, 2022. Although a two-year extension
is provided in the contract, staff notified our current hauler, Waste Management, that a new RFP will be issued
early in 2022. The first step was to review/update the Solid Waste Operating Policy, also known as the SWOP,
as it is the primary document that provides policy guidance for creating service vendor RFPs to perform the
work as directed. The SWOP was reviewed and approved by the City Council in February.
An RFP was prepared by staff for trash, recycling, yard waste, organics, and bulk services for the City of Columbia
Heights. The RFP was prepared so vendors could respond to a single service or any one of the services for the
city. Two vendors provided responses to the RFP: Waste Management and Walters Recycling & Refuse. Over
the past year Waste Management has failed to perform the contract standards for trash collection, as well as
other services, causing delays in service almost weekly. Staff asked Walters Recycling & Refuse to attend the
June 27th council meeting to review their proposal, provide company information , and be available for any
questions from the Council. The Council then directed staff to prepare a contract with Walters.
On July 28th, Walters informed the City Manager and staff that they were withdrawing their proposal due to
worker shortages and inability to hire drivers. Staff then contacted other vendors, including Waste Management
and Republic for providing City refuse services. Both contractors indicated interest in providing services to the
City, but were specific in that they would not pick up in alleys.
Due to ongoing service issues with Waste Management, staff was able to find other contractors to perform
other refuse services such as yard waste (Better Futures), bulky materials (College Hunks), and compost carts
(Haul Star). In our review of the work by Haul Star, they were providing a high level of service using rear load
trucks, which are necessary to service our alleys. Staff inquired if Haul Star had an interest in or would consider
providing trash and recycling service in our alleys, as the alleys require rear load packer trucks.
On September 30th, a proposal from Walters and Haul Star for trash and recycling was received. As a result, the
Council approved a contract for cart services with the Walters / Haul Star team for a 4-year term, with a 1-year
extension option. A separate contract has been prepared with Walters Recycling and Refuse (only) for dumpster
services; and is attached.
42
Item 9.
City of Columbia Heights - Council Letter Page 2
STAFF RECOMMENDATION: Staff recommends approving the contract with Walters Recycling & Refuse for
providing dumpster services to the City.
RECOMMENDED MOTION(S):
MOTION: Move to approve a refuse dumpster service contract with Walters Recycling & Refuse; and authorize
the Mayor and City Manager to enter into a contract for the same.
ATTACHMENT: Refuse Services Dumpster Contract
43
Item 9.
44
Item 9.
45
Item 9.
46
Item 9.
47
Item 9.
48
Item 9.
49
Item 9.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT
MEETING DATE NOVEMBER 14, 2022
ITEM: Approve Change Order for Contract for Painting of Public Safety Building
DEPARTMENT: Police/Fire BY/DATE: Chief Lenny Austin, Nov 10, 2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength _Excellent Housing/Neighborhoods
_Equity and Affordability _Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
In February of this year, as part of the project for replacement of carpet, painting, and office equipment
removal and replacement for the Police and Fire Departments, the City Council approved a contract with
Allen’s Perfect Painting for $15,950.
The original project included painting only the office areas in Police and Fire. However, once the carpet was
replaced we determined that there were several other areas of the building that should be painted as well.
These include the Public Safety building entry area, bathrooms, the hallway between the departments, the
detention area, the locker rooms and workout room, and the hallways in the lower level. This would include
the walls and all trim work in these areas. We received quotes from Allen’s Perfect Painting for these areas.
The additional cost to complete these areas adds an amount of $28,155 to the project. Since this amount was
not budgeted to the Capital Improvement fund, the monies will be coming from the Police Department’s
regular budget. Due to staffing shortages throughout the year, we have unexpended funds in our budget that
would allow for this expenditure.
RECOMMENDED MOTION(S):
MOTION: Move to authorize the Police Department to enter into an agreement with Allen’s Perfect
Painting to repair and paint walls not previously budgeted for in the carpeting project completed earlier this
year. The change order amount to be $28,155, with monies to come from the Police Department’s regular
budget.
ATTACHMENT(S): none.
50
Item 10.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT
MEETING DATE NOVEMBER 22, 2022
ITEM: Approval Resolution 2022-102 Transfer Funds to the Fire Department 2022 Budget
DEPARTMENT: Fire BY/DATE: Charlie Thompson 11/14/2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
X Safe Community _Diverse, Welcoming “Small-Town” Feel
X Economic Strength Excellent Housing/Neighborhoods
_Equity and Affordability _Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
The Minnesota Board of Firefighter Training and Education (MBFTE) provides reimbursements of firefighter
training and certifications costs. The funds are appropriated by the State Legislature from the Fire Safety
Account and are dispersed through an application process. This year, MBFTE awarded $10,106.00 to the CHFD.
This funding covers tuition costs for new recruits who completed Firefighter I, Firefighter II, and Hazardous
Materials operations level training as well as last year’s Emergency Medical Technician course. Award amounts
from MBFTE can vary drastically from year to year.
When preparing our annual budget, we estimate the dollar amount we will receive from the state for the
Volunteer Firefighters Relief Association, a retirement benefit for Paid-On-Call Firefighters. This estimated
dollar amount is allocated to line item 101.2200.41240, Fire Pension POC. This line item is a pass through
which means monies received by the Finance Department from the state are immediately paid back out to
Fire Relief Association. This year we estimated we would receive $103,000.00. The difference that the State
provided above this amount was $30,213.99. The Fire Department recommends amending the $30,213.99
back into the 2022 Fire Department budget.
STAFF RECOMMENDATION:
Approve the transfer of reimbursed funds from the general fund to the Fire Department 2022 Budget.
Breakdown of Reimbursements:
Source Amount
MBFTE $1,610.00
MBFTE $2,715.00
MBFTE $5,775.00
Fire State Aid Amendment $30,213.99
Total $40,313.99
51
Item 11.
City of Columbia Heights - Council Letter Page 2
RECOMMENDED MOTIONS:
MOTION: Move to waive the reading of Resolution No. 2022-102, there being ample copies to the public.
MOTION: Move to adopt Resolution 2022-102, being a resolution amending the 2022 Fire Department
budget.
ATTACHMENT:
Res. 2022-102 Fire Dept. Budget Amendment
52
Item 11.
RESOLUTION NO. 2022-102
A resolution of the city council for the city of Columbia Heights, Minnesota, amending the 2022 budget to
use certain additional revenue:
Whereas, the city has contracted for or received the following revenue:
Source Amount
MBFTE $1,610.00
MBFTE $2,715.00
MBFTE $5,775.00
Fire State Aid Amendment $30,213.99
Total $40,313.99
Whereas, this revenue was not included in the initial 2022 budget adopted by Resolution 2021-102, nor in any
subsequent amendments to that budget; and
Whereas, accordingly, the expense necessary to earn this revenue was also not previously included in the
2022 budget; and
Whereas, the activity related to this revenue and expen se is consistent with the goals and objectives of the
city of Columbia Heights Fire Department;
Now, therefore, in accordance with all ordinances and regulations of the City of Columbia Heights, the city
council of the city of Columbia Heights makes the following:
ORDER OF COUNCIL
IT IS HEREBY RESOLVED, that the 2022 budget for general fund fire department expense is amended for an
increase of $40,313.99, and by a corresponding amount for budgeted revenue.
Passed this 14th day of November, 2022
Offered by:
Seconded by:
Roll Call:
Amáda Márquez Simula, Mayor
Attest:
Sara Ion, City Clerk/Council Secretary
53
Item 11.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT AGENDA
MEETING DATE 11/14/2022
ITEM: Approve the 2023 Contract with Medica for Employee Health Insurance .
DEPARTMENT: Administration BY/DATE: Kelli Wick, 11/14/22
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength _Excellent Housing/Neighborhoods
_Equity and Affordability _Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
Staff has worked with Associated Benefits and Risk Consulting to bid our health insurance for 2023. The City
went out to market for bids. Medica came in initially with a 5% reduction. After offering Proximal which is a
virtual directed-care network benefit Medica reduced premiums by 8%.
STAFF RECOMMENDATION:
Staff recommends City Council approve Medica as the City’s health insurance provider for 202 3 and authorizes
the City Manager to sign the contract once it is received.
RECOMMENDED MOTION(S):
MOTION: Move to approve Medica as the City’s health insurance provider for 2023 and authorize the City
Manager to sign the contract.
ATTACHMENTS: SBC’s
54
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 952-945-8000
(Minneapolis/St. Paul Metro area) or 1-800-952-3455. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment,
deductible, provider, or other underlined terms, see the Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-800-952-3455 to request a
copy.
Important Questions Answers Why This Matters:
What is the overall deductible?No deductible in-network. $2,000 per
person/ $5,000 per family for
out-of-network services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the plan, each family member must meet their
own individual deductible until the total amount of deductible expenses paid by all family members
meets the overall family deductible.
Are there servicescovered before youmeet your deductible?
Yes. In-network services and well child
and prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits. Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$2,000 per person/ $5,000 per family
in-network. $9,000 per person for
out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, they have to meet their own out-of-pocket limits until the overall family
out-of-pocket limit has been met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 952-945-8000 or 1-800-952-3455
(TTY: 711) for a list of Medica Elect
network providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You
will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for
the difference between the provider’s charge and what your plan pays (balance billing). Be aware,
your network provider might use an out-of-network provider for some services (such as lab work).
Check with your provider before you get services.
Do you need a referralto see a specialist?
Yes. This plan requires referrals for
specialists outside your care system.
Coordinate care through your primary
care clinic or care system for best
in-network benefits.
This plan will pay some or all of the costs to see a specialist for covered services but only if you have
a referral before you see the specialist.
1-00123
(202207251251) (194899)
Page 1 of 7
55
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: $15 copay/ visit
Chiropractic: $15 copay/ visit
Retail Health: $5 copay/ visit
Virtual: $5 copay/ visit
Primary: 50% coinsurance
Chiropractic: 50% coinsurance
Retail Health: 50% coinsurance
Virtual: 50% coinsurance
In-network primary care visits provided at an outpatient facilitymay be subject to coinsurance. Limited to 15 visits permember, per year for out-of-network chiropractic care.
Specialist visit $15 copay/ visit 50% coinsurance In-network specialist visits provided at an outpatient facilitymay be subject to coinsurance.
Preventive care/ screening/ immunization No charge Well child care: 0% coinsurance.
Other services: 50% coinsurance.
You may have to pay for services that aren’t preventive. Askyour provider if the services needed are preventive. Thencheck what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: No charge
X-ray: No charge 50% coinsurance ---none---
Imaging (CT/PETscans, MRIs)No charge 50% coinsurance ---none---
Page 2 of 7
56
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost1
Generic drugs Retail: $12/ prescription
Mail order: $24/ prescription 50% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mail orderprescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. The list ofcovered drugs changes periodically. Notification of changeswill be available 30 days prior to the change taking effect. ACA preventive drugs covered at no charge.
Preferred brand drugs Retail: $50/ prescription
Mail order: $100/ prescription 50% coinsurance
Non-preferred brand drugs
Retail: $90/ prescription
Mail order: $180/ prescription 50% coinsurance
Specialty drugs
Preferred: 20% coinsurance No more than $200 copay/ prescription
Non-Preferred: 30% coinsurance
Not covered Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursed or paidby a provider or manufacturer, on your behalf for a product orservice, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)No charge 50% coinsurance ---none---
Physician/surgeon fees No charge 50% coinsurance ---none---
If you need immediate medical
attention
Emergency room care $95 copay/ visit $95 copay/ visit. In-network out-of-pocket applies. Emergency medical transportation No charge 0% coinsurance. In-network out-of-pocket applies.
Urgent care $15 copay/ visit $15 copay/ visit. In-network out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)No charge 50% coinsurance ---none---
Physician/surgeon fees No charge 50% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services $15 copay/ visit 50% coinsurance Coinsurance may apply for some in-network outpatientservices such as intensive outpatient programs. Inpatient services No charge 50% coinsurance Residential treatment is covered as part of inpatient services.
Page 3 of 7
57
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits No charge Prenatal care: 0% coinsurance.
Postnatal care: 50% coinsurance Cost sharing does not apply to in-network preventive services.Depending on the type of services, a copayment, coinsuranceor deductible may apply. Maternity care may include tests andservices described elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services No charge 50% coinsurance
Childbirth/deliveryfacility services No charge 50% coinsurance
If you need help recovering or have
other special health needs
Home health care No charge 50% coinsurance 120 visits in-network and 60 visits out-of-network, per memberper year.
Rehabilitation services $15 copay/ visit 50% coinsurance Physical and occupational therapy combined limited to 20visits out-of-network per member per year. Out-of-networkspeech therapy is limited to 20 visits per member per year.Visit limits are not applicable to behavioral health conditions.
Habilitation services $15 copay/ visit 50% coinsurance Physical and occupational therapy combined limited to 20visits out-of-network per member per year. Out-of-networkspeech therapy is limited to 20 visits per member per year.Visit limits are not applicable to behavioral health conditions.
Skilled nursing care No charge 50% coinsurance 120 day limit combined in and out-of-network per member per year. Durable medical equipment 0% coinsurance 50% coinsurance ---none---
Hospice services No charge 50% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge 50% coinsurance ---none--- Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
Page 4 of 7
58
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
Page 5 of 7
59
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-800-952-3455 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-800-952-3455 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
Page 6 of 7
60
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $0 Copayments $10 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $70
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $0 Copayments $300 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $300
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $0 Copayments $300 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $300
The plan would be responsible for the other costs of these EXAMPLE covered services.
Page 7 of 7
61
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
62
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 952-945-8000
(Minneapolis/St. Paul Metro area) or 1-800-952-3455. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment,
deductible, provider, or other underlined terms, see the Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-800-952-3455 to request a
copy.
Important Questions Answers Why This Matters:
What is the overall deductible?No deductible in-network. $2,000 per
person/ $5,000 per family for
out-of-network services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the plan, each family member must meet their own
individual deductible until the total amount of deductible expenses paid by all family members meets
the overall family deductible.
Are there servicescovered before youmeet your deductible?
Yes. In-network services and well child
and prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits. Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$2,000 per person/ $5,000 per family
in-network. $9,000 per person for
out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, they have to meet their own out-of-pocket limits until the overall family
out-of-pocket limit has been met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 952-945-8000 or 1-800-952-3455
(TTY: 711) for a list of Medica Choice
with UnitedHealthcare network
providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You
will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for
the difference between the provider’s charge and what your plan pays (balance billing). Be aware, your
network provider might use an out-of-network provider for some services (such as lab work). Check
with your provider before you get services. Do you need a referralto see a specialist?No. You don’t need a referral to see a
specialist. You can see the specialist you choose without a referral.
1-00123
(202207251251) (194896)
Page 1 of 7
63
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: $15 copay/ visit
Chiropractic: $15 copay/ visit
Retail Health: $5 copay/ visit
Virtual: $5 copay/ visit
Primary: 50% coinsurance
Chiropractic: 50% coinsurance
Retail Health: 50% coinsurance
Virtual: 50% coinsurance
In-network primary care visits provided at an outpatient facilitymay be subject to coinsurance. Limited to 15 visits permember, per year for out-of-network chiropractic care.
Specialist visit $15 copay/ visit 50% coinsurance In-network specialist visits provided at an outpatient facilitymay be subject to coinsurance.
Preventive care/ screening/ immunization No charge Well child care: 0% coinsurance.
Other services: 50% coinsurance.
You may have to pay for services that aren’t preventive. Askyour provider if the services needed are preventive. Thencheck what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: No charge
X-ray: No charge 50% coinsurance ---none---
Imaging (CT/PETscans, MRIs)No charge 50% coinsurance ---none---
Page 2 of 7
64
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost1
Generic drugs Retail: $12/ prescription
Mail order: $24/ prescription 50% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mail orderprescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. The list ofcovered drugs changes periodically. Notification of changeswill be available 30 days prior to the change taking effect. ACA preventive drugs covered at no charge.
Preferred brand drugs Retail: $50/ prescription
Mail order: $100/ prescription 50% coinsurance
Non-preferred brand drugs
Retail: $90/ prescription
Mail order: $180/ prescription 50% coinsurance
Specialty drugs
Preferred: 20% coinsurance No more than $200 copay/ prescription
Non-Preferred: 30% coinsurance
Not covered Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursed or paidby a provider or manufacturer, on your behalf for a product orservice, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)No charge 50% coinsurance ---none---
Physician/surgeon fees No charge 50% coinsurance ---none---
If you need immediate medical
attention
Emergency room care $95 copay/ visit $95 copay/ visit. In-network out-of-pocket applies. Emergency medical transportation No charge 0% coinsurance. In-network out-of-pocket applies.
Urgent care $15 copay/ visit $15 copay/ visit. In-network out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)No charge 50% coinsurance ---none---
Physician/surgeon fees No charge 50% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services $15 copay/ visit 50% coinsurance Coinsurance may apply for some in-network outpatientservices such as intensive outpatient programs. Inpatient services No charge 50% coinsurance Residential treatment is covered as part of inpatient services.
Page 3 of 7
65
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits No charge Prenatal care: 0% coinsurance.
Postnatal care: 50% coinsurance Cost sharing does not apply to in-network preventive services.Depending on the type of services, a copayment, coinsuranceor deductible may apply. Maternity care may include tests andservices described elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services No charge 50% coinsurance
Childbirth/deliveryfacility services No charge 50% coinsurance
If you need help recovering or have
other special health needs
Home health care No charge 50% coinsurance 120 visits in-network and 60 visits out-of-network, per memberper year.
Rehabilitation services $15 copay/ visit 50% coinsurance Physical and occupational therapy combined limited to 20visits out-of-network per member per year. Out-of-networkspeech therapy is limited to 20 visits per member per year.Visit limits are not applicable to behavioral health conditions.
Habilitation services $15 copay/ visit 50% coinsurance Physical and occupational therapy combined limited to 20visits out-of-network per member per year. Out-of-networkspeech therapy is limited to 20 visits per member per year.Visit limits are not applicable to behavioral health conditions.
Skilled nursing care No charge 50% coinsurance 120 day limit combined in and out-of-network per member per year. Durable medical equipment 0% coinsurance 50% coinsurance ---none---
Hospice services No charge 50% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge 50% coinsurance ---none--- Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
Page 5 of 7
67
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-800-952-3455 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-800-952-3455 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
Page 6 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $0 Copayments $10 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $70
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $0 Copayments $300 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $300
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $0 Copayments $300 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $300
The plan would be responsible for the other costs of these EXAMPLE covered services.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
70
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 952-945-8000
(Minneapolis/St. Paul Metro area) or 1-800-952-3455. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment,
deductible, provider, or other underlined terms, see the Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-800-952-3455 to request a
copy.
Important Questions Answers Why This Matters:
What is the overall deductible?
$3,000 per person/ $6,000 per family
in-network and $6,000 per person/ $12,000 per family for out-of-network
services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the plan, each family member must meet their
own individual deductible until the total amount of deductible expenses paid by all family members
meets the overall family deductible.
Are there servicescovered before youmeet your deductible?
Yes. Preventive care, preventive
prescriptions and prenatal care from
in-network providers or well child and
prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits.
Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$3,000 per person/ $6,000 per family
in-network. $9,000 per person/ $18,000
per family for out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, they have to meet their own out-of-pocket limits until the overall family
out-of-pocket limit has been met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 952-945-8000 or 1-800-952-3455
(TTY: 711) for a list of Medica Elect
network providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You
will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for
the difference between the provider’s charge and what your plan pays (balance billing). Be aware,
your network provider might use an out-of-network provider for some services (such as lab work).
Check with your provider before you get services.
Do you need a referralto see a specialist?
Yes. This plan requires referrals for
specialists outside your care system.
Coordinate care through your primary
care clinic or care system for best
in-network benefits.
This plan will pay some or all of the costs to see a specialist for covered services but only if you have
a referral before you see the specialist.
1-00123
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71
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: 0% coinsurance
Chiropractic: 0% coinsurance
Retail Health: 0% coinsurance
Virtual: 0% coinsurance
Primary care: 25% coinsurance
Chiropractic: 25% coinsurance
Retail Health: 25% coinsurance
Virtual: 25% coinsurance
Limited to 15 visits per member, per year forout-of-network chiropractic care.
Specialist visit 0% coinsurance 25% coinsurance ---none---
Preventive care/ screening/ immunization No charge. Deductible doesnot apply.
Well child care: 0% coinsurance. Deductibledoes not apply.
Other services: 25% coinsurance
You may have to pay for services that aren’tpreventive. Ask your provider if the services neededare preventive. Then check what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: 0% coinsurance
X-ray: 0% coinsurance 25% coinsurance ---none---
Imaging (CT/PETscans, MRIs)0% coinsurance 25% coinsurance ---none---
Page 2 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost2
Generic drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mailorder prescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. Thelist of covered drugs changes periodically. Notificationof changes will be available 30 days prior to thechange taking effect. ACA preventive drugs covered at no charge. Deductible does not apply.
Preferred brand drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance
Non-preferred brand drugs
Preventive: Benefit does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance 25% coinsurance
Specialty drugs Preferred: 0% coinsurance
Non-Preferred: 0% coinsurance Not covered
Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursedor paid by a provider or manufacturer, on your behalffor a product or service, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need immediate medical
attention
Emergency room care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies. Emergency medical transportation 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
Urgent care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services 0% coinsurance 25% coinsurance ---none---
Inpatient services 0% coinsurance 25% coinsurance Residential treatment is covered as part of inpatient services.
Page 3 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits Prenatal care: No charge. Deductible does not apply.
Postnatal care: 0% coinsurance
Prenatal care: 0% coinsurance. Deductibledoes not apply.
Postnatal care: 25% coinsurance
Cost sharing does not apply to in-network preventive services. Depending on the type of services, a copayment, coinsurance or deductible may apply.Maternity care may include tests and servicesdescribed elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services 0% coinsurance 25% coinsurance
Childbirth/deliveryfacility services 0% coinsurance 25% coinsurance
If you need help recovering or
have other special health needs
Home health care 0% coinsurance 25% coinsurance 120 visits in-network and 60 visits out-of-network permember per year.
Rehabilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Habilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Skilled nursing care 0% coinsurance 25% coinsurance 120 day limit combined in and out-of-network permember per year. Durable medical equipment 0% coinsurance 25% coinsurance ---none---
Hospice services 0% coinsurance 25% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge. Deductible doesnot apply. 25% coinsurance ---none---
Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
Page 4 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
Page 5 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-800-952-3455 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-800-952-3455 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
Page 6 of 7
76
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $3,000 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $3,060
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $2,200 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $2,200
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $2,800 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $2,800
The plan would be responsible for the other costs of these EXAMPLE covered services.
Page 7 of 7
77
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
78
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 1-866-882-8493. For
general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment, deductible, provider, or other underlined terms, see the
Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-866-882-8493 to request a copy.
Important Questions Answers Why This Matters:
What is the overall deductible?No deductible in-network. $2,000 per
person/ $5,000 per family for
out-of-network services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the plan, each family member must meet their own
individual deductible until the total amount of deductible expenses paid by all family members meets
the overall family deductible.
Are there servicescovered before youmeet your deductible?
Yes. In-network services and well child
and prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits. Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$2,000 per person/ $5,000 per family
in-network. $9,000 per person for
out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, they have to meet their own out-of-pocket limits until the overall family
out-of-pocket limit has been met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 1-866-882-8493 (TTY: 711) for a list
of VantagePlus with Medica network
providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will
pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the
difference between the provider’s charge and what your plan pays (balance billing). Be aware, your
network provider might use an out-of-network provider for some services (such as lab work). Check
with your provider before you get services. Do you need a referral tosee a specialist?No. You don’t need a referral to see a
specialist. You can see the specialist you choose without a referral.
1-00123
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Page 1 of 7
79
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: $15 copay/ visit
Chiropractic: $15 copay/ visit
Retail Health: $5 copay/ visit
Virtual: $5 copay/ visit
Primary: 50% coinsurance
Chiropractic: 50% coinsurance
Retail Health: 50% coinsurance
Virtual: 50% coinsurance
In-network primary care visits provided at an outpatient facilitymay be subject to coinsurance. Limited to 15 visits permember, per year for out-of-network chiropractic care.
Specialist visit $15 copay/ visit 50% coinsurance In-network specialist visits provided at an outpatient facilitymay be subject to coinsurance.
Preventive care/ screening/ immunization No charge Well child care: 0% coinsurance.
Other services: 50% coinsurance.
You may have to pay for services that aren’t preventive. Askyour provider if the services needed are preventive. Thencheck what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: No charge
X-ray: No charge 50% coinsurance ---none---
Imaging (CT/PETscans, MRIs)No charge 50% coinsurance ---none---
Page 2 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost1
Generic drugs Retail: $12/ prescription
Mail order: $24/ prescription 50% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mail orderprescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. The list ofcovered drugs changes periodically. Notification of changeswill be available 30 days prior to the change taking effect. ACA preventive drugs covered at no charge.
Preferred brand drugs Retail: $50/ prescription
Mail order: $100/ prescription 50% coinsurance
Non-preferred brand drugs
Retail: $90/ prescription
Mail order: $180/ prescription 50% coinsurance
Specialty drugs
Preferred: 20% coinsurance No more than $200 copay/ prescription
Non-Preferred: 30% coinsurance
Not covered Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursed or paidby a provider or manufacturer, on your behalf for a product orservice, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)No charge 50% coinsurance ---none---
Physician/surgeon fees No charge 50% coinsurance ---none---
If you need immediate medical
attention
Emergency room care $95 copay/ visit $95 copay/ visit. In-network out-of-pocket applies. Emergency medical transportation No charge 0% coinsurance. In-network out-of-pocket applies.
Urgent care $15 copay/ visit $15 copay/ visit. In-network out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)No charge 50% coinsurance ---none---
Physician/surgeon fees No charge 50% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services $15 copay/ visit 50% coinsurance Coinsurance may apply for some in-network outpatientservices such as intensive outpatient programs. Inpatient services No charge 50% coinsurance Residential treatment is covered as part of inpatient services.
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Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits No charge Prenatal care: 0% coinsurance.
Postnatal care: 50% coinsurance Cost sharing does not apply to in-network preventive services.Depending on the type of services, a copayment, coinsuranceor deductible may apply. Maternity care may include tests andservices described elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services No charge 50% coinsurance
Childbirth/deliveryfacility services No charge 50% coinsurance
If you need help recovering or have
other special health needs
Home health care No charge 50% coinsurance 120 visits in-network and 60 visits out-of-network, per memberper year.
Rehabilitation services $15 copay/ visit 50% coinsurance Physical and occupational therapy combined limited to 20visits out-of-network per member per year. Out-of-networkspeech therapy is limited to 20 visits per member per year.Visit limits are not applicable to behavioral health conditions.
Habilitation services $15 copay/ visit 50% coinsurance Physical and occupational therapy combined limited to 20visits out-of-network per member per year. Out-of-networkspeech therapy is limited to 20 visits per member per year.Visit limits are not applicable to behavioral health conditions.
Skilled nursing care No charge 50% coinsurance 120 day limit combined in and out-of-network per member per year. Durable medical equipment 0% coinsurance 50% coinsurance ---none---
Hospice services No charge 50% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge 50% coinsurance ---none--- Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-866-882-8493 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-866-882-8493 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
Page 6 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $0 Copayments $10 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $70
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $0 Copayments $300 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $300
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $0 Specialist copayment $15 Hospital (facility) copayment $0 Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $0 Copayments $300 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $300
The plan would be responsible for the other costs of these EXAMPLE covered services.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 0%-15 Coverage for: Individual/Family | Plan Type: PPO
86
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 1-866-882-8493. For
general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment, deductible, provider, or other underlined terms, see the
Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-866-882-8493 to request a copy.
Important Questions Answers Why This Matters:
What is the overall deductible?
$3,000 per person/ $6,000 per family
in-network and $6,000 per person/ $12,000 per family for out-of-network
services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the plan, each family member must meet their own
individual deductible until the total amount of deductible expenses paid by all family members meets
the overall family deductible.
Are there servicescovered before youmeet your deductible?
Yes. Preventive care, preventive
prescriptions and prenatal care from
in-network providers or well child and
prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits.
Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$3,000 per person/ $6,000 per family
in-network. $9,000 per person/ $18,000
per family for out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, they have to meet their own out-of-pocket limits until the overall family
out-of-pocket limit has been met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 1-866-882-8493 (TTY: 711) for a list
of VantagePlus with Medica network
providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will
pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the
difference between the provider’s charge and what your plan pays (balance billing). Be aware, your
network provider might use an out-of-network provider for some services (such as lab work). Check
with your provider before you get services. Do you need a referral tosee a specialist?No. You don’t need a referral to see a
specialist. You can see the specialist you choose without a referral.
1-00123
(202210191449) (195318)
Page 1 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: 0% coinsurance
Chiropractic: 0% coinsurance
Retail Health: 0% coinsurance
Virtual: 0% coinsurance
Primary care: 25% coinsurance
Chiropractic: 25% coinsurance
Retail Health: 25% coinsurance
Virtual: 25% coinsurance
Limited to 15 visits per member, per year forout-of-network chiropractic care.
Specialist visit 0% coinsurance 25% coinsurance ---none---
Preventive care/ screening/ immunization No charge. Deductible doesnot apply.
Well child care: 0% coinsurance. Deductibledoes not apply.
Other services: 25% coinsurance
You may have to pay for services that aren’tpreventive. Ask your provider if the services neededare preventive. Then check what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: 0% coinsurance
X-ray: 0% coinsurance 25% coinsurance ---none---
Imaging (CT/PETscans, MRIs)0% coinsurance 25% coinsurance ---none---
Page 2 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost2
Generic drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mailorder prescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. Thelist of covered drugs changes periodically. Notificationof changes will be available 30 days prior to thechange taking effect. ACA preventive drugs covered at no charge. Deductible does not apply.
Preferred brand drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance
Non-preferred brand drugs
Preventive: Benefit does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance 25% coinsurance
Specialty drugs Preferred: 0% coinsurance
Non-Preferred: 0% coinsurance Not covered
Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursedor paid by a provider or manufacturer, on your behalffor a product or service, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need immediate medical
attention
Emergency room care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies. Emergency medical transportation 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
Urgent care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services 0% coinsurance 25% coinsurance ---none---
Inpatient services 0% coinsurance 25% coinsurance Residential treatment is covered as part of inpatient services.
Page 3 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits Prenatal care: No charge. Deductible does not apply.
Postnatal care: 0% coinsurance
Prenatal care: 0% coinsurance. Deductibledoes not apply.
Postnatal care: 25% coinsurance
Cost sharing does not apply to in-network preventive services. Depending on the type of services, a copayment, coinsurance or deductible may apply.Maternity care may include tests and servicesdescribed elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services 0% coinsurance 25% coinsurance
Childbirth/deliveryfacility services 0% coinsurance 25% coinsurance
If you need help recovering or
have other special health needs
Home health care 0% coinsurance 25% coinsurance 120 visits in-network and 60 visits out-of-network permember per year.
Rehabilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Habilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Skilled nursing care 0% coinsurance 25% coinsurance 120 day limit combined in and out-of-network permember per year. Durable medical equipment 0% coinsurance 25% coinsurance ---none---
Hospice services 0% coinsurance 25% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge. Deductible doesnot apply. 25% coinsurance ---none---
Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
Page 4 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
Page 5 of 7
91
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-866-882-8493 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-866-882-8493 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
Page 6 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $3,000 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $3,060
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $2,200 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $2,200
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $2,800 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $2,800
The plan would be responsible for the other costs of these EXAMPLE covered services.
Page 7 of 7
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Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
94
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 952-945-8000
(Minneapolis/St. Paul Metro area) or 1-800-952-3455. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment,
deductible, provider, or other underlined terms, see the Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-800-952-3455 to request a
copy.
Important Questions Answers Why This Matters:
What is the overall deductible?
$1,500 per person/ $3,000 per family
in-network and $3,000 per person/ $6,000 per family for out-of-network
services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the policy, the overall family deductible must be
met before the plan begins to pay.
Are there servicescovered before youmeet your deductible?
Yes. Preventive care, preventive
prescriptions and prenatal care from
in-network providers or well child and
prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits.
Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$1,500 per person/ $3,000 per family
in-network. $6,000 per person/ $12,000
per family for out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, the overall family out-of-pocket limit must be met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 952-945-8000 or 1-800-952-3455
(TTY: 711) for a list of Medica Elect
network providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You
will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for
the difference between the provider’s charge and what your plan pays (balance billing). Be aware,
your network provider might use an out-of-network provider for some services (such as lab work).
Check with your provider before you get services.
Do you need a referralto see a specialist?
Yes. This plan requires referrals for
specialists outside your care system.
Coordinate care through your primary
care clinic or care system for best
in-network benefits.
This plan will pay some or all of the costs to see a specialist for covered services but only if you have
a referral before you see the specialist.
1-00123
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: 0% coinsurance
Chiropractic: 0% coinsurance
Retail Health: 0% coinsurance
Virtual: 0% coinsurance
Primary care: 25% coinsurance
Chiropractic: 25% coinsurance
Retail Health: 25% coinsurance
Virtual: 25% coinsurance
Limited to 15 visits per member, per year forout-of-network chiropractic care.
Specialist visit 0% coinsurance 25% coinsurance ---none---
Preventive care/ screening/ immunization No charge. Deductible doesnot apply.
Well child care: 0% coinsurance. Deductibledoes not apply.
Other services: 25% coinsurance
You may have to pay for services that aren’tpreventive. Ask your provider if the services neededare preventive. Then check what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: 0% coinsurance
X-ray: 0% coinsurance 25% coinsurance ---none---
Imaging (CT/PETscans, MRIs)0% coinsurance 25% coinsurance ---none---
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost2
Generic drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mailorder prescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. Thelist of covered drugs changes periodically. Notificationof changes will be available 30 days prior to thechange taking effect. ACA preventive drugs covered at no charge. Deductible does not apply.
Preferred brand drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance
Non-preferred brand drugs
Preventive: Benefit does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance 25% coinsurance
Specialty drugs Preferred: 0% coinsurance
Non-Preferred: 0% coinsurance Not covered
Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursedor paid by a provider or manufacturer, on your behalffor a product or service, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need immediate medical
attention
Emergency room care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies. Emergency medical transportation 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
Urgent care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services 0% coinsurance 25% coinsurance ---none---
Inpatient services 0% coinsurance 25% coinsurance Residential treatment is covered as part of inpatient services.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits Prenatal care: No charge. Deductible does not apply.
Postnatal care: 0% coinsurance
Prenatal care: 0% coinsurance. Deductibledoes not apply.
Postnatal care: 25% coinsurance
Cost sharing does not apply to in-network preventive services. Depending on the type of services, a copayment, coinsurance or deductible may apply.Maternity care may include tests and servicesdescribed elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services 0% coinsurance 25% coinsurance
Childbirth/deliveryfacility services 0% coinsurance 25% coinsurance
If you need help recovering or
have other special health needs
Home health care 0% coinsurance 25% coinsurance 120 visits in-network and 60 visits out-of-network permember per year.
Rehabilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Habilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Skilled nursing care 0% coinsurance 25% coinsurance 120 day limit combined in and out-of-network permember per year. Durable medical equipment 0% coinsurance 25% coinsurance ---none---
Hospice services 0% coinsurance 25% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge. Deductible doesnot apply. 25% coinsurance ---none---
Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
Page 5 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-800-952-3455 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-800-952-3455 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $1,560
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $1,500
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $1,500
The plan would be responsible for the other costs of these EXAMPLE covered services.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Elect MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
102
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 952-945-8000
(Minneapolis/St. Paul Metro area) or 1-800-952-3455. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment,
deductible, provider, or other underlined terms, see the Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-800-952-3455 to request a
copy.
Important Questions Answers Why This Matters:
What is the overall deductible?
$3,000 per person/ $6,000 per family
in-network and $6,000 per person/ $12,000 per family for out-of-network
services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the plan, each family member must meet their own
individual deductible until the total amount of deductible expenses paid by all family members meets
the overall family deductible.
Are there servicescovered before youmeet your deductible?
Yes. Preventive care, preventive
prescriptions and prenatal care from
in-network providers or well child and
prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits.
Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$3,000 per person/ $6,000 per family
in-network. $9,000 per person/ $18,000
per family for out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, they have to meet their own out-of-pocket limits until the overall family
out-of-pocket limit has been met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 952-945-8000 or 1-800-952-3455
(TTY: 711) for a list of Medica Choice
with UnitedHealthcare network
providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You
will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for
the difference between the provider’s charge and what your plan pays (balance billing). Be aware, your
network provider might use an out-of-network provider for some services (such as lab work). Check
with your provider before you get services. Do you need a referralto see a specialist?No. You don’t need a referral to see a
specialist. You can see the specialist you choose without a referral.
1-00123
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Page 1 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: 0% coinsurance
Chiropractic: 0% coinsurance
Retail Health: 0% coinsurance
Virtual: 0% coinsurance
Primary care: 25% coinsurance
Chiropractic: 25% coinsurance
Retail Health: 25% coinsurance
Virtual: 25% coinsurance
Limited to 15 visits per member, per year forout-of-network chiropractic care.
Specialist visit 0% coinsurance 25% coinsurance ---none---
Preventive care/ screening/ immunization No charge. Deductible doesnot apply.
Well child care: 0% coinsurance. Deductibledoes not apply.
Other services: 25% coinsurance
You may have to pay for services that aren’tpreventive. Ask your provider if the services neededare preventive. Then check what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: 0% coinsurance
X-ray: 0% coinsurance 25% coinsurance ---none---
Imaging (CT/PETscans, MRIs)0% coinsurance 25% coinsurance ---none---
Page 2 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost2
Generic drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mailorder prescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. Thelist of covered drugs changes periodically. Notificationof changes will be available 30 days prior to thechange taking effect. ACA preventive drugs covered at no charge. Deductible does not apply.
Preferred brand drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance
Non-preferred brand drugs
Preventive: Benefit does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance 25% coinsurance
Specialty drugs Preferred: 0% coinsurance
Non-Preferred: 0% coinsurance Not covered
Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursedor paid by a provider or manufacturer, on your behalffor a product or service, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need immediate medical
attention
Emergency room care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies. Emergency medical transportation 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
Urgent care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services 0% coinsurance 25% coinsurance ---none---
Inpatient services 0% coinsurance 25% coinsurance Residential treatment is covered as part of inpatient services.
Page 3 of 7
105
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits Prenatal care: No charge. Deductible does not apply.
Postnatal care: 0% coinsurance
Prenatal care: 0% coinsurance. Deductibledoes not apply.
Postnatal care: 25% coinsurance
Cost sharing does not apply to in-network preventive services. Depending on the type of services, a copayment, coinsurance or deductible may apply.Maternity care may include tests and servicesdescribed elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services 0% coinsurance 25% coinsurance
Childbirth/deliveryfacility services 0% coinsurance 25% coinsurance
If you need help recovering or
have other special health needs
Home health care 0% coinsurance 25% coinsurance 120 visits in-network and 60 visits out-of-network permember per year.
Rehabilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Habilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Skilled nursing care 0% coinsurance 25% coinsurance 120 day limit combined in and out-of-network permember per year. Durable medical equipment 0% coinsurance 25% coinsurance ---none---
Hospice services 0% coinsurance 25% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge. Deductible doesnot apply. 25% coinsurance ---none---
Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
Page 4 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
Page 5 of 7
107
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-800-952-3455 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-800-952-3455 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
Page 6 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $3,000 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $3,060
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $2,200 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $2,200
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $3,000 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $2,800 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $2,800
The plan would be responsible for the other costs of these EXAMPLE covered services.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 3000-0% HSA Coverage for: Individual/Family | Plan Type: PPO
110
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 1-866-882-8493. For
general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment, deductible, provider, or other underlined terms, see the
Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-866-882-8493 to request a copy.
Important Questions Answers Why This Matters:
What is the overall deductible?
$1,500 per person/ $3,000 per family
in-network and $3,000 per person/ $6,000 per family for out-of-network
services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the policy, the overall family deductible must be
met before the plan begins to pay.
Are there servicescovered before youmeet your deductible?
Yes. Preventive care, preventive
prescriptions and prenatal care from
in-network providers or well child and
prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits.
Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$1,500 per person/ $3,000 per family
in-network. $6,000 per person/ $12,000
per family for out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, the overall family out-of-pocket limit must be met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 1-866-882-8493 (TTY: 711) for a list
of VantagePlus with Medica network
providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will
pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the
difference between the provider’s charge and what your plan pays (balance billing). Be aware, your
network provider might use an out-of-network provider for some services (such as lab work). Check
with your provider before you get services. Do you need a referral tosee a specialist?No. You don’t need a referral to see a
specialist. You can see the specialist you choose without a referral.
1-00123
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Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: 0% coinsurance
Chiropractic: 0% coinsurance
Retail Health: 0% coinsurance
Virtual: 0% coinsurance
Primary care: 25% coinsurance
Chiropractic: 25% coinsurance
Retail Health: 25% coinsurance
Virtual: 25% coinsurance
Limited to 15 visits per member, per year forout-of-network chiropractic care.
Specialist visit 0% coinsurance 25% coinsurance ---none---
Preventive care/ screening/ immunization No charge. Deductible doesnot apply.
Well child care: 0% coinsurance. Deductibledoes not apply.
Other services: 25% coinsurance
You may have to pay for services that aren’tpreventive. Ask your provider if the services neededare preventive. Then check what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: 0% coinsurance
X-ray: 0% coinsurance 25% coinsurance ---none---
Imaging (CT/PETscans, MRIs)0% coinsurance 25% coinsurance ---none---
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Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost2
Generic drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mailorder prescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. Thelist of covered drugs changes periodically. Notificationof changes will be available 30 days prior to thechange taking effect. ACA preventive drugs covered at no charge. Deductible does not apply.
Preferred brand drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance
Non-preferred brand drugs
Preventive: Benefit does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance 25% coinsurance
Specialty drugs Preferred: 0% coinsurance
Non-Preferred: 0% coinsurance Not covered
Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursedor paid by a provider or manufacturer, on your behalffor a product or service, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need immediate medical
attention
Emergency room care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies. Emergency medical transportation 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
Urgent care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services 0% coinsurance 25% coinsurance ---none---
Inpatient services 0% coinsurance 25% coinsurance Residential treatment is covered as part of inpatient services.
Page 3 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits Prenatal care: No charge. Deductible does not apply.
Postnatal care: 0% coinsurance
Prenatal care: 0% coinsurance. Deductibledoes not apply.
Postnatal care: 25% coinsurance
Cost sharing does not apply to in-network preventive services. Depending on the type of services, a copayment, coinsurance or deductible may apply.Maternity care may include tests and servicesdescribed elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services 0% coinsurance 25% coinsurance
Childbirth/deliveryfacility services 0% coinsurance 25% coinsurance
If you need help recovering or
have other special health needs
Home health care 0% coinsurance 25% coinsurance 120 visits in-network and 60 visits out-of-network permember per year.
Rehabilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Habilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Skilled nursing care 0% coinsurance 25% coinsurance 120 day limit combined in and out-of-network permember per year. Durable medical equipment 0% coinsurance 25% coinsurance ---none---
Hospice services 0% coinsurance 25% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge. Deductible doesnot apply. 25% coinsurance ---none---
Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
Page 4 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
Page 5 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-866-882-8493 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-866-882-8493 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $1,560
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $1,500
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $1,500
The plan would be responsible for the other costs of these EXAMPLE covered services.
Page 7 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023VantagePlus with Medica MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
118
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share thecost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be provided separately. This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, go to www.Medica.com or call 952-945-8000
(Minneapolis/St. Paul Metro area) or 1-800-952-3455. For general definitions of common terms, such as allowed amount, balance billing, coinsurance, copayment,
deductible, provider, or other underlined terms, see the Glossary. You can view the Glossary at www.healthcare.gov/sbc-glossary or call 1-800-952-3455 to request a
copy.
Important Questions Answers Why This Matters:
What is the overall deductible?
$1,500 per person/ $3,000 per family
in-network and $3,000 per person/ $6,000 per family for out-of-network
services.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan
begins to pay. If you have other family members on the policy, the overall family deductible must be
met before the plan begins to pay.
Are there servicescovered before youmeet your deductible?
Yes. Preventive care, preventive
prescriptions and prenatal care from
in-network providers or well child and
prenatal care from out-of-network
providers.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a
copayment or coinsurance may apply. For example, this plan covers certain preventive services
without cost sharing and before you meet your deductible. See a list of covered preventive services at
https://www.healthcare.gov/coverage/preventive-care-benefits.
Are there other deductibles for specific services?No. You don’t have to meet deductibles for specific services.
What is the out-of-pocket limit forthis plan?
$1,500 per person/ $3,000 per family
in-network. $6,000 per person/ $12,000
per family for out-of-network services.
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other
family members in this plan, the overall family out-of-pocket limit must be met.
What is not included inthe out-of-pocket limit?
Premiums, balance-billing charges
(unless balanced billing is prohibited),
health care this plan doesn’t cover,
out-of-network deductible and
coinsurance.
Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if youuse a network provider?
Yes. See www.Medica.com/FindCare or
call 952-945-8000 or 1-800-952-3455
(TTY: 711) for a list of Medica Choice
with UnitedHealthcare network
providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You
will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for
the difference between the provider’s charge and what your plan pays (balance billing). Be aware, your
network provider might use an out-of-network provider for some services (such as lab work). Check
with your provider before you get services. Do you need a referralto see a specialist?No. You don’t need a referral to see a
specialist. You can see the specialist you choose without a referral.
1-00123
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Page 1 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
All copayment and coinsurance costs shown in this chart are after your deductible has been met, if a deductible applies.
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you visit a health care provider’s
office or clinic
Primary care visit totreat an injury or illness
Primary care: 0% coinsurance
Chiropractic: 0% coinsurance
Retail Health: 0% coinsurance
Virtual: 0% coinsurance
Primary care: 25% coinsurance
Chiropractic: 25% coinsurance
Retail Health: 25% coinsurance
Virtual: 25% coinsurance
Limited to 15 visits per member, per year forout-of-network chiropractic care.
Specialist visit 0% coinsurance 25% coinsurance ---none---
Preventive care/ screening/ immunization No charge. Deductible doesnot apply.
Well child care: 0% coinsurance. Deductibledoes not apply.
Other services: 25% coinsurance
You may have to pay for services that aren’tpreventive. Ask your provider if the services neededare preventive. Then check what your plan will pay for.
If you have a test
Diagnostic test (x-ray,blood work)Lab: 0% coinsurance
X-ray: 0% coinsurance 25% coinsurance ---none---
Imaging (CT/PETscans, MRIs)0% coinsurance 25% coinsurance ---none---
Page 2 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you need drugs
to treat your illness
or condition
More information about
prescription drug coverage is available at www.Medica.com/DrugCost2
Generic drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance Up to a 31-day supply/ retail or 93-day supply/ mailorder prescription. Mail order drugs not covered out-of-network. Insulin: Your cost-share will not exceed $25 per retailprescription unit. Some Over the Counter drugs can be obtained with aprescription at the preventive level of coverage. Thelist of covered drugs changes periodically. Notificationof changes will be available 30 days prior to thechange taking effect. ACA preventive drugs covered at no charge. Deductible does not apply.
Preferred brand drugs
Preventive: Designatedpreventive drugs: No charge. Deductible does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance
25% coinsurance
Non-preferred brand drugs
Preventive: Benefit does not apply.
Retail: 0% coinsurance
Mail order: 0% coinsurance 25% coinsurance
Specialty drugs Preferred: 0% coinsurance
Non-Preferred: 0% coinsurance Not covered
Up to a 31-day supply per prescription received from adesignated specialty pharmacy. Amounts reimbursedor paid by a provider or manufacturer, on your behalffor a product or service, will not apply toward your cost share.
If you have outpatient surgery
Facility fee (e.g.,ambulatory surgery center)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need immediate medical
attention
Emergency room care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies. Emergency medical transportation 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
Urgent care 0% coinsurance 0% coinsurance In-network deductible and out-of-pocket applies.
If you have a hospital stay
Facility fee (e.g.,hospital room)0% coinsurance 25% coinsurance ---none---
Physician/surgeon fees 0% coinsurance 25% coinsurance ---none---
If you need mental health,
behavioral health, or substance
abuse services
Outpatient services 0% coinsurance 25% coinsurance ---none---
Inpatient services 0% coinsurance 25% coinsurance Residential treatment is covered as part of inpatient services.
Page 3 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Common Medical Event Services You May
Need
What You Will Pay
Limitations, Exceptions & Other Important
InformationIn-Network
Provider
(You will pay the least)
Out-of-Network
Provider
(You will pay the most)
If you are pregnant
Office visits Prenatal care: No charge. Deductible does not apply.
Postnatal care: 0% coinsurance
Prenatal care: 0% coinsurance. Deductibledoes not apply.
Postnatal care: 25% coinsurance
Cost sharing does not apply to in-network preventive services. Depending on the type of services, a copayment, coinsurance or deductible may apply.Maternity care may include tests and servicesdescribed elsewhere in the SBC (i.e. certain ultrasounds.) Childbirth/deliveryprofessional services 0% coinsurance 25% coinsurance
Childbirth/deliveryfacility services 0% coinsurance 25% coinsurance
If you need help recovering or
have other special health needs
Home health care 0% coinsurance 25% coinsurance 120 visits in-network and 60 visits out-of-network permember per year.
Rehabilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Habilitation services 0% coinsurance 25% coinsurance
Physical and occupational therapy combined limited to20 visits out-of-network per member per year.Out-of-network speech therapy is limited to 20 visitsper member per year. Visit limits are not applicable tobehavioral health conditions.
Skilled nursing care 0% coinsurance 25% coinsurance 120 day limit combined in and out-of-network permember per year. Durable medical equipment 0% coinsurance 25% coinsurance ---none---
Hospice services 0% coinsurance 25% coinsurance ---none---
If your child needs dental
or eye care
Children’s eye exam No charge. Deductible doesnot apply. 25% coinsurance ---none---
Children’s glasses Not covered Not covered Glasses are not covered by the plan. Children’s dental check-up Not covered Not covered Dental check-ups are not covered by the plan.
Page 4 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Excluded Services & Other Covered Services:
Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of other excluded services.)
Acupuncture exceeding 15 visits per memberper year for in-network and out-of-networkacupuncture services combined Chiropractic care exceeding 15 visits permember per year for out-of-network chiropracticcare. Cosmetic Surgery Dental Care (Adult)
Dental check-up Glasses Hearing aids except for members 18 years ofage and younger for hearing loss that is notcorrectable by other covered procedures;coverage is limited to one hearing aid per earevery three years.
Infertility treatment exceeding $5,000 medical/$3,000 pharmacy per member per yearcombined for in-network and out-of-network. Long Term Care Private-duty nursing Routine foot care except for specified conditions Weight Loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
· Bariatric Surgery in-network only. · Non-emergency care when traveling outside the U.S. · Routine eye care (Adult)
Page 5 of 7
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Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
Your Rights to Continue Coverage: There are agencies that can help if you want to continue your coverage after it ends. The contact information for those agencies is:Medica at 1-800-952-3455 or for group health coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for all other group health coverage, Department of Health and Human Services, Center for Consumer Information and Insurance Oversight, at1-877-267-2323 x61565 or www.cciio.cms.gov. Other coverage options may be available to you too, including buying individual insurance coverage through the Health Insurance Marketplace. For more information about the Marketplace, visit www.HealthCare.gov or call 1-800-318-2596.
Your Grievance and Appeals Rights: There are agencies that can help if you have a complaint against your plan for a denial of a claim. This complaint is called a grievanceor appeal. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Your plan documents also provide completeinformation on how to submit a claim, appeal, or a grievance for any reason to your plan. For more information about your rights, this notice, or assistance, contact: for grouphealth coverage subject to ERISA, Department of Labor’s Employee Benefits Security Administration at 1-866-444-EBSA (3272) or www.dol.gov/ebsa/healthreform; for allother group health coverage you may also contact Medica at 1-800-952-3455 or the Minnesota Department of Commerce at (651) 539-1600 or 1-800-657-3602.
Does this Plan Provide Minimum Essential Coverage? Yes.Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, CHIP,TRICARE, and certain other coverage. If you are eligible for certain types of Minimum Essential Coverage, you may not be eligible for the premium tax credit.
Does this Plan Meet the Minimum Value Standard? Yes.If your plan doesn’t meet the Minimum Value Standards, you may be eligible for a premium tax credit to help you pay for a plan through the Marketplace.
Language Access Services:
To see examples of how this plan might cover costs for a sample medical situation, see the next section.
Page 6 of 7
124
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
About these Coverage Examples:
This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending onthe actual care you receive, the prices your providers charge, and many other factors. Focus on the cost sharing amounts (deductibles, copayments and coinsurance) and excluded services under the plan. Use this information to compare the portion of costs you might pay under different health plans. Pleasenote these coverage examples are based on self-only coverage.
Peg is Having a Baby(9 months of in-network pre-natal care and a hospital delivery) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Specialist office visits (prenatal care)Childbirth/Delivery Professional ServicesChildbirth/Delivery Facility ServicesDiagnostic tests (ultrasounds and blood work)Specialist visit (anesthesia)
Total Example Cost $12,700
In this example, Peg would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $60
The total Peg would pay is $1,560
Managing Joe’s type 2 Diabetes(a year of routine in-network care of a well-controlled condition) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Primary care physician office visits (including disease
education)Diagnostic tests (blood work)Prescription drugs Durable medical equipment (glucose meter)
Total Example Cost $5,600
In this example, Joe would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Joe would pay is $1,500
Mia’s Simple fracture(in-network emergency room visit and follow up care) The plan’s overall deductible $1,500 Specialist coinsurance 0% Hospital (facility) coinsurance 0% Other coinsurance 0%
This EXAMPLE event includes services like: Emergency room care (including medical supplies)Diagnostic test (x-ray)Durable medical equipment (crutches)Rehabilitation services (physical therapy)
Total Example Cost $2,800
In this example, Mia would pay:
Cost Sharing Deductibles $1,500 Copayments $0 Coinsurance $0 What isn’t covered Limits or exclusions $0
The total Mia would pay is $1,500
The plan would be responsible for the other costs of these EXAMPLE covered services.
Page 7 of 7
125
Item 12.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Coverage Period: Beginning on or after 01/01/2023Medica Choice Passport MN 1500-0% HSA Coverage for: Individual/Family | Plan Type: PPO
126
Item 12.
CITY COUNCIL MEETING
AGENDA SECTION CONSENT
MEETING DATE NOVEMBER 14, 2022
ITEM: Rental Occupancy Licenses for Approval
DEPARTMENT: Fire BY/DATE: Assistant Fire Chief Dan O’Brien, 11/14/22
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength X Excellent Housing/Neighborhoods
_Equity and Affordability _Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND: Consideration of approval of attached list of rental housing license applications
RECOMMENDED MOTION:
MOTION: Move to approve the items listed for rental housing license applications for November 14, 2022,
in that they have met the requirements of the Property Maintenance Code.
ATTACHMENT:
Rental Occupancy Licenses for Approval – 11-14-22
127
Item 13.
128
Item 13.
129
Item 13.
130
Item 13.
131
Item 13.
132
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133
Item 13.
CITY OF COLUMBIA HEIGHTS
FINANCE DEPARTMENT
COUNCIL MEETING OF: November 14, 2022.
STATE OF MINNESOTA
COUNTY OF ANOKA
CITY OF COLUMBIA HEIGHTS
Motion: Move that in accordance with Minnesota Statute s the City Council has reviewed the enclosed list of claims paid
by check and by electronic funds transfer in the amount of $2,658,291.65.
134
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 1/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
208.00 101.5129.43050SECURITY JPM 100122ALLIED UNIVERSAL SECURITY SERVICES13348528132(A)MAIN10/21/2022
512.00 101.5129.43050SECURITY JPM 050622-05072213366611132(A)
208.00 101.5129.43050SECURITY JPM 07232213366606132(A)
640.00 101.5129.43050SECURITY JPM 081922-08222213366609132(A)
1,568.00
1,296.70 609.0000.14500093022 INVARTISAN BEER COMPANY3563500133(A)MAIN10/21/2022
(4.81)101.0000.20815100522 INV,BAGS,T.P.BELLBOY BAR SUPPLY0105841100134(A)MAIN10/21/2022
144.66 609.0000.14500100522 INV,BAGS,T.P.0105841100134(A)
43.20 609.0000.14500100522 INV,BAGS0105843800134(A)
155.48 609.0000.14500090722 INV,BAGS0105711800134(A)
166.00 609.0000.14500101222 INV,BAGS0105875300134(A)
(40.50)609.0000.14500100622 INV0105860700134(A)
199.61 609.9791.42171100522 INV,BAGS,T.P.0105841100134(A)
360.00 609.9791.42171101222 INV,BAGS0105875300134(A)
712.40 609.9792.42171100522 INV,BAGS0105843800134(A)
717.55 609.9792.42171090722 INV,BAGS0105711800134(A)
2,453.59
3,210.00 609.0000.14500092822 INV/DEL BELLBOY CORPORATION0096717700135(A)MAIN10/21/2022
3,494.35 609.0000.14500091422 INV/DEL0096517600135(A)
579.60 609.0000.14500100522 INV/DEL0096811700135(A)
(95.00)609.0000.14500091522 INV/DEL0096564100135(A)
(180.00)609.0000.14500101322 INV/DEL0096959400135(A)
47.00 609.9791.42199091422 INV/DEL0096517600135(A)
(1.65)609.9791.42199091522 INV/DEL0096564100135(A)
(1.65)609.9791.42199101322 INV/DEL0096959400135(A)
42.00 609.9792.42199092822 INV/DEL 0096717700135(A)
8.00 609.9793.42199100522 INV/DEL0096811700135(A)
7,102.65
644.00 609.0000.14500101022 INVBLUE CLOUD DISTRIBUTION OF MN, INC.100980583136(A)MAIN10/21/2022
560.00 609.0000.14500100522 INV100980555136(A)
1,204.00
182.00 609.0000.14500092122 INV 700297736BREAKTHRU BEVERAGE MN BEER LLC345754991137(A)MAIN10/21/2022
94.00 609.0000.14500092122 INV 700297736745754307137(A)
75.30 609.0000.14500091622 INV 700297782345709112137(A)
460.80 609.0000.14500091622 INV 700297782345709113137(A)
80.00 609.0000.14500100722 INV 700297736345980721137(A)
408.00 609.0000.14500092722 INV 700297717345818077137(A)
186.60 609.0000.14500092722 INV 700297717345818078137(A)135
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 2/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
67.60 609.0000.14500092822 INV 700297736345839509137(A)
306.00 609.0000.14500093022 INV 700297782345876937137(A)
9,155.80 609.0000.14500100422 INV 700297717345909514137(A)
152.40 609.0000.14500100422 INV 700297717345909515137(A)
1,100.00 609.0000.14500093022 INV 700297717345877352137(A)
376.00 609.0000.14500093022 INV 700297717345876934137(A)
16,630.95 609.0000.14500082322 INV 700297717345367565137(A)
(783.40)609.0000.14500082622 INV 700297717410063759137(A)
28,492.05
368.37 609.0000.14500091622 INV/DEL 700297717BREAKTHRU BEVERAGE MN W&S LLC345707437138(A)MAIN10/21/2022
3,118.75 609.0000.14500091622 INV/DEL 700297717345707433138(A)
63.00 609.0000.14500092322 INV 700297782345793580138(A)
63.00 609.0000.14500092322 INV 700297717345793567138(A)
620.35 609.0000.14500093022 INV/DEL 700297736345874978138(A)
395.08 609.0000.14500093022 INV/DEL 700297736345874976138(A)
1,035.00 609.0000.14500093022 INV/DEL 700297736345874980138(A)
852.70 609.0000.14500093022 INV/DEL 700297736345874979138(A)
848.55 609.0000.14500093022 INV/DEL 700297717345874970138(A)
295.49 609.0000.14500093022 INV/DEL 700297717345874974138(A)
368.00 609.0000.14500093022 INV/DEL 700297717345874969138(A)
232.00 609.0000.14500100722 INV/DEL 700297717345978986138(A)
144.00 609.0000.14500100722 INV/DEL 700297736345978992138(A)
1,108.25 609.0000.14500100722 INV/DEL 700297717345978987138(A)
376.10 609.0000.14500100722 INV/DEL 700297717345978988138(A)
731.96 609.0000.14500100722 INV/DEL 700297717345978989138(A)
(63.00)609.0000.14500100322 INV 700297782410170679138(A)
(21.00)609.0000.14500092622 INV 700297782410152568138(A)
1.92 609.9791.42199091622 INV/DEL 700297717345707437138(A)
33.35 609.9791.42199091622 INV/DEL 700297717345707433138(A)
8.05 609.9791.42199093022 INV/DEL 700297717345874970138(A)
11.50 609.9791.42199093022 INV/DEL 700297717345874974138(A)
4.80 609.9791.42199093022 INV/DEL 700297717345874969138(A)
5.75 609.9791.42199100722 INV/DEL 700297717345978986138(A)
9.39 609.9791.42199100722 INV/DEL 700297717345978987138(A)
6.90 609.9791.42199100722 INV/DEL 700297717345978988138(A)
5.75 609.9791.42199100722 INV/DEL 700297717345978989138(A)
11.50 609.9792.42199093022 INV/DEL 700297736345874978138(A)
0.38 609.9792.42199093022 INV/DEL 700297736345874976138(A)
11.50 609.9792.42199093022 INV/DEL 700297736345874980138(A)
11.50 609.9792.42199093022 INV/DEL 700297736345874979138(A)
2.30 609.9792.42199100722 INV/DEL 700297736345978992138(A)136
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 3/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
10,661.19
4,628.22 609.0000.14500092122 INVCAPITOL BEVERAGE SALES LP2741604139(A)MAIN10/21/2022
2,552.93 609.0000.14500092222 INV2742295139(A)
3,429.39 609.0000.14500100622 INV2748199139(A)
3,940.00 609.0000.14500092622 INV2742888139(A)
13,909.07 609.0000.14500092922 INV2745200139(A)
(177.70)609.0000.14500092122 INV2741603139(A)
(18.10)609.0000.14500092222 INV2742294139(A)
(95.30)609.0000.14500092922 INV21510077139(A)
28,168.51
600.80 609.0000.14500092322 INVJOHNSON BROTHERS LIQUOR CO.2143933140(A)MAIN10/21/2022
112.00 609.0000.14500092122 INV2141655140(A)
108.00 609.0000.14500092122 INV2141651140(A)
28.00 609.0000.14500100522 INV2151653140(A)
54.00 609.0000.14500100522 INV2151650140(A)
36.00 609.0000.14500100722 INV2153917140(A)
46.00 609.0000.14500100522 INV2151649140(A)
427.00 609.0000.14500100622 INV2152840140(A)
168.58 609.0000.14500100622 INV2152836140(A)
471.83 609.0000.14500100622 INV2152829140(A)
234.00 609.0000.14500100622 INV2152832140(A)
442.00 609.0000.14500100622 INV2152833140(A)
1,402.50 609.0000.14500100522 INV2151652140(A)
720.00 609.0000.14500100522 INV2151648140(A)
459.00 609.0000.14500100522 INV2151651140(A)
563.50 609.0000.14500100522 INV2151647140(A)
172.20 609.0000.14500100522 INV2151645140(A)
402.00 609.0000.14500100522 INV2151646140(A)
414.00 609.0000.14500100522 INV2151644140(A)
522.99 609.0000.14500100722 INV2153915140(A)
725.00 609.0000.14500100622 INV2152831140(A)
192.00 609.0000.14500100622 INV2152828140(A)
396.00 609.0000.14500100622 INV2152827140(A)
876.00 609.0000.14500100722 INV2153916140(A)
(13.50)609.0000.14500090922 INV220828140(A)
(10.72)609.0000.14500090922 INV220825140(A)
(10.00)609.0000.14500090822 INV220532140(A)
(27.00)609.0000.14500091222 INV220957140(A)
(18.66)609.0000.14500092222 INV222593140(A)
(15.66)609.0000.14500092222 INV222592140(A)
16.20 609.9791.42199092322 INV2143933140(A)
137
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 4/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
1.35 609.9791.42199100722 INV2153917140(A)
1.35 609.9791.42199100522 INV2151649140(A)
14.28 609.9791.42199100622 INV2152829140(A)
6.74 609.9791.42199100622 INV2152832140(A)
12.16 609.9791.42199100622 INV2152833140(A)
8.09 609.9791.42199100522 INV2151647140(A)
1.35 609.9791.42199100522 INV2151645140(A)
5.40 609.9791.42199100522 INV2151646140(A)
2.70 609.9791.42199100522 INV2151644140(A)
5.40 609.9791.42199100722 INV2153915140(A)
5.40 609.9791.42199100622 INV2152831140(A)
5.79 609.9791.42199100622 INV2152828140(A)
2.70 609.9791.42199100622 INV2152827140(A)
5.40 609.9791.42199100722 INV2153916140(A)
13.54 609.9792.42199100622 INV2152840140(A)
4.06 609.9792.42199100622 INV2152836140(A)
4.05 609.9793.42199092122 INV2141655140(A)
2.70 609.9793.42199092122 INV2141651140(A)
1.35 609.9793.42199100522 INV2151653140(A)
1.35 609.9793.42199100522 INV2151650140(A)
21.58 609.9793.42199100522 INV2151652140(A)
10.80 609.9793.42199100522 INV2151648140(A)
5.40 609.9793.42199100522 INV2151651140(A)
9,637.00
219.95 240.5500.42185AUDIOBOOK ORDERMIDWEST TAPE502695573141(A)MAIN10/21/2022
463.89 240.5500.42185AUDIOBOOK ORDER502722143141(A)
48.73 240.5500.42189DVD ORDER502618490141(A)
286.86 240.5500.42189DVD ORDER502749851141(A)
1,019.43
1,472.00 609.0000.14500092222 INVPHILLIPS WINE & SPIRITS INC6466821142(A)MAIN10/21/2022
150.00 609.0000.14500092222 INV6466818142(A)
763.00 609.0000.14500100622 INV6474599142(A)
450.15 609.0000.14500100522 INV6473631142(A)
95.00 609.0000.14500100522 INV6473632142(A)
452.05 609.0000.14500100622 INV6474598142(A)
861.75 609.0000.14500100522 INV6473630142(A)
1,845.00 609.0000.14500100522 INV6473633142(A)
33.78 609.9791.42199092222 INV6466821142(A)
8.10 609.9791.42199092222 INV6466818142(A)
1.35 609.9791.42199081722 DEL6447464142(A)
1.35 609.9791.42199081722 DEL6447466142(A)
138
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 5/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
2.70 609.9791.42199081822 DEL6448500142(A)
14.18 609.9791.42199100622 INV6474599142(A)
3.94 609.9791.42199100522 INV6473631142(A)
1.35 609.9791.42199100522 INV6473632142(A)
5.40 609.9791.42199100622 INV6474598142(A)
10.12 609.9791.42199100522 INV6473630142(A)
16.20 609.9791.42199100522 INV6473633142(A)
6,187.42
681.40 609.0000.14500092922 INV/DELSOUTHERN GLAZER'S2264662143(A)MAIN10/21/2022
1,950.00 609.0000.14500092922 INV/DEL2264661143(A)
671.45 609.0000.14500092922 INV/DEL2264656143(A)
826.30 609.0000.14500092922 INV/DEL2264660143(A)
258.10 609.0000.14500092922 INV/DEL2264665143(A)
1,841.36 609.0000.14500092922 INV/DEL2264648143(A)
681.40 609.0000.14500092922 INV/DEL2264653143(A)
447.50 609.0000.14500092922 INV/DEL2264651143(A)
545.00 609.0000.14500092922 INV/DEL2264649143(A)
508.00 609.0000.14500092922 INV/DEL2264664143(A)
1,015.67 609.0000.14500092922 INV/DEL2264663143(A)
131.12 609.0000.14500100622 INV/DEL2267226143(A)
128.60 609.0000.14500090822 INV/DEL2256203143(A)
64.30 609.0000.14500091522 INV/DEL2259007143(A)
11,686.89 609.0000.14500091522 INV/DEL2259001143(A)
2,600.00 609.0000.14500092922 INV/DEL2264654143(A)
448.00 609.0000.14500100622 INV/DEL2267231143(A)
753.95 609.0000.14500100622 INV/DEL2267370143(A)
504.00 609.0000.14500100622 INV/DEL2267371143(A)
935.60 609.0000.14500100622 INV/DEL2267221143(A)
1,053.84 609.0000.14500100622 INV/DEL2267222143(A)
22.83 609.0000.14500100622 INV/DEL2267223143(A)
3,870.00 609.0000.14500100622 INV/DEL2267225143(A)
224.95 609.0000.14500100622 INV/DEL2267227143(A)
(43.74)609.0000.14500092922 INV0080140143(A)
5.12 609.9791.42199092922 INV/DEL2264648143(A)
11.52 609.9791.42199092922 INV/DEL2264653143(A)
7.68 609.9791.42199092922 INV/DEL2264651143(A)
7.68 609.9791.42199092922 INV/DEL2264649143(A)
2.56 609.9791.42199100622 INV/DEL2267226143(A)
46.40 609.9791.42199091522 INV/DEL2259001143(A)
61.44 609.9791.42199092922 INV/DEL2264654143(A)
11.52 609.9791.42199100622 INV/DEL2267221143(A)139
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 6/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
10.88 609.9791.42199100622 INV/DEL2267222143(A)
0.22 609.9791.42199100622 INV/DEL2267223143(A)
25.60 609.9791.42199100622 INV/DEL2267225143(A)
1.71 609.9791.42199100622 INV/DEL2267227143(A)
11.52 609.9792.42199092922 INV/DEL2264662143(A)
35.84 609.9792.42199092922 INV/DEL2264661143(A)
2.56 609.9792.42199092922 INV/DEL2264656143(A)
11.84 609.9792.42199092922 INV/DEL2264660143(A)
2.77 609.9792.42199092922 INV/DEL2264665143(A)
7.68 609.9792.42199092922 INV/DEL2264664143(A)
27.31 609.9792.42199092922 INV/DEL2264663143(A)
3.84 609.9792.42199090822 INV/DEL2256203143(A)
1.28 609.9792.42199091522 INV/DEL2259007143(A)
1.92 609.9792.42199101222 DEL2269321143(A)
8.96 609.9792.42199100622 INV/DEL2267231143(A)
0.64 609.9793.42199100622 DEL2267369143(A)
14.08 609.9793.42199100622 INV/DEL2267370143(A)
3.84 609.9793.42199100622 INV/DEL2267371143(A)
32,132.93
1,836.05 609.9791.43810101822 SOLAR POWERARES NEE HOLDINGS, LLC17-000243144(A)MAIN10/27/2022
1,179.39 609.9792.43810101822 SOLAR POWER17-000243144(A)
3,015.44
573.70 609.0000.14500101422 INVARTISAN BEER COMPANY3566140145(A)MAIN10/27/2022
1,478.20 609.0000.14500100422 INV3563865145(A)
641.05 609.0000.14500101222 INV3565441145(A)
2,411.40 609.0000.14500100722 INV3564836145(A)
(478.00)609.0000.14500100422 INV345055145(A)
4,626.35
4,429.50 609.0000.14500101222 INV/DELBELLBOY CORPORATION0096906000146(A)MAIN10/27/2022
1,792.65 609.0000.14500101222 INV/DEL0096906100146(A)
1,668.50 609.0000.14500100522 INV/DEL0096812400146(A)
3,708.90 609.0000.14500100522 INV/DEL009681110146(A)
4,196.25 609.0000.14500092822 INV/DEL0096715700146(A)
(178.00)609.0000.14500100622 INV/DEL0096865500146(A)
(144.90)609.0000.14500100622 INV/DEL0096865900146(A)
42.00 609.9791.42199101222 INV/DEL0096906000146(A)
40.00 609.9791.42199100522 INV/DEL009681110146(A)
53.50 609.9791.42199092822 INV/DEL0096715700146(A)
(1.65)609.9791.42199100622 INV/DEL0096865900146(A)
14.00 609.9792.42199100522 INV/DEL0096812400146(A)
140
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 7/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
(1.65)609.9792.42199100622 INV/DEL0096865500146(A)
18.00 609.9793.42199101222 INV/DEL0096906100146(A)
15,637.10
8,698.20 609.0000.14500081922 INV 700297782BREAKTHRU BEVERAGE MN BEER LLC345351042147(A)MAIN10/27/2022
1,390.00 609.0000.14500101422 INV 700297717346087220147(A)
146.00 609.0000.14500101122 INV 700297717346008991147(A)
117.50 609.0000.14500101122 INV 700297717346009035147(A)
(4.90)609.0000.14500082622 INV 700297782410061777147(A)
(78.40)609.0000.14500082622 INV 700297782410061774147(A)
(18.40)609.0000.14500082622 INV 700297782410061776147(A)
(70.20)609.0000.14500082622 INV 700297782410061773147(A)
(4.90)609.0000.14500082622 INV 700297782410061778147(A)
(288.00)609.0000.14500082622 INV 700297782410061775147(A)
9,886.90
1,345.30 609.0000.14500101422 INV/DEL 700297717BREAKTHRU BEVERAGE MN W&S LLC346080108148(A)MAIN10/27/2022
1,129.44 609.0000.14500101422 INV/DEL 700297717346080109148(A)
383.20 609.0000.14500101422 INV/DEL 700297736346080111148(A)
704.63 609.0000.14500101422 INV/DEL 700297736346080110148(A)
200.00 609.0000.14500101422 INV/DEL 700297736346080112148(A)
750.09 609.0000.14500093022 INV/DEL 700297782345874981148(A)
337.00 609.0000.14500101422 INV/DEL 700297782346080115148(A)
1,142.99 609.0000.14500100722 INV/DEL 700297736345978993148(A)
400.00 609.0000.14500100722 INV/DEL 700297736345978994148(A)
460.55 609.0000.14500100722 INV/DEL 700297736345978991148(A)
1,871.97 609.0000.14500100722 INV/DEL 700297717345978990148(A)
300.00 609.0000.14500100722 INV/DEL 700297782345978998148(A)
(22.73)609.0000.14500101322 INV/DEL 700297782410209355148(A)
(137.00)609.0000.14500101722 INV/DEL 700297782410218931148(A)
(180.00)609.0000.14500101122 INV/DEL 700297736410198162148(A)
(251.99)609.0000.14500101122 INV/DEL 700297717410198161148(A)
14.95 609.9791.42199101422 INV/DEL 700297717346080108148(A)
6.90 609.9791.42199101422 INV/DEL 700297717346080109148(A)
11.50 609.9791.42199100722 INV/DEL 700297717345978990148(A)
(1.15)609.9791.42199101122 INV/DEL 700297717410198161148(A)
3.45 609.9792.42199101422 INV/DEL 700297736346080111148(A)
25.30 609.9792.42199101422 INV/DEL 700297736346080110148(A)
5.75 609.9792.42199101422 INV/DEL 700297736346080112148(A)
8.05 609.9792.42199100722 INV/DEL 700297736345978993148(A)
4.60 609.9792.42199100722 INV/DEL 700297736345978994148(A)
2.49 609.9792.42199100722 INV/DEL 700297736345978991148(A)
(1.15)609.9792.42199101122 INV/DEL 700297736410198162148(A)
141
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 8/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
37.95 609.9793.42199093022 INV/DEL 700297782345874981148(A)
3.45 609.9793.42199101422 INV/DEL 700297782346080115148(A)
3.45 609.9793.42199100722 INV/DEL 700297782345978998148(A)
(1.15)609.9793.42199101322 INV/DEL 700297782410209355148(A)
(1.15)609.9793.42199101722 INV/DEL 700297782410218931148(A)
8,556.69
3,834.13 609.0000.14500101222 INVCAPITOL BEVERAGE SALES LP2750026149(A)MAIN10/27/2022
146.00 609.0000.14500100522 INV2748269149(A)
1,988.19 609.0000.14500100522 INV2747546149(A)
825.22 609.0000.14500100322 INV2746228149(A)
2,337.75 609.0000.14500101022 INV2749169149(A)
3,247.32 609.0000.14500101322 INV2750986149(A)
12,378.61
2,500.00 101.0000.22010REFUND HYDRANT METER DEPOSITFER-PAL CONSTRUCTION USA LLC27700150(A)MAIN10/27/2022
520.00 609.0000.14500100522 INVJOHNSON BROTHERS LIQUOR CO.2151655151(A)MAIN10/27/2022
108.00 609.0000.14500101322 INV2157511151(A)
659.30 609.0000.14500101322 INV2157508151(A)
495.25 609.0000.14500101322 INV2157505151(A)
84.00 609.0000.14500101222 INV2156311151(A)
108.00 609.0000.14500101222 INV2156325151(A)
36.00 609.0000.14500101222 INV2156323151(A)
808.00 609.0000.14500101222 INV2156330151(A)
472.00 609.0000.14500101322 INV2157516151(A)
84.00 609.0000.14500101222 INV3156319151(A)
1,296.93 609.0000.14500101322 INV2157504151(A)
334.50 609.0000.14500101322 INV2157506151(A)
453.00 609.0000.14500101322 INV2157507151(A)
513.20 609.0000.14500101322 INV2157509151(A)
234.00 609.0000.14500101322 INV2157510151(A)
2,580.00 609.0000.14500101222 INV2156312151(A)
666.00 609.0000.14500101222 INV2156313151(A)
406.00 609.0000.14500101222 INV2156314151(A)
371.25 609.0000.14500101222 INV2156315151(A)
367.45 609.0000.14500101222 INV2156316151(A)
600.00 609.0000.14500101222 INV2156317151(A)
495.00 609.0000.14500101222 INV2156321151(A)
2,918.55 609.0000.14500101422 INV2158585151(A)
983.00 609.0000.14500100622 INV2152835151(A)
360.00 609.0000.14500100622 INV2152839151(A)
954.00 609.0000.14500100522 INV2151654151(A)
142
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 9/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
396.00 609.0000.14500100622 INV2152830151(A)
139.50 609.0000.14500100622 INV2152837151(A)
666.00 609.0000.14500100522 INV2151656151(A)
414.00 609.0000.14500100522 INV2151657151(A)
781.50 609.0000.14500101222 INV2156332151(A)
915.00 609.0000.14500101222 INV2156326151(A)
2,580.00 609.0000.14500101222 INV2156327151(A)
675.00 609.0000.14500101222 INV2156331151(A)
427.50 609.0000.14500101222 INV2156328151(A)
172.20 609.0000.14500101222 INV2156318151(A)
495.00 609.0000.14500101222 INV2156320151(A)
608.83 609.0000.14500101322 INV2157515151(A)
1,425.00 609.0000.14500101322 INV2157514151(A)
564.00 609.0000.14500101222 INV2156322151(A)
159.20 609.0000.14500101222 INV2156324151(A)
2.70 609.9791.42199101322 INV2157511151(A)
16.19 609.9791.42199101322 INV2157508151(A)
16.21 609.9791.42199101322 INV2157505151(A)
2.70 609.9791.42199101222 INV2156311151(A)
18.90 609.9791.42199101322 INV2157504151(A)
4.05 609.9791.42199101322 INV2157506151(A)
4.06 609.9791.42199101322 INV2157507151(A)
9.44 609.9791.42199101322 INV2157509151(A)
2.70 609.9791.42199101322 INV2157510151(A)
28.35 609.9791.42199101222 INV2156312151(A)
2.70 609.9791.42199101222 INV2156313151(A)
5.40 609.9791.42199101222 INV2156314151(A)
6.08 609.9791.42199101222 INV2156315151(A)
5.40 609.9791.42199101222 INV2156316151(A)
8.10 609.9791.42199101222 INV2156317151(A)
13.50 609.9791.42199101222 INV2156321151(A)
25.30 609.9791.42199101422 INV2158585151(A)
0.34 609.9792.42199092822 DEL2146563151(A)
2.70 609.9792.42199100522 INV2151655151(A)
22.96 609.9792.42199101222 INV2156330151(A)
12.13 609.9792.42199101322 INV2157516151(A)
2.70 609.9792.42199101222 INV3156319151(A)
16.38 609.9792.42199100622 INV2152835151(A)
4.05 609.9792.42199100622 INV2152839151(A)
13.49 609.9792.42199100522 INV2151654151(A)
2.70 609.9792.42199100622 INV2152830151(A)
1.35 609.9792.42199100622 INV2152837151(A)143
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 10/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
2.70 609.9792.42199100522 INV2151656151(A)
2.70 609.9792.42199100522 INV2151657151(A)
16.20 609.9792.42199101222 INV2156332151(A)
10.80 609.9792.42199101222 INV2156326151(A)
28.35 609.9792.42199101222 INV2156327151(A)
5.40 609.9792.42199101222 INV2156331151(A)
2.70 609.9792.42199101222 INV2156328151(A)
1.35 609.9792.42199101222 INV2156318151(A)
13.50 609.9792.42199101222 INV2156320151(A)
9.46 609.9792.42199101322 INV2157515151(A)
20.93 609.9792.42199101322 INV2157514151(A)
2.70 609.9793.42199101222 INV2156325151(A)
1.35 609.9793.42199101222 INV2156323151(A)
8.10 609.9793.42199101222 INV2156322151(A)
1.35 609.9793.42199101222 INV2156324151(A)
27,704.33
938.21 701.0000.14120JOYSTICKMAC QUEEN EQUIPMENT LLCP45304152(A)MAIN10/27/2022
546.00 609.0000.14500101322 INVPHILLIPS WINE & SPIRITS INC6478267153(A)MAIN10/27/2022
565.00 609.0000.14500101222 INV6477311153(A)
215.00 609.0000.14500101222 INV6477312153(A)
565.00 609.0000.14500101222 INV6477316153(A)
504.00 609.0000.14500101322 INV6478270153(A)
215.00 609.0000.14500101222 INV6477317153(A)
166.50 609.0000.14500101222 INV6477308153(A)
423.00 609.0000.14500101222 INV6477309153(A)
95.90 609.0000.14500101222 INV6477210153(A)
861.75 609.0000.14500100522 INV6473634153(A)
288.00 609.0000.14500100522 INV6473636153(A)
990.00 609.0000.14500100522 INV6473635153(A)
666.95 609.0000.14500101222 INV6477315153(A)
211.50 609.0000.14500101222 INV6477314153(A)
17.55 609.9791.42199101322 INV6478267153(A)
26.99 609.9791.42199101222 INV6477311153(A)
2.70 609.9791.42199101222 INV6477312153(A)
1.35 609.9791.42199101222 INV6477308153(A)
2.70 609.9791.42199101222 INV6477309153(A)
1.35 609.9791.42199101222 INV6477210153(A)
27.01 609.9792.42199101222 INV6477316153(A)
16.20 609.9792.42199101322 INV6478270153(A)
2.70 609.9792.42199101222 INV6477317153(A)
10.12 609.9792.42199100522 INV6473634153(A)
144
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 11/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
4.05 609.9792.42199100522 INV6473636153(A)
14.85 609.9792.42199100522 INV6473635153(A)
7.42 609.9792.42199101222 INV6477315153(A)
1.35 609.9792.42199101222 INV6477314153(A)
6,449.94
4,462.05 609.0000.14500101222 INV/DELSOUTHERN GLAZER'S2269315154(A)MAIN10/27/2022
1,259.55 609.0000.14500101222 INV/DEL 2269317154(A)
719.50 609.0000.14500101222 INV/DEL2269318154(A)
719.50 609.0000.14500101222 INV/DEL2269319154(A)
262.90 609.0000.14500101222 INV/DEL2269425154(A)
1,259.55 609.0000.14500101222 INV/DEL2269322154(A)
251.00 609.0000.14500101222 INV/DEL2269320154(A)
66.16 609.0000.14500093022 INV/DEL5089173154(A)
3,777.45 609.0000.14500100622 INV/DEL2267229154(A)
955.50 609.0000.14500100622 INV/DEL2267236154(A)
1,075.00 609.0000.14500092222 INV/DEL2261785154(A)
980.00 609.0000.14500092922 INV/DEL2264659154(A)
327.00 609.0000.14500092922 INV/DEL2264657154(A)
218.00 609.0000.14500100622 INV/DEL2267230154(A)
278.00 609.0000.14500100622 INV/DEL2267233154(A)
935.43 609.0000.14500100622 INV/DEL2267234154(A)
152.97 609.0000.14500100622 INV/DEL2267235154(A)
359.98 609.0000.14500100622 INV/DEL2267237154(A)
840.00 609.0000.14500100622 INV/DEL2267238154(A)
259.00 609.0000.14500100622 INV/DEL2267239154(A)
314.96 609.0000.14500093022 INV/DEL5089175154(A)
192.90 609.0000.14500091522 INV/DEL2259005154(A)
314.96 609.0000.14500093022 INV/DEL5089172154(A)
1,272.53 609.0000.14500100622 INV/DEL2267220154(A)
732.21 609.0000.14500101222 INV/DEL2269314154(A)
980.00 609.0000.14500092922 INV/DEL2264658154(A)
302.40 609.0000.14500092222 INV/DEL2261767154(A)
695.95 609.0000.14500092922 INV/DEL2264652154(A)
955.50 609.0000.14500100622 INV/DEL2267228154(A)
1,315.35 609.0000.14500100622 INV/DEL2267224154(A)
120.00 609.0000.14500093022 INV/DEL5089174154(A)
(192.90)609.0000.14500092922 INV0080141154(A)
(980.00)609.0000.14500100622 INV0080342154(A)
(302.40)609.0000.14500092922 INV0080139154(A)
(695.95)609.0000.14500100622 INV0080341154(A)
0.32 609.9791.42199092922 DEL 2264650154(A)145
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 12/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
42.56 609.9791.42199101222 INV/DEL2269315154(A)
6.72 609.9791.42199101222 INV/DEL 2269317154(A)
7.04 609.9791.42199101222 INV/DEL2269318154(A)
7.04 609.9791.42199101222 INV/DEL2269319154(A)
1.28 609.9791.42199093022 INV/DEL5089172154(A)
10.02 609.9791.42199100622 INV/DEL2267220154(A)
6.61 609.9791.42199101222 INV/DEL2269314154(A)
7.68 609.9791.42199092222 INV/DEL2261767154(A)
5.23 609.9791.42199092922 INV/DEL2264652154(A)
5.12 609.9791.42199100622 INV/DEL2267228154(A)
20.48 609.9791.42199100622 INV/DEL2267224154(A)
3.20 609.9791.42199101222 DEL2269313154(A)
6.72 609.9792.42199101222 INV/DEL2269322154(A)
2.56 609.9792.42199101222 INV/DEL2269320154(A)
0.64 609.9792.42199093022 INV/DEL5089173154(A)
25.60 609.9792.42199100622 INV/DEL2267229154(A)
5.12 609.9792.42199100622 INV/DEL2267236154(A)
7.68 609.9792.42199092222 INV/DEL2261785154(A)
5.12 609.9792.42199092922 INV/DEL2264659154(A)
5.12 609.9792.42199092922 INV/DEL2264657154(A)
2.56 609.9792.42199100622 INV/DEL2267230154(A)
1.71 609.9792.42199100622 INV/DEL2267233154(A)
14.08 609.9792.42199100622 INV/DEL2267234154(A)
0.75 609.9792.42199100622 INV/DEL2267235154(A)
2.99 609.9792.42199100622 INV/DEL2267237154(A)
6.40 609.9792.42199100622 INV/DEL2267238154(A)
1.92 609.9792.42199100622 INV/DEL2267239154(A)
1.28 609.9792.42199093022 INV/DEL5089175154(A)
5.12 609.9792.42199091522 INV/DEL2259005154(A)
5.12 609.9792.42199092922 INV/DEL2264658154(A)
2.56 609.9792.42199093022 INV/DEL5089174154(A)
1.28 609.9793.42199101222 INV/DEL2269425154(A)
24,411.68
16,718.64 101.3121.440002022 STREET REHABILITATION PROGRAMVALLEY PAVING INC.4155(A)MAIN10/27/2022
13,795.25 212.3190.440002022 STREET REHABILITATION PROGRAM4155(A)
(35,668.68)415.0000.206102022 STREET REHABILITATION PROGRAM4155(A)
103,454.20 415.6400.44000.22062022 STREET REHABILITATION PROGRAM4155(A)
508,771.19 415.9999.45185.22022022 STREET REHABILITATION PROGRAM4155(A)
70,634.38 430.6323.45185.22082022 STREET REHABILITATION PROGRAM4155(A)
677,704.98
159.00 609.0000.14500101222 INV56 BREWING LLC5620389192695MAIN10/27/2022
146
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 13/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
464.15 101.2100.43810100622 SOLAR POWERAEP ENERGY INC419-21394913192696MAIN10/27/2022
464.15 101.2200.43810100622 SOLAR POWER419-21394913192696
2,980.27 240.5500.43810100622 SOLAR POWER419-21394913192696
1,421.39 701.9950.43810100622 SOLAR POWER419-21394913192696
5,329.96
420.00 101.2200.42171FRX ELECTRODESALLINA HEALTH SYSTEMSCI00027162192697MAIN10/27/2022
96.06 609.9792.44020101322 MOPS,MATS,TOWELSARAMARK UNIFORM & CAREER APPAR2500113374192698MAIN10/27/2022
49.91 609.9793.44020101322 MOPS,MATS,TOWELS2500113288192698
145.97
2,800.00 415.6450.44000REMOVE BOX ELDER TREE 4201 7TH ST NEARBOTECH STUMP & TREE REMOVAL2271192699MAIN10/27/2022
252.20 101.2100.42172PANTS, SHIRTS, PATCHESASPEN MILLS, INC.301999192700MAIN10/27/2022
85.70 101.2100.42172UNDER VEST SHIRTS, PATCHES 300997192700
76.90 101.2100.42172SHIRTS, EMBROIDERY, PATCHES 301484192700
93.90 101.2100.42172UNDER VEST SHIRTS, PATCHES 301282192700
110.90 101.2100.42172SHIRTS, PATCHES, EMBROIDERY300994192700
59.95 101.2100.42172CARGO PANTS300921192700
8.85 101.2100.42172NAME TAG 302448192700
39.95 101.2100.42172REPAIR VELCRO ON VEST302459192700
385.05 101.2100.42172SHIRTS, SWEATER, EMBROIDERY302346192700
327.10 101.2100.42172POLOS, PANTS302345192700
37.00 101.2100.42172NAME EMBROIDERED, BODY CAM CLIP302449192700
18.85 101.2100.42172BADGE HOLDER302508192700
1,496.35
116.97 101.5129.44020MONITORING 1022-1222 MURZYNASSET MANAGEMENT SYSTEMS INC12403015192701MAIN10/27/2022
324.80 101.5004.43050BACH TO ROCK INSTRUCTORS BACH TO ROCK214478192702MAIN10/27/2022
301.97 609.0000.14500101322 INVBANGSTAD BREWING COMPANY LLC03339192703MAIN10/27/2022
355.25 609.0000.14500101322 INV03332192703
657.22
267.00 609.0000.14500101422 INVBERGMAN LEDGE LLCE-8006192704MAIN10/27/2022
144.00 609.0000.14500101322 INVBLACK STACK BREWING19635192705MAIN10/27/2022
54.66 701.0000.14120V-BELTBMJ CORPORATION67-126391192706MAIN10/27/2022
3,760.00 415.9999.43050.2202ZONES 6 & 7 STAKINGBOLTON & MENK, INC0297571192707MAIN10/27/2022
72.00 609.0000.14500101322 INVBREW D'ETAT LLC221013192708MAIN10/27/2022 147
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 14/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
340.00 609.0000.14500100422 INVBROKEN CLOCK BREWING COOP6941192709MAIN10/27/2022
745.30 101.2100.42171AR-15 TRIGGER KITS, TRIGGER PINSBROWNELL'S INC2022410463352192710MAIN10/27/2022
213.98 101.1940.43810101922 SOLAR GARDENCARLSON COMMUNITY SOLAR LLC15797192711MAIN10/27/2022
128.69 602.9600.43810101922 SOLAR GARDEN15797192711
1,207.90 701.9950.43810101922 SOLAR GARDEN15797192711
1,550.57
185.00 204.6314.43050ENERGY AUDIT COST SHARE REIMBURSEMENTCENTER FOR ENERGY & ENVIRONMENT21646192712MAIN10/27/2022
53.77 609.9792.43210100722 763 788-0290 045CENTURYLINK7637880290045192713MAIN10/27/2022
53.77 609.9792.43210100722 763 788-0064 1647637880064164192713
107.54
27.94 101.1510.43320UBER 101622 - AIRPORT TO HOTELCHRISTENSEN/MITCHELL101622192714MAIN10/27/2022
11.80 101.2100.44020TOWELS, AIR FRESH 100722CINTAS INC4133699644192715MAIN10/27/2022
24.66 101.2100.44020TOWELS, MATS, AIR SRV PS 1021224135100319192715
11.80 101.2200.44020TOWELS, AIR FRESH 1007224133699644192715
7.40 101.2200.44020TOWELS, MATS, AIR SRV PS 1021224135100319192715
30.10 101.5129.44020MOPS JPM 1018224134584611192715
31.99 701.9950.42172UNIFORM RENTAL 1007224133699624192715
31.99 701.9950.42172UNIFORM RENTAL 1014224134378760192715
149.74
278.81 101.2100.43050IT SUPPORT 1022CITY OF ROSEVILLE0231316192716MAIN10/27/2022
19.44 101.1110.43250101522 934571297COMCAST157570435192717MAIN10/27/2022
29.16 101.1320.43250101522 934571297157570435192717
63.18 101.1510.43250101522 934571297157570435192717
4.86 101.1940.43250101522 934571297157570435192717
131.23 101.2100.43250101522 934571297157570435192717
121.50 101.2200.43250101522 934571297157570435192717
68.04 101.3100.43250101522 934571297157570435192717
9.72 101.3121.43250101522 934571297157570435192717
34.02 101.5000.43250101522 934571297157570435192717
9.72 101.5129.43250101522 934571297157570435192717
9.72 101.5200.43250101522 934571297157570435192717
14.58 201.2400.43250101522 934571297157570435192717
19.44 204.6314.43250101522 934571297157570435192717
14.58 225.9844.43250101522 934571297157570435192717
204.13 240.5500.43250101522 934571297157570435192717
4.86 601.9600.43250101522 934571297157570435192717
4.86 602.9600.43250101522 934571297157570435192717
148
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 15/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
641.31 609.9791.43250101522 934571297157570435192717
617.01 609.9792.43250101522 934571297157570435192717
602.43 609.9793.43250101522 934571297157570435192717
9.72 701.9950.43250101522 934571297157570435192717
131.24 720.9980.43250101522 934571297157570435192717
2,764.75
1,601.67 101.3121.42160MV4 WEAR ASPHALTCOMMERCIAL ASPHALT220930192718MAIN10/27/2022
2,516.43 601.9600.42990IPERL METERSCORE & MAIN LPR265009192719MAIN10/27/2022
1,499.14 101.5129.43810101922 SOLAR GARDENCORNILLIE 2 COMMUNITY SOLAR15798192720MAIN10/27/2022
62.11 604.9600.43810101922 SOLAR GARDEN15798192720
1,561.25
80.00 609.0000.14500101222 INV/DELCRYSTAL SPRINGS ICE LLC9000845192721MAIN10/27/2022
4.00 609.9792.42199101222 INV/DEL9000845192721
84.00
410.46 701.0000.14120COOLER, THERMOSTAT, GASKETSCUMMINS INCE4-44593192722MAIN10/27/2022
417.36 701.0000.14120WATER PUMP, TENSIONER BELTE4-44328192722
827.82
23.26 701.0000.14120PANEL, BOLTCUSHMAN MOTOR CO INC206493192723MAIN10/27/2022
190.36 101.2100.42171TWLS, TP, WIPES, CLNR, LNRDALCO ENTERPRISES INC3994897192724MAIN10/27/2022
190.36 101.2200.42171TWLS, TP, WIPES, CLNR, LNR3994897192724
380.72
38.97 881.5000.42171BASEBALL PANTSDAVES SPORT SHOP43778192725MAIN10/27/2022
440.00 884.5000.44349BROKEN GLASS WINDOW REPAIR 092722DORGLASS INC61407192726MAIN10/27/2022
513.26 212.3190.42171STREET NAME SIGNSEARL F ANDERSEN INC0131037-IN192727MAIN10/27/2022
36.30 101.1410.43500PUBLIC ACCURACY TEST 101422ECM PUBLISHERS INC915676192728MAIN10/27/2022
30.16 602.9600.43050DRUG TEST 0922FIRST ADVANTAGE LNS SCREEN INC2506072209192729MAIN10/27/2022
13.16 701.0000.14120BRASS FITTINGSFLEETPRIDE INC102976538192730MAIN10/27/2022
3.24 701.0000.14120FILTER102883511192730
195.00 701.0000.14120FILTERS102822059192730
100.79 701.0000.14120FILTERS102885690192730
89.26 701.0000.14120FILTERS102957383192730
148.80 701.0000.14120FILTERS102822007192730
71.96 701.0000.14120FILTERS102957385192730 149
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 16/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
(62.98)701.0000.14120RTN FILTERS102976334192730
559.23
450.00 101.2100.43050DEPT AND INDIVIDUAL PHOTOSFLY BOY PHOTO2022-06192731MAIN10/27/2022
360.00 101.5001.44330SOFTBALL FIELDS RENTAL 092922-102022FRIDLEY/CITY OFFA-1176192732MAIN10/27/2022
23.74 701.0000.14120FLOOR DRYGENUINE PARTS/NAPA AUTO4342-887141192733MAIN10/27/2022
5.41 701.0000.14120LICENSE PLATE BULB4342-886961192733
47.48 701.9950.42171FLOOR DRY4342-887148192733
23.74 701.9950.42171FLOOR DRY4342-886960192733
100.37
576.00 101.1110.42171FACE PAINTING - TRUCK OR TREAT 2022HENNINGSON/JESSI100192734MAIN10/27/2022
35.67 101.2200.42010REPLACEMENT VACUUM HOSE HILLYARD INC700520555192735MAIN10/27/2022
186.62 101.2100.43810101622 SOLAR GARDENHINTERLAND CSG, LLCSP-035-000128192736MAIN10/27/2022
186.62 101.2200.43810101622 SOLAR GARDENSP-035-000128192736
373.24
2,071.75 609.0000.14500101422 INVHOHENSTEINS INC549791192737MAIN10/27/2022
877.70 609.0000.14500101422 INV550054192737
2,035.30 609.0000.14500100722 INV547979192737
354.70 609.0000.14500100722 INV547978192737
5,339.45
1,795.00 884.5200.44342LMCIT CLAIM CP227577 CIRCLE TERRACEHOLMLUND MASONRY INC6045192738MAIN10/27/2022
1,000.00 884.5200.44349LMCIT CLAIM CP227577 CIRCLE TERRACE6045192738
2,795.00
54.09 101.5200.42160VALVES, COPPER PIPEHOME DEPOT #28027224936192739MAIN10/27/2022
54.09 101.5200.42160COPPER PIPE, VALVES7014421192739
(54.09)101.5200.42160RTN COPPER PIPE, VALVES7224935192739
54.09
9.29 101.1510.42171PLASTIC KNIVES,COPY APPER, PAPER PADS, SURGE PROTECTORINNOVATIVE OFFICE SOLUTIONS LLCIN3963803192740MAIN10/27/2022
1.44 101.1940.42000GLUE STICKSIN3963806192740
13.21 101.1940.42000PLASTIC KNIVES,COPY APPER, PAPER PADS, SURGE PROTECTORIN3963803192740
21.34 101.1940.42171PLASTIC KNIVES,COPY APPER, PAPER PADS, SURGE PROTECTORIN3963803192740
45.28
26.60 603.9530.44200PROCEED SHAREKIWANIS COLUMBIA HTS-FRIDLEY101122192741MAIN10/27/2022
150.00 101.2100.43050SQUAD DECONTAMINATION #8171KROPIDLOWSKI/MARK133619192742MAIN10/27/2022 150
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 17/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
1,000.00 884.9450.44349WATER MAIN BREAK GL218378LEAGUE OF MN CITIES INS TRUST7565192743MAIN10/27/2022
2,198.84 609.0000.14500101422 INVM AMUNDSON CIGAR & CANDY CO LLP350531192744MAIN10/27/2022
2,102.13 101.2100.43105TRNG PREP, PD SUPERVISORS TRAINING MADDEN, GALANTER, HANSEN LLP101222192745MAIN10/27/2022
157.07 101.2100.43810101622 SOLAR GARDENMADISON ENERGY INVESTMENTS IV LLCSP-151-000052192746MAIN10/27/2022
161.60 101.2100.43810101622 SOLAR GARDENSP-150-000052192746
157.07 101.2200.43810101622 SOLAR GARDENSP-151-000052192746
161.59 101.2200.43810101622 SOLAR GARDENSP-150-000052192746
637.33
81.86 101.1940.43810101622 SOLAR GARDENMADISON ENERGY INVESTMENTS LLCSP-001-000193192747MAIN10/27/2022
1,162.22 101.5200.42171POW FLAGS, CITY FLAGSMAIN STREET DESIGN33527192748MAIN10/27/2022
1,001.08 101.2100.42012CAMERA REPLACEMENTMARCO, INCINV10109055192749MAIN10/27/2022
880.00 101.2100.42012CAMERA REPLACEMENTINV10398275192749
603.00 101.2100.42012CAMERA REPLACEMENTINV10373618192749
(399.60)101.2100.42012CAMERA RETURNCM533936192749
481.26 101.2200.42012CAMERA REPLACEMENTINV10109055192749
440.00 101.2200.42012CAMERA REPLACEMENTINV10398275192749
3,005.74
1,300.00 101.2100.43050PERSONNEL EVALUATIONMARTIN-MCALLISTER INC14863192750MAIN10/27/2022
261.25 609.0000.14500101422 INVMCDONALD DISTRIBUTING CO654935192751MAIN10/27/2022
766.75 609.0000.14500101422 INV655505192751
975.00 609.0000.14500100722 INV654469192751
2,003.00
336.00 609.0000.14500101222 INVMEGA BEER LLC17753192752MAIN10/27/2022
6.99 101.1110.42171CAUTION TAPEMENARDS CASHWAY LUMBER-FRIDLEY75856192753MAIN10/27/2022
5.19 101.5129.42171RIVETS76045192753
8.49 601.9600.42171STRAIGHT VALVE75677192753
20.67
87.12 701.0000.14120CATALYTIC CONVERTER SENSOR MIDWAY FORD591630192754MAIN10/27/2022
52.00 201.0000.3219280% REFUND OF BUILDING PERMIT FEEMILLER/MICHAEL2022-01120192755MAIN10/27/2022
480.00 101.5001.42171SOFTBALLS - 12 INCHMINNESOTA ASA3590192756MAIN10/27/2022
278.40 101.3121.42160ASPHALT EMULSIONMINNESOTA ROADWAYS86857192757MAIN10/27/2022
450.00 101.2200.44330MEMBERSHIP 2023MINNESOTA STATE FIRE DEPT ASSC2023192758MAIN10/27/2022 151
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 18/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
267.00 609.0000.14500101322 INVMODIST BREWING CO LLCE-35450192759MAIN10/27/2022
10,553.10 201.2400.43050TECHNICAL ASSISTANCE 0922NORTHWEST ASSOC CONSULTNTS INC26002192760MAIN10/27/2022
80.98 101.2100.42000YELLOW TONEROFFICE DEPOT264744576001192761MAIN10/27/2022
240.18 101.2100.42000COPY PAPER, MEMO BOOKS, POST ITS267356484001192761
321.16
68.00 101.5200.44100SATELLITE RENT-LOMIANKION SITE SANITATION INC0001413860192762MAIN10/27/2022
368.00 101.5200.44100SATELLITE RENT-HUSET0001413859192762
136.00 101.5200.44100SATELLITE RENT-HUSET0001413858192762
232.00 101.5200.44100SATELLITE RENT-SILVER LK BEACH0001413857192762
232.00 101.5200.44100SATELLITE RENT-RAMSDELL0001413856192762
68.00 101.5200.44100SATELLITE RENT-PRESTEMON0001413855192762
68.00 101.5200.44100SATELLITE RENT-GAUVITTE0001413854192762
62.00 101.5200.44100SATELLITE RENT-LABELLE0001413853192762
62.00 101.5200.44100SATELLITE RENT-KEYES0001413852192762
140.00 101.5200.44100SATELLITE RENT-SULLIVAN0001413851192762
124.00 101.5200.44100SATELLITE RENT-MCKENNA0001413850192762
220.00 101.5200.44100SATELLITE RENT-HUSET0001413849192762
1,780.00
791.65 609.0000.14500101222 INV/DELPAUSTIS & SONS WINE COMPANY180718192763MAIN10/27/2022
10.50 609.9791.42199101222 INV/DEL180718192763
802.15
343.00 101.2200.43050PRE-EMPLOYMENT PHYSICAL,DRUG TEST, HEP B, MASK FITTINGPERFORMANCE PLUS LLC123064192764MAIN10/27/2022
21.75 101.1110.42171102022 WATERPREMIUM WATERS INC319057678192765MAIN10/27/2022
8.00 101.1510.42171093022 COOLER RENTALS319019686192765
8.70 101.1510.42171102022 WATER319057677192765
8.70 101.1510.42171102022 WATER319057680192765
13.05 201.2400.42171102022 WATER319057679192765
60.20
116.64 609.0000.14500101322 INVRED BULL DISTRIBUTION CO INC5003401200192766MAIN10/27/2022
1.44 433.0000.20120UB refund for account: 301-0335-00-03REID P JOHNSON10/20/2022192767MAIN10/27/2022
23.41 601.0000.20120UB refund for account: 301-0335-00-0310/20/2022192767
17.31 602.0000.20120UB refund for account: 301-0335-00-0310/20/2022192767
7.91 603.0000.20120UB refund for account: 301-0335-00-0310/20/2022192767
7.56 604.0000.20120UB refund for account: 301-0335-00-0310/20/2022192767
57.63 152
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 19/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
1,520.27 101.3100.43050GIS SERVICES 0922RESPEC INCINV-0922-1401192768MAIN10/27/2022
140.77 101.3121.43050GIS SERVICES 0922INV-0922-1401192768
140.77 101.5200.43050GIS SERVICES 0922INV-0922-1401192768
337.84 601.9600.43050GIS SERVICES 0922INV-0922-1401192768
337.84 602.9600.43050GIS SERVICES 0922INV-0922-1401192768
337.82 701.9950.43050GIS SERVICES 0922INV-0922-1401192768
2,815.31
448.00 101.5001.43050UMPIRE SOFTBALL 092922-101422RICHSMANN/MARK101622192769MAIN10/27/2022
17.73 101.1410.44000SHREDDING 092622ROHN INDUSTRIES INC584245192770MAIN10/27/2022
1,000.00 884.0000.15510INSURANCE SERVICE 1122ROSS NESBIT AGENCIES, INC110122192771MAIN10/27/2022
175.00 101.5129.44020BEER LINE CLEANING 101722SHAMROCK GROUP-ACE ICE2824170192772MAIN10/27/2022
2,267.96 402.3191.43050.230637TH PLACE FINAL DESIGNSHORT ELLIOT HENDRICKSON INC434599192773MAIN10/27/2022
713.05 651.9999.43050.220337TH AVE WM REHAB433908192773
2,981.01
2,500.00 101.2100.43105MEDIA TRAININGSKOOGMAN/ANDREW000019192774MAIN10/27/2022
1,093.02 609.0000.14500101422 INV/DELSMALL LOT MNMN57465192775MAIN10/27/2022
12.00 609.9791.42199101422 INV/DELMN57465192775
1,105.02
100.92 603.9510.42930YARD WASTE 0922SPECIALIZED ENVIRO TECHNO INC702450192776MAIN10/27/2022
44.66 603.9510.42930YARD WASTE 0922702737192776
66.70 603.9510.42930YARD WASTE 0922703927192776
45.24 603.9510.42930YARD WASTE 0922704127192776
56.84 603.9510.42930YARD WASTE 0922705648192776
31.32 603.9510.42930YARD WASTE 0922705790192776
146.74 603.9510.42930YARD WASTE 0922707577192776
178.06 603.9510.42930YARD WASTE 0922707631192776
216.92 603.9510.42930YARD WASTE 0922707683192776
221.56 603.9510.42930YARD WASTE 0922708001192776
205.54 603.9510.42930ORGANICS 0922701272192776
183.18 603.9510.42930ORGANICS 0922701603192776
473.00 603.9510.42930ORGANICS 0922702109192776
718.10 603.9510.42930ORGANICS 0922702535192776
274.34 603.9510.42930ORGANICS 0922702777192776
233.92 603.9510.42930ORGANICS 0922703093192776
85.14 603.9510.42930ORGANICS 0922703253192776
74.82 603.9510.42930ORGANICS 0922703254192776
251.98 603.9510.42930ORGANICS 0922703512192776
153
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 20/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
260.58 603.9510.42930ORGANICS 0922703830192776
188.34 603.9510.42930ORGANICS 0922704454192776
139.32 603.9510.42930ORGANICS 0922704764192776
248.54 603.9510.42930ORGANICS 0922705237192776
210.70 603.9510.42930ORGANICS 0922705543192776
218.44 603.9510.42930ORGANICS 0922705900192776
180.60 603.9510.42930ORGANICS 0922706211192776
116.10 603.9510.42930ORGANICS 0922706462192776
186.62 603.9510.42930ORGANICS 0922706870192776
190.92 603.9510.42930ORGANICS 0922707194192776
141.04 603.9510.42930ORGANICS 0922707593192776
148.78 603.9510.42930ORGANICS 0922707969192776
229.62 603.9510.42930ORGANICS 0922708151192776
53.32 603.9510.42930ORGANICS 0922708152192776
6,121.90
207.00 609.0000.14500101122 INVSTEEL TOE BREWING LLC47504192777MAIN10/27/2022
79.99 101.2100.42172BELTSTREICHER'S GUN'S INC/DONI1594989192778MAIN10/27/2022
728.64 101.2100.42172BELT, 36 STRIKE CQC MOUNT PLATFORM, SPEED CLIPI1594356192778
450.00 101.2100.42172HAT BADGESI1595136192778
372.99 101.2100.42172HAT BADGESI1592020192778
54.98 101.2100.42172BELT, TACTICAL POUCHI1591734192778
44.98 101.2100.42172DUTY HAT, HAT BUTTONI1593287192778
46.97 101.2100.42172RAIN CAP COVERS, BELTI1591732192778
87.96 101.2100.42172DUTY HATS, HAT BUTTONSI1593286192778
2,892.00 101.2100.42173VESTS, CARRIERS, TRAUMA PLATESI1591537192778
4,758.51
5,290.54 884.2100.42281LMCIT CLAIM #CA241048 REPAIR #8166SUBURBAN AUTO BODY INC56285192779MAIN10/27/2022
1,000.00 884.2100.44349LMCIT CLAIM #CA241048 REPAIR #816656285192779
6,290.54
361.00 101.2100.42172BADGES 157 & 158SUN BADGE COMPANY INC410942192780MAIN10/27/2022
749.25 101.3121.42160AC AGGREGATE MIXEST A SCHIFSKY & SONS INC68475192781MAIN10/27/2022
1,502.25 101.3121.42160AC AGGREGATE MIXES68453192781
2,622.00 101.3121.42160AC SAND MIX, AC 3/8" AGGREGATE MIXES68498192781
747.00 101.3121.42160AC SAND MIX68405192781
5,620.50
840.00 101.2100.42172CHPD SHOULDER PATCHESTHE EMBLEM AUTHORITY40616192782MAIN10/27/2022
128.00 201.0000.3212580% REFUND OF RENTAL INSPECTION FEETHORNTON/THOMAS2022-00547192783MAIN10/27/2022 154
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 21/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
200.38 101.1410.43050PLANNING COMMISSION 090722, CC MEETING 091222TIMESAVER OFF SITE SECRETR INCM27637192784MAIN10/27/2022
207.75 101.1410.43050CC AND EDA MEETINGS 092622M27679192784
154.00 201.2400.43050PLANNING COMMISSION 090722, CC MEETING 091222M27637192784
160.50 204.6314.43050CC AND EDA MEETINGS 092622M27679192784
722.63
112.35 101.1940.44000LAWN SERVICE-CITY HALLTRUGREEN CHEMLAWN166894189192785MAIN10/27/2022
42.24 101.2100.44000LAWN SERVICE-PSB 092822166894190192785
42.24 101.2200.44000LAWN SERVICE-PSB 092822166894190192785
59.86 240.5500.44020LAWN SERVICE-LIBRARY166894187192785
113.03 609.9791.44000LAWN SERVICE-TV1 & TV2 090722166894188192785
94.75 609.9792.44000LAWN SERVICE-TV1 & TV2 090722166894188192785
464.47
299.58 609.0000.14500101122 INVURSA MINOR BREWING LLCE-2963192786MAIN10/27/2022
1,639.16 101.2100.43211100122 542000689-00001VERIZON WIRELESS9917106200192787MAIN10/27/2022
931.42 101.2100.43250101022 742128747-000019917914786192787
246.90 101.2200.43211100122 542000689-000019917106200192787
239.85 101.3100.43211100122 342019817-000019917069664192787
235.52 101.3121.43211100122 342019817-000019917069664192787
41.15 101.5000.43211100122 542000689-000019917106200192787
235.51 101.5200.43211100122 342019817-000019917069664192787
51.21 101.6102.43211100122 342019817-000019917069664192787
617.58 601.9600.43211100122 342019817-000019917069664192787
617.57 602.9600.43211100122 342019817-000019917069664192787
25.61 603.9520.43211100122 342019817-000019917069664192787
25.60 603.9530.43211100122 342019817-000019917069664192787
61.21 604.9600.43211100122 342019817-000019917069664192787
43.49 609.9791.43250100322 442044911-000029917301439192787
86.98 609.9792.43250100322 442044911-000029917301439192787
51.21 701.9950.43211100122 342019817-000019917069664192787
51.21 705.9970.43211100122 342019817-000019917069664192787
5,201.18
192.00 609.0000.14500101822 INVVINOCOPIA INC0314982-IN192788MAIN10/27/2022
192.61 609.0000.14500100522 INV/DEL0314023-IN192788
481.50 609.0000.14500100622 INV0314134-IN192788
1,086.32 609.0000.14500100622 INV/DEL0314137-IN192788
104.00 609.0000.14500101722 INV0314930-IN192788
6.25 609.9791.42199100622 INV/DEL0314137-IN192788
3.00 609.9792.42199100522 INV/DEL0314023-IN192788 155
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 22/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
2,065.68
462.89 609.9791.43810SOLAR POWERVIRIDI INVESTMENTS LLCCH-10172022192789MAIN10/27/2022
26.28 101.2100.43310LUNCH 101222 & 101322WEISSER/MITCHELL101322192790MAIN10/27/2022
100.00 101.5001.44330GATE FEE 10U STATE 2022WINDSCHITL/KEITH9237192791MAIN10/27/2022
100.00 101.5001.44330GATE FEE 12U STATE 20229238192791
200.00
1,572.91 101.2100.43810101122 51-5047554-2XCEL ENERGY (N S P)0995203459192792MAIN10/27/2022
1,572.92 101.2200.43810101122 51-5047554-20995203459192792
65.61 101.2200.43810100622 51-4217828-351-4217828-3192792
22.95 101.3121.43810101222 51-4159573-151-4159573-1192792
10.56 101.3160.43810100322 51-4174399-1993612856192792
10.57 101.3160.43810100322 51-4941920-1993608927192792
32.78 101.3160.43810100622 51-7867950-20994504301192792
215.32 101.3160.43810100622 51-7867659-80994509143192792
13,750.14 101.3160.43810101222 51-4159573-151-4159573-1192792
180.57 101.5129.43810100622 51-4697130-60994464308192792
133.65 101.5200.43810101222 51-5950185-00995477876192792
128.02 101.5200.43810100622 51-0010057576-70994518184192792
58.19 101.5200.43810100622 51-0011039127-70994510764192792
17.72 101.5200.43810100622 51-9597586-90994511447192792
110.95 101.5200.43810100722 51-8042065-30994729004192792
82.07 101.5200.43810100622 51-0012266105-30994550249192792
580.08 101.5200.43810101222 51-4159573-151-4159573-1192792
226.62 101.5200.43810101422 51-7654903-40996086581192792
140.87 212.3190.43810100622 51-0011980129-40994531693192792
50.91 212.3190.43810100622 51-9893848-40994513347192792
575.16 212.3190.43810101222 51-4159573-151-4159573-1192792
762.36 228.6317.43810100622 51-0013059132-80994552992192792
1,021.02 240.5500.43810100522 51-0011136455-00994268767192792
1,411.33 601.9600.43810101222 51-4159573-151-4159573-1192792
145.77 602.9600.43810100622 51-0013099828-30994556118192792
602.00 602.9600.43810101222 51-4159573-151-4159573-1192792
106.71 603.9530.43810101222 51-4159573-151-4159573-1192792
30.05 604.9600.43810100622 51-0010836533-80994511953192792
197.33 604.9600.43810101222 51-4159573-151-4159573-1192792
566.02 609.9792.43810100722 51-8335212-30994733525192792
644.02 609.9793.43810100622 51-4436024-50994472273192792
115.81 609.9794.43810100622 51-0014068181-70994570598192792
2,643.68 701.9950.43810101222 51-4159573-151-4159573-1192792
27,784.67
156
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 23/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
1,747.88 101.1510.43320HOTEL, LYFT, PARKING, MEALS BS&A CONF 101622-101922ZILLMER/JACKIE102022192793MAIN10/27/2022
212.29 101.5129.41400QUARTER 3, 2022 MN UNEMPLOYMENTMINNESOTA UI FUND15667481167(E)MAIN11/01/2022
709.38 240.5500.41400QUARTER 3, 2022 MN UNEMPLOYMENT15667481167(E)
88.41 609.9791.41400QUARTER 3, 2022 MN UNEMPLOYMENT15667481167(E)
1,010.08
1,855.60 701.0000.14120WEAR SEGMENTKANDI KOUNTRY INC45210211(S)MAIN11/03/2022
(1,855.60)701.0000.14120RTN WEAR SEGMENT11384611(S)
0.00
203.10 609.0000.14500100622 INVARTISAN BEER COMPANY3564469156(A)MAIN11/03/2022
36.90 609.0000.14500101822 INV3566470156(A)
1,588.20 609.0000.14500101822 INV3566471156(A)
140.00 609.0000.14500101322 INV3565776156(A)
1,968.20
3,723.90 609.0000.14500101222 INV/DELBELLBOY CORPORATION0096906300157(A)MAIN11/03/2022
28.00 609.9792.42199101222 INV/DEL0096906300157(A)
3,751.90
1,440.00 609.0000.14500100722 INV 700297782BREAKTHRU BEVERAGE MN BEER LLC345980718158(A)MAIN11/03/2022
117.50 609.0000.14500100722 INV 700297782345980723158(A)
1,557.50
63.00 609.0000.14500100722 INV 700297782BREAKTHRU BEVERAGE MN W&S LLC345978999159(A)MAIN11/03/2022
109.04 609.0000.14500092822 INV/DEL 700297717345854349159(A)
(10.00)609.0000.14500100322 INV/DEL 700297736410170678159(A)
0.19 609.9791.42199092822 INV/DEL 700297717345854349159(A)
(0.19)609.9792.42199100322 INV/DEL 700297736410170678159(A)
162.04
1,183.02 609.0000.14500101922 INVJOHNSON BROTHERS LIQUOR CO.2161056160(A)MAIN11/03/2022
468.00 609.0000.14500101922 INV2161053160(A)
644.50 609.0000.14500101922 INV2161058160(A)
626.00 609.0000.14500101922 INV2161054160(A)
352.00 609.0000.14500101922 INV2161057160(A)
40.00 609.0000.14500101922 INV2161055160(A)
472.50 609.0000.14500102022 INV2162207160(A)
304.00 609.0000.14500102022 INV2162208160(A)
651.75 609.0000.14500102022 INV2162210160(A)
159.20 609.0000.14500102022 INV2162212160(A)
623.25 609.0000.14500102022 INV2162209160(A)157
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 24/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
458.80 609.0000.14500102022 INV2162213160(A)
54.00 609.0000.14500102022 INV2162211160(A)
60.00 609.0000.14500102122 INV2163379160(A)
373.00 609.0000.14500101922 INV2161067160(A)
193.00 609.0000.14500101922 INV2162071160(A)
164.00 609.0000.14500101922 INV2161073160(A)
599.00 609.0000.14500102122 INV2163382160(A)
36.00 609.0000.14500102122 INV2163381160(A)
264.00 609.0000.14500101922 INV2161061160(A)
854.25 609.0000.14500102722 INV2167041160(A)
676.00 609.0000.14500102722 INV2167043160(A)
1,728.00 609.0000.14500102722 INV2167045160(A)
593.00 609.0000.14500102722 INV2167046160(A)
542.50 609.0000.14500101922 INV2161062160(A)
442.00 609.0000.14500101922 INV2161063160(A)
905.10 609.0000.14500101922 INV2161064160(A)
515.50 609.0000.14500101922 INV2161060160(A)
321.50 609.0000.14500102122 INV2163380160(A)
321.50 609.0000.14500102122 INV2163383160(A)
464.50 609.0000.14500101922 INV2162070160(A)
979.00 609.0000.14500101922 INV2161069160(A)
2,167.08 609.0000.14500101922 INV2161068160(A)
472.22 609.0000.14500101922 INV2161065160(A)
455.83 609.0000.14500101922 INV2161072160(A)
234.00 609.0000.14500101922 INV2161059160(A)
(5.58)609.0000.14500090822 INV220531160(A)
(10.00)609.0000.14500090822 INV220533160(A)
14.85 609.9791.42199101922 INV2161056160(A)
4.05 609.9791.42199101922 INV2161053160(A)
14.85 609.9791.42199101922 INV2161058160(A)
8.10 609.9791.42199101922 INV2161054160(A)
5.40 609.9791.42199101922 INV2161057160(A)
1.35 609.9791.42199101922 INV2161055160(A)
4.05 609.9791.42199102022 INV2162207160(A)
4.05 609.9791.42199102022 INV2162208160(A)
10.80 609.9791.42199102022 INV2162210160(A)
1.35 609.9791.42199102022 INV2162212160(A)
20.23 609.9791.42199102022 INV2162209160(A)
12.15 609.9791.42199102022 INV2162213160(A)
1.35 609.9791.42199102022 INV2162211160(A)
1.35 609.9791.42199102122 INV2163379160(A)
20.24 609.9791.42199102722 INV2167041160(A)158
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 25/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
13.50 609.9791.42199102722 INV2167043160(A)
17.55 609.9791.42199102722 INV2167045160(A)
16.22 609.9791.42199102722 INV2167046160(A)
2.70 609.9791.42199102122 INV2163380160(A)
11.14 609.9792.42199101922 INV2161067160(A)
6.76 609.9792.42199101922 INV2162071160(A)
4.05 609.9792.42199101922 INV2161073160(A)
10.50 609.9792.42199102122 INV2163383160(A)
8.10 609.9792.42199101922 INV2162070160(A)
9.45 609.9792.42199101922 INV2161069160(A)
21.59 609.9792.42199101922 INV2161068160(A)
4.06 609.9792.42199101922 INV2161065160(A)
6.74 609.9792.42199101922 INV2161072160(A)
1.35 609.9792.42199101922 INV2161059160(A)
12.15 609.9793.42199102122 INV2163382160(A)
1.35 609.9793.42199102122 INV2163381160(A)
5.40 609.9793.42199101922 INV2161061160(A)
2.70 609.9793.42199101922 INV2161062160(A)
4.05 609.9793.42199101922 INV2161063160(A)
18.89 609.9793.42199101922 INV2161064160(A)
6.75 609.9793.42199101922 INV2161060160(A)
19,691.59
15,926.40 408.6414.430503841 CENTRAL AVE WATER DISCONNECTMEYER CONTRACTING INC221091-3WD161(A)MAIN11/03/2022
(19,243.92)652.0000.20610CENTRAL AVE SEWER MANHOLE IMPROVEMENTS2204-3161(A)
384,878.38 652.9999.45190.2204CENTRAL AVE SEWER MANHOLE IMPROVEMENTS2204-3161(A)
381,560.86
104.19 240.5500.42189DVD ORDERMIDWEST TAPE502832477162(A)MAIN11/03/2022
143.18 240.5500.42189DVD ORDER502798136162(A)
247.37
95.85 609.0000.14500102022 INVPHILLIPS WINE & SPIRITS INC6482199163(A)MAIN11/03/2022
1,563.84 609.0000.14500102022 INV6482200163(A)
195.55 609.0000.14500102022 INV6482202163(A)
868.00 609.0000.14500102122 INV6483073163(A)
255.61 609.0000.14500102122 INV6483074163(A)
521.28 609.0000.14500102122 INV6483075163(A)
1,430.00 609.0000.14500102722 INV6486044163(A)
96.00 609.0000.14500102022 INV6482201163(A)
72.00 609.0000.14500102022 INV6482203163(A)
480.00 609.0000.14500102022 INV6482208163(A)
221.25 609.0000.14500102122 INV6483077163(A)
159
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 26/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
42.00 609.0000.14500102722 INV6486042163(A)
270.50 609.0000.14500102722 INV6486043163(A)
717.50 609.0000.14500101922 INV6481245163(A)
549.33 609.0000.14500102022 INV6482209163(A)
63.91 609.0000.14500102022 INV6482206163(A)
521.28 609.0000.14500102022 INV6482207163(A)
1.35 609.9791.42199102022 INV6482199163(A)
8.10 609.9791.42199102022 INV6482200163(A)
2.70 609.9791.42199102022 INV6482202163(A)
14.85 609.9791.42199102722 INV6486044163(A)
1.35 609.9791.42199102022 INV6482201163(A)
1.35 609.9791.42199102022 INV6482203163(A)
1.35 609.9791.42199102722 INV6486042163(A)
4.05 609.9791.42199102722 INV6486043163(A)
6.75 609.9792.42199102022 INV6482208163(A)
5.40 609.9792.42199102022 INV6482209163(A)
1.35 609.9792.42199102022 INV6482206163(A)
2.70 609.9792.42199102022 INV6482207163(A)
1.35 609.9793.42199102122 DEL6483076163(A)
5.40 609.9793.42199102122 INV6483073163(A)
4.05 609.9793.42199102122 INV6483074163(A)
2.70 609.9793.42199102122 INV6483075163(A)
8.10 609.9793.42199102122 INV6483077163(A)
7.43 609.9793.42199101922 INV6481245163(A)
8,044.23
120.00 609.0000.14500093022 INV/DELSOUTHERN GLAZER'S5089171164(A)MAIN11/03/2022
297.80 609.0000.14500101222 INV/DEL2269316164(A)
2.56 609.9791.42199093022 INV/DEL5089171164(A)
5.12 609.9791.42199101222 INV/DEL2269316164(A)
425.48
1,518.00 609.0000.14500102122 INVWINE MERCHANTS7400685165(A)MAIN11/03/2022
19.13 609.9791.42199102122 INV7400685165(A)
1,537.13
2,465.05 101.2200.44020PREVENTATIVE MAINT, REPAIRSA DYNAMIC DOOR CO INC22209151192794MAIN11/03/2022
260.00 101.5001.42170FALL SOFTBALLTROPHIES 2022AAA AWARDS19176192795MAIN11/03/2022
35.50 101.5200.42030LIONS BENCH PLATES19159192795
295.50
343.22 101.3121.44000RELOCATE CAMERA, REPLACE LIGHT, REMOUNT LASERACTION FLEET LLCI5465192796MAIN11/03/2022 160
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 27/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
715.00 101.3121.44000INSTALL MONITOR & CAMERASI5444192796
590.00 101.3121.44000INSTALL MONITOR & CAMERASI5433192796
1,648.22
33.26 101.0000.20810REFUND DAMAGE DEPOSITAHMED/GEMECHU102122192797MAIN11/03/2022
466.74 101.0000.34780REFUND DAMAGE DEPOSIT102122192797
500.00
14.35 701.0000.14120WINDOW CRANK HANDLEALLIANCE PARTS AND TRAILER SALES007P42911192798MAIN11/03/2022
37.50 101.2100.43250BROADBAND CONN 1122ANOKA COUNTYB221015G192799MAIN11/03/2022
37.50 101.2200.43250BROADBAND CONN 1122B221015G192799
18.75 101.3100.43250BROADBAND CONN 1122B221015G192799
3.75 101.3121.43250BROADBAND CONN 1122B221015G192799
3.75 101.5200.43250BROADBAND CONN 1122B221015G192799
3.75 601.9600.43250BROADBAND CONN 1122B221015G192799
3.75 602.9600.43250BROADBAND CONN 1122B221015G192799
3.75 701.9950.43250BROADBAND CONN 1122B221015G192799
112.50
350.00 604.9600.431052022 FALL CONFERENCEAPWA - MN CHAPTER2022PWMNFLLCNREA007Z192800MAIN11/03/2022
90.56 609.0000.14500101822 MOPS,MATS,TOWELSARAMARK UNIFORM & CAREER APPAR2500115584192801MAIN11/03/2022
90.56 609.9791.44020102522 MOPS,MATS,TOWELS2500119771192801
96.06 609.9792.44020102022 MOPS,MATS,TOWELS2500117811192801
96.06 609.9792.44020102722 MOPS,MATS,TOWELS2500122238192801
49.91 609.9793.44020102022 MOPS,MATS,TOWELS2500117727192801
49.91 609.9793.44020102722 MOPS,MATS,TOWELS2500122141192801
473.06
125.80 101.2100.42172JACKET, CHEVRONS, PATCHESASPEN MILLS, INC.302634192802MAIN11/03/2022
263.30 101.2100.42172PANTS, MACE HOLDER302822192802
52.95 101.2100.42172GLOVES302921192802
268.94 101.2200.42172CLASS A UNIFORM QR295733192802
710.99
1,102.50 701.9950.42171PADLOCKS, RE-KEYASSURED SECURITY INCC111401192803MAIN11/03/2022
210.00 701.9950.44020PADLOCKS, RE-KEYC111401192803
1,312.50
11.45 601.9600.43211082522 287307857001AT&T MOBILITY II, LLC287307857001X0903202192804MAIN11/03/2022
11.32 601.9600.43211092522 287307857001287307857001X1003202192804
11.45 602.9600.43211082522 287307857001287307857001X0903202192804
11.32 602.9600.43211092522 287307857001287307857001X1003202192804
161
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 28/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
11.45 604.9600.43211082522 287307857001287307857001X0903202192804
11.33 604.9600.43211092522 287307857001287307857001X1003202192804
68.32
425.01 240.5500.42180BOOK ORDERBAKER & TAYLOR2037026452192805MAIN11/03/2022
190.66 240.5500.42180BOOK ORDER2037080829192805
12.31 240.5500.42180BOOK ORDER2037076476192805
168.49 240.5500.42180BOOK ORDER5017745047192805
511.26 240.5500.42180BOOK ORDER2037040535192805
467.96 240.5500.42180BOOK ORDER2037055497192805
521.19 240.5500.42180BOOK ORDER2037026476192805
2,296.88
435.00 402.9999.43050.211037TH AVE TEMP EASEMENTSBARNA GUZY & STEFFEN LTD253126192806MAIN11/03/2022
50.60 402.9999.43050.211037TH AVE-EMINENT DOMAIN253127192806
485.60
498.57 415.6450.44000BOARD UP 841 49TH AVEBAUER SERVICES II INC1315192807MAIN11/03/2022
19.98 701.0000.14120FOB BATTERIESBMJ CORPORATION67-126686192808MAIN11/03/2022
22.99 701.9950.42171WIRE TERMINALS67-126573192808
42.97
21,385.00 101.1510.44030ANNUAL SUPPORT FEE 110122-110123BS&A SOFTWARE143573192809MAIN11/03/2022
55.48 240.5500.42180LARGEPRINT BOOK ORDERCENGAGE LEARNING INC79471133192810MAIN11/03/2022
166.44 240.5500.42180LARGEPRINT BOOK ORDER79444454192810
221.92
313.33 101.1940.43830101722 8000014661-5CENTER POINT ENERGY8000014661-5192811MAIN11/03/2022
260.12 101.5129.43830101722 8000014661-58000014661-5192811
92.37 101.5200.43830101722 8000014661-58000014661-5192811
69.95 601.9600.43830101722 8000014661-58000014661-5192811
131.02 609.9791.43830101722 8000014661-58000014661-5192811
253.04 609.9792.43830101722 8000014661-58000014661-5192811
25.43 609.9793.43830101722 8000014661-58000014661-5192811
241.95 701.9950.43830101722 8000014661-58000014661-5192811
1,387.21
26.21 240.5500.42180LARGEPRINT BOOK ORDERCENTER POINT LARGE PRINT INC1957096192812MAIN11/03/2022
886.41 884.9430.44342DAMAGES-4648 FILLMORE STCENTERPOINT ENERGY1CNP2022163285-ZC192813MAIN11/03/2022
21.45 101.1940.44020RUGS CITY HALL 102122CINTAS INC4135100293192814MAIN11/03/2022
30.10 101.5129.44020MOPS JPM 1025224135260015192814
162
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 29/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
31.99 701.9950.42172UNIFORM RENTAL, RUGS 1021224135100237192814
38.21 701.9950.44020UNIFORM RENTAL, RUGS 1021224135100237192814
121.75
1,419.64 601.9600.42990IPERL METERSCORE & MAIN LPR639681192815MAIN11/03/2022
1,755.99 601.9600.42990OMNI METER, FLANGE KITR826295192815
1,250.00 601.9690.44000FLEXNET M2 SOFTWARE SUPPORT 102022-101923R759921192815
1,250.00 602.9690.44000FLEXNET M2 SOFTWARE SUPPORT 102022-101923R759921192815
5,675.63
(473.93)602.9600.42010RETURNED WHEELSCUES INCMO017574192816MAIN11/03/2022
1,720.00 602.9600.44030SOFTWARE SUPPORT 120422-120323621901192816
430.00 604.9600.44030SOFTWARE SUPPORT 120422-120323621901192816
1,676.07
114.91 601.0000.20120UB refund for account: 219-1150-00-01DU-ALL SERVICES10/31/2022192817MAIN11/03/2022
108.63 602.0000.20120UB refund for account: 219-1150-00-0110/31/2022192817
372.59 604.0000.20120UB refund for account: 219-1150-00-0110/31/2022192817
596.13
101.20 240.5500.42181RATE ADJUSTMENT INV#1637934EBSCO PUBLISHING2301502192818MAIN11/03/2022
(7.50)240.5500.42181DISCONTINUED MAGAZINE INV#16379342204242192818
93.70
200.00 204.6314.443302022 EDAM MEMBERSHIPECONOMIC DEVELOPMENT ASSOC. OF MN2022-10679192819MAIN11/03/2022
44.48 601.0000.20120FINAL/REFUND 4549 POLK STELSAFY/IKBAL021021192820MAIN11/03/2022
229.00 601.9600.42010TRANSFER PUMPFERGUSON WATERWORKS INC0502791192821MAIN11/03/2022
813.20 601.9600.42160HYDRANT PARTS0502255192821
813.20 601.9600.42160HYDRANT PARTS0502263192821
1,855.40
9.60 701.0000.14120AIR FITTINGSFLEETPRIDE INC103027716192822MAIN11/03/2022
897.00 602.9600.42010LEADER HOSESFLEXIBLE PIPE TOOL CO INC28104192823MAIN11/03/2022
91.00 701.9950.42171POLYETHYLENE SPLIT LOOMGENUINE PARTS/NAPA AUTO4342-888010192824MAIN11/03/2022
37.80 101.2100.42175TEEN ACADEMY FOODHANSON/ERIK102022192825MAIN11/03/2022
240.00 101.5004.44378AIRBRUSH TATTOO ARTIST 102922HENNINGSON/JESSI102192826MAIN11/03/2022
201.75 609.0000.14500101422 INVHOHENSTEINS INC549808192827MAIN11/03/2022
26.04 101.5200.42160CONCRETEHOME DEPOT #28024016239192828MAIN11/03/2022
15.98 601.9600.42171INSULATION TAPE7610562192828
163
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 30/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
42.02
2,472.00 101.1940.44020BUILDING MAINTENANCE 1022-1222HORWITZ INC500001670192829MAIN11/03/2022
3,633.45 101.2100.44020REPLACE ASCO VALVES500001795192829
1,124.00 101.2100.44020BUILDING MAINTENANCE 1022-1222500001670192829
1,124.00 101.2200.44020BUILDING MAINTENANCE 1022-1222500001670192829
1,773.00 101.5129.44020BUILDING MAINTENANCE 1022-1222500001670192829
250.00 101.5200.44020BUILDING MAINTENANCE 1022-1222500001670192829
2,722.00 240.5500.44020BUILDING MAINTENANCE 1022-1222500001670192829
25.00 601.9600.44020BUILDING MAINTENANCE 1022-1222500001670192829
75.00 602.9600.44020BUILDING MAINTENANCE 1022-1222500001670192829
824.00 609.9791.44020BUILDING MAINTENANCE 1022-1222500001670192829
724.00 609.9792.44020BUILDING MAINTENANCE 1022-1222500001670192829
275.00 609.9793.44020BUILDING MAINTENANCE 1022-1222500001670192829
1,074.00 701.9950.44020BUILDING MAINTENANCE 1022-1222500001670192829
16,095.45
3,490.00 415.9999.43050.2202MATERIALS TESTING 2022 STREET REHABINDEPENDENT TESTING TECH, INC.41535192830MAIN11/03/2022
3,530.00 415.9999.43050.2202MATERIALS TESTING 2022 STREET REHAB41628192830
7,020.00
10.32 101.1940.42000POST ITS, ID REELSINNOVATIVE OFFICE SOLUTIONS LLCIN3984695192831MAIN11/03/2022
75.66 101.3121.431051122 SAFETY SERVICESINTEGRATED LOSS CONTROL INC14951192832MAIN11/03/2022
75.67 101.5200.431051122 SAFETY SERVICES14951192832
75.66 601.9600.431051122 SAFETY SERVICES14951192832
75.67 602.9600.431051122 SAFETY SERVICES14951192832
75.67 604.9600.431051122 SAFETY SERVICES14951192832
75.67 701.9950.431051122 SAFETY SERVICES14951192832
454.00
23.97 603.0000.20120UB refund for account: 208-0270-00-03JAMES MACKENZIE11/01/2022192833MAIN11/03/2022
495.00 604.9600.44000EMERGENT VEGETATION-LABELLE LAKE RESTORATION INCINV030228192834MAIN11/03/2022
250.00 604.9600.44000EMERGENT VEGETATION-SILVER LAKE BOAT LANDINGINV030230192834
495.00 604.9600.44000EMERGENT VEGETATION-ZUREK PONDINV030226192834
250.00 604.9600.44000EMERGENT VEGETATION-LIBRARY PONDINV030227192834
345.00 604.9600.44000EMERGENT VEGETATION-PRESTEMON PONDINV030229192834
1,835.00
4,494.40 609.0000.14500102822 INVM AMUNDSON CIGAR & CANDY CO LLP351269192835MAIN11/03/2022
4,266.56 609.0000.14500102822 INV351270192835
1,505.04 609.0000.14500102822 INV351271192835 164
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 31/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
10,266.00
48.95 240.5500.44000PRINTER MAINT SERVICESMARCO, INCINV10456172192836MAIN11/03/2022
32.00 240.5500.42181ONE YEAR SUBSCRIPTONMAYO CLINIC HEALTH LETTERMCHL1022192837MAIN11/03/2022
27.86 101.2200.42171METAL SRPING CLAMPMENARDS CASHWAY LUMBER-FRIDLEY76648192838MAIN11/03/2022
29.98 601.9600.42010MAUL, TARP, CABLE TIES75854192838
15.93 601.9600.42171COUPLING, RISER75599192838
6.39 601.9600.42171CPMPRESSION SLEEVES & NUTS75659192838
11.97 601.9600.42171VALVE, COMPRESSION SLEEVES75669192838
35.98 601.9600.42171MAUL, TARP, CABLE TIES75854192838
128.11
24.60 701.0000.14120SPARK PLUGSMIDWAY FORD741804192839MAIN11/03/2022
25.00 101.6102.443302023 TREE CARE REGISTRYMN DEPT OF AGRICULTURE20106911192840MAIN11/03/2022
305.36 415.9999.43050.2202CONCRETE & BITUMINOUS PLANT INSPECTIONSMN DEPT OF TRANSPORTATIONP00016155192841MAIN11/03/2022
550.00 604.9600.431052023 MECA CONFERENCE MN EROSION CONTROL ASSOCZPNTTCTZH5F192842MAIN11/03/2022
46.56 101.0000.20810REFUND DAMAGE DEPOSIT & SECURITY DEPOSITMONCAYO/PATRICIA102122192843MAIN11/03/2022
653.44 101.0000.34781REFUND DAMAGE DEPOSIT & SECURITY DEPOSIT102122192843
700.00
37.78 101.2200.42000PHONE MESSAGE PADSOFFICE DEPOT271738061001192844MAIN11/03/2022
214.00 101.1110.44100SATELLITE RENT-TRUCK OR TREAT 2022ON SITE SANITATION INC0001426258192845MAIN11/03/2022
116.00 101.5129.44020PEST CONTROL JPM 102122ORKIN INC232710606192846MAIN11/03/2022
(5.65)101.0000.20815102622 -10013121POPP.COM INC992755474192847MAIN11/03/2022
5.66 101.1110.43210102622 -10013121992755474192847
37.39 101.1320.43210102622 -10013121992755474192847
49.65 101.1510.43210102622 -10013121992755474192847
2.92 101.1940.43210102622 -10013121992755474192847
134.79 101.2100.43210102622 -10013121992755474192847
48.23 101.2200.43210102622 -10013121992755474192847
68.35 101.3100.43210102622 -10013121992755474192847
5.98 101.3121.43210102622 -10013121992755474192847
40.41 101.5000.43210102622 -10013121992755474192847
0.97 101.5129.43210102622 -10013121992755474192847
9.12 101.5200.43210102622 -10013121992755474192847
29.58 204.6314.43210102622 -10013121992755474192847
23.94 240.5500.43210102622 -10013121992755474192847
5.58 601.9600.43210102622 -10013121992755474192847 165
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 32/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
55.67 609.9791.43210102622 -10013121992755474192847
24.84 609.9792.43210102622 -10013121992755474192847
7.40 609.9793.43210102622 -10013121992755474192847
4.91 701.9950.43210102622 -10013121992755474192847
14.30 720.9980.43210102622 -10013121992755474192847
564.04
346.00 609.0000.14500101422 INVPRYES BREWING COMPANY LLCW-44747192848MAIN11/03/2022
5,084.50 101.1110.43050COUNCIL MEMBER INVESTIGATIONRED CEDAR CONSULTING, LLC000113192849MAIN11/03/2022
3.61 433.0000.20120UB refund for account: 314-0065-00-01REID LARSON10/26/2022192850MAIN11/03/2022
45.43 601.0000.20120UB refund for account: 314-0065-00-0110/26/2022192850
35.43 602.0000.20120UB refund for account: 314-0065-00-0110/26/2022192850
20.86 603.0000.20120UB refund for account: 314-0065-00-0110/26/2022192850
19.00 604.0000.20120UB refund for account: 314-0065-00-0110/26/2022192850
124.33
113.98 433.0000.20120UB refund for account: 106-0235-00-03ROMULO PICON10/26/2022192851MAIN11/03/2022
92.06 601.0000.20120UB refund for account: 106-0235-00-0310/26/2022192851
206.04
579.52 701.0000.14120TIRESROYAL TIRE303-202421192852MAIN11/03/2022
259.65 101.5129.42990POP JPM 102022SHAMROCK GROUP-ACE ICE2824317192853MAIN11/03/2022
590.12 651.9999.43050.220337TH AVE WM REHABSHORT ELLIOT HENDRICKSON INC432404192854MAIN11/03/2022
1,735.05 651.9999.43050.220337TH AVENUE WM REHAB432404192854
4,312.09 651.9999.43050.220337TH AVE WM REHAB430481192854
1,904.27 651.9999.43050.220337TH AVE WM REHAB432201192854
8,541.53
172.89 609.9791.4200010 KEY CALCULATORSSTAPLES ADVANTAGE359569211192855MAIN11/03/2022
44.44 609.9791.42000PAPER,CLOROX WIPES,KLEENEX,CLEANERS3519569213192855
46.69 609.9791.42171PAPER,CLOROX WIPES,KLEENEX,CLEANERS3519569213192855
39.37 609.9792.42171PAPER,CLOROX WIPES,KLEENEX,CLEANERS3519569213192855
10.54 609.9793.42171PAPER,CLOROX WIPES,KLEENEX,CLEANERS3519569213192855
313.93
2,577.00 101.2100.42172ENAMEL BADGESSUN BADGE COMPANY INC411993192856MAIN11/03/2022
8,299.15 101.5200.44000CITY PARKS LAWN SERVICE 090622-090822TRUGREEN CHEMLAWN166894186192857MAIN11/03/2022
108.90 101.2100.42171EVIDENCE TAPEULINE INC154509218192858MAIN11/03/2022
1,064.20 101.5001.43050TAE KWON DO & LITTLE TIGERS FALL 2022ULTIMATE MARTIAL ARTS INC102722192859MAIN11/03/2022
166
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 33/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
507.54 609.0000.14500101322 INVVINOCOPIA INC0314761-IN192860MAIN11/03/2022
132.00 101.3170.44000PAVEMENT MARKINGS PAINTWARNING LITES OF MINNESOTA INC240956192861MAIN11/03/2022
1,188.00 212.3190.44000PAVEMENT MARKINGS PAINT240956192861
1,320.00
2,162.27 101.1940.43810102022 51-7085831-0XCEL ENERGY (N S P)0997123378192862MAIN11/03/2022
1,233.08 101.5129.43810102022 51-4350334-80997098042192862
3,395.35
227.41 601.9600.43810SOLAR SUBSCRIPTION 0922XCEL ENERGY SOLUTIONS002865192863MAIN11/03/2022
143.22 701.0000.14120PEDAL ASSYZIEGLER INCIN000728856192864MAIN11/03/2022
5.28 701.0000.14120PIN/SPRINGIN000730495192864
148.50
98.69 101.1510.44300FINANCE CHARGE/LATE FEEQUADIENT LEASING USA, INC.101822192865MAIN11/03/2022
25.50 101.0000.11500ACCIDENTAL PURCHASE ON CITY CC WELLS FARGO CREDIT CARD091522 CC166(E)MAIN11/09/2022
(97.00)101.0000.11500FRAUDULENT CHARGE REVERSAL KH CC101422 CC166(E)
(0.92)101.0000.20815FOOD/PROGRAM SUPPLIES092922 WALMART166(E)
(0.48)101.0000.20815KEY TAG RACK SLOT STYLE2535440166(E)
(8.63)101.0000.20815CANDY-FD OPEN HOUSE/TRUCK OR TREAT101422 TGT166(E)
(1.00)101.0000.37640FRAUDULENT CHARGE REVERSAL KH CC101422 CC166(E)
19.99 101.1110.42171MOVIE IN THE PARK DVD-ENCANTO093022 TGT166(E)
(19.99)101.1110.42171RETURN DVD-ENCANTO100722 TGT166(E)
34.08 101.1110.42175POPCORN-MOVIE IN THE PARK7790622166(E)
96.61 101.1110.42175ICE CREAM-BOARDS & COMMISSIONS SOCIAL2166(E)
8.99 101.1110.42175SNACK-CITY COUNCIL MEETING092622 CUB166(E)
11.28 101.1110.44380SNACKS-YOUTH COMMISSION MTG091422 TGT166(E)
10.49 101.1110.44380SNACKS-YOUTH COMMISSION100922 TGT166(E)
75.99 101.1320.42011INTERNAL SOLID STATE DRIVE-BEN S2709807166(E)
384.00 101.1320.44330SURVEYMONKEY ANNUAL FEE43264916166(E)
18.99 101.1510.42000MEMORY FOAM OFFICE CHAIR ARMREST PADS9938603166(E)
135.00 101.1510.43105ANNUAL GOVERNMENTAL GAAP UPDATE3070096166(E)
418.23 101.2100.42000POSTCARDS7984205166(E)
371.89 101.2100.42000TONER CARTRIDGES3306616166(E)
29.44 101.2100.42000PADDED ENVELOPES3869017166(E)
25.48 101.2100.42010TV MOUNT-LUNCHROOM4353807166(E)
1,203.97 101.2100.4201043 IN TV'S-GYM,50 IN TV-LUNCHROOM5626637166(E)
49.80 101.2100.42012GIGABIT POE EXTENDER-PUB PARKING CAMERA3653825166(E)
38.14 101.2100.42170FIRST AID KITS,WRIST BANDS-OPEN GYM4427460166(E)
59.06 101.2100.42170SHIPPING TAGS-MARKING EVIDENCE6549812166(E)167
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 34/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
430.95 101.2100.421703000 BADGE STICKERS539_662893166(E)
76.41 101.2100.42171FRAMED CERTIFICATE-MM STAFF & COMMAND TRNG20220919021807785166(E)
106.16 101.2100.42171BATTERIES,GUN CLEANER SOLUTION1505046166(E)
7.40 101.2100.4217110 PHOTO PRINTS0809845166(E)
419.66 101.2100.42175DELI TRAYS-PROMOTION RECOGNITION2166(E)
28.56 101.2100.42175SNACKS-PROMOTION RECOGNITION092422 TGT166(E)
78.98 101.2100.42175CAKES-BASURTO,FLETCHER SWEARING-IN092222 CUB166(E)
17.25 101.2100.42175DONUTS-CRIM JUSTICE ACADEMY MTG00000036166(E)
14.98 101.2100.42175SODA-MEDIA TRAINING100522 TGT166(E)
16.98 101.2100.42175SNACKS-MEDIA TRAINING100522 CUB166(E)
19.97 101.2100.42175SNACKS-MEDIA TRAINING100622 CUB166(E)
166.54 101.2100.42175LUNCH-MEDIA TRAINING13165680032645121166(E)
39.00 101.2100.42175DONUTS WITH A COP EVENT534166(E)
34.80 101.2100.42175DONUTS-DEPT MTG00000119166(E)
24.17 101.2100.42175CANDY-TEEN ACADEMY100622 MENARDS166(E)
42.85 101.2100.42175COFFEE-DONUTS WITH A COP706623166(E)
74.99 101.2100.42175COFFEE-DONUTS WITH A COP711224166(E)
25.00 101.2100.43105TAC TRAINING-ROMANIK25756166(E)
100.00 101.2100.43105CRITICAL ISSUES WEBINAR13403166(E)
17.53 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG323166(E)
16.04 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG324166(E)
15.72 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG316166(E)
15.72 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG325166(E)
11.88 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG1886320166(E)
26.75 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG1004-14712166(E)
62.38 101.2100.43310FUEL-MARKHAM STAFF & COMMAND TRNG25046166(E)
71.65 101.2100.43310FUEL-MARKHAM STAFF & COMMAND TRNG178346166(E)
10.39 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG262346166(E)
10.39 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG263571166(E)
10.39 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG259625166(E)
10.39 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG258764166(E)
10.39 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG260699166(E)
14.86 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG318166(E)
16.44 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNGTM1015166(E)
16.44 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNGTM1026166(E)
15.37 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG20012166(E)
10.91 101.2100.43310LUNCH-MARKHAM STAFF & COMMAND TRNG138166(E)
62.50 101.2100.43310FUEL-STAFF & COMMAND TRNG MARKHAM256359166(E)
10.00 101.2100.43320PARKING-BCA CONF 6073166(E)
80.00 101.2100.44030TIME IQ SUBSC 1006-11052220221006-000723166(E)
0.74 101.2100.44310LICENSE TABS #8166151284124166(E)
29.75 101.2100.44390LICENSE TABS #8166151284124166(E)168
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 35/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
1,125.00 101.2200.42010SEARCH & RESCUE HELMET W/GOGGLESIN1733170166(E)
300.00 101.2200.43105AMEM CONFERENCE-KP20190193166(E)
365.00 101.2200.43105MSFCA CONFERENCE CT4548166(E)
1,565.00 101.2200.43105MSFCA 2022 CONFERENCE DO,AC,ZP,CA,AC4545166(E)
759.54 101.2200.43320LODGING-MSFCA CONFERENCE538699226166(E)
599.88 101.2200.44030CREATIVE CLOUD SUBSC 1YR2275778130166(E)
532.00 101.2200.44330EMT/PARAMEDIC RECERT FEE X 20395174166(E)
25.98 101.2300.42000PHOTO PAPER9007401166(E)
1,012.63 101.3100.44080PLATINUM PLUS FILM APPLICATION #040150012830166(E)
17.55 101.3100.44300EMERGENCY QUICK CHARGE #0401100522 ELEC166(E)
210.00 101.3121.431052022 FALL MAINTENANCE EXPO318118231166(E)
50.00 101.3121.44030SOFTWARE LICENSE 0919229770166(E)
112.32 101.5000.42171PLANNERS,PENS,MARKERS,NOTEBOOKS6576247166(E)
99.98 101.5001.42171SOCCER GOALS5260256166(E)
65.39 101.5004.42171PRIZE WHEEL,PRIZES-TABLE EVENTS1873030166(E)
17.84 101.5004.42171SIDEWALK CHALK,CANVAS PAPER PAD7035416166(E)
31.89 101.5004.42171YOUTH PRIZES-FD OPEN HOUSE6389001166(E)
134.17 101.5004.42175CANDY-FD OPEN HOUSE/TRUCK OR TREAT101422 TGT166(E)
93.33 101.5004.44378HALLOWEEN PRIZES-TRUCK OR TREAT 3567414166(E)
18.32 101.5040.42170FOOD/PROGRAM SUPPLIES092922 WALMART166(E)
30.32 101.5040.42170SIDEWALK CHALK,CANVAS PAPER PAD7035416166(E)
104.52 101.5040.42175FOOD/PROGRAM SUPPLIES092922 WALMART166(E)
506.25 101.6102.42160.2013BARK PROTECTORS472378166(E)
16.99 101.6102.42171IPHONE XR SPIDERCASE5382615166(E)
175.00 101.6102.443302023 MEMBERSHIP DUES GENTER1169059166(E)
295.00 204.6314.44330EDAM MEMBERSHIP AARON100722166(E)
275.00 225.9844.43050ADA SERVICES22845166(E)
200.00 225.9844.43105MAGC FALL CONFERENCE REGIS-WR,BS01030166(E)
300.00 225.9844.44330MRPA MEMBERSHIP-ROTTLER01533166(E)
1,580.16 240.5500.44030DEEPFREEZE & MAINT-LIB PUBLIC COMPUTERSINUS0215939166(E)
2,712.00 240.5500.44030MS WINDOWS & OFFICE LIC-LIBRARY3528078166(E)
62.91 262.5016.42170PORTABLE CHARGER,GLOW BRACELETS4375416166(E)
77.94 262.5016.42170BANDANAS 6858610166(E)
31.77 262.5017.42170SLIME SUPPLIES0473033166(E)
113.84 262.5017.42170CONTAINERS,JARS,FAIRY/PLANT DECOR,CLAY4322647166(E)
23.23 262.5017.42170SCENTED OILS5856204166(E)
14.95 262.5017.42170ARTIFICIAL SNOW2677021166(E)
29.20 262.5017.42170SANITIZER,WIPES,BOWLS092322 TGT166(E)
80.98 262.5017.42170VARIOUS PROGRAM SUPPLIESMIK54015465166(E)
687.20 265.2100.43320FLIGHT-NAPSSW CONF INDIANAPOLIS CROSBY0062339548307166(E)
300.00 272.2100.43105NAPSSW CONFERENCE-CAPT JOHNSTON1136166(E)
300.00 272.2100.43105NAPSSW CONFERENCE-EILEEN CROSBY1138166(E)169
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 36/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
300.00 272.2100.43105NAPSSW CONFERENCE-JESSICA TORREY1137166(E)
20.24 601.9600.42171IPAD PRO SCREEN PROTECTOR/CASE2971422166(E)
324.26 601.9600.43320LODGING AWWA CONF HAUTH31767781166(E)
20.24 602.9600.42171IPAD PRO SCREEN PROTECTOR/CASE2971422166(E)
324.25 602.9600.43320LODGING AWWA CONF HAUTH31767781166(E)
363.63 603.9530.42030REFUSE & RECYCLING POSTCARDSVP_9DZ4512P166(E)
124.32 603.9530.42030REFUSE & RECYCLING POSTCARDSVP_4FWF3Q73166(E)
216.00 603.9530.43250SECURITY CAMERA DATA PLAN 092322-09232399055298-0001166(E)
7.46 609.9791.42171KEY TAG RACK SLOT STYLE2535440166(E)
105.87 701.9950.42010DIAL CALIPER3935429166(E)
69.99 701.9950.42011BATTERY BACKUP & SURGE PROTECTOR-ERIC H8325843166(E)
60.00 701.9950.431052022 FALL MAINTENANCE EXPO318118231166(E)
149.95 720.9980.42000BATTERY-SERVER DISK CONTROLLER2429846166(E)
12.49 720.9980.42011DIGITAL PROGRAMMABLE TIMER-IT4292234166(E)
129.60 720.9980.44030INCREASE DUO LICENSES FROM 80 TO 9010707925166(E)
845.00 720.9980.44030PASSWORD/DATA VAULT-12 USERS55YBQ-075034425166(E)
2,890.51 720.9980.44030GREENBONE SECURITY SCANNER SUBSCINV80838166(E)
(96.33)720.9980.44030REFUND-CANCELLED SUBSCRIPTIONE0700KDE4A166(E)
(20.66)720.9980.44030SALES TAX REFUND 813340753166(E)
76.44 881.5040.42170ART SUPPLIES,DECORATIONS02158Q166(E)
687.20 883.2100.43320FLIGHT-NAPSSW CONF INDIANAPOLIS JOHNSTON9093514199166(E)
687.20 883.2100.43320FLIGHT-NAPSSW CONF INDIANAPOLIS JTORREY9439529422166(E)
231.47 884.5200.42281FENDER #023047523166(E)
27,742.40
120.00 609.0000.14500021822 INVARTISAN BEER COMPANY326674168(A)MAIN11/09/2022
(7.84)101.0000.20815101922 INV/ICE MELT/6PK RINGS/C FOLD TOWELSBELLBOY BAR SUPPLY0105906600169(A)MAIN11/09/2022
43.20 609.0000.14500102622 BAGS,INV0105935400169(A)
168.66 609.0000.14500101922 INV/ICE MELT/6PK RINGS/C FOLD TOWELS0105906600169(A)
126.36 609.0000.14500101922 INV/6PK RINGS/BAGS0105905400169(A)
187.90 609.9791.42171101922 INV/6PK RINGS/BAGS0105905400169(A)
406.84 609.9792.42171101922 INV/ICE MELT/6PK RINGS/C FOLD TOWELS0105906600169(A)
181.50 609.9793.42171102622 BAGS,INV0105935400169(A)
1,106.62
2,558.35 609.0000.14500101922 INV/DELBELLBOY CORPORATION0097003200170(A)MAIN11/09/2022
(1,000.00)609.0000.14500102422 INV0097061800170(A)
20.00 609.9792.42199101922 INV/DEL0097003200170(A)
1,578.35
1,880.00 609.0000.14500102522 INV 700297717BREAKTHRU BEVERAGE MN BEER LLC346207082171(A)MAIN11/09/2022
62.50 609.0000.14500101822 INV 700297717346109649171(A)170
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 37/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
2,128.35 609.0000.14500101822 INV 700297717346109647171(A)
10,092.80 609.0000.14500101422 INV 700297782346087118171(A)
14,163.65
406.00 609.0000.14500102822 INV/DEL 700297717BREAKTHRU BEVERAGE MN W&S LLC346279843172(A)MAIN11/09/2022
522.79 609.0000.14500102822 INV/DEL 700297717346279844172(A)
159.30 609.0000.14500102122 INV/DEL 700297717346176393172(A)
727.36 609.0000.14500102122 INV/DEL 700297782346176404172(A)
159.01 609.0000.14500102122 INV/DEL 700297717346176392172(A)
405.90 609.0000.14500102122 INV/DEL 700297717346176395172(A)
558.60 609.0000.14500102122 INV/DEL 700297717346176394172(A)
1,020.00 609.0000.14500102122 INV/DEL 700297717346176398172(A)
858.93 609.0000.14500102122 INV/DEL 700297717346176396172(A)
363.68 609.0000.14500101422 INV/DEL 700297717346080107172(A)
(48.16)609.0000.14500102722 INV/DEL 700297717410252943172(A)
1.15 609.9791.42199102822 INV/DEL 700297717346279843172(A)
23.00 609.9791.42199102822 INV/DEL 700297717346279844172(A)
5.75 609.9791.42199102122 INV/DEL 700297717346176393172(A)
0.77 609.9791.42199102122 INV/DEL 700297717346176392172(A)
6.90 609.9791.42199102122 INV/DEL 700297717346176395172(A)
9.20 609.9791.42199102122 INV/DEL 700297717346176394172(A)
12.65 609.9791.42199102122 INV/DEL 700297717346176398172(A)
3.83 609.9791.42199102122 INV/DEL 700297717346176396172(A)
18.40 609.9791.42199101422 INV/DEL 700297717346080107172(A)
(1.15)609.9791.42199102722 INV/DEL 700297717410252943172(A)
6.90 609.9793.42199102122 INV/DEL 700297782346176404172(A)
5,220.81
6,155.71 609.0000.14500101922 INVCAPITOL BEVERAGE SALES LP2753413173(A)MAIN11/09/2022
292.50 609.0000.14500102622 INVJOHNSON BROTHERS LIQUOR CO.2165795174(A)MAIN11/09/2022
1,065.29 609.0000.14500102822 INV2166236174(A)
1,838.71 609.0000.14500102822 INV2168235174(A)
589.00 609.0000.14500102722 INV2167056174(A)
388.00 609.0000.14500102722 INV2167044174(A)
253.50 609.0000.145001027222167054174(A)
179.00 609.0000.14500102722 INV2167052174(A)
36.00 609.0000.14500102722 INV2167048174(A)
1,872.00 609.0000.14500102722 INV2167057174(A)
202.50 609.0000.14500102522 INV2164571174(A)
810.00 609.0000.14500102622 INV2165790174(A)
1,620.00 609.0000.14500102522 INV2164573174(A)
237.00 609.0000.14500102522 INV2164572174(A)
171
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 38/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
591.00 609.0000.14500102522 INV2164574174(A)
120.00 609.0000.14500102722 INV2167047174(A)
60.00 609.0000.14500102722 INV2167042174(A)
618.50 609.0000.14500102722 INV2167040174(A)
297.00 609.0000.14500102722 INV2167039174(A)
640.00 609.0000.14500102822 INV2168233174(A)
185.33 609.0000.14500102822 INV2168234174(A)
1,431.94 609.0000.14500102822 INV2168232174(A)
3,158.71 609.0000.14500102822 INV2168231174(A)
540.00 609.0000.14500102622 INV2165792174(A)
924.00 609.0000.14500102622 INV2165793174(A)
470.75 609.0000.14500102722 INV2167050174(A)
630.00 609.0000.14500102722 INV2167038174(A)
355.50 609.0000.14500102722 INV2167051174(A)
924.92 609.0000.14500102722 INV2167055174(A)
297.00 609.0000.14500102722 INV2167053174(A)
202.50 609.0000.14500102622 INV2165796174(A)
810.00 609.0000.14500102622 INV2165791174(A)
1,063.00 609.0000.145001026222 INV2165794174(A)
1,080.00 609.0000.14500102622 INV2165797174(A)
3,600.00 609.0000.14500102622 INV2165798174(A)
4.17 609.9791.42199102522 INV2164571174(A)
10.50 609.9791.42199102622 INV2165790174(A)
11.47 609.9791.42199102522 INV2164573174(A)
4.05 609.9791.42199102522 INV2164572174(A)
2.70 609.9791.42199102522 INV2164574174(A)
4.05 609.9791.42199102722 INV2167047174(A)
1.35 609.9791.42199102722 INV2167042174(A)
9.46 609.9791.42199102722 INV2167040174(A)
1.35 609.9791.42199102722 INV2167039174(A)
25.65 609.9791.42199102822 INV2168232174(A)
62.08 609.9791.42199102822 INV2168231174(A)
8.10 609.9792.42199102622 INV2165795174(A)
18.90 609.9792.42199102822 INV2166236174(A)
36.47 609.9792.42199102822 INV2168235174(A)
17.59 609.9792.42199102722 INV2167056174(A)
6.73 609.9792.42199102722 INV2167044174(A)
6.75 609.9792.421991027222167054174(A)
4.05 609.9792.42199102722 INV2167052174(A)
1.35 609.9792.42199102722 INV2167048174(A)
17.55 609.9792.42199102722 INV2167057174(A)
6.76 609.9792.42199102722 INV2167050174(A)172
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 39/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
5.40 609.9792.42199102722 INV2167038174(A)
5.41 609.9792.42199102722 INV2167051174(A)
9.45 609.9792.42199102722 INV2167055174(A)
1.35 609.9792.42199102722 INV2167053174(A)
4.17 609.9792.42199102622 INV2165796174(A)
4.05 609.9792.42199102622 INV2165791174(A)
12.16 609.9792.421991026222 INV2165794174(A)
6.07 609.9792.42199102622 INV2165797174(A)
27.00 609.9792.42199102622 INV2165798174(A)
9.45 609.9793.42199102822 INV2168233174(A)
2.70 609.9793.42199102822 INV2168234174(A)
2.70 609.9793.42199102622 INV2165792174(A)
13.49 609.9793.42199102622 INV2165793174(A)
27,748.13
107,400.61 602.9480.42900DECEMBER 2022 WASTEWATERMETROPOLITAN COUNCIL WASTEWATE0001147756175(A)MAIN11/09/2022
95.00 609.0000.14500102622 INVPHILLIPS WINE & SPIRITS INC6484951176(A)MAIN11/09/2022
381.50 609.0000.14500102822 INV6486916176(A)
72.00 609.0000.14500102722 INV6486050176(A)
72.00 609.0000.14500102722 INV6486048176(A)
42.00 609.0000.14500102722 INV6486041176(A)
247.50 609.0000.14500102522 INV6483964176(A)
80.00 609.0000.14500102822 INV6486918176(A)
489.10 609.0000.14500102722 INV6486045176(A)
381.50 609.0000.14500102822 INV6486915176(A)
207.00 609.0000.14500102722 INV6486049176(A)
1.35 609.9791.42199102522 INV6483964176(A)
6.76 609.9791.42199102722 INV6486045176(A)
1.35 609.9791.42199102822 INV6486917176(A)
6.75 609.9791.42199102822 INV6486915176(A)
1.35 609.9792.42199102622 INV6484951176(A)
6.75 609.9792.42199102822 INV6486916176(A)
1.35 609.9792.42199102822 DEL6486919176(A)
1.35 609.9792.42199102722 INV6486050176(A)
1.35 609.9792.42199102722 INV6486048176(A)
1.35 609.9792.42199102722 INV6486041176(A)
2.70 609.9792.42199102722 INV6486049176(A)
1.35 609.9793.42199102822 INV6486918176(A)
2,101.36
301.50 609.0000.14500102622 INV/DELSOUTHERN GLAZER'S2274587177(A)MAIN11/09/2022
449.92 609.0000.14500102022 INV/DEL2272358177(A)
173
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 40/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
1,113.51 609.0000.14500102622 INV/DEL2274577177(A)
384.00 609.0000.14500102622 INV/DEL 2274590177(A)
955.16 609.0000.14500102622 INV/DEL2274579177(A)
320.00 609.0000.14500102622 INV/DEL2274581177(A)
1,745.95 609.0000.14500102022 INV/DEL2272366177(A)
540.00 609.0000.14500102022 INV/DEL 2272365177(A)
188.50 609.0000.14500102022 INV/DEL2272364177(A)
651.80 609.0000.14500102022 INV/DEL2272363177(A)
296.88 609.0000.14500102022 INV/DEL2272362177(A)
1,040.97 609.0000.14500102022 INV/DEL2272361177(A)
1,190.75 609.0000.14500102022 INV/DEL2272360177(A)
2,281.25 609.0000.14500102022 INV/DEL2272359177(A)
1,828.55 609.0000.14500102022 INV/DEL2272375177(A)
282.75 609.0000.14500102022 INV/DEL2272376177(A)
666.90 609.0000.14500102022 INV/DEL2272377177(A)
1,245.80 609.0000.14500102022 INV/DEL2272378177(A)
1,769.15 609.0000.14500102022 INV/DEL2272379177(A)
776.15 609.0000.14500102022 INV/DEL2272369177(A)
2,281.25 609.0000.14500102022 INV/DEL2272370177(A)
540.00 609.0000.14500102022 INV/DEL2272374177(A)
995.76 609.0000.14500102022 INV/DEL2272372177(A)
1,527.00 609.0000.14500102022 INV/DEL2272371177(A)
216.00 609.0000.14500102022 INV/DEL2272373177(A)
414.15 609.0000.14500102022 INV/DEL2272368177(A)
990.00 609.0000.14500102022 INV/DEL2272367177(A)
423.44 609.0000.14500102022 INV/DEL2272524177(A)
5.12 609.9791.42199102622 INV/DEL2274587177(A)
3.84 609.9791.42199102022 INV/DEL2272358177(A)
7.79 609.9791.42199102622 INV/DEL2274577177(A)
10.24 609.9791.42199102622 INV/DEL2274579177(A)
8.96 609.9791.42199102622 INV/DEL2274581177(A)
10.56 609.9791.42199102022 INV/DEL2272366177(A)
7.68 609.9791.42199102022 INV/DEL 2272365177(A)
2.56 609.9791.42199102022 INV/DEL2272364177(A)
8.96 609.9791.42199102022 INV/DEL2272363177(A)
5.12 609.9791.42199102022 INV/DEL2272362177(A)
16.11 609.9791.42199102022 INV/DEL2272361177(A)
8.96 609.9791.42199102022 INV/DEL2272360177(A)
37.12 609.9791.42199102022 INV/DEL2272359177(A)
4.16 609.9791.42199102022 INV/DEL2272368177(A)
6.40 609.9791.42199102022 INV/DEL2272367177(A)
3.84 609.9792.42199102622 INV/DEL 2274590177(A)174
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 41/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
10.24 609.9792.42199102022 INV/DEL2272375177(A)
3.84 609.9792.42199102022 INV/DEL2272376177(A)
11.52 609.9792.42199102022 INV/DEL2272377177(A)
7.04 609.9792.42199102022 INV/DEL2272378177(A)
17.28 609.9792.42199102022 INV/DEL2272379177(A)
5.12 609.9792.42199102022 INV/DEL2272369177(A)
37.12 609.9792.42199102022 INV/DEL2272370177(A)
7.68 609.9792.42199102022 INV/DEL2272374177(A)
13.12 609.9792.42199102022 INV/DEL2272372177(A)
10.24 609.9792.42199102022 INV/DEL2272371177(A)
3.84 609.9792.42199102022 INV/DEL2272373177(A)
6.40 609.9793.42199102022 INV/DEL2272524177(A)
25,697.95
245.00 609.0000.14500101822 INV56 BREWING LLC5620453192866MAIN11/10/2022
490.95 101.2100.43810110422 SOLAR POWERAEP ENERGY INC419-21400582192867MAIN11/10/2022
490.95 101.2200.43810110422 SOLAR POWER419-21400582192867
2,086.45 240.5500.43810110422 SOLAR POWER419-21400582192867
1,166.53 701.9950.43810110422 SOLAR POWER419-21400582192867
4,234.88
486.00 101.5003.43050TOTAL BODY CONDITIONING 092122-110222ALFERNESS/DONNA M110222192868MAIN11/10/2022
200.00 609.0000.14500102122 INV/DELAM CRAFT SPIRITS SALES& MRKTNG15624192869MAIN11/10/2022
849.80 609.0000.14500101822 INV/DEL15591192869
5.05 609.9791.42199101822 INV/DEL15591192869
5.05 609.9792.42199102122 INV/DEL15624192869
1,059.90
400.90 609.0000.14500101922 INVAMERICAN BOTTLING COMPANY3562833326192870MAIN11/10/2022
803.95 609.0000.14500102622 INV3576125127192870
(2.70)609.0000.14500101922 INV3562833327192870
1,202.15
672.00 101.5003.43050UMPIRE MENS SOFTBALLANDREWS/TERRY S101322192871MAIN11/10/2022
8,736.00 101.2200.42011TOUGHBOOKS,DOCKS,KEYBOARDS,PWR SUPPLIES BAYCOM INCEQUIPINV_040404192872MAIN11/10/2022
4,649.88 603.9510.42930YARD WASTE PICK UP 101022-101422BETTER FUTURES MNINV1101192873MAIN11/10/2022
4,714.25 603.9510.42930YARD WASTE PICK UP 101722-102122INV1102192873
7,820.94 603.9510.42930YARD WASTE PICK UP 102422-102822INV1107192873
17,185.07
54.34 701.0000.14120POWER PLUGS, SPARK PLUGSBMJ CORPORATION67-126779192874MAIN11/10/2022
175
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 42/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
7.99 701.0000.14120FUSE HOLDER67-126604192874
8.49 701.0000.14120FUSE TAP67-126577192874
70.82
181.44 272.2100.44300PA CONF REIMB 082722-090122BULLER/ERIN090122192875MAIN11/10/2022
56.27 609.9791.43210102822 763 572-2695 528CENTURYLINK7635722695528192876MAIN11/10/2022
148.76 701.0000.14120PURUS, TRANS FLUIDCHAMBERLAIN OIL COMPANY INC414660-00192877MAIN11/10/2022
91.33 101.5129.44020MATS, MOPS JPM 110122CINTAS INC4135964098192878MAIN11/10/2022
31.99 701.9950.42172UNIFORM RENTAL 1029224135785248192878
123.32
468.51 101.3121.42160ASPHALT MIX 4ACITY OF ST PAULIN51117192879MAIN11/10/2022
273.18 415.0000.3425126-30-24-24-0186 DUP PMT 4921 6TH STCOLORADO 315530192880MAIN11/10/2022
719.46 101.3121.42160MV4 WEAR ASPHALTCOMMERCIAL ASPHALT221015192881MAIN11/10/2022
1,475.26 101.5200.42010PRESS & PLAY ACTIVATOR KIT, FASTENERSCOMMERCIAL RECREATION SPCLSTS0021153192882MAIN11/10/2022
191.39 272.2100.44300PA CONF REIMB 082722-083122CROSBY/EILEEN083122192883MAIN11/10/2022
92.50 609.0000.14500102622 INV/DELCRYSTAL SPRINGS ICE LLC2007672192884MAIN11/10/2022
210.60 609.0000.14500102622 INV/DEL2007673192884
220.50 609.0000.14500102622 INV/DEL2007675192884
4.00 609.9791.42199102622 INV/DEL2007673192884
4.00 609.9792.42199102622 INV/DEL2007675192884
4.00 609.9793.42199102622 INV/DEL2007672192884
535.60
337.45 101.3170.42171WRONG WAY SIGNS, SIGN POSTSEARL F ANDERSEN INC0131338-IN192885MAIN11/10/2022
397.50 212.3190.42171WRONG WAY SIGNS, SIGN POSTS0131338-IN192885
734.95
196.93 609.9791.43420102122 OCTOBER ADECM PUBLISHERS INC917475192886MAIN11/10/2022
155.03 609.9792.43420102122 OCTOBER AD917475192886
67.04 609.9793.43420102122 OCTOBER AD917475192886
419.00
621.76 701.0000.14120STROBE LIGHTSEMERGENCY AUTOMOTIVE TECH INC.CG101822-51192887MAIN11/10/2022
1,499.99 415.9999.42010.1906SILOXANE SEALER, PRO PUMP, WIRE WHEELFARRELL EQUIPMENT & SUPPLYINV00000001295254192888MAIN11/10/2022
5,099.97 415.9999.42161.1906SILOXANE SEALER, PRO PUMP, WIRE WHEELINV00000001295254192888
1,251.45 609.9791.42010CONCRETE MIXER, MORTAR MIXINV00000001295677192888
145.98 609.9791.42160CONCRETE MIXER, MORTAR MIXINV00000001295677192888
176
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 43/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
7,997.39
77.84 701.0000.14120FILTERSFLEETPRIDE INC103352698192889MAIN11/10/2022
22.76 701.0000.14120FILTERS103352699192889
100.60
3.80 701.9950.42171FASTENERSFRATTALONE'S HARDWARE & GARDENA14993/R192890MAIN11/10/2022
35.29 701.0000.14120RELAYGENUINE PARTS/NAPA AUTO4342-888309192891MAIN11/10/2022
115.00 701.0000.14120BATTERY4342-890038192891
105.48 701.0000.14120FILTERS4342-889955192891
255.77
389.88 609.0000.14500102722 INV/DELGRAPE BEGINNINGS INCMN00120960192892MAIN11/10/2022
2.25 609.9791.42199102722 INV/DELMN00120960192892
392.13
953.33 609.0000.14500103122 INVGREAT LAKES COCA-COLA DISTRBTN3599216135192893MAIN11/10/2022
900.83 609.0000.14500101822 INV3587213060192893
1,854.16
38,305.00 603.9510.42930YARD WASTE SERVICE 1022HAULSTAR1009192894MAIN11/10/2022
61.88 101.1550.42030ASSESSING ENVELOPESHEINRICH ENVELOPE CORP471121192895MAIN11/10/2022
47.76 101.5200.42171ANTI-FREEZEHOME DEPOT #28026010138192896MAIN11/10/2022
23.65 101.5200.42171TAPE, PRIMER, STOP RUST4010407192896
71.41
240.00 101.5001.43050SOCCER REFEREE FEES 2022IMMACULATE CONCEPTION CHURCH110122192897MAIN11/10/2022
10,678.28 101.5130.44020GYM MAINT 070122-093022INDEPENDENT SCHOOL DIST #132321192898MAIN11/10/2022
24.67 101.3100.42000DESK FILE, POST-ITS, PLANNERSINNOVATIVE OFFICE SOLUTIONS LLCIN3973937192899MAIN11/10/2022
20.81 101.5200.42000DESK FILE, POST-ITS, PLANNERSIN3973937192899
45.48
4,249.00 601.9600.44000VFD REPAIR-PUMP STATION #3INSTRUMENT CONTROL CO INCCD99455342192900MAIN11/10/2022
150.00 101.2100.43050SQUAD DECONTAMINATION BLUE CHARGERKROPIDLOWSKI/MARK133628192901MAIN11/10/2022
79,344.00 884.0000.15510COMMERCIAQL INSURANCE 2022-2023LEAGUE OF MN CITIES INS TRUST110422192902MAIN11/10/2022
300.00 609.9791.44000GRAFFITI REMOVAL TV1 LUCIOW/ALLEN062222192903MAIN11/10/2022
4,615.65 701.0000.141101,399 GAL DIESEL FUELMANSFIELD OIL COMPANY23725421192904MAIN11/10/2022
8,599.59 701.0000.141103,000 GAL UNLEADED FUEL23725420192904 177
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 44/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
1,979.51 701.0000.14110600 GAL DIESEL FUEL23725422192904
15,194.75
1,345.29 101.2100.42012PD PUBLIC PARKING 360 CAMERAMARCO, INCINV10109049192905MAIN11/10/2022
990.00 101.2100.43050THERAPY SESSIONS & CHECK-INS 1022MARIE RIDGEWAY LICSW LLC1939192906MAIN11/10/2022
1,500.12 609.0000.14500101922 INV/DELMAVERICK WINE COMPANYINV858010192907MAIN11/10/2022
9.00 609.9791.42199101922 INV/DELINV858010192907
1,509.12
13.98 609.9792.42171WD-40MENARDS CASHWAY LUMBER-FRIDLEY77002192908MAIN11/10/2022
262.56 701.0000.14120FILTERSMIDWAY FORD742536192909MAIN11/10/2022
289.96 701.0000.14120ROTORS, BRAKE PADS742525192909
552.52
22.99 101.6102.421718" BLADEMINNEAPOLIS SAW CO INC148673192910MAIN11/10/2022
1,280.00 604.9600.42160CUSTOM BLEND COMPOSTMN MULCH & SOIL, LLCW23744192911MAIN11/10/2022
1,170.00 101.5003.42170SOFTBALLSMN REC & PK ASSOC - MRPA10571192912MAIN11/10/2022
2,350.00 101.5129.44020REPLACE BLOWER MOTOR JPMMODERN HEATING & AIR INCS072009192913MAIN11/10/2022
872.86 603.9510.42930LEAF DISPOSAL 102022-102122MORRELL ENTERPRISES LP41297192914MAIN11/10/2022
1,241.42 603.9510.42930LEAF DISPOSAL 101022-10132241270192914
2,114.28
324.70 101.5003.43050YOGA, MEDITATION 092022-102522O'DONNELL/KELLY102822192915MAIN11/10/2022
9.22 101.1940.42000POST IT NOTESOFFICE DEPOT273970360001192916MAIN11/10/2022
67.46 101.2300.42000PENS 271739124001192916
76.68
150.00 101.0000.32150FLASHER DEPOSIT REFUNDOLSON, CHRISTOPHER M15625192917MAIN11/10/2022
100.00 101.1110.42171DEPOSIT 2023 SNOWBLAST - MINI PONIESOLSON/JOANNA504554192918MAIN11/10/2022
700.00 415.0000.1230036-30-24-41-0024 REFUND PARTIAL PMT OF CERT ASSMTOMAR, ABDULLAHI15426192919MAIN11/10/2022
79.00 609.0000.14500102622 INV/DELPAUSTIS & SONS WINE COMPANY182077192920MAIN11/10/2022
1,212.65 609.0000.14500102622 INV/DEL182086192920
2,488.00 609.0000.14500102022 INV/DEL181424192920
18.00 609.9791.42199102622 INV/DEL182086192920
37.50 609.9791.42199102022 INV/DEL181424192920
4.00 609.9792.42199102622 INV/DEL182077192920
3,839.15
178
Item 14.
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:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
29.00 101.3121.42172COL HTS LOGO POLOPICTURES AND GIFTS LLC2085192921MAIN11/10/2022
51.72 701.0000.14120SPARE RIMPIONEER RIM & WHEEL CO.01CO8818192922MAIN11/10/2022
4.50 609.9791.42171102622 WATERPREMIUM WATERS INC319067000192923MAIN11/10/2022
18.00 609.9792.42171102522 WATER319064035192923
9.00 609.9793.42171102622 WATER319066999192923
31.50
442.56 609.0000.14500102722 INV RED BULL DISTRIBUTION CO INC5003560842192924MAIN11/10/2022
209.28 609.0000.14500102722 INV5003561402192924
651.84
1,161.00 101.5200.42160GRASS SEEDREINDERS INC3091732-00192925MAIN11/10/2022
112.00 101.5003.43050UMPIRE MENS SOFTBALL 102022RICHSMANN/MARK110322192926MAIN11/10/2022
269.60 701.0000.14120TIRES ROYAL TIRE303-202316192927MAIN11/10/2022
74.63 101.1940.44020PREVENT MAINT 1022SCHINDLER ELEVATOR CORP INC8106075519192928MAIN11/10/2022
74.63 101.5129.44020PREVENT MAINT 10228106075520192928
185.89 609.9791.44020PREVENT MAINT 10228106073343192928
335.15
4,160.00 603.9510.42910BULK, APPLIANCE & ELECTRONICS PICKUP SHOREVIEW HUNKS LLC102822192929MAIN11/10/2022
2,550.00 603.9510.42920BULK, APPLIANCE & ELECTRONICS PICKUP 102822192929
30.00 603.9540.43050BULK, APPLIANCE & ELECTRONICS PICKUP 102822192929
6,740.00
312.12 609.0000.14500101922 INV/DELSMALL LOT MNMN57629192930MAIN11/10/2022
1,089.48 609.0000.14500101922 INV/DELMN57628192930
1,264.08 609.0000.14500102822 INV/DELMN57925192930
9.00 609.9791.42199101922 INV/DELMN57628192930
16.50 609.9791.42199102822 INV/DELMN57925192930
5.00 609.9792.42199101922 INV/DELMN57629192930
2,696.18
580.60 101.5200.42171ULTRA NUSTRAW MULCHSPECIALTY SOLUTIONSI51764192931MAIN11/10/2022
16.40 101.1410.42000NAME BADGES, ENVELOPES, NAPKINSSTAPLES ADVANTAGE3521778487192932MAIN11/10/2022
15.26 101.1940.42000NAME BADGES, ENVELOPES, NAPKINS3521778487192932
4.37 101.1940.42171NAME BADGES, ENVELOPES, NAPKINS3521778487192932
36.03
168.00 101.5003.43050ZUMBA 100322-102422SUMANGIL/ANNE110222192933MAIN11/10/2022 179
Item 14.
CHECK DISBURSEMENT REPORT FOR CITY OF COLUMBIA HEIGHTS 46/46Page
:
11/10/2022 09:24 AM
User: mchristensen
DB: Columbia Heights CHECK DATE FROM 10/21/2022 - 11/10/2022
AmountGL #DescriptionPayeeInvoiceCheck #BankCheck Date
432.00 609.0000.14500102022 INV/DELTRADITION WINE & SPIRITS LLC33798192934MAIN11/10/2022
12.00 609.9791.42199102022 INV/DEL33798192934
444.00
54.83 101.5129.42171TOILET PAPER DISPENSORSTRIO SUPPLY COMPANY INC8003700000192935MAIN11/10/2022
740.00 101.1510.43050PTF UPDATE FOR ISERIESTSG SERVER & STORAGE INC2022-0662192936MAIN11/10/2022
156.66 609.0000.14500101822 INVURSA MINOR BREWING LLCE-3014192937MAIN11/10/2022
570.15 101.2200.43210102522 586753132-00001VERIZON WIRELESS9919080220192938MAIN11/10/2022
3,218.78 609.0000.14500101922 INV/DELVINOCOPIA INC0315141-IN192939MAIN11/10/2022
757.75 609.0000.14500101922 INV/DEL0315139-IN192939
37.50 609.9791.42199101922 INV/DEL0315141-IN192939
16.00 609.9792.42199101922 INV/DEL0315139-IN192939
4,030.03
85.50 609.0000.14500102022 INVVIP WINE & SPIRITS, LTD560192940MAIN11/10/2022
1,800.00 609.0000.14500101922 INV/DELWINE COMPANY/THE217988192941MAIN11/10/2022
30.00 609.9791.42199101922 INV/DEL217988192941
1,830.00
1,500.00 604.9600.430502022 SWAMPWSB & ASSOCIATES INCR-016805-000-3192942MAIN11/10/2022
9.50 101.3160.43810102822 51-4159572-0XCEL ENERGY (N S P)998769572192943MAIN11/10/2022
10.59 101.3160.43810102822 51-0013562395-2998769685192943
985.72 601.9600.43810102522 51-0012949181-30998100550192943
1,005.81
337.22 701.0000.14120OIL, BLADES, ADDITIVEZIEGLER INCIN000750693192944MAIN11/10/2022
29.98 701.0000.14120BRAKE ADDITIVE IN000750684192944
1,121.92 701.0000.14120OIL, FILTER, ADDITIVEIN000752478192944
1,489.12
2,066,391.20 TOTAL OF 297 CHECKSTOTAL - ALL FUNDS
180
Item 14.
StatusDepositCheck AmountGrossNameCheck NumberBankCheck Date
DirectPhysicalCheck
For Check Dates 10/21/2022 to 11/10/2022
11/10/2022 09:26 AM Check Register Report For City Of Columbia Heights Page 1 of 2
Cleared0.00112.00112.00INSCCU 90714PR10/21/2022
Open0.00595.00595.00UNION 49 90715PR10/21/2022
Open0.0010,083.2710,083.27DELTA DENTAL OF MINNESOTA 90716PR10/21/2022
Cleared0.002,034.702,034.70SUN LIFE FINANCIAL 90717PR10/21/2022
Cleared0.001,705.171,705.17SUN LIFE FINANCIAL 90718PR10/21/2022
Cleared0.002,691.002,691.00MEDICA HEALTH PLANS 90719PR10/21/2022
Open0.00134,073.63134,073.63MEDICA 90720PR10/21/2022
Cleared0.00299.00299.00MEDICA 90721PR10/21/2022
Open0.00464.00464.00NCPERS GROUP LIFE INS MBR BEN 90722PR10/21/2022
Cleared0.00392.53392.53FIDELITY SECURITY LIFE INSURANCE COMPANY 90723PR10/21/2022
Cleared0.001,047.381,047.38SUN LIFE FINANCIAL 90724PR10/21/2022
Open0.00112.00112.00INSCCU 90737PR11/04/2022
Open0.001,365.001,365.00LAW ENFORCEMENT LABOR SERVICES 90738PR11/04/2022
Open0.00260.00260.00LAW ENFORCEMENT LABOR SERVICES 90739PR11/04/2022
Cleared0.00200.00200.00COL HTS LOCAL 1216 EFT725PR10/21/2022
Cleared0.002,312.632,312.63MSRS MNDCP PLAN 650251 EFT726PR10/21/2022
Cleared0.008,144.938,144.93HSA BANK EFT727PR10/21/2022
Cleared0.0017,090.6717,090.67VANTAGEPOINT TRANSFER 457 EFT728PR10/21/2022
Cleared0.0084,637.5784,637.57IRS EFT729PR10/21/2022
Cleared0.0082,092.3982,092.39PERA 397400 EFT730PR10/21/2022
Cleared0.00144.50144.50COL HGTS POLICE ASSN EFT731PR10/21/2022
Cleared0.00724.81724.81VANTAGEPOINT TRANSFER AGENTS EFT732PR10/21/2022
Cleared0.002,052.232,052.23VANTAGEPOINT TRANSFER -401 EFT733PR10/21/2022
Cleared0.0017,463.1817,463.18STATE OF MN TAX EFT734PR10/21/2022
Cleared0.00538.85538.85AFSCME COUNCIL 5 EFT735PR10/21/2022
Open0.00200.00200.00COL HTS LOCAL 1216 EFT736PR11/04/2022
Open0.00270.00270.00COLHTS FIREFIGHTER ASSN EFT737PR11/04/2022
Open0.002,312.632,312.63MSRS MNDCP PLAN 650251 EFT738PR11/04/2022
Open0.008,144.958,144.95HSA BANK EFT739PR11/04/2022
Open0.0018,435.6718,435.67VANTAGEPOINT TRANSFER 457 EFT740PR11/04/2022 181
Item 14.
StatusDepositCheck AmountGrossNameCheck NumberBankCheck Date
DirectPhysicalCheck
For Check Dates 10/21/2022 to 11/10/2022
11/10/2022 09:26 AM Check Register Report For City Of Columbia Heights Page 2 of 2
Open0.0087,339.1487,339.14IRS EFT741PR11/04/2022
Open0.0083,595.1583,595.15PERA 397400 EFT742PR11/04/2022
Open0.00144.50144.50COL HGTS POLICE ASSN EFT743PR11/04/2022
Open0.00724.81724.81VANTAGEPOINT TRANSFER AGENTS EFT744PR11/04/2022
Open0.002,052.232,052.23VANTAGEPOINT TRANSFER -401 EFT745PR11/04/2022
Open0.0017,974.9317,974.93STATE OF MN TAX EFT746PR11/04/2022
Open0.0070.0070.00FINANCIAL ONE EFT747PR11/04/2022
23
14
Total Check Stubs:
Total Physical Checks:
0.00591,900.45591,900.45Number of Checks: 037Totals:
182
Item 14.
CITY COUNCIL MEETING
AGENDA SECTION PUBLIC HEARINGS
MEETING DATE 11/14/2022
ITEM: Adopt Resolution For Emergency Abatement
DEPARTMENT: Fire BY/DATE: Assistant Fire Chief Dan O’Brien
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
_Economic Strength X Excellent Housing/Neighborhoods
_Equity and Affordability _Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
Adopt Resolution 2022-101, being a Declaration of Nuisance and Emergency Abatement of Violations within
the City of Columbia Heights regarding property at:
4201 7th St N.E.
for ordinance violations pursuant to City Code.
RECOMMENDED MOTION(S):
MOTION: Move to close the public hearing and to waive the reading of Resolution 2022-101, there being
ample copies available to the public.
MOTION: Move to adopt Resolution Number 2022-101, being a resolution of the City Council of the City
of Columbia Heights declaring the property listed a nuisance and approving the emergency abatement,
and any subsequent abatements, of the hazardous situation located at 4201 7th St NE.
ATTACHMENT:
2022-101 Res – Emerg Abatement (Board Up) 4201 7th St.
183
Item 15.
RESOLUTION NO. 2022-101
Resolution of the City Council for the City of Columbia Heights declaring the property a nuisance and approving
emergency, and any subsequent, abatement of the hazardous conditions pursuant to City Code, of the property
owned by Marvin J. Stover, Deceased (Hereinafter "Owner of Record").
Whereas, the owner of record is the legal owner of the real property located at 4201 7th St N.E., Columbia
Heights, Minnesota.
Now, therefore, in accordance with the foregoing, and all ordinances and regulations of the City of Columbia
Heights, the City Council of the City of Columbia Heights Makes the following:
FINDINGS OF FACT
1. That on 2/10/2022, the city’s utility department notified the fire department that they believed that the
listed property was vacant and water usage was significantly higher than normal.
2. That on 2/11/2022, inspectors verified that the property was vacant and office staff discovered that the
Property owner, Marvin J Stover, was deceased.
3. That on 8/3/2022, a complaint-based inspection was conducted on the property listed above. Inspectors
found violations of city code. A compliance order was sent via regular mail to the owner at the address
and posted on the property.
4. That on 9/12/22 pursuant to city code, inspectors found the front and rear doors of the home and garage
unlocked and unsecured with structural and roof concerns.
5. That on 9/19/2022, inspectors issued orders to the property owner to secure the vacant structure.
6. That the owner of said property is deceased, that no other parties have come forward to care for the
property.
7. That on 11/8/2022, inspectors performed a re-inspection and noted that violations remained
uncorrected. A Statement of Cause and Notice of Public Hearing was mailed via regular mail to the
owner’s address on file and a copy was posted on the property.
8. That based upon said records of the Fire Department, the following conditions and violations of City
Codes(s) were found to exist and have been abated, to wit:
A. Shall close vacant structure. All openings shall be properly boarded up. Closing of vacant
structures. If the structure is vacant and unfit for human habitation and occupancy, and is not in
danger of structural collapse, the Code Official is authorized to post a placard of condemnation
on the premises and notify the owner, to order the structure closed up so as not to constitute a
public nuisance. Upon failure of the owner to close up the premises within the time specified in
the order, the Code Official shall cause the premises to be closed and secured through any
available public agency or by contract or arrangement by private persons. Cost to close and
secure structures shall be charged against the real estate upon which the structure is located and
shall be a lien upon such real estate.
CONCLUSIONS OF COUNCIL
1. That the property located at 4201 7th Street N.E is in violation of the provisions of the Columbia Heights
City Code as set forth in the Notice of Abatement.
184
Item 15.
City of Columbia Heights - Council Resolution Page 2
2. That the emergency abatement, and any subsequent abatements, of the hazardous situation located at
4201 7th Street N.E. is hereby approved.
ORDER OF COUNCIL
1. The property located at 4201 7th Street N.E constitutes a nuisance pursuant to City Code.
Passed this _________ day of ______________________, 2022
Offered by:
Seconded by:
Roll Call:
Amáda Márquez Simula, Mayor
Attest:
City Clerk/Council Secretary
185
Item 15.
CITY COUNCIL MEETING
AGENDA SECTION ITEMS FOR CONSIDERATION
MEETING DATE NOVEMBER 14, 2022
ITEM: Conditional Use Permit to Allow Accessory Outdoor Storage at 660 39th Avenue NE
DEPARTMENT: Community Development BY/DATE: Aaron Chirpich – 11/08/2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
X Safe Community _Diverse, Welcoming “Small-Town” Feel
X Economic Strength _Excellent Housing/Neighborhoods
_Equity and Affordability _Strong Infrastructure/Public Services
_Opportunities for Play and Learning _Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
Bona Management Company, LLC has requested approval of a conditional use permit to the allow accessory
outdoor storage of vehicles in conjunction with an automobile repair use (Din Auto, Inc.) located at 660 39 th
Avenue NE.
Vehicles to be stored outdoors will be those awaiting repairs or pick-up following repair work and will be parked
south of the repair shop building. A maximum of 79 vehicles are proposed to be stored outdoors at one time.
The subject one-acre site is zoned I-2, General Industrial. Accessory outdoor storage activities are listed as a
conditional use in the district and are therefore subject to conditional use permit processing. Automobile repair
uses (the principal use of the property) are listed as permitted uses in the I -2 District. The subject site is bordered
on all sides by industrial uses, several of which include outdoor storage.
The subject 3,120 square foot building located on the site is presently occupied by an auto repair shop operated
by Din Auto. Din Auto will also have towing vehicles onsite that are u sed to tow customer vehicles to the shop
for repair.
COMPREHENSIVE PLAN
The City’s 2040 Comprehensive Plan directs industrial use of the subject site. This land use directive is
implemented via the application of the I-2, General Industrial zoning designation upon the subject property.
The proposed principal and accessory uses upon the site are consistent with the land use goals of the
Comprehensive Plan.
ZONING ORDINANCE
Within the applicable I-2, General Industrial District, outdoor storage is allowed by conditional use permit. In
this regard, Section 9.107(C)(35) of the Zoning Ordinances imposes certain conditions upon outdoor storage
uses. The following is a listing of the required conditions followed by a Staff comment:
a) The outdoor storage area shall be accessory to a commercial or industrial use.
186
Item 16.
City of Columbia Heights - Council Letter Page 2
Staff Comment. Outdoor storage activities upon the site must be accessory to the principal use (the
automobile repair business). In this regard, the storage of vehicles which are not awaiting repair
and/or pick-up on the site are not considered an accessory to the principal use and therefore are not
allowed to be stored upon the property. It is recommended that this requirement be made a
condition of conditional use permit approval.
b) Outdoor storage within the public right-of-way is prohibited.
Staff Comment. The proposed location for the outdoor storage is south of the building and within
property boundaries. As a condition of conditional use permit approval, it is recommended that the
outdoor storage of vehicles within the public right-of-way be prohibited.
c) All outdoor storage areas shall meet the setback requirements for a principal structure in the zoning
district in which the use is located.
The setback requirements for principal buildings within the I-2 District are as follows:
Front yard: 20 feet
Side yard: 12 feet
Rear yard: 24 feet
Staff Comment. Except for the west side yard where a 2-foot structure setback exists, all applicable
principal building setback requirements have been satisfied. To be noted is that the existing 2-foot
side yard setback was legally established and is therefore considered a legal nonconforming
condition which holds grandfather rights.
Also, to be noted is that parking areas in the I-2 District are subject to a minimum side yard setback
requirement of 5 feet. Presently, the proposed outdoor storage area on the site extends to
perimeter property lines with no setbacks. Again, such setback condition is considered a legally
nonconforming condition.
d) Outdoor storage areas shall be located in rear yards or in the side yard behind the front building line
of the principal structure.
Staff Comment. The submitted site plan and accompanying conditional use permit application
indicate that the outdoor storage area will be located south of the building and contained in the rear
yard.
e) The storage area shall be fenced and screened from adjacent uses and the public right-of-way.
Required screening shall consist of a fence, wall, earth berming and/or vegetation no less than six (6)
feet in height and no less than 80% opaque on a year-round basis.
Staff Comment. The proposed outdoor storage area is currently secured and screened via a chain
link fence with a mesh fabric cover (see photograph below). The fence appears to measure six feet
in height.
187
Item 16.
City of Columbia Heights - Council Letter Page 3
Looking Northwest
f) All goods, materials and equipment shall be stored on an impervious surface.
Staff Comment. The site plan and accompanying the conditional use permit application indicate that
the proposed outdoor storage area is currently surfaced in asphalt. Thus, this condition has been
satisfied.
g) All goods, materials and equipment shall be stored in an orderly fashion, with access aisles of
sufficient width to accommodate emergency vehicles as needed.
Staff Comment. Appropriately, the submitted site plan illustrates individual outdoor vehicle parking
stalls and drives aisles. In total, 79 vehicle parking spaces are illustrated. The proposed vehicle
parking stalls (9’ x 20’) and drive aisles (24’ in width) are appropriately dimensioned. As a condition
of conditional use permit approval, all individual vehicle parking stalls within the outdoor storage
area should be delineated with pavement striping such that they are easily identifiable.
In addition, drive aisles within the outdoor storage area, as depicted on the submitted site plan dated
August 29, 2022, shall be maintained to ensure proper site circulation and emergency vehicle access.
h) The height of materials stored, excluding operable vehicles and equipment, shall not exceed the
height of the screening provided.
Staff Comment. It is recommended that this condition be imposed as a condition of conditional use
permit approval.
OTHER ISSUES
1. Access
Primary access to the site is provided from the north along 39 th Avenue NE. A secondary, gated access is also
provided on the south side of the site along 38 th Place NE.
188
Item 16.
City of Columbia Heights - Council Letter Page 4
To ensure emergency vehicle access to the site, it is recommended that the Fire Department be provided a
means to access the site from the south (from 38th Place NE). This issue should be subject to further comment
and recommendation by the Fire Department.
2. Parking
According to the Zoning Ordinance, automobile repair facilities must provide one parking space per 300 square
feet of gross floor area, plus two spaces per service bay. The existing automobile repair shop measures 3,120
gross square feet in size. As a result, a total of 11 spaces are required, plus one space per service bay. Of the
required spaces, one shall be designated as a disabilit y parking stall.
The submitted site plan does not illustrate customer and employee parking stalls. Based upon the aerial
photograph below, it appears that 10 off-street parking stalls exist on the north and east sides of the building.
As a condition of conditional use permit approval, the site plan should be modified to illustrate required off -
street parking stalls.
Looking South
3. Signage
The applicants have not indicated whether new signage is proposed upon the site.
Signs are required to have a building permit and are subject to review for compliance by City Staff. As a condition
of conditional use permit approval, all new signage shall be subject to sign permit and must be reviewed and
approved by the City.
4. Trash Handling and Loading
It is unclear where trash handling and loading activities will occur on the site. As a condition of conditional use
permit approval, it is recommended that the submitted site plan be modified to illustrate trash handling and
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City of Columbia Heights - Council Letter Page 5
loading locations.
5. Lighting
According to the submitted application materials, outdoor lighting presently exists on the south side of the
repair shop building. It is assumed such lighting illuminates the outdoor storage area to the south for security
purposes. Section 9.106(K) of the Zoning Ordinance imposes the following conditions upon exterior lighting:
(1) In general. No use shall be operated or occupied so as to create light or glare in such an amount or to
such a degree of intensity as to constitute a hazardous condition or a public nuisance. Lighting shall not
create a sense of brightness that is substantially greater than the ambient lighting conditions so as to
cause annoyance, discomfort, decreased visibility or a hazard for vehicular or pedestrian traffic.
(2) Lighting fixtures. Lighting fixtures shall be of a downcast with flat lens, cut-off type that conceals the
light source from view and prevents light from shining on adjacent property. At no time should a fixture
be aimed and/or tilted above a horizontal plane in commercial or industrial districts, with the exception
of architectural up-lighting or landscape lighting.
(3) Lighting intensity. Lighting shall not directly or indirectly cause illumination or glare in excess of one -
half footcandle as measured at the closest residential property line and three footcandles as measured
at the closest street curb line or non-residential property line. Lighting shall be maintained stationary
and constant in intensity and color, and shall not be of a flashing, moving or interm ittent type.
As a condition of conditional use permit approval, all exterior lighting on the site must comply with the preceding
requirements as provided in Section 9.106(K) of the Zoning Ordinance.
6. Neighborhood Notification
As required, neighborhood notification of the conditional use permit application has been provided to property
owners within 350 feet of the subject property.
At the time of this report, City Staff has not received any comments from neighboring property owners regarding
the development proposal.
7. Staff Review
The Public Works Department, Police Department, and Fire Department have been provided copies of the
application materials. No concerns with the development plan were conveyed to Planning Staff regarding this
application.
FINDINGS OF FACT
In addition to the conditions cited earlier which are specific to “outdoor storage” uses, the Zoning Ordinance
also outlines certain requirements that all conditional use permits must meet in order to be considered for
approval. The following is a listing of such requirements and related Staff findings:
(a) The use is one of the conditional uses listed for the zoning district in which the property is located, or is a
substantially similar use as determined by the Zoning Administrator.
Staff Comment: “Outdoor storage” as an accessory use is specifically listed as a conditional use in the I-
2, General Industrial District under Section 9.111(E)(3)(c). This requirement has been satisfied. 190
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City of Columbia Heights - Council Letter Page 6
(b) The use is in harmony with the general purpose and intent of the Comprehensive Plan.
Staff Comment: The City’s 2040 Comprehensive Plan guides the subject site for “industrial use.” The
proposed use is permitted within the applicable I-2, General Industrial zoning district and will, with
conditions, be in harmony with the general purpose and intent of the 2040 Comprehensive Plan.
(c) The use will not impose hazards or disturbing influences on neighboring properties.
Staff Comment: Provided certain conditions of conditional use permit approval are imposed and
satisfied, Staff does not believe the proposed use will have disturbing influences on neighboring
properties.
(d) The use will not substantially diminish the use of property in the immediate vicinity.
Staff Comment: The site is located in an area which is characterized by industrial uses. The proposed
use is not expected to negatively impact properties in the immediate vicinity.
(e) The use will be designed, constructed, operated and maintained in a manner that is compatible with the
appearance of the existing or intended character of the surrounding area.
Staff Comment: The propose outdoor storage use will occupy an of the site which has historically been
used for the outdoor storage of vehicles. With the possible exception of new site signage at some point,
no significant exterior changes to the site and building design are proposed.
It is the opinion of Staff that the placement of vehicles in a more organized manner on the site (in
accordance with the submitted site plan) will serve to improve the appearance of the site. In this regard,
it is believed the character of the neighborhood may improve.
(f) The use and property upon which the use is located are adequately served by essential public facilities
and services.
Staff Comment: The site is presently serviced by adequate utilities and services. No changes to public
services or facilities are proposed.
(g) Adequate measures have been or will be taken to minimize traffic congestion on the public streets and
to provide for appropriate on-site circulation of traffic.
Staff Comment: Traffic generated by the proposed use is not expected to result in congestion along
either 39th Avenue NE to the north or 38th Place NE to the south.
(h) The use will not cause a negative cumulative effect, when considered in conjunction with the cumulative
effect of other uses in the immediate vicinity.
Staff Comment: The proposed accessory outdoor storage use is not expected to have a negative
cumulative effect on the area.
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City of Columbia Heights - Council Letter Page 7
(i) The use complies with all other applicable regulations for the district in which it is located.
Staff Comment: Recognizing that the existing building setback to the west and zero lot line parking
setback within the outdoor storage area represent legal nonconforming conditions, the proposed use
will comply with all other applicable I-2, General Industrial District regulations.
SUMMARY / RECOMMENDATION
The applicant has requested approval of a conditional use permit to allow accessory outdoor storage in
association with an automobile repair business upon property located at 660 39th Avenue NE.
In review of the conditional use permit application materials, Staff finds the request to be a reasonable use of
the property which, with conditions, will not negatively impact the health, safety, or welfare of the City, its
residents, and property owners. On November 1, 2022, the Planning Commission voted 7-0 to recommend
approval to the City Council on this matter.
Staff recommends that the City Council approve the Conditional Use Permit for Accessory Outdoor Storage as
presented, subject to the conditions listed below.
1. Outdoor storage upon the subject site shall be limited to vehicles which are accessory to the principal
use of the property (automobile repair) and awaiting repair and/or pick-up. Vehicles which are not
awaiting repair and/or pick-up on the site are not considered an accessory to the principal use and
therefore are not allowed to be stored upon the property.
2. There shall be no storage of junk vehicles used for parts on the premises.
3. There shall be no vehicles for sale on the property, and custome rs shall not buy vehicles from the site.
4. All vehicles stored on the premises shall be currently licensed, registered and insured.
5. The outdoor storage of vehicles within the public rights-of-way shall be prohibited.
6. All vehicles to be stored outdoors shall be located on an impervious surface.
7. In accordance with the submitted site plan dated August 29, 2022, a maximum of 79 vehicles shall be
stored upon the site at one time.
8. Outdoor storage activities shall be limited to the rear yard of the site (sou th of the automobile repair
building).
9. All individual vehicle parking stalls within the outdoor storage area shall meet the required dimensions
outlined in Section 9.106(L) of the Zoning Ordinance, and be delineated with pavement striping, as
depicted on the submitted site plan dated August 29, 2022.
10. Drive aisles within the outdoor storage area, as depicted on the submitted site plan dated August 29,
2022, shall be maintained to ensure proper site circulation and emergency vehicle access.
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City of Columbia Heights - Council Letter Page 8
11. The Fire Department shall be provided a means to access the site from the south (from 38 th Place NE) in
the event of emergency. This issue shall be subject to further comment and recommendation by the
Fire Department.
12. The site plan shall be modified to illustrate required off-street parking stalls (11 spaces, plus one space
per service bay). Of the required spaces, one shall be designated on the site plan and on the property
as a disability parking stall.
13. All new signage shall be subject to sign permit and shall be reviewed and approved by the City.
14. The submitted site plan shall be modified to illustrate trash handling and loading locations.
15. All exterior lighting on the site shall comply with the preceding requirements as provided in Section
9.106(K) of the Zoning Ordinance.
16. All required state and local codes, permits, licenses and inspections shall be met and be in full
compliance.
RECOMMENDED MOTION(S):
MOTION: Move to waive the reading of Resolution 2022-98, there being ample copies available to the
public.
MOTION: Move to approve Resolution 2022-98, a resolution approving a Conditional Use Permit for
Accessory Outdoor Storage within the I-2, General Industrial District in the City of Columbia Heights,
Minnesota.
ATTACHMENT(S):
Resolution 2022-98
Application/Narrative
Site Location Map
Site Plan/Survey
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Item 16.
RESOLUTION NO. 2022-98
RESOLUTION APPROVING A CONDITIONAL USE PERMIT FOR
ACCESSORY OUTDOOR STORAGE WITHIN THE I-2, GENERAL INDUSTRIAL DISTRICT
IN THE CITY OF COLUMBIA HEIGHTS, MINNESOTA
WHEREAS, a proposal (Case #2022-1001) has been submitted by City Staff to the City Council
requesting a conditional use permit from the City of Columbia Heights at the following site:
ADDRESS: 660 39th Avenue NE
LEGAL DESCRIPTION: On file at City Hall.
THE APPLICANT SEEKS THE FOLLOWING PERMIT: A Conditional Use Permit per Code
Section 9.107(C)(35) to allow accessory outdoor storage in the I-2, General Industrial
District
WHEREAS, the subject site is zoned I-2, General Industrial which makes an allowance for
accessory outdoor storage uses via conditional use permit; and
WHEREAS, the proposed outdoor storage of vehicles is an accessory to an automobile repair
use located upon the property, and
WHEREAS, the Planning Commission held a public hearing, as required by the City Zoning Code,
on November 1, 2022; and recommended approval of the conditional use permit subject to
various conditions; and
WHEREAS, the City Council has considered the advice and recommendations of the Planning
Commission regarding the effect of the proposed conditional use permit upon the health,
safety, and welfare of the community and its Comprehensive Plan, as well as any concerns
related to compatibility of uses, traffic, property values, light, air, danger of fire, and risk to
public safety in the surrounding areas; and
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Columbia Heights that,
after reviewing the proposal, the City Council accepts and adopts the following findings of the
Planning Commission:
1. The use is one of the conditional uses listed for the zoning district in which the property
is located, or is a substantially similar use as determined by the Zoning Administrator.
2. The use is in harmony with the general purpose and intent of the Comprehensive Plan.
3. The use will not impose hazards or distributing influences on neighboring properties.
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Item 16.
4. The use will not substantially diminish the use of property in the immediate vicinity.
5. The use will be designed, constructed, operated and maintained in a manner that is
compatible with the appearance of the existing or intended character of the
surrounding area.
6. The use and property upon which the use is located are adequately served by essential
public facilities and services.
7. Adequate measures have been or will be taken to minimize traffic congestion on the
public streets and to provide for appropriate on-site circulation of traffic.
8. The use will not cause a negative cumulative effect, when considered in conjunction
with the cumulative effect of other uses in the immediate vicinity.
9. The use complies with all other applicable regulations for the district in which it is
located.
FURTHER, BE IT RESOLVED, that the attached conditions, maps, and other information shall
become part of this permit and approval; and in granting this permit the City and the applicant
agree that this permit shall become null and void if the project has not been co mpleted within
one (1) calendar year after the approval date, subject to petition for renewal of the permit.
CONDITIONS ATTACHED:
1. Outdoor storage upon the subject site shall be limited to vehicles which are accessory to
the principal use of the property (automobile repair) and awaiting repair and/or pick-up.
Vehicles which are not awaiting repair and/or pick-up on the site are not considered an
accessory to the principal use and therefore are not allowed to be stored upon the
property.
2. There shall be no storage of junk vehicles used for parts on the premises.
3. There shall be no vehicles for sale on the property, and customers shall not buy vehicles
from the site.
4. All vehicles stored on the premises shall be currently licensed, registered and insured.
5. The outdoor storage of vehicles within the public rights-of-way shall be prohibited.
6. All vehicles to be stored outdoors shall be located on an impervious surface.
7. In accordance with the submitted site plan dated August 29, 2022, a maximum of 79
195
Item 16.
vehicles shall be stored upon the site at one time.
8. Outdoor storage activities shall be limited to the rear yard of the site (south of the
automobile repair building).
9. All individual vehicle parking stalls within the outdoor storage area shall meet the
required dimensions outlined in Section 9.106(L) of the Zoning Ordinance, and be
delineated with pavement striping, as depicted on the submitted site plan dated August
29, 2022.
10. Drive aisles within the outdoor storage area, as depicted on the submitted site plan
dated August 29, 2022, shall be maintained to ensure proper site circulation and
emergency vehicle access.
11. The Fire Department shall be provided a means to access the site from the south (from
38th Place NE) in the event of emergency. This issue shall be subject to further comment
and recommendation by the Fire Department.
12. The site plan shall be modified to illustrate required off-street parking stalls (11 spaces,
plus one space per service bay). Of the required spaces, one shall be designated on the
site plan and on the property as a disability parking stall .
13. All new signage shall be subject to sign permit and shall be reviewed and approved by the
City.
14. The submitted site plan shall be modified to illustrate trash handling and loading
locations.
15. All exterior lighting on the site shall comply with the preceding requirements as provided
in Section 9.106(K) of the Zoning Ordinance.
16. All required state and local codes, permits, licenses and inspections shall be met a nd be
in full compliance.
Passed this 14th day of November 2022
Offered by:
Seconded by:
Roll Call:
196
Item 16.
__________________________________
Amáda Márquez Simula, Mayor
Attest:
______________________________________
Sara Ion, City Clerk
197
Item 16.
198
Item 16.
Page 2 of 3
REASON FOR REQUEST (please attach a written narrative describing the intended use of the property and justification
for your request. Describe any modifications and/or limitations of the use that have been made to insure its
compatibility with surrounding uses and with the purpose and intent of the Zoning Ordinance and the Comprehensive
Plan.)
FOR OFFICE USE ONLY
CASE NO: _______________________
APPLICATION REC’D BY: ________________________ DATE APPLICATION REC’D: _______________
$500 APPLICATION FEE REC’D: _____________________ RECEIPT NUMBER: ____________________
Approved by Planning & Zoning Commission on ____________
Approved by City Council on _____________________
Rev
Revised June 2017
Din Auto operates an automotive mechanical and collision repair shop and is seeking a conditional use permit
related to the outdoor storage of vehicles as they await repairs.
Stored vehicles would be stored in the lot directly south of the building, which is currently fenced, screened from
public view, paved, and partially lit via lights from the south side of the building.
Included in this application is an aerial site plan which includes how vehicles would be parked and ingress/egress
pathways for emergency vehicles.
199
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200
Item 16.
201
Item 16.
CITY COUNCIL MEETING
AGENDA SECTION ITEMS FOR CONSIDERATION
MEETING DATE NOVEMBER 14, 2022
ITEM: Resolution 2022-105 Early Redemption of Taxable G.O. Housing Improvement Area Bonds,
Series 2008A.
DEPARTMENT: Finance BY/DATE: Joseph Kloiber, Finance Director/Nov 9,
2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
X Economic Strength X Excellent Housing/Neighborhoods
_ Equity and Affordability _ Strong Infrastructure/Public Services
_Opportunities for Play and Learning _ Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
In 2008, the City was approached by the Sullivan Shores Townhomes Association for assistance with financing
a major rehabilitation of their members’ townhomes due to extensive water damage. This action was under a
provision in state statute designed to aid homeowner associations when conventional financing is not
available or not practical.
In this case, the rehabilitation costs were over $42,000 for each of the 65 townhomes in the Sullivan Shores
development. A majority of the 65 homeowners voted to approve the project, but there were some dissenting
votes. Under the applicable state statute and association rules, only majority approval was required to impose
the project on all 65 townhomes in the development.
43 of the homeowners were able to pay their entire share in 2008 from a combination of savings and/or
private financing such as home equity loans. 22 homeowners either did not have those resources available in
2008 or decided not to use those resources. A 15-year special assessment including interest of 6.3% was
imposed on those 22 properties in lieu of full payment in 2008.
For a fee, the City acted as a fiscal agent for this project. The amount the 43 owners paid in full in 2008 was
deposited in a project fund. The City issued bonds to provide project funds on behalf of the 22 homeowners
paying by the 15-year special assessment. As the special assessments were collected each year (since 2009),
the City used the special assessments to pay the semi-annual debt service on the bonds.
The original payment schedule for the bonds planned for payments through February 1, 2024. The special
assessments collected through 2022 however are enough to pay off the remaining bonds. Consequently, it is
advisable to redeem (pay off) the remaining outstanding bonds of this project now, in 2022. This action will
reduce the interest costs of the project by $7,000 and allow the City to end its administrative role in this
project at this time.
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City of Columbia Heights - Council Letter Page 2
An additional consequence of collecting enough special assessments through 2022 to pay off the remain ing
bonds is that the final installment (2023) of the 15-year special assessment is not required by this project. That
final installment of the special assessment will be cancelled and will not appear on the 2023 property tax
statements of the 22 properties on the special assessment roll.
Lastly, we note that in addition to reimbursing the City for its administrative costs, the financing used for this
private housing project was at taxable market rates, rather than the City’s lower tax-exempt rates. This
project has not been supported financially in any way by the City budget or by Columbia Heights taxpayers.
RECOMMENDED MOTION(S):
MOTION: Move to waive the reading of Resolution 2022-105, there being ample copies available to the
public.
MOTION: Move to adopt Resolution 2022-105, being a resolution calling for redemption of Taxable General
Obligation Housing Improvement Area Bonds, Series 2008A.
ATTACHMENT(S):
Resolution 2022-105
Debt Service Analysis Report by Ehlers & Associates
203
Item 17.
1
CL162-65-834069.v1
CITY OF COLUMBIA HEIGHTS, MINNESOTA
RESOLUTION NO. 2022-105
RESOLUTION CALLING FOR REDEMPTION OF TAXABLE
GENERAL OBLIGATION HOUSING IMPROVEMENT AREA
BONDS, SERIES 2008A
BE IT RESOLVED by the City Council (the “Council”) of the City of Columbia Heights,
Minnesota (the “City”), as follows:
A. The City has heretofore issued its Taxable General Obligation Housing Improvement Area
Bonds, Series 2008A, dated July 16, 2008 (the “Bonds”), in the original aggregate principal amount of
$975,000, of which $180,000 in principal amount is currently outstanding.
B. The Bonds are currently subject to call for prior redemption at the option of the City on
any date at a price of par plus accrued interest.
C. The City Council deems it desirable and in the best interests of the sound financial
management of the City that the outstanding Bonds maturing on February 1, 2024, comprised of a term
bond with two remaining mandatory sinking fund redemption installments due on February 1 in the years
2023 and 2024, which constitute all of the Bonds subject to redemption, be prepaid and redeemed on
December 16, 2022 (or on the first date thereafter on which the City elects to redeem the Bonds and for
which U.S. Bank Trust Company, National Association (formerly, U.S. Bank, National Association), as
registrar for the Bonds (the “Registrar”) can provide proper notice to the holders of the Bonds).
NOW THEREFORE, BE IT RESOLVED by the City Council of the City of Columbia Heights,
Minnesota, as follows:
1. The Bonds maturing on February 1, 2024, are hereby called for redemption and prepayment
in the aggregate principal amount of $180,000 on December 16, 2022, at a price of par and accrued interest.
2. The City Finance Director is hereby authorized and directed to cause the Registrar to mail
notice of the call for redemption of the Bonds, in substantially the form attached hereto in EXHIBIT A, to
The Depository Trust Company, as the registered owner of the Bonds to be redeemed, at the address shown
on the registration books kept by the Registrar. The Registrar is hereby authorized to take any and all other
actions deemed by the Registrar to be necessary or appropriate for the cash redemption and prepayment of
the Bonds maturing on and after December 16, 2022, and for all other actions related thereto.
3. The redemption price of the Bonds, comprised of the outstanding principal amount of the
Bonds plus accrued interest to December 16, 2022, will be paid from: (i) available cash revenues of the
City; and (ii) any amounts deposited in the debt service fund previously established for the Bonds.
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Item 17.
2
CL162-65-834069.v1
Passed by the City Council of the City of Columbia Heights, Anoka County, Minnesota, and this
14th day of November, 2022.
Attest: Amáda Márquez Simula, Mayor
_______________________________________
Sara Ion, City Clerk
205
Item 17.
A-1
CL162-65-834069.v1
EXHIBIT A
NOTICE OF CALL FOR REDEMPTION
CITY OF COLUMBIA HEIGHTS, MINNESOTA
TAXABLE GENERAL OBLIGATION HOUSING IMPROVEMENT AREA BONDS,
SERIES 2008A
NOTICE IS HEREBY GIVEN that by order of the City Council of the City of Columbia Heights,
Anoka County, Minnesota (the “City”), there have been called for redemption and prepayment on
December 16, 2022
(the “Redemption Date”) the entire outstanding principal amount of the Taxable General Obligation
Housing Improvement Area Bonds, Series 2008A, dated July 16, 2008 (the “Series 2008A Bonds”), having
the stated maturity date set forth below, and totaling $180,000 remaining in aggregate principal, with the
interest rate and CUSIP number set forth below:
Maturity Date
Principal
Amount
Rate
CUSIP
February 1, 2024* $ 180,000 6.05% 197684 MZ3
___________________________
*Term bond subject to mandatory sinking fund redemption on February 1, 2023, in the principal amount
of $85,000, and on February 1, 2024, in the principal amount of $95,000.
The Series 2008A Bonds are being called at a price of par, plus accrued interest to the Redemption Date.
U.S. Bank Trust Company, National Association (formerly U.S. Bank, National Association) in Saint Paul,
Minnesota, as Bond Registrar, shall pay the Redemption Price to The Depository Trust Company in
accordance with the provisions of the Letter of Representations. No interest shall accrue on the Series
2008A Bonds subject to redemption and prepayment after December 16, 2022.
Important Notice: In compliance with the Economic Growth and Tax Relief Reconciliation Act of
2003, the City is required to withhold a specified percentage of the principal amount of the redemption
price payable to the holder of any Bonds subject to redemption and prepayment on the Redemption Date,
unless the City is provided with the Social Security Number or Federal Employer Identification Number of
the holder, properly certified. Submission of a fully executed Request for Taxpayer Identification Number
and Certification, Form W-9 (Rev. December 2011), will satisfy the requirements of this paragraph.
The City is not responsible for the selection or use of the CUSIP numbers with respect to the Series
2008A Bonds. The CUSIP numbers in this Notice of Optional Redemption are provided solely for the
convenience of the holders of the Series 2008A Bonds and no representation is made by the City as to the
accuracy of such CUSIP numbers.
Dated: [Date of submission to DTC].
BY ORDER OF THE CITY COUNCIL OF THE
CITY OF COLUMBIA HEIGHTS, MINNESOTA
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Item 17.
CL162-65-834069.v1
STATE OF MINNESOTA
COUNTY OF ANOKA
CITY OF COLUMBIA HEIGHTS
I, the undersigned, being the duly qualified and acting City Clerk of the City of Columbia Heights,
Minnesota, DO HEREBY CERTIFY that I have carefully compared the attached and foregoing extract of
minutes of the City Council of the City held on the date therein indicated, with the original thereof on file
in my office, and the same is a full, true and complete transcript there from insofar as the same relates to
calling for redemption the outstanding Taxable General Obligation Housing Improvement Area Bonds,
Series 2008A.
WITNESS my hand as such Clerk this ____ day of _____________, 2022.
City Clerk
207
Item 17.
City of Columbia Heights, MN
$184,084 Cash Current Refunding on December 16, 2022 of:
Taxable G.O. Housing Bonds, Series 2008
Sources & Uses
Dated 12/16/2022 | Delivered 12/16/2022
Sources Of Funds
Par Amount of Bonds $184,083.75
Total Sources $184,083.75
Uses Of Funds
Deposit to Current Refunding Fund 184,083.75
Total Uses $184,083.75
2022 Cash Cur Ref 2008A T | SINGLE PURPOSE | 10/19/2022 | 12:44 PM
208
Item 17.
City of Columbia Heights, MN
$184,084 Cash Current Refunding on December 16, 2022 of:
Taxable G.O. Housing Bonds, Series 2008
Debt Service Comparison
Date Total P+I
Net New
D/S Old Net D/S Savings
12/16/2022 ----
12/16/2023 184,083.75 184,083.75 93,318.75 (90,765.00)
12/16/2024 --47,873.75 47,873.75
Total $184,083.75 $184,083.75 $141,192.50 (42,891.25)
PV Analysis Summary (Net to Net)
Gross PV Debt Service Savings 7,108.75
Effects of changes in DSR investments (50,000.00)
Net PV Cashflow Savings @ 0.000%(Escrow Yield)(42,891.25)
Net Present Value Loss $(42,891.25)
Net PV Loss / $191,192.50 PV Refunded Debt Service (22.434%)
Net PV Loss / $180,000 Refunded Principal (23.828%)
Net PV Loss / $184,084 Refunding Principal (23.300%)
Refunding Bond Information
Refunding Dated Date 12/16/2022
Refunding Delivery Date 12/16/2022
2022 Cash Cur Ref 2008A T | SINGLE PURPOSE | 10/19/2022 | 12:45 PM
209
Item 17.
City of Columbia Heights, MN
$184,084 Cash Current Refunding on December 16, 2022 of:
Taxable G.O. Housing Bonds, Series 2008
Current Refunding Escrow
Date Rate Receipts Disbursements
Cash
Balance
12/16/2022 -184,083.75 184,083.75 -
Total -$184,083.75 $184,083.75 -
Investment Parameters
Investment Model [PV, GIC, or Securities]Securities
Default investment yield target Unrestricted
Cash Deposit 184,083.75
Total Cost of Investments $184,083.75
Target Cost of Investments at bond yield $184,083.75
Yield to Receipt -
Yield for Arbitrage Purposes -
2022 Cash Cur Ref 2008A T | SINGLE PURPOSE | 10/19/2022 | 12:45 PM
210
Item 17.
City of Columbia Heights, MN
$184,084 Cash Current Refunding on December 16, 2022 of:
Taxable G.O. Housing Bonds, Series 2008
Summary Of Bonds Refunded
Issue Maturity Type
of
Bond Coupon
Maturity
Value Call Date Call Price
Dated 8/01/2022 | Delivered 8/01/2022
2008A Txbl GO Hsg Bds - CashCurRef file 2022 02/01/2023 Serial Coupon 6.050%85,000 12/16/2022 100.000%
2008A Txbl GO Hsg Bds - CashCurRef file 2022 02/01/2024 Serial Coupon 6.050%95,000 12/16/2022 100.000%
Subtotal --$180,000 --
Total --$180,000 --
2022 Cash Cur Ref 2008A T | SINGLE PURPOSE | 10/19/2022 | 12:45 PM
211
Item 17.
City of Columbia Heights, MN
$180,000 Taxable G.O. Housing Bonds, Series 2008
15 Year Term
Debt Service To Maturity And To Call
Date
Refunded
Bonds
Refunded
Interest D/S To Call Principal Coupon Interest
Refunded
D/S
12/16/2022 180,000.00 4,083.75 184,083.75 ----
02/01/2023 ---85,000.00 6.050%5,445.00 90,445.00
08/01/2023 -----2,873.75 2,873.75
02/01/2024 ---95,000.00 6.050%2,873.75 97,873.75
Total $180,000.00 $4,083.75 $184,083.75 $180,000.00 -$11,192.50 $191,192.50
Yield Statistics
Base date for Avg. Life & Avg. Coupon Calculation 12/16/2022
Average Life 0.653 Years
Average Coupon 6.0500000%
Weighted Average Maturity (Par Basis) 0.653 Years
Weighted Average Maturity (Original Price Basis) 0.653 Years
Refunding Bond Information
Refunding Dated Date 12/16/2022
Refunding Delivery Date 12/16/2022
2008A Txbl GO Hsg Bds - C | SINGLE PURPOSE | 10/19/2022 | 12:45 PM
212
Item 17.
CITY COUNCIL MEETING
AGENDA SECTION ITEMS FOR CONSIDERATION
MEETING DATE NOVEMBER 14, 2022
ITEM: Resolution 2022-106 Appropriating $600,000 of existing fund balance for use in the 2022
budgets of the governmental operating funds.
DEPARTMENT: Finance BY/DATE: Joseph Kloiber, Finance Director/Nov 10,
2022
CITY STRATEGY: (please indicate areas that apply by adding a bold “X” in front of the selected text below)
_Safe Community _Diverse, Welcoming “Small-Town” Feel
X Economic Strength _ Excellent Housing/Neighborhoods
_ Equity and Affordability _ Strong Infrastructure/Public Services
_Opportunities for Play and Learning _ Engaged, Multi-Generational, Multi-Cultural Population
BACKGROUND:
As discussed with the City Council at the October and November 2022 work sessions, the 2022 actual
expenditures within the governmental operating funds are projected to exceed the amounts currently
budgeted by approximately 1% by the end of 2022.
The main causes of this difference from prior budget estimates are two changes that occurred in early 2022
after initial adoption of the 2022 budget in December 2021 :
The City Council adopted new employee pay scales in response to a city-wide compensation study
performed by an external consultant. This was to comply with the state statute for pay equity within
local government, and to remain a competitive employer in the metro area.
The actual workers compensation premiums charged by the Leagu e of MN Cities Insurance Trust
(LMCIT) in 2022 for front-line workers was much higher than the 2021 rates used to estimate the 2022
budget.
The City Charter and generally accepted accounting principles treat any dollar amount expended over the
legally adopted budget as a reportable compliance violation, even if there are additional funds on hand to pay
for the excess expenditures. In addition, this restriction is applied at the individual fund level, and not at the
level of all City funds combined. Consequently, staff recommends increasing the legal level of the 2022
budget in the governmental operating funds by 3% to allow for any variance from the 1% estimate and the
uncertainty of which fund could vary.
RECOMMENDED MOTION(S):
MOTION: Move to waive the reading of Resolution 2022-106, there being ample copies available to the
public.
MOTION: Move to adopt Resolution 2022-105, being a resolution appropriating $600,000 of existing fund
balance for use in the 2022 budgets of the governmental operating funds.
ATTACHMENT(S): Resolution 2022-106
213
Item 18.
RESOLUTION NO. 2022-106
APPROPRIATE $600,000 OF EXISTING FUND BALANCE FOR USE IN THE 2022 BUDGETS OF THE
GOVERNMENTAL OPERATING FUNDS
WHEREAS, the City Council of the City of Columbia Heights, as required by the City charter and Minnesota
statue, adopted an initial 2022 budget on December 19, 2021, and certain subsequent revisions to that
budget; and
WHEREAS, that initial budget and subsequent revision were based on the best estimates of 2022 activity
available at the time; and
WHEREAS, it is now estimated that the actual 2022 final expenditures of the governmental operating funds
listed in Exhibit A will exceed those prior estimates by the close of the City’s 2022 fiscal year on December 31st;
and
WHEREAS, the principal differences from those prior estimates have been reviewed by the City Council, and
determined to be reasonable and necessary; and
WHEREAS, the City Charter requires that all expenditures be budgeted;
NOW, THEREFORE, BE IT RESOLVED that the 2022 City of Columbia Heights’ budget is amended to appropriate
$600,000 from the fund balances of government operating funds as listed on Exhibit A for 2022 use within
those same funds.
Passed this _________ day of ______________________, 2022
Offered by:
Seconded by:
Roll Call:
Mayor Amáda Márquez Simula
Attest:
Sara Ion, City Clerk/Council Secretary
214
Item 18.
CITY OF COLUMBIA HEIGHTS
RESOLUTION 2022-106
EXHIBIT A
ORIGINAL 2022 BUDGET ADDITIONAL
AND CUMULATIVE APPROPRIATION
REVISIONS THROUGH BY RESOLUTION
GOVERNMENTAL OPERATING FUNDS 13-Nov-22 2022-106
Fund 101 - GENERAL 16,586,787 400,000
Fund 201 - PLANNING & INSPECTIONS 440,771 20,000
Fund 204 - EDA ADMINISTRATION 400,228 40,000
Fund 225 - CABLE TELEVISION 419,150 20,000
Fund 228 - DOWNTOWN PARKING 44,324 40,000
Fund 240 - LIBRARY 1,286,500 80,000
TOTAL 19,177,760 600,000 3%
215
Item 18.