Item O1 County of Monroe ortya BOARD OF COUNTY COMMISSIONERS
Mayor Sylvia Murphy,District 5
The Florida Keys J Mayor Pro Tem Danny Kolhage,District 1
,iii,t,' Michelle Coldiron,District 2
` Heather Carruthers,District 3
David Rice,District 4
County Commission Meeting
March 21, 2019
Agenda Item Number: 01
Agenda Item Summary #5178
REVISED BACKUP DAY OF MEETING: Added attachments:
c) letter from City Marathon d) letter from Jack Bridges, P.A.
BULK ITEM: No DEPARTMENT: Emergency Services
TIME APPROXIMATE: STAFF CONTACT: James Callahan (305) 289-6088
3:00 P.M. PUBLIC HEARING
AGENDA ITEM WORDING: A public hearing to consider an application for issuance of a Class
A Certificate of Public Convenience and Necessity (COPCN) to Falck Southeast II Corporation
d/b/a American Ambulance Service for the operation of an ALS Transport Service in Monroe
County, Florida for the period 3/21/19 through 3/20/21 for responding to requests for inter-facility
transports.
ITEM BACKGROUND: The previous COPCN issued to Falck Southeast II Corporation d/b/a
American Ambulance Service expired on September 21, 2018. A renewal application was received
by MCFR on December 10, 2018. Due to the time lapse that occurred,the County Attorney's office
advised that the applicant must submit for a new certificate instead of a renewal. Monroe County
Code Sections 11-171 et seq., requires the BOCC to hold a public hearing to consider the application
for a new certificate. At the hearing, the Board may receive a report from the County Administrator
or his designee,testimony from the applicant or any other interested party;and other relevant
information. The Board will consider the public's convenience and necessity for the proposed
service and whether the applicant has the ability to provide the necessary service(s). The Board shall
then authorize the issuance of the certificate with such conditions as are in the public's interest or
deny the application, setting forth the reason(s) for denial.
PREVIOUS RELEVANT BOCC ACTION: On September 21, 2016, Item C.28, BOCC granted
approval for issuance (renewal) of a Class A Certificate of Public Convenience and Necessity
(COPCN)to Falck Southeast II Corporation d/b/a American Ambulance Service for the operation of
an ALS transport ambulance service beginning 9/22/16 and ending 9/21/18. On January 23, 2019,
item C.7, the Board granted approval to advertise for a Public Hearing to be held on February 20,
2019,to consider the new application of Falck Southeast II Corporation d/b/a American Ambulance
Service. On February 20, 2019, item R.9 was continued to March 21, 2019.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION:
DOCUMENTATION:
Class A COPCN Falck 3/21/19 - 3/20/21
Application Falck
Letter from City of Marathon dated 3 19 2019 re 01 and 02 PH COPCNs
2019.02.19 Letter to Commissioner Rice from Jack Bridges, P.A.
FINANCIAL IMPACT:
Effective Date: 2/21/19
Expiration Date: 2/20/21
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: No If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
N/A
REVIEWED BY:
Pedro Mercado Completed 02/01/2019 11:44 AM
James Callahan Completed 02/01/2019 11:47 AM
Kathy Peters Completed 02/04/2019 10:54 AM
Board of County Commissioners Completed 02/20/2019 9:00 AM
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t, EMERGENCY MEDICAL SERVICES °
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CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY ¢~
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WHEREAS, the Monroe County Code allows for t_ t_llti: 11> S-- _
he issuance of Certificates of Public Convenience and
+,.' Necessity for Emergency Medical Services by the Board of County Commissioners of Monroe County; .,Ie�
and,
. ,► WHEREAS, the Falck Southeast If DBA American Ambulance Service provides quality emergency ".
"' medical services to the citizens of Monroe County; and, °'•'
l_ WHEREAS, there has been demonstrated that there is a need for the above named service to operate
c in this Countytoprovide essential emergency medical services to the citizens ofthis County; and, �'
9
WHEREAS, the above named service has indicated that it will comply with all the requirements of the
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Monroe County Code and Chapter 401 Florida Statutes, the Board of County Commissioners of
Monroe County hereby issues a Certificate of Public Convenience and Necessity to this service for the
period beginning March 21, 2019 and ending March 20, 2021. ''�'
.f. CeIn issuing this certificate it is understood that the above named service will meet the requirements of a =�
❑BLS or ®ALS, ®Transport or❑Non-transport service, and provide service on a twenty-four hour /='
rsd,,,..(
4(1 basis for the following area(s):
,( +or Monroe County ,
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Certificate #: 19-02
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,,IMarch 21,2019
1°tt DATE OF ISSUANCE ✓v.f
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CLERK CHAIRMAN, BOARD OF COUNTY COMMISSIONERS ' (fie`
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MONROE COUNTY, FLORIDA RECEIVED
APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY(COPCN)
CLASS A EMERGENCY MEDICAL SERVICE
IKE 1 $ 2018
(PRINT OR TYPE)
Monroe County Fire Rescue
❑ INITIAL APPLICATION-$50.00 0 RENEWAL APPLICA"�$v'r D '
IF RENEWAL,PLEASE LIST NUMBER OF PREVIOUS CERTIFICATE:# Faick Southeast II, Corp.
I. NAME OF SERVICE Faick Southeast II, Corp. d/b/a American Ambualnce Service
BUSINESS MAILING ADDRESS 6605 NW 74th Ave Miami, FL 33166
BUSINESS PHONE NUMBER 305-304-2444 EMERGENCY PHONE NUMBER 305-925-2000
2. TYPE OF OWNERSHIP(i.e.,Sole Proprietor,Partnership,Corporation,etc.) Corporation
DATE OF INCORPORATION OR FORMATION OF THE BUSINESS ASSOCIATION 02/28/2012
3. LIST ALL OFFICERS,DIRECTORS,AND SHAREHOLDERS(Use separate sheet if necessary):
NAME AGE ADDRESS TELEPHONE# POSITION/TITLE
Benamin David 51 13oMdrosliarbour Place Jupile,LF 33456 561-512-1757 Regional Manging Director
Brian Richmond 45 9309 California D SW,Seattle,WA 98136 425-892-1187 Secretary
Matt Gallagher 48 2933 Young Tustin,CA 92782 714-383-3812 President
•
4, LEVEL OF CARE TO BE PROVIDED: ❑ BLS or®ALS
IF ALS:®TRANSPORT or❑NON TRANSPORT
5. DESCRIBE THE ZONES(S)THAT YOUR SERVICE DESIRES TO SERVE(Use separate sheet if necessary):
Monroe County
6. LIST THE ADDRESS AND/OR DESCRIBE THE LOCATION OF YOUR BASE STATION AND ALL SUB-
STATIONS(Use separate sheet if necessary):
BASE STATION 6767 NW 74th Ave Miami, FL 33166
SUB-STATION
Page l of 6
7. DESCRIBE YOUR COMMUNICATION SYSTEM(Attach copy of all FCC licenses):
FREQUENCIES CALL NUMBERS #OF MOBILES #OF PORTABLES
Contract for business network with Highland Wireless attached
8. LIST THE NAMES AND ADDRESSES OF THREE(3)U.S.CITIZENS WHO WILL ACT AS REFERENCES FOR
YOUR SERVICE:
NAME ADDRESS
Randy Watler 1 Diamond Dr, Big Coppitt, FL 33040
David Oeh 111 12 St# 101, Key West, FL 33040
Elmer Loalza 6855 Red Road, Coral Gbales, FL 33143
9. ATTACH A SCHEDULE OF RATES WHICH YOUR SERVICE WILL CHARGE DURING THE COPCN PERIOD.
10. PROVIDE VERIFICATION OF ADEQUATE INSURANCE COVERAGE DURING THE COPCN PERIOD.
1I. 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 SERVICE,DO HEREBY ATTEST MY SERVICE
MEETS ALL OF THE REQUIREMENTS 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 HE BEST OF MY KNOWLEDGE,IS TRUE AND CORRECT.
•
SIGNATURE 0 PLIC /AUTHORIZED REPRESENTATIVE
""`k, RAFAEL DIAZ
NOTARY SEAL 140
MY COMMISSION M G0231631
'4+d EXPIRES:August 06.2022
id/0/M
NOTARY SIG,RilIt DATE
Page 2 of 6
PERSONNEL—PARAMEDICS
NAME PARAMEDIC CERTIFICATION
First,Middle,Last SOCIAL SECURITY# CERTIIFICATION# EXPIRATION DATE
Acevedo, Jackelin PMD530697 12/01/2020
Berry, Tiffany PMD 520964 12/01/2020
Castro, Matthew PMD514732 12/01/2020
Joseph Feldman PMD525338 12/01/2020
Chanying, Yoshio PMD520807 12/01/2020
Stewart, Brianna `= PMD532685 12/01/2020
I
Page 3 of 6
I 1
PERSONNEL—EMERGENCY MEDICAL.TECHNICIANS
NAME EMT CERTIFICATION
First,Middle Last SOCIAL SECURITY# CERTIFICATION# EXPIRATION DATE
Abreu, Gene EMT 556587 12/01/2020
Aira, Francisco EMT 557880 12/01/2020
Camacho, Javier EMT 560907 12/01/2020
Campbell, Andre EMT 556707 12/01/2020
Chavez, Alexander EMT545913 12/01/2020
Garcia, Juan EMT534285 12/01/2020
.1111111
Page 4 of 6
PERSONNEL DRIVERS
NAME STATE
First,Middle,Last SOCIAL SECURITY# DATE OF BIRTH DRIVER LICENSE# OF ISSUANCE EXPIRATION DATE
I DO HEREBY ATTEST,TO THE BEST OF MY KNOWLEDGE,THAT ALL OF THE ABOVE NAMED DRIVERS DO MEET ALL OF THE REQUIREMENTS OF
CHAPTER 401.281 F.S.AND CHAPTER 64E-2.012 FAC FOR AMBULANCE DRIVERS.
NOTARY SEAL
NOTARY SIGNATURE
Page 5 of 6
VEHICLES
For Each Ambulance Operated By Your Service,Please Provide the Following Information(Use Separate Sheet If Necessary)
HRS SPECIFY
LICENSE VEHICLE SPECIFY TRANSPORT or
AMBULANCE TYPE MODEL YEAR MILEAGE CHASSIS# TAG NUMBER PERMIT# ALS or BLS NON TRANSPORT
III Ford 2011 341,478 1 FDWE3FS9BDA31776 MIK54H 19898 ALS TRANSPORT
II Ford 2014 216,722 1FDSS3ES2EDA08546 MIK44H 4730 BLS TRANPSORT
Page 6 of 6
Aillir11101111111 Ai flhll Amor
�i� n ran ! !UIPI. L! IIVL
Monroe County Published Rates
As of 8/01/2016
• Advanced Life Support (ALS1)
o Non-Emergency $850.00
o Emergency $1020.00
• ALS2 $1075.00
• SCT $1360.00
• Basic Life Support
o Non-Emergency $655.00
o Emergency $710.00
• Mileage $13.60
P.O. Box 66-8710 • Miami, FL 33166-8710 • Phone (888)876-2100 • Fax(786)621-3664
� CITY OF
t - �;. MAR.ATHON,FLORIDA
\,, : 9805 Overseas I Iighway, Marathon, FL 33050
""f`"a `` Phone (305) 743-0033 I www.ci.marathon.fl.us
VIA EMAIL AND U.S. MAIL
March 18, 2019
The Honorable Danny Kolhage
Monroe County Board of County Commissioners
530 Whitehead Street
Key West, Florida 33040
RE: March 21, 2019 County Commission Meeting—Items 0.1 and 0.2
}
Dear Mayor Pro Tern Kolhage:
I am writing on behalf of the City of Marathon regarding agenda items 0.1 and 0.2 on the March
21, 2019 County Commission meeting. These agenda items regard an application for issuance of
a Class A Certificate of Public Convenience and Necessity (COPCN) for Falck Southeast II
Corporation d/b/a American Ambulance Service, and an application for issuance of a Class A
and Class B COPCN for Rapid Response Medical Transportation, respectively. Both of these
applications propose such services within the City of Marathon.
Section 11-173(d)(2) of the Monroe County Code, which addresses such matters, provides in
relevant part:
"The board will consider the public's convenience and the necessity for the
service in the zone or area requested and whether the applicant has the ability to
provide the necessary service. The board will consider recommendations from
municipalities within the applicant's requested service zone or area."
The City has reviewed the applications and recommends that the Commission deny both
applications based on the first two criteria listed in Section 11-173(d)(2): the public's
convenience and necessity for the service in the zone or area requested.
1. The Public's Convenience
Granting these applications does not make things more convenient for the public. To the
contrary,there is the potential for the public's convenience to be negatively impacted.
In the past when other companies were granted the ability to provide services to our City
they would cause our fire department to scale down in size, only to have to expand when
they were unable to provide the service for multiple reasons, including but not limited to:
personnel, cost of running the service in the Keys, etc. Our Fire Chief has been with the
city for over 7 years and has seen this happen twice. Our Fire Chief is responsible for
providing the citizens and visitors of Marathon with the highest level of medical care
from home to hospital, hospital to hospital, and scene to Trauma Star if required.
Because the city provides all of the above services, our Fire Chief can ensure that our
equipment, personnel, and system meet theses high standards and provide required
services to anyone who needs it.
2. Necessity for the Service
There is no need for these additional companies, as the current providers in Monroe
County are more than adequate for the amount of emergencies that we have. Our Fire
Chief has spoken to Fishermen's Hospital and asked if they requested additional services.
They responded that they had not. We did not ask or require any additional assistance for
our services. Thus, we do not know of any reason why there is the need for additional
services.
Additionally, Florida Keys Ambulance, Inc. has already provided you with written
correspondence that gives its arguments as to why the COPN applications should be denied, and
the City agrees with the reasoning in its letter.
Based upon the above, it is the City of Marathon's recommendation, in accordance with Section
11-173(d)(2) of the Monroe County Code, that the COPCN applications for both Falck Southeast
II Corporation d/b/a American Ambulance Service and Rapid Response Medical Transportation
be denied for the reasons set forth herein.
Respec
David Migut
City Attorney
Copy: Marathon City Council
Chuck Lindsey, City Manager
John Johnson,Fire Chief
Roman Gastesi, Monroe County Administrator
Bob Shillinger, Monroe County Attorney
James Callahan, Monroe County Fire Chief/Emergency Services Division Director
Law Office of Jack Bridges, P. A.
Post Office Box 1714
Tavernier, Florida 33070-1714
(305) 664-9690
Jack@JackBridges.us
February 19, 2019
The Hon. David R. Rice
District Four Commissioner
Monroe County Board of County Commissioners
9400 Overseas Highway, Suite 210
Marathon, Florida 33050
RE: Certificates of Public Convenience and Need
Dear Commissioner Rice:
This office represents Florida Keys Ambulance, Inc., a provider of non-emergency, inter-facility
medical transport. Florida Keys Ambulance (FKA) serves the Upper Keys, Marathon, and Key
West.
I urge you to oppose the requests for certificate of public convenience and need for two
additional ambulance companies which are on the Board's agenda for tomorrow's meeting. As
you know, bringing in more ambulance companies will not result in more demand for inter-
facility, non-emergency transport. What it will result in is a reduction in business for FKA and a
reduction of business opportunity for the other companies.
FKA currently equips its trucks with the latest cutting-edge technology. In fact, FKA has
invested 1.7 million dollars in new equipment since 2017. Considering that other ambulances
are highly unlikely to compete for less than FKA charges (which is the same as the County and
Medicaid rates for the uninsured),this additional competition will likely prevent any of the
competitors from earning enough in revenue to continuously reinvest in technology. As a result,
the increased competition will actually harm, not benefit, Monroe County residents and visitors.
Currently, FKA complements Marathon Fire Rescue and TraumaStar. This is a healthy level of
competition which brings out the best in all competitors. Too much competition, however,will
only bring down the level of service as the competitors are forced to cut costs. The additional
ambulance services will also likely cost Monroe County money, as TraumaStar is
February 19, 2019
Letter to Commissioner Rice
Page Two:
the backup used by Lower Keys Medical Center for inter-facility transport when FKA is unable
to handle a request in Key West. With more trucks available,the demand for TraumaStar will be
reduced.
Florida Keys Ambulance has been serving Monroe County for many years. Locally owned and
operated, it pays out nearly$100,000.00 in payroll each month. It has transported patients more
than two million miles with no accidents and without complaints by any of the three (3) Monroe
County hospitals. It contributes to local not-for-profit organizations, including investing in
Leadership Monroe. It has never sent a nonpaying patient to collections. Its experience is
unsurpassed. In fact, it is my understanding that at least one of the proposed service providers
has little or no experience in medical transport, having just been incorporated in October.
Florida law provides that the governing board of the County has a certain level of discretion in
granting or denying requests for certification. For instance, the County is required to consider
the opinions of municipalities. Other factors, such as the duplicitousness of service, the
negative impact on financial feasibility of the service providers and quality of care, may
also be relevant.
Given the above considerations, I respectfully urge this esteemed Board to deny the requests for
certificates of public convenience and need.
Respectfully,
LAW OFFICE OF JACK BRIDGES, P. A.
/s/Jack Bridges
Jack Bridges
Attorney at Law
0.1
t, BOARD OF COUNTY COMMISSIONERS
County of Monroe Mayor Sylvia Murphy,District 5
The Florida Keys l'U � � Mayor Pro Tern Danny Kolhage,District 1
�pw° Michelle Coldiron,District 2
Heather Carruthers,District 3
David Rice,District 4
County Commission Meeting
March 21, 2019
Agenda Item Number: 0.1
Agenda Item Summary #5178
BULK ITEM: No DEPARTMENT: Emergency Services
TIME APPROXIMATE: STAFF CONTACT: James Callahan (305) 289-6088
3:00 P.M. PUBLIC HEARING
AGENDA ITEM WORDING: A public hearing to consider an application for issuance of a Class
A Certificate of Public Convenience and Necessity (COPCN) to Falck Southeast 11 Corporation
d/b/a American Ambulance Service for the operation of an ALS Transport Service in Monroe
County, Florida for the period 3/21/19 through 3/20/21 for responding to requests for inter-facility
transports.
ITEM BACKGROUND: The previous COPCN issued to Falck Southeast II Corporation d/b/a
American Ambulance Service expired on September 21, 2018. A renewal application was received
by MCFR on December 10, 2018. Due to the time lapse that occurred, the County Attorney's office
advised that the applicant must submit for a new certificate instead of a renewal. Monroe County
Code Sections 11-171 et seq., requires the BOCC to hold a public hearing to consider the application
for a new certificate. At the hearing, the Board may receive a report from the County Administrator
or his designee, testimony from the applicant or any other interested party, and other relevant
information. The Board will consider the public's convenience and necessity for the proposed
service and whether the applicant has the ability to provide the necessary service(s). The Board shall
then authorize the issuance of the certificate with such conditions as are in the public's interest or
deny the application, setting forth the reason(s)for denial.
PREVIOUS RELEVANT BOCC ACTION: On September 21, 2016, Item C.28, BOCC granted
approval for issuance (renewal) of a Class A Certificate of Public Convenience and Necessity
(COPCN)to Falck Southeast II Corporation d/b/a American Ambulance Service for the operation of
an ALS transport ambulance service beginning 9/22/16 and ending 9/21/18. On January 23, 2019,
item C.7, the Board granted approval to advertise for a Public Hearing to be held on February 20,
2019, to consider the new application of Falck Southeast 11 Corporation d/b/a American Ambulance
Service. On February 20, 2019, item R.9 was continued to March 21, 2019.
CONTRACT/AGREEMENT CHANGES:
N/A
STAFF RECOMMENDATION:
Packet Pg. 1856
0.1
DOCUMENTATION:
Class A COPCN Falck 3/21/19 - 3/20/21
Application Falck
FINANCIAL IMPACT:
Effective Date: 3/21/19
Expiration Date: 3/20/21
Total Dollar Value of Contract:
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: No If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
N/A
REVIEWED BY:
Pedro Mercado Completed 02/01/2019 11:44 AM
James Callahan Completed 02/01/2019 11:47 AM
Kathy Peters Completed 02/04/2019 10:54 AM
Board of County Commissioners Completed 02/20/2019 9:00 AM
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MONROE COUNTY, FLORIDA RECEIVED
APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY(COPCN)
CLASS A EMERGENCY MEDICAL SERVICE
(PRINT OR TYPE) Monroe County Fire Rescue
❑ INITIAL APPLICATION-$50.00 ® RENEWAL APPLICAIIAN
IF RENEWAL,PLEASE LIST NUMBER OF PREVIOUS CERTIFICATE:# Faick Southeast II, Corp.
1. NAME OF SERVICE Falck Southeast ll, Corp. d/b/a American Ambualnce Service
BUSINESS MAILING ADDRESS 6605 NW 74th Ave Miami, FL 33166
BUSINESS PHONE NUMBER 305-304-2444 EMERGENCY PHONE NUMBER 305-925-2000
0
2. TYPE OF OWNERSHIP(i.e.,Sole Proprietor,Partnership,Corporation,etc.) Corporation
W
... ........_
U)
DATE OF INCORPORATION OR FORMATION OF THE BUSINESS ASSOCIATION 02/28/2012
3. LIST ALL OFFICERS,DIRECTORS,AND SHAREHOLDERS(Use separate sheet if necessary):
__..... ....._.. ......... ......... . ......... ......... .........
(n
....
NAME AGE ADDRESS TELEPHONE# POSITION/TITLE ca
Benamin David 51 130 Andros" rMwAJuole,LF a 561-512-1757 Regional Manging Director
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Brian Richmond 45 9309 California D SW,seafte WA 98136 425-892-1187 Secretary
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Matt Gallagher 48 2933 Young Tustin, CA 92782 714-383-3812 President
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4. LEVEL OF CARE TO BE PROVIDED: ❑ BLS or JZ ALS
IF ALS: ®TRANSPORT or❑NON TRANSPORT 2
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5. DESCRIBE THE ZONES(S)THAT YOUR SERVICE DESIRES TO SERVE(Use separate sheet if necessary):
Monroe County
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6. LIST THE ADDRESS AND/OR DESCRIBE THE LOCATION OF YOUR BASE STATION AND ALL SUB-
STATIONS(Use separate sheet if necessary):
BASE STATION 6767 NW 74th Ave Miami, FL 33166
SUB-STATION
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7. DESCRIBE YOUR COMMUNICATION SYSTEM(Attach copy of all FCC licenses):
FRE UENCIES CALL NUMBERS #OF MOBILES #OF PORTABLES
Contract for business network with Highland Wireless attached
9. LIST THE NAMES AND ADDRESSES OF THREE(3)U.S.CITIZENS WHO WILL ACT AS REFERENCES FOR
YOUR SERVICE:
NAME ADDRESS
Randy Watler 1 Diamond Dr, Big Coppitt, FL 33040
David Oeh 111 12 St# 101, Key West, FL 3300
Elmer Loaiza 6855 Red Road, Coral Gbales, FL 33143
9. ATTACH A SCHEDULE OF RATES WHICH YOUR SERVICE WILL CHARGE DURING THE COPCN PERIOD.
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10. PROVIDE VERIFICATION OF ADEQUATE INSURANCE COVERAGE DURING THE CCN PERIOD. cu
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. U
13. ATTACH A CHECK OR MONEY ORDER IN THE APPROPRIATE AMOUNT,MADE PAYABLE TO THE
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS.
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1,THE UNDERSIGNED REPRESENTATIVE OF THE ABOVE NAMED SERVICE,DO HEREBY ATTEST MY SERVICE
MEETS ALL OF THE REQUIREMENTS 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 HE BEST OF MY KNOWLEDGE,IS TRUE AND CORRECT,
SIGNATURE O V7
PLIC /AUTHORIZED REPRESENTATIVE
RAFAEL DIAZ
MY COMMISSION Y GO231631
NOTARY SEAL +Z.'5f EXPtRFS Augur 2M=2
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NOTARY SIGN DATE
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Packet Pg. 1860
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PERSONNEL—PARAMEDICS
NAME PARAMEDIC CERTIFICATION
First,Middle,Last SOCIAL SECURITY# CERTIFICATION# EXPIRATION DATE
Acevedo, Jackelin PMD530697 12/01/2020
Berry, Tiffany PMD 520964 12/01/2020
Castro, Matthew PMD514732 12/01/2020
Joseph Feldman PMD525338 12/01/2020
Chanying, Yoshio PMD520807 12/01/2020
Stewart, Brianna PMD532685 12/01/2020
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Packet Pg. 1861
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PERSONNEL—EMERGENCY MEDICAL TECHNICIANS
NAME EMT CERTIFICATION
First Middle Last SOCIAL SECURITY# CERTIFICATION# EXPIRATION DATE
Abreu, Gene EMT 556587 12/01/2020
Aira, Francisco EMT 557880 12/01/2020
Camacho, Javier EMT 660907 12/01/2020
Campbell, Andre EMT 556707 12/01/2020
Chavez, Alexander EMT545913 12/01/2020
Garcia, Juan EMT534285 12/01/2020
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Monroe County Published Rates
As of 8/01/2016
• Advanced Life Support (ALS1)
o Non-Emergency $850.00
o Emergency $1020.00
• ALS2 $1075.00 w
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• SCT $1360.00
• Basic Life Support
o Non-Emergency $655.00 U
o Emergency $710.00 U
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• Mileage $13.60
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P.O. Box 66-8710 Miami, FL 33166-8710 • Phone (888)876-2100 • Fax (786)621-3664
Packet Pg. 1865