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Item K4
V BOARD OF GOVERNORS FIRE AND AMBULANCE DISTRICT I AGENDA ITEM SUMMARY Meeting Date:November 20, 2013 Division: Emergency Services Bulk Item: Yes X No Department: Fire Rescue Staff Contact Person: Callahan/ Pfiester 289-6088 AGENDA ITEM WORDING: Approval of Resolution authorizing the write-off of a total of 683 Fire Rescue ground ambulance accounts receivable for CY 2008,totaling$325,166.82 from the Fire Rescue District I Fund Account 141-115002. This write-off was inadvertently executed by the Clerk of the Courts office; the item was pulled from the September 2012 agenda. ITEM BACKGROUND: Monroe County contracts with Advanced Data Processing Inc., (ADPI) for ground- ambulance billing. After 210 days of inactivity with ADPI, outstanding accounts are then placed with the collection agency, Municipal Services Bureau (MSB). Three years from the date of incident, Monroe County Finance Department administratively writes-off these debts after BOCC resolution. The attached Resolution authorizes the write-off of the balances of 683 accounts totaling$325,166.82, which primarily represents the one-year period from January 1,2008 through December 31, 2008 (see attached Exhibit A). These debts represent accounts which have been determined further collection efforts are fruitless. Insurance has paid the maximum allowable on these claims, and the service recipients are now either: deceased with no available funds in the estate; in bankruptcy; a minor with no guardian or patient found; uncollectible balances of Medicaid/Medicare; small exceptions balances; HMO balances; patient financially indigent(homeless); foreign address; unwarranted transports (transport did not meet the medical necessity criteria required by Medicaid); and/or refusals to pay. Even though this is written off for accounting purposes,the collection agency will continue to attempt collections on these accounts; if payments were to be received, revenue would be reinstated. PREVIOUS RELEVANT BOG ACTION: On August 20, 2008 Resolution No. 250-2008 authorized the write off of Fire Rescue ground ambulance accounts receivables in the total amount of$249,833.14. On September 16, 2009 Resolution No. 280-2009 authorized the write off of Fire Rescue ground ambulance account receivables in the total amount of$311,040.13. On August 18, 2010 Resolutions 248-2010 and 246-2010 authorized the write off of Fire Rescue ground ambulance accounts receivables in the total amount of$315,822.09. On September 21, 2011 Resolution 282a-2011 authorized the write off of Fire Rescue ground ambulance accounts receivables in the total amount of$284,953.95. CONTRACT/AGREEMENT CHANGES: N/A STAFF RECOMMENDATIONS: Approval. TOTAL COST: N/A INDIRECT COST: BUDGETED: Yes No DIFFERENTIAL OF LOCAL PREFERENCE: N/A COST TO COUNTY: N/'A SOURCE OF FUNDS: N/A REVENUE PRODUCING: Yes_ No_ AMOUNT 7PR MONTH Year _ g APPROVED BY: County Atty O� /Pur c �asin g Risk Management, .. DOCUMENTATION: Included X Not Required DISPOSITION: AGENDA ITEM# Emergency Services 11 "IN •! I N4' 6 • • WHEREAS, Monroe County Fire Rescue Services provides ground ambulance service; and WHEREAS, the Board of County Commissioners of Monroe County contracts with Advanced Data Processing, Inc. (ADPI) for Rescue Ambulance Billing and Related Professional Services; and WHEREAS, after 210 days of billing, accounts are placed with Municipal Services Bureau, a collection agency, to further attempt collection; and WHEREAS, once a period of 3 years from the date of the billable incident has elapsed, and all efforts of collecting the debt have been exhausted, Monroe County Finance Department directs the write -off of these debts; and WHEREAS, a report was provided by Municipal Services Bureau on accounts that met the above criteria, and were deemed uncollectible, for the time period of January 2008 through December 2008; and WHEREAS, a report was provided by Advanced Data Processing, Inc. on accounts that it was determined that further collection efforts are fruitless as insurance has paid the maximum allowable on these claims, and the service recipients are now either deceased with no available funds in the estate, in the estate, in bankruptcy, a minor with no guardian or patient found, have uncollectible balances of Medicaid /Medicare, and /or have small exceptions balances for the time period of January 2008 through December 2008. WHEREAS, it is desired that these uncollectible ground ambulance service accounts receivable be written off at this time; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1 OF MONROE COUNTY, FLORIDA: Receivables for ground ambulance service accounts listed on attached Exhibit A in the amount of $325,166.82 be deleted from the Fire Rescue District 1 Fund Account 141- 115002. PASSED AND ADOPTED by the Board of Governors, Fire and Ambulance District 1 of Monroe County,. Florida, at a regular meeting of said Board held on the 20` day of November, 2013. (SEAL) ATTEST: AMY HEAVIL, CLERK Deputy Clerk 1 11611VIJENOW9 • • • 0 Mayor / Chairperson Mayor of Monroe County, George Neugent Mayor of Layton, Norm Anderson Councilman Clark Snow Commissioner Danny Kolhage Commissioner David Rice Exhibit A Monroe County Fire Rescue CY 2008 Grouu6.�-- Original balance (or Balance when sent � Account # Date of Service to collections) Adjustments ents Final Balance These accounts are with MSB 800225-01 2/07/08 $ 518.00 $ $ $ 518.00 730009-01 7/03/08 $ 509.00 $ $ $ 509.00 790005-02 7/09/08 $ 518.00 $ $ $ 518.00 810005-03 8/31/08 $ 509.00 $ $ $ 509.00 800500-01 3/17/08 $ 518.00 $ $ $ 518.00 800513-01 3/22/08 $ 527.00 $ $ $ 527.00 680008-01 6/28/08 $ 509.00 $ $ $ 509.00 940004-01 9/04/08 $ 563.00 $ $ $ 563.00 60001-01 10/16/08 $ 672.00 $ $ $ 672.00 800236-01 2/06/08 $ 50.00 $ $ $ 50.00 800266-01 2/10/08 $ 618.00 $ $ $ 618.00 910005-02 9/01/08 $ 680.00 $ $ $ 680.00 950005-01 9/05/08 $ 518.00 $ $ $ 518.00 860001-01 8/26/08 $ 518.00 $ $ $ 518.00 800037-01 1106/08 $ 527.00 $ $ $ 527.00 820004-01 8/12/08 $ 671.00 $ $ $ 671.00 840004-01 8/14/08 $ 689.00 $ $ $ 689.00 780004-03 7/28/08 $ 590.00 $ $ $ 590.00 810387-01 12/20/08 $ 840.00 $ $ $ 840.00 960002-01 9/06/08 $ 626.00 $ $ $ 626.00 820009-01 8/02/08 $ 572.00 $ $ $ 572.00 800946-01 5/26/08 $ 518.00 $ $ $ 518.00 880615-01 11/17/08 $ 612.00 $ $ $ 612.00 880622-01 11/20/08 $ 612.00 $ $ $ 612.00 980005-01 9/18/08 $ 612.00 $ $ $ 612.00 840006-02 8/24/08 $ 599.00 $ $ $ 599.00 4-01 10/1 0/08 $ 612.00 $ $ $ 612.00 20001-01 10/02/08 $ 792.00 $ $ $ 792.00 800973-01 5/27/08 $ 716.40 $ $ $ 716.00 790002-01 7/09/08 536.00 $ $ $ 536.00 900005-02 9/30/08 $ 541.60 $ $ $ 541.60 840011-01 8/24/08 $ 527.00 $ $ $ 527.00 50003-02 10/25/08 $ 840.00 $ $ $ 840.00 820349-01 12/20/08 $ 624.00 $ $ $ 624.00 800553-01 3/25/08 $ 509.00 $ $ $ 509.00 800082-01 1/13/08 $ 635.00 $ $ $ 635.00 800452-01 3/12/08 $ 662.00 $ $ $ 662.00 800288-01 2/14/08 $ 716.00 $ $ $ 716.00 800488-01 3/09/08 $ 509.00 $ $ $ 509.00 830742-01 12/05/08 $ 816.00 $ $ - $ 816.00 30001-02 10/23/08 $ 624.00 $ $ $ 624.00 800762-01 4/25/08 $ 545.00 $ $ $ 545.00 800942-01 5/26/08 $ 662.00 $ $ $ 662.00 940003-02 9/14/08 $ 680.00 $ $ $ 680.00 880672-01 12/25/08 $ 624.00 $ $ $ 624.00 610003-03 6/21/08 $ 509.00 $ $ $ 509.00 800910-01 5/23/08 $ 518.00 $ $ $ 518.00 800404-01 3/03/08 $ 509.00 $ $ $ 509.00 730003-04 7/23/08 $ 509.00 $ $ $ 509.00 910003-02 9/01/08 $ 609.00 $ $ $ 609.00 800662-01 4/11/08 $ 518.00 $ $ $ 518.00 800699-01 4/14/08 $ 662.00 $ $ $ 662.00 600002-01 6/30/08 $ 509.00 $ $ $ 509.00 830764-01 12/14/08 $ 828.00 $ $ 828.00 720001-02 7/02/08 $ 518.00 $ $ $ 518.00 740004-01 7/24/08 $ 509.00 $ $ $ 509.00 800342-01 2/23/08 $ 680.00 $ $ $ 680.00 800224-01 2/09/08 $ 626.00 $ $ $ 626.00 800562-01 3/26/08 $ 509.00 $ $ $ 509.00 700001-01 7/1 $ 509.00 $ $ $ 509.00 880679-01 12/30/08 $- 612.00 $ $ $ 612.00 800241-01 2/08/08 $ 509.00 $ $ $ 509.00 800673-01 4/12/08 $ 509.00 $ $ $ 509.00 880652-01 12/11/08 $ 696.00 $ $ $ 696.00 750004-01 7/05/08 $ 644.00 $ $ $ 644.00 690008-01 6/29/08 $ 653.00 $ $ $ 653.00 810379-01 12/16/08 $ 840.00 $ $ $ 840.00 800698-01 4/16/08 $ 563.00 $ $ $ 563.00 800816-01 5/03/08 $ 698.00 $ $ $ 698.00 730001-01 7/13/08 $ 545.00 $ $ $ 545.00 880680-01 12/31/08 $ 612.00 $ $ $ 612.00 800268-01 2/11/08 $ 509.00 $ $ $ 509.00 800504-01 3/20/08 $ 509.00 $ $ $ 509.00 990001-01 9/09/08 $ 509.00 $ $ $ 509.00 800609-01 4/01/08 $ 509.00 $ $ $ 509.00 801019-01 6/02/08 $ 509.00 $ $ $ 509.00 801029-01 6/05/08 $ 509.00 $ $ $ 509.00 800029-01 1/07/08 $ 509.00 $ $ $ 509.00 830760-01 12/12/08 $ 636.00 $ $ $ 636.00 690009-01 6/29/08 $ 653.00 $ $ $ 653.00 880625-01 , 11/21/08 $ 660.00 $ $ $ 660.00 Exhibit A: Page 2 of 17 Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 800730-01 4/21/08 $ 554.00 $ $ $ 554.00 50004-01 10/25/08 $ 612.00 $ $ $ 612.00 800810-01 5/03/08 $ 671.00 $ $ $ 671.00 10002-01 10/11/08 $ 612.00 $ $ $ 612.00 700002-01 7/20/08 $ 509.00 $ $ $ 509.00 880652-02 12/11/08 $ 696.00 $ $ $ 696.00 800836-01 5/08/08 $ 518.00 $ $ $ 518.00 880652-03 12/11/08 $ 696.00 $ $ $ 696.00 70003-01 10/07/08 $ 816.00 $ $ $ 816.00 750006-01 7/05/08 $ 626.00 $ $ $ 626.00 880653-01 12/12108 $- 624.00 $ $ $ 624.00 800413-01 3/03/06 $ 635.00 $ $ $ 635.00 801009-01 6/01/08 $ 743.00 $ $ $ 743.00 820008-01 8/02/08 $ 680.00 $ $ $ 680.00 830708-01 11/13/08 $ 960.00 $ $ $ 960.00 830730-01 11/27/08 $ 840.00 $ $ $ 840.00 900006-01 9/30/08 $ 708.00 $ $ $ 708.00 880624-01 11/21/08 $ 648.00 $ $ $ 646.00 800127-01 1/22/08 $ 518.00 $ $ $ 518.00 10003-02 10/21/08 $ 744.00 $ $ $ 744.00 770001-02 7/17/08 $ 762.00 $ $ 762.00 870297-01 12/31/08 $ 744.00 $ $ $ 744.00 880675-03 12/26/08 $ 624.00 $ $ $ 624.00 890350-01 12/26/08 $ 612.00 $ $ $ 612.00 800480-01 3/10/08 $ 509.00 $ $ $ 509.00 800920-01 5/24/08 $ 518.00 $ $ $ 518.00 870291-01 12/24/08 $ 648.00 $ $ $ 648.00 800044-01 1/09/08 $ 509.00 $ $ $ 509.00 801057-01 6/09/08 $ 518.00 $ $ $ 518.00 890339-01 12/17/08 $ 720.00 $ $ $ 720.00 880675-02 12/26/08 $ - $ $ $ - 800779-01 4/26/08 $ 860.00 $ $ $ 860.00 800497-01 3/16/08 $ 509.00 $ $ $ 509.00 830002-01 8/03/08 $ 680.00 $ $ $ 680.00 800830-01 5/06/08 $ 509.00 $ $ $ 509.00 830006-01 8/03/08 $ 509.00 $ $ $ 509.00 830792-01 12/30/08 $ 764.00 $ $ $ 764.00 801087-01 6/14/08 $ 635.00 $ $ $ 635.00 800811-01 5/03/08 $ 509.00 $ $ $ 509.00 801084-01 6/13/08 $ 509.00 $ $ $ 509.00 801097-01 6/15/08 $ 518.00 $ $ $ 518.00 800849-01 5/11/08 $ 518.00 $ $ $ 518.00 790001-01 , 7/19/08 $ 509.00 $ $ $ 509.00 Exhibit A: Page 3 of 17 Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 880632-01 11/30/06 $ 612.00 $ $ $ 612.00 50002-01 10/05/08 $ 612.00 $ $ $ 612.00 800344-01 2/22/08 $ 671.00 $ $ $ 671.00 800338 -01 2/22/08 $ 509.00 $ $ $ 509.00 800234-01 2/05/08 $ 536.00 $ $ $ 536.00 800043-01 1/05/08 $ 554.00 $ $ $ 554.00 870003-01 8/07/08 $ 635.00 $ $ $ 635.00 880671-01 12/23/08 $ 612.00 $ $ $ 612.00 800564-01 3/27/08 $ 626.00 $ $ $ 626.00 800038-01 1/08/08 $ 518.00 $ $ $ 518.00 800825-01 5/05/08 $ 518.00 $ $ $ 518.00 801003-01 5/31/08 $ 518.00 $ $ $ 518.00 800796-01 4/27/08 $ 518.00 $ $ $ 518.00 10004-01 10/11/08 $ 744.00 $ $ $ 744.00 770003-01 7/07/08 $ 509.00 $ $ $ 509.00 650001-01 6/25108 $ 698.00 $ $ $ 698.00 770006-02 7/17/08 $ 707.00 $ $ $ 707.00 780005-01 7/18/08 $ 554.00 $ $ $ 554.00 800339-01 2/22/08 $ 509.00 $ $ $ 509.00 800121-01 1/22/08 $ 671.00 $ $ $ 671.00 720006-02 7/22/08 $ 626.00 $ $ $ 626.00 800142-01 1/25/08 $ 554.00 $ $ $ 554.00 800947-01 5/27/08 $ 554.00 $ $ $ 554.00 800558-01 3/22/08 $ 671.00 $ $ $ 671.00 800758-01 4/25/08 $ 599.00 $ $ $ 599.00 800179-01 1/31/08 $ 518.00 $ $ $ 518.00 800605-01 4/04/08 $ 545.00 $ $ $ 545.00 800905-01 5/22/08 $ 518.00 $ $ $ 518.00 860008-01 8/16/08 $ 545.00 $ $ $ 545.00 800386-01 2/17/08 $ 545.00 $ $ $ 545.00 800479-01 3/09/08 $ 509.00 $ $ $ 509.00 870280-01 12/1 $ 744.00 $ $ $ 744.00 810002-01 8/11/08 $ 770.00 $ $ $ 770.00 800134-01 1/23/08 $ 509.00 $ $ $ 509.00 800135-01 1/24/08 $ 518.00 $ $ $ 518.00 800136-01 1/25/08 $ 527.00 $ $ $ 527.00 800137-01 1/27/08 $ 545.00 $ $ $ 545.00 750008-01 7/05/08 $ 644.00 $ $ $ 644.00 800104-01 1/18/08 $ 707.00 $ $ $ 707.00 800362-01 2/26/08 $ 716.00 $ $ $ 716.00 800309-01 2/19/08 $ 509.00 $ $ $ 509.00 800414-01 3/01/08 $ 509.00 $ $ $ 509.00 800482-01 , 3/10/ Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 800274-01 2/11/08 $ 671.00 $ $ $ 671.00 900005-01 9/20/08 $ 660.00 $ $ $ 660.00 750001-01 7/05/08 $ 572.00 $ $ $ 572.00 890315-01 11/09/08 $ 660.00 $ $ $ 660.00 910002-01 9/01/08 $ 545.00 $ $ $ 545.00 760006-01 7/06/08 $ 509.00 $ $ $ 509.00 630001-01 6/23/08 $ 518.00 $ $ $ 518.00 710002-03 7/01/08 $ 518.00 $ $ $ 518.00 720007-02 7/12/08 $ 518.00 $ $ $ 518.00 1-01 10/10/08 $ 804.00 $ $ $ 804.00 800337-01 2/23/08 $ 95.40 $ $ $ 95.40 800399-01 2/27/08 $ 653.00 $ $ $ 653.00 830741-01 12/05/08 $ 828.00 $ $ $ 828.00 800042-01 1/05/08 $ 236.00 $ $ $ 236.00 800919-01 5/23/08 $ 518.00 $ $ $ 518.00 800784-01 4/29/08 $ 245.00 $ $ $ 245.00 800714-01 4/19/08 $ 518.00 $ $ $ 518.00 80001-01 10/08/08 $ 696.00 $ $ $ 696.00 800263-01 2/09/08 $ 725.00 $ $ $ 725.00 990006-01 9/09/08 $ 37.85 $ $ $ 37.85 800496-01 3/16/08 $ 671.00 $ $ $ 671.00 810001-03 8/31/08 $ 518.00 $ $ $ 51 8.00 910007-03 9/21/08 $ 660.00 $ $ $ 660.00 801039-01 6/07/08 $ 509.00 $ $ $ 509.00 940002-02 9/14/08 $ 626.00 $ $ $ 626.00 800568-01 3/26/08 $ 509.00 $ $ $ 509.00 800926-01 5/25/08 $ 509.00 $ $ $ 509.00 800495-01 3/15/08 $ 509.00 $ $ $ 509.00 830690-01 11/03/08 $ 756.00 $ $ $ 756.00 700004-01 7/20/08 $ 509.00 $ $ $ 509.00 801047-01 6/09/08 $ 518.00 $ $ $ 518.00 840006-01 B/14/08 $ 545.00 $ $ $ 545.00 850004-01 8/05/08 $ 518.00 $ $ $ 518.00 680013-01 6/28/08 $ 689.00 $ $ $ 689.00 880623-01 11/21/08 $ 612.00 $ $ $ 612.00 620312-01 10/29/08 $ 50.00 $ $ $ 50.00 30002-02 10/13/08 $ 672.00 $ $ $ 672.00 80002-02 10/18/08 $ 816.00 $ $ $ 816.00 40004-01 10/04/08 $ 840.00 $ $ $ 840.00 800602-01 3/30/08 $ 563.00 $ $ $ 563.00 870272-01 11/26/08 $ 720.00 $ $ $ 720.00 800593-01 3/30/08 $ 671.00 $ $ $ 671.00 870250-01 10/28/08 $ 624.00 $ $ $ 624.00 IN mjgs�. •� Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 600018-01 1/05/08 $ 618.00 $ $ $ 618.00 800615-01 4/04/08 $ 509.00 $ $ $ 509.00 600270-01 2/10/08 $ 635.00 $ $ $ 635.00 800484-01 3/09/08 $ 680.00 $ $ $ 680.00 800283-01 2/16/08 $ 689.00 $ $ $ 689.00 830716-01 11/17/08 $ 816.00 $ $ $ 816.00 40001-01 10/14/08 $ 599.00 $ $ $ 599.00 801015-01 6/02/08 $ 545.00 $ $ $ 545.00 800476-01 3/08/08 $ - $ $ $ - 800856-01 5/13/08 $ 545.00 $ $ $ 545.00 930002-01 9/03/08 $ 680.00 $ $ $ 680.00 800941-01 5/25/08 $ 689.00 $ $ $ 689.00 750009-01 7/05/08 $ 554.00 $ $ $ 554.00 20002-01 10/02108 $ 804.00 $ $ $ 804.00 710003-02 7121/08 $ 509.00 $ $ $ 509.00 840001-01 8/04/08 $ - $ $ $ - 810354-01 11/26/08 $ 612.00 $ $ $ 612.00 800607-01 4/05/08 $ 518.00 $ $ $ 518.00 830787-01 12/28/08 $ 117.75 $ $ $ 117.75 850003-02 8/15/08 $ 590.00 $ $ $ 590.00 60003-01 10/26/08 $ 636.00 $ $ $ 636.00 800464-01 3/15/08 $ 617.00 $ $ $ 617.00 800535-01 3/22/08 $ 375.00 $ $ $ 375.00 770005-01 7/17/08 $ 443.00 $ $ $ 443.00 790004-01 7/09/08 $ 518.00 $ $ $ 518.00 801091-01 6/15/OB $ 518.00 $ $ $ 518.00 880590-01 11/01/08 $ - $ $ $ - 800611-01 4/04/08 $ 779.00 $ $ $ 779.00 970001-01 9/27/08 $ 612.00 $ $ $ 612.00 800006-01 1/02/08 $ 644.00 $ $ $ 644.00 800240-01 2105/08 $ 509.00 $ $ $ 509.00 800320-01 2119/08 $ 30.00 $ $ $ 30.00 830701-01 11/09/08 $ 352.80 $ $ $ 352.60 800911-01 5/20/08 $ 580.00 $ $ $ 580.00 680005-01 6/18/08 $ 698.00 $ $ $ 698.00 690001-02 6/29/08 $ 527.00 $ $ $ 527.00 690014-01 6/29/08 $ 662.00 $ $ $ 662.00 740002-02 7/04/08 $ 518.00 $ $ $ 518.00 830731-01 11/28/08 $ 900.00 $ $ $ 900.00 90001-03 10/19/08 $ 229.00 $ $ $ 229.00 800776-01 4/22/08 $ 635.00 $ $ $ 635.00 800511-01 3/21/08 $ 671.00 $ $ $ 671.00 800077-01 1/12/08 $ 518.00 $ $ $ 518.00 Exhibit A: Page 6 of 17 Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 40011-01 10/24/08 $ 636.00 $ $ $ 636.00 800255-01 2110/08 $ - $ $ $ - 760004-01 7/26/08 $ 644.00 $ $ $ 644.00 800101-01 1/16/08 $ 671.00 $ $ $ 671.00 800257-01 2/10/08 $ 734.00 $ $ $ 734.00 800587-01 3/29/08 $ 662.00 $ $ $ 662.00 800858-01 5/14/08 $ 91.80 $ $ $ 91.80 800746-01 4/23/08 $ 671.00 $ $ $ 671.00 800481-01 3/09/08 $ 509.00 $ $ $ 509.00 820325-01 11/24/08 $ 648.00 $ $ $ 648.00 70003-02 10/17/08 $ 624.00 $ $ $ 624.00 770003-02 7/17/08 $ 518.00 $ $ $ 518.00 800455-01 3/13/08 $ 545.00 $ $ $ 545.00 890005-01 8/19/08 $ 282.00 $ $ $ 282.00 800210-01 2/04/08 $ 509.00 $ $ $ 509.00 800720-01 4/19/ $ 608.00 $ $ $ 608.00 800192-01 2/03/08 $ - $ $ $ - 801151 -01 6/20/08 $ 133.24 $ $ $ 133.24 870296-01 12/28/08 $ 840.00 $ $ $ 840.00 810397-01 12/28/08 $ 780.00 $ $ $ 780.00 710004-01 7/11/08 $ 104.78 $ $ $ 104.78 890314-01 11/07/08 $ - $ $ $ - 980006-01 9/18/08 $ 744.00 $ $ $ 744.00 800669-01 4/12/08 $ 509.00 $ $ $ 509.00 800125-01 1/21/08 $ 518.00 $ $ $ 518.00 830778-01 12/24/08 $ 864.00 $ $ $ 864.00 800317-01 2/18/08 $ 707.00 $ $ $ 707.00 830752-01 12/09/08 $ 816.00 $ $ $ 816.00 60006-01 10/26/08 $ 732.00 $ $ $ 732.00 800178-01 1/30/08 $ 671.00 $ $ $ 671.00 800592-01 3/30/08 $ 318.00 $ $ $ 318.00 860004-01 8/06/08 $ 509.00 $ $ $ 509.00 720005-01 7/12/08 $ 527.00 $ $ $ 527.00 800096-01 1/16/08 $ 662.00 $ $ $ 662.00 800567-01 3/24/08 -$ 518.00 $ $ $ 518.00 630002-01 6/23/08 $ 635.00 $ $ $ 635.00 810004-01 8/01/08 $ 527.00 $ $ $ 527.00 820005-01 8/02/08 $ 518.00 $ $ $ 518.00 980009-01 9/18/08 $ - $ $ $ - 00962 -01 5/29/08 $ 554.00 $ $ $ 554.00 800366-01 2/27/08 $ 536.00 $ $ $ 536.00 800198-01 2/02/08 $ 518.00 $ $ $ 518.00 810384-01 12/19/08 $ 840.00 $ $ $ 840.00 Exhibit A: Page 7 of 17 Exhibit A Monroe County Fire Rescu- 1 1 ouTd &nbulaTQL-,AQQQUTt YL-ceivables for %Vrh' 800677-01 4/09/06 $ 734.00 $ $ $ 734.00 800181-01 1/31/08 $ 545.00 $ $ $ 545.00 800004-03 8/20/08 $ 51 B.00 $ $ $ 518.00 800400-01 2/27/08 $ 370.60 $ $ $ 370.60 800420-01 3/04/08 $ 662.00 $ $ $ 662.00 800748-01 4/24/08 $ 403.70 $ $ $ 403.70 800788-01 4/29/08 $ 698.00 $ $ $ 698.00 690007-01 6/29/08 $ 80.81 $ $ $ 80.81 790006-02 7/29/08 $ 581.00 $ $ $ 581.00 800032-01 1/08/08 $ 662.00 $ $ (662.00) $ - 00648 -01 4/09/08 $ 761.00 $ $ $ 761.00 930001-02 9/13/08 $ 509.00 $ $ $ 509.00 800831 -01 5/07/08 $ 617.00 $ $ $ 617.00 800052-01 1/10/08 $ 509.00 $ $ $ 509.00 800013-01 1/03/08 $ 653.00 $ $ $ 653.00 830003-01 8/03/08 $ 716.00 $ $ $ 716.00 800075-01 1/12/08 $ 599.00 $ $ $ 599.00 800526-01 3/22/08 $ 590.00 $ $ $ 590.00 800712-01 4/19/08 $ 599.00 $ $ $ 599.00 800538-01 3/23/08 $ 617.00 $ $ $ 617.00 80004-02 10/1 $ 864.00 $ $ $ 864.00 800936-01 5/26/08 $ 527.00 $ $ $ 527.00 800975-01 5/29/08 $ 671.00 $ $ $ 671.00 880597-01 11/06/08 $ 612.00 $ $ $ 612.00 880600-02 11/07/08 $ 82.85 $ $ $ 82.85 800162-01 1/29/08 $ 671.00 $ $ $ 671.00 830005-01 8/03/08 $ 47.85 $ $ $ 47.85 800459-01 3/14/08 $ 662.00 $ $ $ 662.00 800216-01 2/06/08 $ 680.00 $ $ $ 680.00 710002-02 7/21/08 $ 509.00 $ $ $ 509.00 740003-03 7/24/08 $ 671.00 $ $ $ 671.00 890002-03 8/29/08 $ 518.00 $ $ $ 518.00 800665-01 4/11/08 $ - $ $ $ - 60002-01 10/06/08 $ 888.00 $ $ $ 888.00 860005-01 8/06/08 $ 75.93 $ $ $ 75.93 900009-01 9/30/08 $ 840.00 $ $ $ 840.00 800099-01 1/16/08 $ 680.00 $ $ $ 680.00 800081-01 1/13/08 $ 275.08 $ $ $ 275.08 880617-01 11/18/08 $ 612.00 $ $ $ 612.00 800425-01 3/05/08 $ 563.00 $ $ $ 563.00 830681-01 10/27/08 $ 816.00 $ $ $ 816.00 830703-01 11/12/08 $ 828.00 $ $ $ 828.00 830748-01 , 12/06/08 $ 840.00 $ $ $ 840.00 Exhibit A: Page 8 of 17 Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 800704-01 4/18/08 $ 725.00 $ $ $ 725.00 870002-02 8/26/08 $ 424.00 $ $ $ 424.00 870001-02 8/27/08 $ 518.00 $ $ $ 518.00 800392-01 2/13/08 $ 653.00 $ $ $ 653.00 800747-01 4/23/08 $ 662.00 $ $ $ 662.00 940001-01 9/04/08 $ 509.00 $ $ $ 509.00 800120-01 1/20/08 $ 653.00 $ $ $ 653.00 800258-01 2/10/08 $ 959.00 $ $ $ 959.00 801069-01 6/11/08 $ 545.00 $ $ $ 545.00 950001-02 9/25/08 $ 612.00 $ $ $ 612.00 800182-01 1/31/08 $ 662.00 $ $ $ 662.00 880607-01 11/12/08 $ 624.00 $ $ $ 624.00 830768-01 12/17/08 $ 912.00 $ $ $ 912.00 830753-01 12/09/08 $ 840.00 $ $ $ 840.00 800157-01 1/27/08 $ 743.00 $ $ $ 743.00 800972-01 5/27/08 $ 671.00 $ $ $ 671.00 90004-02 10/09/08 $ 636.00 $ $ $ 636.00 800424-01 3/04/08 $ 509.00 $ $ $ 509.00 801055-01 6/09/08 $ 509.00 $ $ $ 509.00 800928-01 5/25/08 $ 509.00 $ $ $ 509.00 890338-01 12/16/08 $ - $ $ $ - 900001 -01 9/10/08 $ 527.00 $ $ $ 527.00 800870-01 5/12/08 $ 518.00 $ $ $ 518.00 940001-02 9/14/08 $ 509.00 $ $ $ 509.00 810002-03 8/31/08 $ 203.07 $ $ $ 203.07 730002-02 7/03/08 $ 426.00 $ $ $ 426.00 820343-01 12/13/08 $ 400.00 $ $ $ 400.00 800679-01 4/12/08 $ 644.00 $ $ $ 644.00 920003-01 9/02/08 $ 680.00 $ $ $ 680.00 880633-01 11/30/08 $ 612.00 $ $ $ 612.00 910003-03 9/11/08 $ 509.00 $ $ $ 509.00 880661-01 12/18/08 $ 672.00 $ $ $ 672.00 800555-01 3/26/08 $ 43.08 $ $ $ 43.08 800211-01 2/04/08 $ 608.00 $ $ $ 608.00 840005-01 8/04/08 $ 199.70 $ $ $ 199.70 820322-01 11/18/08 $ 95.40 $ $ $ 95.40 800105-01 1/19/08 $ 689.00 $ $ $ 689.00 760008-01 7/06/08 $ 86.78 $ $ $ 86.78 930003-02 9/13/08 $ 545.00 $ $ $ 545.00 880619-01 11/18/08 $ 612.00 $ $ $ 612.00 990005-02 9/19/08 $ 612.00 $ $ $ 612.00 760002-02 7/26/08 $ 509.00 $ $ $ 509.00 880004-01 , 8/28/078777� $ 671.00 $ $ Exhibit A: Page 9 of 17 Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Ofi 890328-01 11/29/08 $ 696.00 $ $ $ 696.00 800552-01 3/25/08 $ 509.00 $ $ $ 509.00 800759-01 4/25/08 $ 509.00 $ $ $ 509.00 800551-01 3/24/08 $ 518.00 $ $ $ 518.00 800575-01 3/28/08 $ 689.00 $ $ $ 689.00 800807-01 5/01/08 $ 509.00 $ $ $ 509.00 801042-01 6/08/08 $ 509.00 $ $ $ 509.00 660002-01 6/26/08 $ 509.00 $ $ $ 509.00 800520-01 3/15/08 $ 536.00 $ $ $ 536.00 801065-01 6/10/08 $ 662.00 $ $ $ 662.00 800594-01 3/31/08 $ - $ $ $ - B00519 -01 3/21/08 $ 509.00 $ $ $ 509.00 800771-01 4/26/08 $ 545.00 $ $ $ 545.00 800805-01 5/01/08 $ 572.00 $ $ $ 572.00 800595-01 3/31/08 $- 698.00 $ $ $ 698.00 820345-01 12/17/08 $ 266.13 $ $ $ 266.13 850004-02 8/15/08 $- 680.00 $ $ $ 680.00 830755-01 12/10/08 $ 116.43 $ $ $ 116.43 810334-01 10/29/08 $ 130.00 $ $ $ 130.00 810352-01 11/23/08 $ 416.00 $ $ $ 416.00 830743-01 12/05/08 $ 500.00 $ $ $ 500.00 880585-01 10/31/08 $ 322.40 $ $ 322.40 800785-01 4/29/08 $ 617.00 $ $ 617.00 800786-01 4/29/08 $ 166.00 $ $ $ 166.00 801041-01 6/07/08 $ 789.00 $ $ $ 789.00 800005-03 8/20/08 $ 698.00 $ $ 698.00 800943-01 5/26/08 $ 509.00 $ $ 509.00 770003-03 7/27/08 $ 509.00 $ $ $ 509.00 800932-01 5/25/08 $ 509.00 $ $ $ 509.00 690013-01 6/29/08 $ 644.00 $ $ 644.00 801033-01 6/06/08 $ 509.00 $ $ 509.00 830793-01 12/30/08 $ 744.00 $ $ $ 744.00 870295-01 12/27/08 $ 68.37 $ $ $ 68.37 810378-02 12/16/08 $ 133.60 $ $ (133.60) $ - 730006-01 7/03/08 $ 458.00 $ $ - $ 458.00 890006-02 8/29/08 $ - $ $ $ - 800002 -01 8/10/08 $ 207.50 $ $ $ 207.50 880620-01 11/19/08 $ 202.00 $ $ $ 202.00 850008-01 8/25/08 $ 99.62 $ $ $ 99.62 880675-01 12/26/08 $ 74.80 $ $ $ 74.80 990001-03 9/29/08 $ 840.00 $ $ $ 840.00 870258-01 11/08/08 $ - $ $ $ - 720005-02 , 7/22/08 $ 572.00 $ $ $ 572.22___j Exhibit A: Page 10 of 17 Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 940002-01 9/04/08 $ 509.00 $ $ $ 509.00 950003-01 9/05/08 $ 509.00 $ $ $ 509.00 840007-01 8/24/08 $ 42.20 $ $ $ 42.20 900001-03 9/30/08 $ 465.24 $ $ $ 465.24 830771-01 12/19/08 $ 357.15 $ -+$ $ (150.00) 207.15 MSB TOTALS $237,289.51 $ (945.60) $ - 236,343.91 Original balance (or Balance when sent Account # Date of Service to collections) Aments Payments Final Balance These accounts are with ADPI 80000501 1/1/2008 $ 545.00 $ - $ - $ 545.00 80000301 1/2/2008 $ 617.00 $ 145.92 $ 368.67 $ 102.41 80000701 1/212008 $ 554.00 $ 198.26 $ 276.41 $ 77.33 80003001 1/7/2008 $ 527.00 $ 170.14 $ 256.86 $ 100.00 80003301 IM2008 $ 680.00 $ $ 475.12 $ 207.37 2 .49 80007401 1/11/2008 $ 590.00 $ - $ 442.50 $ 147.50 80007801 1/12/2008 $ 716.00 $ 112.31 $ 482.95 $ 120.74 80008401 1/13/2008 $ 680.00 $ - $ 544.00 $ 136.00 80008601 1/14/2008 $ 527.00 $ - $ 107.84 $ 419.16 80005701 1/17/2008 $ 770.00 $ 127.79 $ 513.77 $ 128.44 80010201 1/17/2008 $ 707.00 $ 178.90 $ 453.10 $ 75.00 80010301 1/18/2008 $ 509.00 $ 104.96 $ 323.23 $ 80.131 80015101 1/19/2008 $ 653.00 $ 104.96 $ 438.43 $ 109.61 80012801 1/23/2008 $ 671.00 $ - $ - $ 671.00 80014001 1/23/2008 $ 509.00 $ $ $ 509.00 80014101 1/24/2008 $ 518.00 $ $ $ 518.00 80015901 1/24/2008 $ 518.00 $ $ $ 518.00 80015501 1/28/2008 $ 905.00 $ $ $ 905.00 80017301 1/30/2008 $ 671.00 $ 167.33 $ 402.94 $ 100.73 80019301 2/2/2008 $ 716.00 $ 343.60 $ 352.40 $ 20.00 80019701 2/2/2008 $ 518.00 $ $ 414.40 $ 103.60 80020201 2/2/2008 $ 581.00 $ $ - $ 581.00 80023201 2/5/2008 $ 536.00 $ 104.96 $ 344.83 $ 86.21 80023701 2/6/2008 $ 635.00 $ - $ $ 635.00 80021301 2/7/2008 $ 509.00 $ - $ - $ 509.00 80023101 217/2008 $ 509.00 $ 104.96 $ 323.23 $ 80.81 80022601 2/8/2008 $ 536.00 $ - $ 120.40 $ 415.60 Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off WIM ........... Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 80090901 5/24/2008 �-Igw*�:: 6/10/2008 tpcyggoi-� : 6/28/2008 6/211/2010 W V�11111-1= 7/21/2 M w1w11 7/25/2008 W. Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off �-IJWPASIII- IIIIIIXIJM I 8/17/2008 ------------------------------- sit I I SEEM WJPIIPTM i • IN oil 9/24/2008 9/27/2008 of Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off - 0 101148�,- ., i� 10/18/2008 10/20/2008 MIIIIIII=; - 10/21/2008 10/23/2008 10/24/2008 10/24/2008 11/23/ 2008 - 0 101148�,- ., i� Exhibit A Monroe County Fire Rescue CY 2008 Ground Ambulance Account Receivables for Write Off 88065602 12/19/2008 $ 660.00 $ $ - $ 660.00 83077201 12/20/2008 $ 924.00 $ $ 788.84 $ 135.16 82035101 12/21/2008 $ 612.00 $ $ - $ 612.00 82035201 12/21/2008 $ 612.00 $ $ - $ 612.00 87028801 12/21/2008 $ 720.00 $ 254.40 $ 364.38 $ 101.22 89034601 12/21/2008 $ 684.00 $ $ 634.00 $ 50.00 83077701 12/22/2008 $ 852.00 $ - $ - $ 852.00 81039101 12/24/2008 $ 852.00 $ 250.03 $ 556.58 $ 45.39 83078301 12/26/2008 $ 840.00 $ - $ 175.00 $ 665.00 83078401 12/26/2008 $ 828.00 $ 475.60 $ 332.40 $ 20.00 88067301 12/26/2008 $ 624.00 $ - $ - $ 624.00 ADPI TOTALS $160,783.00 $15,161.15 $56,798.94 $ 88,822.91 GRAND TOTALS $55,853 Exhibit A: Page 17 of 17