Loading...
Item P12Y 3:00 P.M. PUBLIC HEARING x BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: January 16, 2008 - KW Division County Attorney _ Bulk Item: Yes No X Staff Contact Person.: Cynthia Hall #3174 AGENDA ITEM WORDING: A Public Hearing regarding the Issuance of Certificate of Public Convenience and Necessity (COPCN) to Air Methods Corp., through its subsidiary Rocky Mountain Holdings, L.L.C. d/b/a LifeNet for the operation for an ALS transport air ambulance service for the period January 16, 2008 through January 15, 2010. ITEM BACKGROUND: LifeNet submitted an application for the issuance of a Class A Certificate of Public Convenience and Necessity in order to operate an ALS air transport service for pre -hospital and inter -facility transports in the territorial limits of Monroe County, Florida. A copy of the application and a revision submitted by LifeNet in July 2007 are attached. Under Monroe County Code §6.5-5(d), the Board shall schedule a public hearing to consider the application. The applicant and all current holders of certificates have been notified by mail as required by this section. PREVIOUS RELEVANT BOCC ACTION: A Public Hearing was held 11/14/07. After allowing public input and discussion, the Board granted approval of a temporary COPCN for the period beginning on November 14, 2007 and ending on February 12, 2008, conditional upon LifeNet returning to the BOCC with a signed agreement and commitment to integrate into the existing MCFR system for response to trauma transports. Those discussions have been held and have resulted in an agreement between Monroe County Fire Rescue and LifeNet. CONTRACT/AGREEMENT CHANGES: Issuance of COPCN through January 15, 2010. STAFF RECOMMENDATIONS: Approval. TOTAL COST: 0.00 COST TO COUNTY: 0,00 BUDGETED: Yes NIA No SOURCE OF FUNDS: REVENUE PRODUCING: Yes X No AMOUNT PER MONTH NIA YEAR NIA APPROVED BY: County Atty _ OMB/Purchasing Risk Management DOCUMENTATION: Included X Not Required 01/09/2008 16:25 8506229557 PAGE 01/02 F To: Cynthia L. Mali Fax number: (30 ;) 292-3516 From: Randy Layman Fax number: 866-799-9384 Date: 1/9/2008 'Regarding; Letter of Agreement Phone number for follow-up; 850-398-2299 Comments: Cynthia, iL Enclosed is the signed letter of agreement with Trauma Star. s; Please let me know if this will suffice or that you need additional information. Thank you, Randy Layman, CMTE Florida Director of Business Development Air Methods/LifeNet rlayman@airmethods.com 01/09/2008 16:25 8506229557 RAGE 02r 02 UNSo�MON ROE rwi:srLonioaasoati tS05l 2sa.aW Vie E�rinAil Ms. W. R. Leman, CMTE Florida. Rushwes V"Oloprxn W Dkeetor Sa Regio nll..ifem't Community Based Division Dear Randy: BOARD 6F COUNTY COMN=DEM Mayor Chaff "Sotnrw" MCCOY, IXsMct 3 Mayor Fro 7em MMG ER Gennaro, District 4 ofxfe M. SpettNr, DMiO 1 George Nnugant, Didrict 2 Blida I Murphy, txstri t 5 3aauwy 9, 2008 As you know, at the November 2007 tix% of the Monroe County Board of County the BOCC issued u temporary COPCN to Air Meihoda (TlhifoNet) conditional upon I: &Net returning to the BOCC with a sited agr excn=t and commitment to integrate into the existing MCFR system foe mponse to trauma trettspnM, Further to this, it zs my U0061staxnding t13at we have: rcached agrcen=t on the follovdag points, listed below, and that the parties intend that this agrtrnient should fW611 the ditcctive of the BOCC. Air Methods (WeNet) agrees to the following Monroe County Vim R=ua iutogmtim mc=res: T. KeNct will participate in QI =6u itiesi with the MUR Medical Director and Air Medical Srrviocs Chief related to trauma ftArncpoxts from MCFR gmund aunts, a minimum of cluaziuly and as re3quemed by the MCFR Medical Director; 1:&Net will Participate in LZ txabiwg and Disaster Prepmduess training with MCFR Traum Starr throughout Monroe County as identified try the D4=tar of Aviation and Air Medical Services Chief-- a mWouox of annual ttnWng for dme (3) Ong MC."M sbAb and volunteer fire deparftne nt tjr&wjmg swsions; aqd I_.ifeNet will contnu nic ate with MCSQIFR. Central Dispatch when not emexgenntly available at the Key West base (oo transport, down far maivknance, etc,). Couimmuicatiozn will be via xadio transmission or phone line. If you arc in agteemettt with the foregoing please sign below and retaw to xna today. Thatilt you io advance for your assist ce.,, Very truly yours, e Marienson Air Mefficht Services Chief, Trauma Stu Air Methods (Huron gh its srmbsidiary Rocky Mountain Holdings LLC d1b/a Life Abet) is :in agreement with the foregoing. 33y W. R. C B l;lorida. Busine Dcve: opment Director S.B, ReagiowufeNet Community Based DivWoo v sy m cD cL7 m rt F.L. P� ro o M�i "Ct A d c0 . prL ' W (D f�9 ; i�. (n0 A iD cD A cr, rn W O S3. lV Q' ri O ~ in O z m O o n O i9 �. 2• fp , n O i9 ro (Z oll o I-- � N m m p rz o o cn to ;j �. 0 w lz 2 A. rn � Cop ° r n; O a cn`�°o BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY 5:01 PM Meeting Date: November_l_4, 2007 Division: County Attorney Public Hearing Bulk Item: Yes No X Staff Contact Person/Phone #: Cynthia Hall x 3174 AGENDA ITEM WORDING: Public Hearing regarding the Issuance of Certificate of Public Convenience and Necessity (COPCN) to Air Methods Corp., Subsidiary Rocky Mountain Holdings L.L.C. d/b/a LifeNet for the operation of an ALS transport air ambulance service for the period November 14, 2007 through November 13, 2009. ITEM BACKGROUND: LifeNet submitted an application for the issuance of a Class A Certificate of Public Convenience and Necessity in order to operate an ALS air transport service for pre -hospital and inter -facility in the territorial limits of Monroe County, Florida. A copy of the application and a revision submitted by LifeNet in July 2007 are attached. Under Monroe County Code §6.5-5(d), the Board shall schedule a public hearing to consider the application. The applicant and all current holders of certificates have been notified by mail as required by this section. PREVIOUS RELEVANT BOCC ACTION: None. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: None. TOTAL COST: 0.00 BUDGETED: Yes No COST TO COUNTY: 0.00 SOURCE OF FUNDS: REVENUE PRODUCING: Yes No AMOUNT PER MONTH Year APPROVED BY: County Atty OMB/Purchasing N/A DOCUMENTATION: DISPOSITION: Revised t I/06 Included X Not Required Risk Management AGENDA ITEM # NIA UdNROE COUNTY,FLORIDA APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY CLASS A EMERGENCYMEDICAL SERVICE (PRINT OR TYPE) TYPE OF APPLICATION: XXR INITIALS`-- $50.00 ❑ RENEWAL --- $25.00 IF RENEWAL, PLEASE LIST NUMBER OF PREVIOUS CERTIFICATE: # 1. NAME OF SERVICE-- 1,1 BUSINESS MAILING ADDRESS 14739 Sty 128 Street, Miami, FL 33186 BUSINESS PHONE NUMBER 786-573-3485 EMERGENCY PHONE NUMBER 1--800-806-1916 2. TYPE OF OWNERSHIP (i.e. Sole Proprietor, Partnership, Corporation, etc.) Publicly traded Corp. DATE OF INCORPORATION OR FORMATION OF THE BUSINESS ASSOCIATION 1982 3. LIST ALL OFFICERS, DIRECTORS, AND SHAREHOLDERS (use separate sheet if necessary). NAME AGE See Attached List 0 ADDRESS TELEPHONE POSITION a 4. LEVEL OF CARE TO BE PROVIDED: ❑ BLS or 9IXALS 1F ALS, Xb TRANSPORT or © NONTRANSPORT 5. DESCRIBE THE ZONES) THAT YOUR SERVICE DESIRES TO SERVE. (Use separate sheet if necessary.) mits of Monroe County. 6. UST THE ADDRESS AND/OR DESCRIBE THE LOCATION OF YOUR BASE STATION AND ALL SUB -STATIONS. (Use separate sheet if necessary.) BASE STATION 14739 SW 128 St., Miami, FL 331.86 Build. 504 SUB -STATION LifeNet Miami c/o F'ishermens Hospital 3301 Overseas Hwy, Marathon 7. DESCRIBE YOUR COMMUNICATION SYSTEM. (Attach copy of all FCC licenses.) FREQUENCIES CALL NUMBERS NUMBER OF MOBILES / PORTABLES 4.53.175/458.175 WPW 1649 3 6 8. LIST THE NAMES AND ADDRESSES OF THREE U.S. CITIZENS WHO WILL ACT AS REFERENCES FOR YOUR SERVICE. [0riOv, See d Letters ADDRESS 9. ATTACH A SCHEDULE OF RATES WHICH YOUR SERVICE WILL CHARGE DURING THE CERTIFICATE PERIOD. 10. PROVIDE VERIFICATION OF ADEQUATE INSURANCE COVERAGE DURING THE CERTIFICATE PERIOD. 11, ATTACH A COPY OF YOUR SERVICE'S CONTRACT WITH A MEDICAL DIRECTOR. 12, ATTACH A COPY OF ALL STANDING ORDERS AS ISSUED BY YOUR MEDICAL, DIRECTOR. 13. ATTACH A CHECK OR MONEY ORDER IN THE APPROPRIATE AMOUNT, MADE PAYABLE TO THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS. I, THE UNDERSIGNED REPRESENTATIVE OF THE ABOVE NAMED SER VICE, DO HEREBY ATTEST MY SERVICE MEETS ALL OF THE REGU1REMENTS FOR OPERATION OF AN EMERGENCY MEDICAL SERVICE IN MONROE COUNTY AND THE STATE OF FLORIDA. I FURTHER ATTEST THAT ALL THE INFORMATION CONTAINED IN THIS APPLICATION, TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT. �q-41 8LIIABETH EL KOtfAY h1YCOMMISSHiN#DD589oa1 NOTARY SEAL ' o 6J(0 ThS.I?ecem5er1i,2o1D . 0ddmNa!aryPub!ictlnd�,��tar ffi Sf N UR F APPLICANT/AUTHOR(ZEp REPRESENTATIVE NOTAR SIG TUBE DATE Certificate of'Public Convenience and Necessity Request: Air Methods Corporation With its wholly owned subsidiary Rocky Mountain Holdings, LLC d/b/a Li%Net Responses to Section ;: Air Methods Corporation (FEIN: 840915893) Subsidiary: Rocky Mountain Holdings, LLC d/b/a LifeNet (FEIN: 87-0533822) 7301 South Peoria Street Englewood, CO 80112 Phone: 3 03-792-7400 Fax: 303-792-7420 Senior Officers s of Corporation 1.1. Aaron D. Todd Director and Chief Executive Officer Residence: Colorado 1.2. David L. Dolstein Senior dice President, Community Based Services Residence: California 1.3. Michael Allen Senior Vice President, Air Medical Services Residence: Colorado 1.4. Trent J. Carman Chief Financial Officer, Secretary and Treasurer Residence: Colorado 1.5. Sharon J. Keck Chief Accounting Officer and Controller Residence: Colorado Board of Directors 1.6. Aaron D. Todd Residence: Colorado 1.7. George W, Belsey - Chairman of the Board Residence: Colorado 1.8. Ralph J. Bernstein Residence: New York It 1.9. Samuel H. Gray Residence: New Jersey 1.10 C. David Kikurraoto Residence: Colorado 1.11 MG Carl H. McNair, Jr. (Ret.) Residence: Virginia 1.12 Lowell D. Miller, PhD Residence: Missouri 1.13 Morad Tahbaz Ij Residence: Connecticut 1.14 Paul H. Tate Residence: Colorado 2. Type and number of shares outstanding 2.1 Common Shares 11.05 million outstanding 2.2 Publicly traded corporation, traded on a daily basis on the NASDAQ 3. Date incorporated: air Methods is a Delaware corporation originally incorporated in Colorado in 1982. 4. Services to be provided: Critical Care Air Ambulance — Helicopter a 5. Present Florida Base locations: LifeNet Tallahassee 3256 Capital Circle SW Tallahassee, FL 32310 Baptist Medical Center LifeFlight 800 Prudential Dr. Jacksonville, FL 32207 LifeNet Polk 415 Bartow Municipal Airport Bartow, FL 33830 LifeNet Sumpter 6450 County Road 139 Wildwood, FL 34785 9. Patient Charges: LifeNet uses a national fee schedule that is consistent for all current 67 locations throughout the country. Currently this consists of a Base fee of $ 7735.00 and $49.50 per loaded mile. LifeNet will notify the county of changes to this structure at the time of any change. Y n 2 co W w pQP O P co CO 07 co or.) co Z d \\ cv c*t \ N O P O O o O N N N d a x� w� w U o 't co O P 0 t-- cn w t-, r-1 it'S N M 0 co O+ :� 'D nt In O %0 O ¢ P m rn ti N-:1 P a� Q N r-r o .--i •-+ r•a r-i Ln a < < U_ LL_ {— ft w w U F , ui ui u n w a X < >q X a S >< < > Ia z x � w a LU w w Co N r r � � N N a W C C w ? L O CJ Co O � � < � 7 N ta Qf q •rl U} Z Q'] 'y I-� 'b G} fJ QJ 0 -d O E Qa a •H E O Cd •H K Ql rK �. t•rl w ; ,•I f3 O ra •r 0 O du 'm Ql ,51 Pilots o1a Staff Christopher George Debs ss. 220-15-0516 Current Commercial Pilot Certificate 26-971-96, Issued — March 7, 2004 — No Expiration Richard W. Kellogg ss. 415-06-0106 Commercial Pilot Certificate 415-06-0106 Issued — November 18, 2002 — No Expiration Romed Diether ScarpatetU ss. 543-55-2271 Commercial Pilot Certificate 25-960-33 Issued — August 7, 2005 -- No Expiration 3 t11 E— ua w v u� cr 0 ti m LL 0 LU C] tit: F- w U} 0 U) N tU m Q w C01� Er w Ex O m uw m� d .Q X. ' b� .j .J. i 0 ILI � 1— a� w �— v E' zd � C3 � t] LL v- co W tll � Lu cc 0 F' 4 w M 0 W vi 2i Wk W M al Registered Nurses on Staff Jaclyn MaclCnnon SS. 073 46 6763 RN License 2097712 Expires 7/31108 Paramedic Certificate dA 200801 Expires 12/08 Beverly Grace Klautlry-Nix ss. 366 94 7514 RN License 2933182 Expires 7/31/08 Paramedic Certificate .TA 200796 Expires 12/08 Marie Rowland-Bonneman ss. 266 23 9434 RN License 1838822 Expires 4/30109 Paramedic Certificate JA 205244 Expires 12/08 Erin Nicole Kinlough ss. 498 90 4917 RN'License 9195709 Expires Bari C. Bier -Conte ss. 265 87 4463 ARNP License 1941112 Expires 10/31 /07 Certified Nurse Practitioner F1102023 Expires 10/31/07 Kathleen Maxine Templeton ss. 430 35 7955 RN License 9249200 Expires 7/31/08 Sara E. Lee ss. 256 63 6957 RN License 9192346 Expires 7/31/08 Paramedic Certificate 205886 Expires 12/08 le a O F G Q �aci U a IL m < z rOa Zco F i� Q fir° wW'a �ma 0 cn j m Cl) 7E R O 0 Z¢� Q i UFO O v d i z cM1v z w m 3 z v_> d C'i 2 O (V U o a+ N Q cn N w Z \ � W 7 E- D Q z d E (� cv ¢ O+ ns a to O + O ?- > c�c to Q 41 Q CD O z w � W U U •W. •rl a a N d C S w 0. rW r 47 41 gaw i Hpr 2:fb U'/ ? F-a 36p Rai' Meth11 ods Core 655. 1212 #a, 2 WMT TRANSFERABLE UNI,rED LtTATES r AMERICr ThE [rkiirate DEPARTMENT OF TRANSPORTATION - FE DtFRAL AVIATfOTd A'Ji/I£i`ttSTRATEON msml tt, Ir, the mr- CERTIFICATE OF AJRCF A:r-T REGISTRATION r.ral4 t.hc;: oh==gteG_ AIRCRAFT StREAL NO. NATiGNALITY AND W427Ars# ReGISTRATION MARKS 49092 MANUFACTURER AND MANUFACTUH K'S DES] N IOI•I OF AIRCRAFT tCAO Afrcra . Address Carle: 59 i3a� iaSugA iat h'irffo- BA.tdL:OfiP EQtiIP49E"fdf FI t 4E INC Ilan ;.crpasc. en1.1 s 13010 SW 68TH PKVN 1 snd is aqi = rr;rtil- itme nl W917 s PORTLMO OR 97223-8367 I Tarr F ailp[d1 ir`t!a- U 3= 71 ilaa ACrnini;lraliva j 'Irnr Ilq! dBIwnwe ,JgtsIs 01 Otvnvl-tig {j pl•Y.hSs:, 3 � it ss irllilit'd Ilm Me shgvs' deice ihl•d andall *: L,>qn dntrrarl art aw wn!-wr OE flln _ li £edsrSE 5Yi13:Or1 ,idmtrji@I[atlgn, Ilniled Status 01 1•134:ic1 iq accnrdnart- ctith rhs Cnuyeftl n qn IFtlernaticnat CiYEl rv£at{ua r saki Iface-snbN >? "I 71 t, and wi tt Ti11„ as. United SIANC Carla. J.S. D zpurtm*n1 I and ir'?}ul.ttl4n: rsr.et: lberamd I Of T1iln;porta[too 1 fecte .Zt Aviation OF.TE OF ISSUE . -: . ' r.� oczrabcr 18, 201 r0lfd14I5.R.dif7R i a: tdrm IlilaQ-311[:2(tU31 Sup,;rsddrx (trivial[: '.3 u ,nn-S nR �c-rc.14 ...... HP3^ 24 2007 1 a 24PM HP LRSERJEi rF€:{ P• 1 7. 1 aq :a O en R9 yya Sa,n w C1 3 �n fn N �w 47 m 5 a�T if u 2 m t4i M 4 e�x 3 Z N � _ L;1 ri7 N M ;p m cP` y !Aug O D fn K r r ✓ v Mal � -3 M Sy �G � V ja o _ 2 P2 � 'iP I Qrholh i3 ^ � w o 4G ..g'g } 4 &41 g ­4 m7 ::4 0 qy" � � Qo Q p n z '° , ra n% m z P P N. R boo � s O S►1 � � 5 a H L a 20O7 0.1.24f 17:24 7RCF7491Q9 f aGed —r—+Z6f UL998L "-'R1 Vi-PG-Looz � M.� €ffielffamum m8T 7RAMMHAULE {J1ipT6p $TATUB OP L1LrMNIC,4 TAt9 svn!)iecta DEPARTMENT OF TRAWSPORTATHall P�DG€fAL AVIATION ADMtPlrlaTtrAYIUFi start bn ra tNp all^ Fir. T AI 1 C R i!Q craft wtan apartsao. MATIONA ITY +Affix 1 13TR&TION NlAFM13 WOO 49DD2 A F .. IC�1#�4 t� L6. 409 ICAO 1n41*4g r dras c4 g �l�aziz� T9tts tarlE fNta is I y trassea far raaf�tp- s W i UI IFIRANlCINS ING Tap epees r.3 f'4 SW47 and la f 1 IF al3rS11- S dmoM VILLE FL 329,41.0347 fame of 1{Ills. + i 7Ak 4ndkrat Rv1a- i tlai! ggnlpfrtrol'o + t Q dais M 8alIM10 f llphu 91 owakrchlp r 48 3 1y69A @l1Y+11m ' {t araska ; ' it fi cwsFlla4 tSa1 lit ak+ai4 ffiapol{b'bd aIT&tLlr ht: mraa 6&34taa � iha raptzFar ai Ih0 FDdeml AVfprEan Qdbla;#1rktf9a, URltpa 9lowt al arparlm. In waBrt mo Will On VC14vanllah an Intkmallakaf CIM AYMtkn Orad flkrrmbdf 7, 1994, dal wf!!t rllta By, Ilnfi®d Stalks Cask. u.S, 04parimm TArattlaks Istdad ihrrrualas. of Trant=f emnlaa a Fadml v�as8evn ; 2OD4 $ea4irsn s . nC I[>im GSA ;�i10l2aflSl �t�d>otsdaaa ptkalaut gktt�kn .. ..r... • ,,, . ,�,�,,,,...,,,,,,,-... .. ASS.e i �~ u+stfLII iTai�;! CtrAAsaPtCA `. dSNA€iTMENTOP-TRANSPCJATAFfONr-FEDERAL AVtafI0NA0MlNISTMTi0n! STANDARD AIRWORTHIWESS CERTIFOCATE [ an11,141.4ZNp g ua4turpCruRxRara7rri7gAl 3 vACRIEtrf wRfAL a CA1'Cf oG . 1 tr AtsYlsTRnr[OrtPaM $E, HMICDFM TOMDN mims6p N4 30Q CAWA MODEL 430 49OD2 ITWSPORT ! 5 AU'NORIT3'43V{}OMISIOR1$SLIANCE e Thtd kpF.asitld,garCafltl,C�0sk,16UPO(W+HIJmttEa nlO sdpa+rl AYceirChAald}195a�nd[SitdrrS lft3L ad a![AWllafa91r1atrhrtee,t+t9 aaataA t6 wrsf[n xsvaa i7dd t�tp;R ttaa kr41 fa Yn4r M conform [o aTa IYpaCa�tA,Cktk 1Rkratdf.la p[ sn aaCanmR lCr ail@ l aaarasrpn atsaharlrs�pM�krhn�ywnsAn+pp,.r¢s�h7a,�tsa�spurrfrrfg�ni><plE�paApGda6lswmpress,snsr�arrCekst�;&alaruuOrcfbrla�r4�ass Dtov,nadtrpaeyy��r3'3 Y�i `3.LFIr �a\ai �� wSa7;OsnalWtwofl tfeagpst9at ',Ll Emergency_ it i ckings Exemption 4395 L11 p T6:RF15AH6COf4DITfflIV$ - -- --- �' 1N448r somas kurranrAra4 sulponw-4 Wi-%4oL ar 0 Qftnrjp�y, 0A {tale, is af7T m= t4la4115no !ty M Attm 1�lv=r 1hr. sima t imn cart him if anacim as tarty as tn9 trtd,=n;nt4 Wpxgarpt:wa rea[Mpttaaal: arsvatta;altma bra rrarf%rmw to ' apaA•QaRGtwriRPLr1S21.sS,agtlalgrVyP�ralavlahpPFiCpu1!{iaro,SsaAF kt 0.d+tptttr®u'C'ntirArdpnrae¢td[nrhailnrcpp Sim: par@OFISSUANCE Faan6PALUENrATM! .."„�,,� UESEi#1'fAF1CkVtdlPubF�t;f: „ my 2, 2001 i1ART-142030-SO Anyilr4rdnafr,tapfatX[t:[tiN¢'Rltzveoara[rkt:t+ntrC.u¢m�rOppynrrhp�ra6yaAnanaigatas0�nya14aQ [Lruncnrantrtart7nalcs�aemtly YOM of 041ft TKS CeRPFI ATE Nvor W t9laPLAM 04 TM ttlRrVAsT IN RCCORfSnNC& VrlTtr atRPttG�4.61 PC4$1r1aL For m-- 010-2 mv? 0-7,GQVCt1riMTPRWINQWPM 14s1lty.©.S12-145^_ a 9. Patient Charges: LifeNet uses a national fee schedule that is consistent for all current 67 Iocations throughout the country. Currently this consists of a Base fee of $ 7735.00 and $49.50 per loaded mile. LifeNet will notify the county of changes to this structure at the time of any change. July 13, 2007 Suzanne Hutton Esq. Munroe County Attorney's office P.O. Box 1026 Key west FL 33041-1026 Dear Ms. Hutton, I am writing you today in reference to our Monroe County's Certificate of Public Convenience and Necessity (COPCN), which was submitted on May 2", 2007. Since that time, we have determined a need to change out intended SUB -STATION location and request this letter serve as notice of the amendment to our application. On the main application form, we request a change to page 1 number 6 under the heading "SUB- STATION." This line should DELETE all content and reference to Fisherman's Hospital. Please instead INSERT, "Lower Keys Medical Center, Key West" as our SUB -STATION. Upon the recommendation of Cynthia Hall from your office, I am submitting this letter to provide notice and request acknowledgment of this amendment. Please advise at your earliest opportunity if you will need further information or action on my part in this regard. Thank rdnes, RVP ,thoCorporation unity Based Services Division 14739 SW 128th Street 504, Miami, Florida 33186 C UNTi' O�VROE KEY WEST FLo€iIDA 33040 (305)284-46e1 Suzanne A. Mutton, County Attorney" Robert B. Shillinger, Chief Assistant County Attorney ** Pedro J. Mercado, Assistant County Attorney Susan M. Grimsley, Assistant County Attorney Ptatileene W. Cassel, Assistant County Attorney Cynthia Hall, Assistant County Attorney ** Board Certified in City, County & Local Govt. law September 25, 2007 Via U.S. Nail and E-mail kglrimes @ ai rmethods.corn Mr. Ken Grimes SE Regional Vice President Air Methods Corporation Community Based Services Division 14739 SW 28'h St. #504 Miami, FL 33186 Dear Mr. Grimes: BOARD. -OF -COUNTY COMM1551 HERS Mayor, Mario Di Gennaro, District 4 Mayor Pro Tem Dixie M. Spehar, District 1 George Neugent, District 2 Charles "Sonny" McCoy, District 3 Sylvia ]. Murphy, District 5 Office of the County Attorney PO Box 1026 Key West, FL 33041-1026 (305) 292-3470 -- Phone (305) 292-3516 — Fax Monroe County has reviewed your amended application for a Certificate of Public Convenience and Necessity, and requests some additional information. Please provide the following: 1. A copy of the certificate issued by the FAA pursuant to 14 CFR part 135 (1 see several certificates attached to the COPCN application, but perhaps because of photocopy quality, none appear to be the part 135 certificate); 2. A copy of the part 135 Certificate operations specification, where the operations specification defines the aircraft proposed to be used under this COPCN; 3. Please state whether the Part 135 certificate has ever been subject to an FAA letter of investigation (LOI) within the past five (5) years, and if so, the disposition; 4. Please state whether the Part 135 certificate has ever been the subject of an FAA reportable incident or accident within the past seven (7) years, and if so, the details of the incident or accident, and the disposition or resolution; 5. The Agreement for Medical Director Services expired on 7-13-07. Please provide a current copy of the agreement or an extension or renewal of the agreement, and include a signature pages showing signatures of both parties. Mr. Ken Grimes Air Methods September 25, 2007 Page 2 6. Please provide verification of current insurance as requested in Question 10 of the application. We look forward to receiving this information. Please contact me if you have any questions regarding the foregoing. Thank you for your assistance. Thank you. Very truly yours, Cynt is L. Hall Assistant County Attorney Page 1 of 2 Hall -Cynthia From: Ken Grimes [KGRIMES@airmethods.com] Sent: Friday, September 28, 2007 11:42 AM To: Hall -Cynthia Subject: RE: Request for Information -- COPCN Mrs. Hall Below is the language in MD contract. It automatically renewed in July. How do you want me to address this? So far, I have asked Dr Steed to send a letter to you indicating same. Term.of Agreement. This Agreement shall commence as of the date set forth above and shall continue for a period of I (one) year, and will automatically renew at the end of the first year for 5 (five) successive years, unless terminated by either party as contained in this paragraph. This Agreement may be terminated by either party by giving ninety (90) days written notice to the other party. DOCTOR shall be entitled to compensation through the effective date of termination of this Agreement, providing services continue to be provided as contained herein. Also, can I provide the requested documentation in electronic format? Thank you in advance. Ken Grimes 727-423-4289 From: Fall -Cynthia mailto:Hall-Cynthia@MonroeCounty-Fl-.Gov] Sent: Wednesday, September 26, 2007 8:56 AM To: Ken Grimes Subject: Request for Information -- COPCN Good morning, Mr. Grimes. Attached please find a letter requesting a small amount of additional information. The next BOCC meeting is on October 17, 2007, and if we can receive your response and if the County Administrator has no further questions, I would like to aim to put the item on that agenda. The 1 st deadline for putting items on the agenda is Tuesday, October 2, 2007. l can put items on the agenda after that as an add -on, but it would be preferable to make the first deadline if possible. Please give me a call anytime if you have any questions, and otherwise, I look forward to receiving the information. Thank you very much. Regards, Cynthia L. Wall Monroe County Attorney's Office P.O. Box 1026 Key West, FL 33041-1026 Tel (305) 295-3174 Fax (305) 292-3516 Please note: Florida has a very broad public records law. Most written communications to or from the County regarding County business are public records available to the public and media upon request. Your e-mail communication may be subject to public disclosure. 10/30/2007 DATE (MhVDDIYY) ACORD,,. CERTIFICATE OF LIABILITY INSURANCE 03/28/2008 04/11/2007 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lackton Companies, LLC-0 Denver p ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8110 E Union Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 700 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver CO80237 (303) 414-6000 _ .. _ .... .. ... INSURERS AFFORDING COVERAGE _---.._..--- ...__ ._ .- INSURED Air Methods Corporation INSURER A: Evanston Insurance Company 1055381 7301 South Peoria Street INSURER e Englewood, CO 80134 INSURER Q : INSURER D : INSURER E . rnvicenncc F.M IHcSilocnrcFIO riEuOnniNSnR„000cD0E5N0�COnN5onTnnErcoO king "=r-=r21I��NAi'Culnlr%=0 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR POLICY EFFECTIVE POLICY EXPIRATION', LTR TYPE OF INSURANCE POLICY NUMBER Y DATE MM D➢IYY LIMITS :.GENERAL LIABILITY ''. EACH OCCURRENCE ,, s XXXXXXX . COMMERCIAL GENERAL LIABILITY NOT APPLICABLE ;....... FIRE DAMAGE {Any one lire) ., S XXXXXXX .. CLAIMS MADE '': OCCUR i, MEN. EXP tMy One person) '�, S XXXXXXX iPERSONAL&ADV$NJURY....9._.XXXXXXX-__-_- ' ................ GENERAL AGGREGATE_.., I�,$ XXXXXXX._. GEN'L AGGREGATE LIMIT APPLIES PER: ' '. PRODUCTS.- COMP/OP AGG s XXXXXXX PRO- _ ................ POLICY : JECT '- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT s XXXXXXX ANY AUTO NOT APPLICABLE (Ea accident} ALL OWNED AUTOS BODILY INJURY $ XXXXXXX SCHEDULED AUTOS (Per person) HIRED AUTOS - BODILY INJURY XXXXXXX NON -OWNED AUTOS ,. iPeracc1dent) .. '.. PROPERTY DAMAGE $ XXXXXXX ',. IPer aWdent) GARAGE LIABILITY AUTO ONLY, EA ACCIDENT ': $ XXXXXXX _ ANY AUTO NOT APPLICABLE i OTHER THAN EA ACC $ XXXXXXX - AUTO ONLY: AGG $ XXXXXXX EXCESS LIABILITY EACH OCCURRENCE $ XXXXXXX OCCUR CLAIMS MADE NOT APPLICABLE AGGREGATE S XXXXXXX UMBRELLA S XXXXXXX DEDUCTIBLE FORM 5 XXXXXXX RETENTION XXXXXXX WORKERS COMPENSATION AND NOT APPLICABLE :We STATU- 'OTH- TQRY LIMITS_. 'ER_ _...................... ... EMPLOYERS' LIABILITY E.L. EACH ACCIDENT s XXXXXXX E.L. DISEASE - EA EMPLOYEE $ _ XXXXXXX - E.L. DISEASE • POLICY LIMIT. $ XXXXXXX OTHER A Professional Liability SM-849993 03/28/2007 03/28/2008 Pcr Claim - $5,000,000 Aggregate - S8,000.000 Ded. Per Claim - $I00,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES1EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Named Insured includes: Air Methods Corporation DBA Complete Billing Systems, Mercy Air Service, Inc., Mercy Air Service, Tri County LLC, Lifcnct Inc. dba Arch Air Medical Services and Rocky Mountain Holdings, LLC. CEHTIFIGATE MULDEH ADDITIONAL INSURED. INSURER LETTER: CANUf_LLA I IUIY 284010E SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Air Methods Corporation DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. [AUTHORIZED REPRESENTATIVE } BCr1Rr19fi-RI7IA71 Fornuoebonsmnard€nnthlacaruncate.contactthenumberlistedIntho'Producer'sectlonaboveandspecltytheclientcode'AIRMEDY. 0ACORO EORPORATICIN19BB x October 1, 2007 Cynthia L. Hall Monroe County Attorney's Office P.O. Box 1026 Key West, FL 33041-1026 Dear Mrs. Hall I am writing you today in reference to our Monroe County's Certificate of Public Convenience and Necessity (COPCN). I am pleased to let you know that for operational reasons we have changed the 1992 spare aircraft listed in the application with anew, state of the art Eurocopter model EC 135P2. Please replace the 1992 Bell Helicopter model 430, license tag number 430Q with the following: ® Type of ambulance: Eurocopter Helicopter ® Model: EC135 P2 ® Year:2007 ® Mileage: NIA * License tag number N230AV1 ® HRS Permit Number: 1382 o Specify BLS or ALS: ALS ® Transport or Non -transport: Transport Please let me know if you require any further information. Community Based Services Division 14739 SW 128th Street #504, Miami, Florida 33186 U.B. DepaAment of Transporiai on F lcraiAVation f?pe€'adol€sSpecification's Administraton 11e i trot€o€� 1�do, Serial No. Aircraft /NMIS N911 NM 47569 BIi>'_222-f1 N904CM 23013 BTIT-230-230 N2478M 53176 BI Y-407--407 N407AMi 53309 BH'I`-407-407 N407CX 53279 BII-407-407 N407GA, 53104 BHT-407-407 N4071T 53719 B1I'i-407-407 N4071-L 53561 B11T-407-407 N407L.N 53191 BOT-407-407 N407S7 53422 BHT-4407-407 N407SL 53564 BHT-407-407 N407MI 53345 BRI-407-407 N407W 53476 BHT-407-407 NMOS AM 53445 BHT-407-407 N408GA 53392 1 lfr-407-407 N408 L1, 5340 BHT- 407-407 N4(781YH 53663 BIIT-407-407 N434BC. 53446 BI-TT-407-40? N772AL 53040 Blrr-407-407 N773 AL 53160 BI-IT-407-407— N 90511A 53497 z'.1•IT-407-407 N 911 AL 53144 BUT-407 -407 N91 INVN 53360 BTIT-407407 N40I NIA 33060 BHT-412-412 N4051..N 3301-5 BHT-412-412 N554AL 33017 IBfIT-412-412 N 7 78 AM 33033 BI IT-412-412 N412LG 33209 BI iT-412-412-SP N596AC 36009 B114-412-412-S1' N206C*M 49041 BUT-430-430 N209 3,1 49010 BH C-430-430 -_ -N427A NI 49092 BlI T`-430-430 N43011 49096 BHT-430-430 N430C1 49002 BIIT-430-430 N430UH 49056 BYIT-430-430 N556UH 49117 BIIT-430-430 N5 57BA 49120 BIIT-430-430 . 557UH 49119 i lfr-430-430 NI 17NY 7110 BK-117-r,3 i%F420MB 7077 BK-117-A3 N 117CW 7125 BK-1 I7-A4 N11s:N4' 7115 B-I17-A4 N 12 513C" 7065 BK-117-A4 N 137I 1TI 7107 5Y, 1 11 A4 N138I1H 70C£1 B-117-A4 N 1 S8I3Y; 7051 13k - 117-A4 Printhate: 130',5-3 CextifirateNo.: O14ILA2`3U Air ?.4etliods Cop.