Item H1 � H.1
� � � BOARD OF COUNTY COMMISSIONERS
County of Monroe � ��r�i
�r � ,s ll� Mayor Heather Carruthers,District 3
The Florida.Keys � � � ������]�j Mayor Pro Tem Michelle Coldiron,District 2
Craig Cates,District 1
David Rice,District 4
Sylvia J.Murphy,District 5
County Commission Meeting
August 19, 2020
Agenda Item Number: H.1
Agenda Item Summary #7176
BULK ITEM: No DEPARTMENT: Fire & Ambulance District 1 Board of
Governors
TIME APPROXIMATE: STAFF CONTACT: James Callahan (305) 289-6088
9:30 A.M. BOARD OF GOVERNORS
AGENDA ITEM WORDING: Approval of a one (1) year extension to the existing agreement
with Professional Emergency Services, Inc. for a Medical Director of Monroe County Fire Rescue
pursuant to the exemption from the competitive bidding process for professional services under
Chapter 4 of the purchasing policies and procedures.
ITEM BACKGROUND:
MCFR's existing agreement with Professional Emergency Services, Inc. for a Medical Director
of Monroe County Fire Rescue will expire on September 30, 2020.
Per Chapter 4 of the Monroe County Purchasing Policy, Purchase of Professional Services,
because differences in price may only be a minor concern compared to qualitative considerations,
as can be the case with medical services, Professional Services may be exempted by the BOCC
from the competitive bidding process. In accordance with the Purchasing Policy, MCFR
is requesting BOG exemption approval from the competitive bidding process and BOG
approval for a one (1)year contract extension to the Professional Emergency Services,
Inc. agreement for a Medical Director of Monroe County Fire Rescue.
Professional Emergency Services, Inc. has agreed to an extension of the contract from
October 1, 2020 until September 30, 2021 at the same annual rate as last year.
PREVIOUS RELEVANT BOCC ACTION:
On June 8, 2011, sealed bids were opened for the professional services of a physician to
provide medical direction for Monroe County Fire Rescue. Professional Emergency Services,
Inc. was chosen by a selection committee consisting of seven (7) members on July 13, 2011.
On October 16, 2013, the BOCC (Item C.34) and BOG (Item G.2) granted approval for execution
of the lst Renewal Option of the Contract between the BOCC, the BOG, and
Professional Emergency Services, Inc. effective October 1, 2013 expiring September 30, 2015.
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On September 16, 2015, the BOCC (Item C.47) and BOG (Item G.5) approved and exercised the
2nd and Final Renewal Option of the contract between the BOCC, the BOG, and
Professional Emergency Services, Inc. to provide Medical Direction for Monroe County Fire
Rescue pursuant to Chapter 401, F.S. and Chapter 64J-1, FAC, resulting in the contract
being extended and a new expiration date of September 30, 2017.
On July 19, 2017, the BOCC (Item C.10) and BOG (Item H.2) granted approval for an
amendment and extension to the existing agreement with Professional Emergency Services, Inc.
to include additional medical oversight in the expansion of the Trauma Star secondary air
transport ambulance with a new expiration date of September 30, 2020.
CONTRACT/AGREEMENT CHANGES:
One (1)year extension to Professional Emergency Services, Inc. Agreement with no increase in
costs
STAFF RECOMMENDATION: Approval of the exemption to the purchasing policies and
procedures and approval of the extension to the agreement.
DOCUMENTATION:
Medical Director- Extension Agreement August 2020
Professional Emergency Services, Inc. - Signed Extension for Medical Director 10-01-2020 thru 09-
30-2021
BOCC 7-19-2017 Agenda Item C.10 and H.2 -Professional Emergency Services Agreement
FINANCIAL IMPACT:
Effective Date: 10/01/2020
Expiration Date: 09/30/2021
Total Dollar Value of Contract: $112,000.00
Total Cost to County: $112,000.00
Current Year Portion: $9,333.34
Budgeted: Yes
Source of Funds: 141-11500 and 101-11001
CPI: N/A
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts: N/A
Revenue Producing: No If yes, amount: N/A
Grant: N/A
County Match: N/A
Insurance Required: Yes
Additional Details: N/A
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H.1
There is no increase in costs for the one (1)year contract extension. Per the existing agreement
with Professional Emergency Services Inc., the annual cost for ground medical direction is
$58,000 and the annual cost for air medical direction is $36K,plus the additional $1,500 per
month for air medical direction which commenced on October 1, 2019.
08/19/20 141-11500 FIRE& RESCUE CENTRAL $58,000.00
08/19/20 101-11001 MEDICAL AIR TRANSPORT $54,000.00
Total: $112,000.00
REVIEWED BY:
James Callahan Completed 08/03/2020 8:39 AM
Pedro Mercado Completed 08/03/2020 10:49 AM
Purchasing Completed 08/03/2020 11:46 AM
Budget and Finance Completed 08/03/2020 12:27 PM
Maria Slavik Completed 08/03/2020 2:09 PM
Kathy Peters Completed 08/03/2020 2:37 PM
Board of County Commissioners Pending 08/19/2020 9:00 AM
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H.1.a
EXTENSION AGREEMENT TO THE CONTRACT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
AND
THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1
AND i)
PROFESSIONAL EMERGENCY SERVICES, INC.
THIS AGREEMENT dated the 19th of August, 2020 is made by and between the Board 6
of County Commissioners of Monroe County, Florida, and the Board of Governors of Fire and
Ambulance District 1, hereinafter called the "COUNTY" and Professional Emergency Services,
Inc., hereinafter referred to as "MEDICAL DIRECTOR". 0
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WITNESSETH:
WHEREAS, the parties hereto entered into an agreement August 17, 2011 (Original
Agreement), for medical direction of Fire and Emergency Medical Services and Aeromedical
Operations, as required by FAC 64J-2.005, and
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WHEREAS, the parties have previously agreed to renewals of the Original Agreement
dated October 1, 2013, October 1, 2015 and July 19, 2017; and M
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WHEREAS, the parties desire to extend the Agreement in order to avoid interruption in
continuity of ground and air emergency care and transport services to critically ill and injured
patients;
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NOW THEREFORE, the parties agree as follows: E
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Section 1. Paragraph 1 of the original agreement is amended to read as follows;
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1. Term
This extension to the contract shall become effective October 1,2020 and shall run through
September 30, 2021. a
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Section 2. All other terms and conditions of the Original Agreement entered into on August 17
2011 and the Extension and Amendment Agreement dated July 19,2017 not inconsistent herewith E
shall remain in full force and effect.
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H.7.a
(SEAL) BOARD OF COUNTY COMMISSIONERS
ATTEST: KEVIN MADOK OF MONROE COUNTY, FLORIDA
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By: By:
Deputy Clerk Mayor Heather Carruthers
BOARD OF GOVERNORS OF FIRE AND
AMBULANCE DISTRICT 1 OF E
MONROE COUNTY, FLORIDA w
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By:
Mayor/Chairman 0
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PROFESSIONAL EMRGENCY SERVICES INC.
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Authorized Representative- Sandra Schwemmer
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EXTENSION AGREEMENT TO THE CONTRACT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS X
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AND
THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1
AND �0
PROFESSIONAL EMERGENCY SERVICES, INC.
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THIS AGREEMENT dated the 19th of August, 2020 is made by and between the Board
of County Commissioners of Monroe County, Florida, and the Board of Governors of Fire and "?
Ambulance District 1, hereinafter called the "COUNTY" and Professional Emergency Services,
Inc.,hereinafter referred to as "MEDICAL DIRECTOR".
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WITNESSETH:
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WHEREAS, the parties hereto entered into an agreement August 17, 2011 (Original
Agreement), for medical direction of Fire and Emergency Medical Services and Aeromedical U
Operations, as required by FAC 64J-2.005, and
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WHEREAS, the parties have previously agreed to renewals of the Original Agreement
dated October 1,2013,October 1, 2015 and July 19, 2017;and
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WHEREAS, the parties desire to extend the Agreement in order to avoid interruption in y
continuity of ground and air emergency care and transport services to critically ill and injured
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patients; 'U
NOW THEREFORE,the parties agree as follows:
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Section 1. Paragraph 1 of the original agreement is amended to read as follows;
1. Term
This extension to the contract shall become effective October 1,2020 and shall run through
September 30,2021.
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Section 2. All other terms and conditions of the Original Agreement entered into on August 17,
2011 and the Extension and Amendment Agreement dated July 19,2017 not inconsistent herewith °
shall remain in full force and effect.
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{SEAL} BOARD OF COUNTY COMMISSIONERS
ATTEST: KEVIN MADOK OF MONROE COUNTY,FLORIDA
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By: By.
Deputy Clerk Mayor Heather Carruthers
BOARD OF GOVERNORS OF FIRE AND
AMBULANCE DISTRICT I OF N
MONROE COUNTY, FLORIDA N
By:
Mayor/Chairman
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PROFESSION M GENCY SERVICES INC.
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Authorized Representative-Sandra Schwemmer
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H.7 c
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BOARD OF COUNTY COMMISSIONERS
County of Morffoe Mayor George Neugent,District 2
Mayor Pro Tem David Rice,District 4
The Florida Keys
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Danny L.Kolhage,District I
Heather Carruthers,District 3
Vt Sylvia J.Murphy,District 5
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County Commission Meeting y
July 19, 2017
Agenda Item Number: C.10
Agenda Item Summary #3145
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BULK ITEM: Yes DEPARTMENT: Fire
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TIME APPROXIMATE: STAFF CONTACT: Gary Boswell (305) 289-6004 2
N/A
AGENDA ITEM WORDING: Approval to amend and extend the current agreement with
Professional Emergency Services, Inc. to include additional medical oversight in the expansion of U)
the Trauma Star secondary air transport ambulance.
ITEM BACKGROUND: In order to ensure the continuation of vital air ambulance services to the a�
Keys, a secondary air transport ambulance was added to ensure transport when the current Trauma w
Star helicopter is transporting another patient. As a result, the Medical Director's medical oversight
has increased.
PREVIOUS RELEVANT BOCC ACTION: On August 17, 2011 the BOCC (Item C4) and BOG
(Item G3) approved the initial two year agreement, with two additional two year options.
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CONTRACT/AGREEMENT CHANGES:
Amendment and Extension on Current Agreement with Medical Director
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STAFF RECOMMENDATION: Approval
DOCUMENTATION:
Professional Emergency Services, Inc
Medical Director Agmt executed 08172011
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FINANCIAL IMPACT:
Effective Date: October 1, 2017 U
Expiration Date: September 30, 2020
Total Dollar Value of Contract: $106,000
Total Cost to County: $106,000
Current Year Portion: $94,000 e(
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Budgeted: Yes
Source of Funds: 101-11001 c
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CPI: N/A
Indirect Costs: N/A
Estimated Ongoing Costs Not Included in above dollar amounts: N/A w
Revenue Producing: N/A If yes, amount: N/A
Grant: N/A 0
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County Match: N/A
Insurance Required: 0
Additional Details:
07/19/17 101-11001 MEDICAL AIR TRANSPORT $12,000.00
REVIEWED BY:
Gary Boswell Completed 06/29/2017 10:02 AM v)
Pedro Mercado Completed 06/30/2017 2:14 PM
James Callahan Completed 06/30/2017 3:35 PM
Budget and Finance Completed 06/30/2017 3:56 PM
Maria Slavik Completed 07/01/2017 7:46 PM w
Kathy Peters Completed 07/03/2017 1:21 PM
Board of County Commissioners Pending 07/19/2017 9:00 AMA
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EXTENSION AND AMENDMENT AGREEMENT TO THE CONTRACT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
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THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT 1
AND
PROFESSIONAL EMERGENCY SERVICES, INC.
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This AGREEMENT is dated the 19th of July, 2017 by and between the Board of County
Commissioners of Monroe County, Florida, and the Board of Governors of Fire and Ambulance 0
District 1, hereinafter called the "COUNTY" and Professional Emergency Services, Inc., �--
hereinafter referred to as "MEDICAL DIRECTOR".
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WITNESSETH: 2
WHEREAS, the parties hereto entered into an agreement August 17, 2011, for medical
direction of Fire and Emergency Medical Services and Aeromedical Operations, as required by .2
FAC 64J-2.005, and
WHEREAS, the parties desire to extend the AGREEMENT in order to avoid interruption
in continuity of ground and air emergency care and transport services to critically ill and injured
patients and to allow for the increased personnel oversight responsibilities required with the w
addition, coordination and integration of a third air transport helicopter;
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NOW THEREFORE, the parties agree as follows:
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Section 1. Paragraph 1 of the original agreement is amended to read as follows;
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1. Term =
This extension to the contract shall become effective October 1, 2017 and shall run
through September 30, 2020.
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Section 2. Paragraph 2 of the original agreement is amended to read as follows; E
2. Compensation
2.1 Ground Ambulance
MEDICAL DIRECTOR shall be paid at a rate of $58,000.00 annually to provide ground
ambulance medical direction. Payments shall be made monthly in arrears by COUNTY
pursuant to the Florida Local Government Prompt Payment Act after receipt of proper
invoice submitted by MEDICAL DIRECTOR.
2.2 Air Ambulance
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a. MEDICAL DIRECTOR shall be paid at a rate of $36,000.00 annually to provide air
ambulance medical direction. Payments shall be made monthly in arrears by COUNTY W
pursuant to the Florida Local Government Prompt Payment Act after receipt of proper
invoice submitted by MEDICAL DIRECTOR.
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b. MEDICAL DIRECTOR will be paid an additional $1,000 per month first two years of
extension beginning October 1, 2017 through September 30, 2019, and an additional c
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$1,500 per month third year of extension beginning October 1, 2019 through September o
30, 2020, for air medical direction of the Trauma Star air medical services.
c. These payments are contingent upon COUNTY's decision to continue to operate air
ambulance services under its ALS license, and if, for any reason, COUNTY decides not
to continue to operate air ambulance EMS service under its ALS license, then MEDICAL 2
DIRECTOR shall have no responsibility to serve as MEDICAL DIRECTOR for the air
ambulance service and COUNTY shall have no liability for this portion of MEDICAL
DIRECTOR's compensation.
2.3
Physician "peer to peer" services for collection of denied medical claims will be paid
subject to administrative review, at a rate of $250.00/hour in order to collect funds that
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would otherwise be unpaid.
2.4
COUNTY will reimburse MEDICAL DIRECTOR for any direct expenses associated
with meetings required by COUNTY or Monroe County Sheriff's Office. For the purpose
of this paragraph, the term "direct expenses" means per diem or subsistence allowances,
transportation costs or mileage allowances, and miscellaneous travel expenses, as those
terms are defined by Section 112.061, Florida Statues. All requested travel for required w
meetings will require prior approval and will be reimbursed at the County rate for
mileage reimbursement. All compensation shall be paid according to County Ordinance
and State law.
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2.5
a. MEDICAL DIRECTOR will be provided a county phone and any other equipment ry
required as approved by the Chief of Fire Rescue. s
b. COUNTY will reimburse MEDICAL DIRECTOR for the yearly application fee
required for renewal of the County's Drug Enforcement Administration (DEA)
certificate, if the MEDICAL DIRECTOR has paid the application fee in advance on U
behalf of the COUNTY. E
2.6
Invoices received from MEDICAL DIRECTOR shall be reviewed and approved by
COUNTY Fire Chief or his designee, indicating that the services have been rendered in
conformity with the contract, and then will be sent to the Finance Department for
payment. �+
2.7
In order for both parties to close their books and records, MEDICAL DIRECTOR must
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clearly state "FINAL INVOICE" on MEDICAL DIRECTOR's final and last billing to
COUNTY. This certifies that all services have been properly performed and all charges a)
and costs have been invoiced to Monroe COUNTY. Since this account will thereupon be
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closed, any and other future charges if not properly included in this final invoice are
waived by MEDICAL DIRECTOR. c
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2.8
Nothing in this agreement prohibits MEDICAL DIRECTOR from billing any third party
for medical services rendered outside the scope of this agreement that may arise during or
after the term of this agreement. 2
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Section 3. All other terms and conditions of the original agreement entered into on August 17,
2011 not inconsistent herewith shall remain in full force and effect.
BOARD OF COUNTY COMMISSIONERS BOARD OF GOVERNORS,FIRE AND
OF MONROE COUNTY, FLORIDA AMBULANCE DISTRICT 1 OF MONROE
COUNTY,FLORIDA
By: By:
Mayor/ George Nuegent Mayor/ Chairman,Norm Anderson
PROFESSIONAL EMERGENCY SERVICES, INC.
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By: ry
Authorized Representative, .�
Sandra Schwemmer
(SEAL) MONROE COUNTY ATTORNEY:
ATTEST: KEVIN MADOK E
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By: By:
Deputy Clerk Pedro Mercado
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CONTRACT BETWEEN
THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
AND
THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT I �
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AND
PROFESSIONAL EMERGENCY SERVICES,INC. ca
FOR MEDICAL DIRECTION FOR MONROE COUNTY FIRE SSCUE
THIS CONTRACT is made and entered into this l7th day of August, 2011, by and between the
Board of County Commissioners,The Board of Governors of Fire and Ambulance District I of y
Monroe County, Florida, hereinafter collectively referred to as the "COUNTY," and �
Professional Emergency Services, Inc., hereinafter referred to as "MEDICAL DIRECTOR".. �
WITNESSETH:
WHEREAS, COUNTY provides fire and/or emergency medical services pursuant to Chapter �
401, F.S. and Chapter 64.1-1, FAC; and LU
WHEREAS, COUNTY is required to employ or contract with a MEDICAL DIRECTOR who .2
shall be a Florida licensed physician, Beard Certified in Emergency Medicine with added
qualification in Emergency Medical Services (EMS) and pre-hospital care experience, or a
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business entity that employs or contracts with similarly qualified physicians; and
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WHEREAS, COUNTY has determined it to be in the best interests of the residents of and
visitors to Monroe County to contract with MEDICAL DIRECTOR for the purpose of providing
direction to the Fire and Emergency Medical Services; and
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WHEREAS, MEDICAL DIRECTOR. desires to provide professional services according to the
terms and conditions stated herein.
NOW THEREFORE, in consideration of the mutual understandings and Contracts set forth
herein, COUNTY and MEDICAL.DIRECTOR agree as follows:
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I. Term
This Contract shall become effective on October 1, 2011, and shall run through September 30,
2013, and shall be renewable thereafter at the option of COUNTY for two additional two (2)_
year periods.
. Compensation
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2.1 Ground Ambulance
MEDICAL DIRECTOR shall be paid at a rate of$ 8,000.00 annually to provide ground
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ambulance medical direction. Payments shall be made monthly in arrears by COUNTY pursuant
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to the Florida Local Government Prompt Payment Act after receipt of proper invoice submitted �
by MEDICAL DIRECTOR.
2.2 Air Ambulance
MEDICAL DIRECTOR shall be paid at a rate of $36,000, annually to provide air ambulance
medical direction. Payments shall be made monthly in arrears by COUNTY pursuant to the
Florida Local Government Prompt Payment Act after receipt of proper invoice by MEDICAL
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DIRECTOR. Note. This payment is contingent upon COUNTY's decision to continue to operate
air ambulance services wader its ALS licenser and if, for any reason, COUNTY decides not to
continue to operate air ambulance EMS service under its AL8 license, then. MEDICAL E
DIRECTOR shall have no responsibility to serve as MEDICAL DIRECTOR for the air 2
ambulance service and COUNTY shall have no liability for this portion of MEDICAL
DIRECTOR's compensation.
COUNTY will reimburse MEDICAL DIRECTOR for any direct expenses associated with )
meetings required by COUNTY or Monroe County Sheriff's Office. ,For the purpose of this
paragraph, the terra "direct expenses"` means per diem or subsistence allowances, transportation �
costs or mileage allowances, and miscellaneous travel expenses, as those terms are defined by
Section 112.061, Florida Statutes. A]I compensation shall be according to County Ordinance and
State law.
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COUNTY will reimburse MEDICAL DIRECTOR for the yearly application fee required for �
renewal of the '.ounty`s Drug Enforcement Administration (DEA) certificate, if the MEDICAL
DIRECTOR has paid the application fee in advance on behalf of the COUNTY. ,
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2.
Invoices received from MEDICAL DIRECTOR shall be reviewed and approved by
COUNTY Fire Chief or his designee, indicating that services have been rendered in
conformity with the Contract, and then will be sent to the Finance. Department for
payment.
2.
In order for both parties to chase their books and records, MEDICAL DIRECTOR must
clearly state "FINAL INVOICE" can MEDICAL DIRECTOR'S final and last billing to
COUNTY. This certifies that all services have been properly performed and all charges cV
and costs have been invoiced to Monroe COUNTY, Since this account will thereupon be
closed, any and other-future charges if not properly included in this final invoice are
waived by MEDICAL DIRECTOR. c,
2.6
Nothing in this Contract prohibits MEDICAL DIRECTOR from billing any third party
for medical services rendered outside the :scrape of this Contract that may arise during or
after the term of this Contract.
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3.
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The purpose of this Contract is to assure compliance of COUNTY in Medical Direction of �
Monroe County Fire Rescue in accordance with the provisions of F.S., Chapter 401, and FAC
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Chapter 64J-1.004. �
. Duties and Responsibilities.
4.1
MEDICAL DIRECTOR shall be responsible to Monroe County Fire Rescue and report
directly to the Fire Chief, and/or his/her designee.
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4.2 2
MEDICAL DIRECTOR shall adhere to the responsibilities as set forth in Chapter 401,
F.S., and Rule 4J-1.004, FAC; the applicable rules of any government agency
implementing said chapter; and any duties upon written notice from the Florida
Department of Health that such additional duties are required of MEDICAL DIRECTOR.
These include supervising and accepting responsibility for the medical performance of all
certified/license response personnel functioning within the scope of their official duties
while on duty with Monroe County Fire Rescue (MCFR), including, but not limited to,
members of volunteer fire department under contract with COUNTY and/or Monroe
County Fire and Ambulance District 1. While these duties will typically occur within the
geographical borders of unincorporated Monroe County and the City of Layton, they also include
duties performed at the Key West International Airport, during mutual
performed during mutual aid to requesting municipalities outside those geographical
borders and while transporting patient to out of county medical facilities. For the purpose of this ,
Contract,: Dr. Sandra Schwernmer is the individual who meets the licensing and registration "!
requirements of Chapter 401, F.S. and FAC Chapter 64J-1.004.
4.3
MEDICAL DIRECTOR ;hall be knowledgeable with the standards set by National Fire
Protection Association, and in particular, Standard 15 2: Standard on Comprehensive
Occupational Medical. Program for Fire Departments.
4.4 Standards of Care
MEDICAL. DIRECTOR shall establish and maintain standards of care for EMS providers.
4A.1
MEDICAL DIRECTOR shall gather agency input in the review and development of standards of
care on an annual basis, and establish and revise agency performance standards as necessary;
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4A.2
Develop pre-hospital practice parameters for Fire Rescue Personnel of all levels. The parameters
shall be developed with consideration to budgetary and staffing limitations and the fiscal impact
on MCFR and the citizens of Monroe County.
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4.5 Patient Advocate
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MEDICAL DIRECTOR shall be a patient advocate in the fire rescue system,. and shall ensure
that all aspects of the EMS systems are developed to place the needs of the patient first.
4.6 Protocols and Standing Orders.
4.6.1
MEDICAL DIRECTOR shall develop, revise, implement, and maintain basic and advanced life
support protocols and standing orders under which MCFR personnel will function under medical
control.
4.6.2
MEDICAL DIRECTOR shall review and revise existing protocols and standing orders to ensure E
that they meet nationally accepted standards of practice for use by all system providers, which
permit specified ALS and BLS procedures when communication cannot be established with a
supervising physician, or when any delay in patient care would threaten the life or health of the
patient_ These standards include, but are not limited to, Advanced Cardiac Life Support (ACLS),
Basic Trauma Life Support (BTLS), and Pediatric Advanced Life Support (PALS). In addition
to medical treatment, protocols shall address determination of patient destination.
4.6.
MCFR shall publish and distribute, at its own cost, all protocols and standing orders. The
protocols and, standing orders shall be published in a farm consistent with agency Standard
Operating Procedures. Copies of the protocols and standing orders will be maintained on all
MCFR ambulances (air and ground) and ALS engines, and will be distributed to N
certified/]icensed response personnel. Personnel copies may be provided electronically. MCFR
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shall obtain and retain a receipt from each personnel member verifying receipt of the protocols CL
and any changes. These receipts may be electronic, and shall state clearly that each person is
individually accountable and obligated to follow all rules, regulations and protocols. All
protocols and standing orders shall become public domain upon implementation.
4. .
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MEDICAL DIRECTOR shall develop, review, and revise, when necessary, Trauma Transport
Protocols (TTP) for submission to the Florida Department of Health, Bureau of Emergency
Medical Services for approval in accordance with Rule 64J-2, FAC.
4.6.5
MEDICAL DIRECTOR shall develop enhanced protocols for specialty procedures or services
including but not limited to aeromedical (Trauma Star) transport.
4.6.6 r
MEDICAL DIRECTOR shall conduct an ern-geeing review of all protocols and standing orders as
may be necessary to ensure reliable service delivery, appropriate patient care, and the
maintenance of the current standard of care. This shall include, at a minimum, a comprehensive
annual review and written approval of all protocols and standing; orders. While conducting. the E
annual review, MEDICAL DIRECTOR shall tape into consideration the results of quality
assurance reviews, review of current medical literature, and input from MCFR response
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personnel. Changes shall be developed with consideration to budgetary limitations and the fiscal
impact on MCFR and the citizens of Monroe County. The annual review shall be completed and
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all proposed changes forwarded to the Fire Chief price-to the end of each. Fiscal Year.
4.6.7 2
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MEDICAL DIRECTOR shall ensure that appropriate training for new protocols and standing �
orders is conducted prior to implementation, shall ensure compliance with protocols and standing
orders by all MCFR personnel; and ensure that additional training is conducted for any identified
needs.
.7 Availability. �.
MEDICAL DIRECTOR or his/her previously-approved designee shall be available twenty-four �
(24) hours a day, seven (7) days a week for medical direction to MCFR personnel in order to
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resolve problems, system conflicts, and provide services in an emergency as that term is defined 2
in Section 252.34(3), F.S.
4.8 Trauma Scorecard Methodologies. �
MEDICAL DIRECTOR shall ensure that all certified/licensed response personnel are trained in �
the use of the trauma scorecard methodologies, as provided in Chapter 6 J-2.004, FAC, for adult
trauma patients and 64J-2.005, FAC, for pediatric trauma patients.
4.9 Aeromedical Operations �
4.9.1
MEDICAL DIRECTOR shall participate in Trauma Star safety and quality assurance
committees, and shall attend quarterly mectings to review safety policies, procedures, unusual
occurrences, safety issues, and audit compliance with safety policies and procedures.
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4. .2
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Be knowledgeable with aeromedical requirements of patients and evaluate each patient in
person, by telephone, or by delegated written protocol prior to each interfacility transfer
flight for the purpose of determining that the aircraft, flight and medical crew, and equipment
meet the patient's needs. ti
4.10 Oversight of Medical Qualifications And. Proficiency of MCFR Personnel
4.1 .1
MEDICAL DIRECTOR shall ensure initial and continued medical qualifications and proficiency
of MCFR personnel.
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4.10
MEDICAL DIRECTOR shall establish and periodically update the minimum personnel training: �
standards and certification requirements for all MCFR personnel who provide emergency
medical care. Such standards shall include the requirements for orientation and initial training,. ca
continuing medical education, standards for professional conduct and evaluation standards and
procedures.
4.103
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MEDICAL DIRECTOR shall ensure that all field personnel meet the initial requirements and
continuously comply with established standards to attain and maintain approval to operate within c
the MCFR system.
4.10.4
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MEDICAL DIRECTOR shall establish procedures for issuance, renewal, suspension, and
revocation of practice privileges for MCFR personnel in concert with the Fire Chief, to include a
process for remediation. The procedures shall contain due process provisions and all such
provisions shall be approved, in advance, by the Fire Chief.
4.10.5
MEDICAL DIRECTOR shall provide for direct observation of field level providers while
performing their duties that meets or exceeds Section 401.265, F.S., and Rule 43 1.004, FAC-
4.11 Quality Assurance
4.11.1
MEDICAL DIRECTOR, in coordination with MCFR, shall develop, implement, and maintain an
effective patient care Quality Assurance System to assess the medical performance of all
certified/licensed MCFR response personnel.
4.11.2
MEDICAL DIRECTOR shall develop, implement, and supervise a formal patient care Quality
Assurance System in accordance with Section 401.2 5(2), F.S. and Rule 4J-l.0 4, FAC, to
include the formation and supervision of a quality assurance committee.
4,1. 1.2.1
0
The purpose and tone of the quality assurance review process shall be positive and educational,
however, MEDICAL DIRECTOR may, at any time and without limitation, conduct a quality ry
assurance review investigation or audit to ensure that MCFR personnel comply with the
Protocols and Standard of Care.
4.11.2.2
U
The method and extent of the investigation employed during any given quality assurance review E
shall be determined by MEDICAL DIRECTOR in consultation with the Fire Chief. As a result
of said investigation, MEDICAL DIRECTOR may require remedial training of MCFR personnel
and/or revocation of practice privileges. Remedial training may be conducted by MEDICAL..
DIRECTOR, MCFR personnel, or other personnel at MEDICAL DIRECTOR°s discretion. �
4.11.3 cv
MEDICAL DIRECTOR or designee may also conduct special audits in response to observations
or customer feedback provided by patients, family members, caregivers, bystanders, crew
members, physicians and hospital personnel.
4.11.4
MEDICAL DIRECTOR may also develop procedures for routine auditing of EMS system
performance and adherence to protocols on individual EMS incidents and overall EMS system
compliance.
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4.11.5
0
MEDICAL DIRECTOR or designee shall review, in conjunction with MCFR battalion chiefs or
their designees, patient care reports on an ongoing basis, review all protocol deviations and
initiate or recommend corrective action. MEDICAL DIRECTOR or designee shall review at
least 40 patient care reports per month. MCFR shall provide electronic copies of patient care
reports.
4.11.6
U
MEDICAL DIRECTOR shall periodically visit and communicate with the hospital emergency
departments to exchange information and review the quality of care provided by the MCFR W
personnel.
4,11.7
MEDICAL DIRECTOR shall participate in field activity and system ,monitoring to include the �
following: y
4.11.7.1
Ride along and observe field activity. Ride along shall involve observation and evaluation of
field level providers, and participation as a crew member/observer on a rescue, for a minimum of
twelve (12) hours per quarter. Ride time will be divided into thirds, with one third of the time
(four hours minimum) allocated to each shift. Over the course of the year, ride time shall also be
distributed equally among the various stations. LU
4.11.7.2
c
System monitoring shall include visiting fire stations to discuss issues with MCFR personnel,
4.11.8
MEDICAL DIRECTOR shall document in a quarterly status report to the Fire Chief, evidence of ry
the following required activities;
4.11.8.1
Field observation of MCFR personnel; and U
4,11.8.2
Visitations and interactions with MCFR personnel, hospital emergency department staff, and
other medical and public safety personnel for quality assurance and education activities.
4.12 Educational Programs �
4.12,1 `V
MEDICAL DIRECTOR shall participate in educational programs at all levels, to include all �
certifiedTlicensed response personnel.
4.12.2
MEDICAL DIRECTOR or designee shall present a minimum of ten (10) hours a year of �
continuing medical education related to pre-hospital care or teaching or a combination of both.
4.12.
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MEDICAL DIRECTOR shall actively participate in the development and presentation of EMS
c
continuing education programs by identifying educational topics, presenting lectures and
providing other educational opportunities for the enhancement of the fire rescue system. MCFR N
shall pay the actual direct cost of any course materials, instructors, and certificates.
4.12-.3.1
Education should be geared to reach the specific needs of the audience. As some providers are
volunteers, consideration shall be given to scheduling some training on nights or weekends.
4.12. .
Course content should include system specific issues and items resulting from audit and review.
4.12A
CD
Where MEDICAL DIRECTOR is not the presenter, and training services are conducted by other
CD
COUNTY personnel and/or are subcontracted to an outside provider, MEDICAL DIRECTOR.
will ensure the quality of the Continuing Medical Education (CME) training provided to EMS
personnel by: 2
4.12.4.1 )
Reviewing and approving all curriculum and courses for continuing education units (CEU's
prior to MCFR personnel being trained,
4.12.4.2
Monitoring and auditing at least one (1) class session of every CME course held in which
MEDICAL DIRECTOR is issuing CME; and y
4.12.4.3
Evaluating the educational effectiveness of instruction, courses and programs in consultation
with the CME contractor. ry
4,12.5
MEDICAL DIRECTOR shall host an annual six-hour education seminar, conducted twice on
two different shift days, a a location to be determined jointly by MEDICAL DIRECTOR and
COUNTY. MCFR shall pay the actual direct cost of seminar, including course materials,
instructors, and certificate preparation.
4.12.6
MEDICAL DIRECTOR shall maintain necessary and appropriate instructor certifications and
participate as Medical Director for educational programs sponsored by MCFR such as ACLS, cv
PALS, 13TLS, etc. '
4.12.7 ca
Upon proof of completion, MEDICAL DIRECTOR shall sign documents and approve CME to
these EMT's and EMT-Ps that have completed a minimum of 30 hours of biannual
recertification training, as set forth in Section 41.2715, F.S.
4.13 Agency Liaison
4.13.
Packet Pg. 2067
MEDICAL DIRECTOR shall participate in interagency discussions about specific issues or
problems as necessary. c
4.13. v,
MEDICAL DIRECTOR shall notify MCFR of any pertinent concerns regarding patient care
raised by other agencies and provide advice on a resolution. MEDICAL DIRECTOR shall also �
notify ether agencies of any concerns regarding patient care, raised either by MCFR or
MEDICAL DIRECTOR.
4.13.3
MEDICAL DIRECTOR shall develop and maintain liaisons with the local medical community. �-
hospitals, emergency departments, mental health agencies, physicians, providers, ambulance
services, and other agencies impacting MCFR.
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4.13.4
MEDICAL DIRECTOR shall assist in resolution of problems involving the delivery of pre- �
hospital care and other services in accordance with Rule 641-1.004, FAC.
4.13.5
MEDICAL DIRECTOR shall interact with and educate local government officials on an as
needed basis.
4.13.E
MEDICAL DIRECTOR shall participate in the Florida EMS Medical Director's Association or a
statewide physician's group involved in pre-hospital care, N
4.13.7
0
MEDICAL DIRECTOR shall be an active member of at least one national emergency medicine
constituency group such as the National Association of EMS Physicians, the American College `V
of Emergency Physicians, etc.
4.13.,
MEDICAL DIRECTOR shall interact with county, regional, state and federal authorities, U
regulators and legislators to ensure standards, needs, and requirements are met, and resource
utilization is optimized.
4.13.9
MEDICAL DIRECTOR shall participate in grant application process for system funding,
expansion, and. research.
4.14 Stress Management Programs.
MEDICAL DIRECTOR shalt participate in stress management programs for providers within
the system, as needed.
4.15 Community Access to Healthcare Initiatives.
MEDICAL DIRECTOR, in conjunction with MCFR, shall coordinate community access to
healthcare initiatives such as public access to automatic external defibrillators.
Packet Pg. 2068
4.16 EMT Oversight.
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4.16.1
In accordance with Rules 64J-1.004 (g) and (h), FAC, Assume direct responsibility for: the use
of an automatic or semi--automatic defibrillator; the use of a glucometer; the administration of
aspirin; the use of any medicated auto injector, the performance of airway patency techniques
including airway adjuncts, not to include endotracheal incubation; and on routine interfcilit
transports, the monitoring and maintenance of non-medicated I.'V.s by an EMT.
4.1 .
MEDICAL DIRECTOR shall ensure that all EMTs are trained to perform these procedures, �-
shall establish and/or maintain written protocols for performance of these procedures; and
shall provide written evidence to the Florida Department of Health documenting compliance
with provisions of these administrative rules,
4.17 Disaster Assistance and planning
4.17.1
MEDICAL DIRECTOR shall be available 'for consultation and/or response during a disaster
situation occurring in Monroe County.
4.17.2
MEDICAL DIRECTOR shall function as a liaison between field EMS operations, hospitals and
public health agencies during disaster situations.
4.17.3 y
MEDICAL DIRECTOR shall provide specific information to assist in the mitigation of the EMS
aspects during a disaster situation. CL
.17.4 `V
MEDICAL DIRECTOR shall cooperate in planning, updating, and following applicable sections
of the Monroe County Comprehensive Emergency Management flan, including, but not limited
to participation in disaster-drill and emergency management drills. ti
4.18 Controlled Substances, Medical Equipment and Supplies.
4.18.1
In accordance with F.S., Chapter 401 and Rule 64J-1.004(4)(c), FAC, MEDICAL DIRECTOR
shall possess proof of current registration as a medical director with the U.S. Department of
Justice, i iEA, to provide controlled substances to an EMS provider. The DEA registration shall
include each address at which controlled substances are stared. Proof of such registration shall
he maintained on file with MCFR, which shall maintain the copies and make them readily
available for inspection. MCFR will forward all renewal documents as received from IDEA to
MEDICAL DIRECTOR in order to ensure continuous registration and will reimburse
MEDICAL DIRECTOR for the cost of such registration. Copies of physician license and
registrations must be provided to MCFR. E
4.1 S.2
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MEDICAL DIRECTOR shall formulate and ensure adherence to detailed written procedures to
cover the purchase, storage, use, and accountability for medications,. fluids, and controlled
C
substances used by MCFR personnel, in accordance with Chapters 499 and 893, F.S., and Rule .2
64J-1.02 1, FAC..
4.18.3
MEDICAL DIRECTOR shall ensure and certify that security procedures of all MCFR providers 2
for medications, fluids and controlled substances are in accordance with Chapters 499 and 893,
F.S., and Rule 64J-1.021„ FAC.
4.18..4
MEDICAL DIRECTOR shall establish a list of mandatory equipment, medications and medical
supplies that must be on board a Rescue or ALS Engine for it to respond to EMS incidents.
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4.18.5
MEDICAL DIRECTOR shall advise MCFR can appropriate staffing, structural requirements, �
equipment and supplies necessary to ensure that the air ambulance complies with Rule 64J-
1.005, FAC, and. Section 401251(4), F.S. w
4.18.E
MEDICAL DIRECTOR shall conduct an on-going and comprehensive review of all EMS
medical equipment, medications and medical supplies as may be necessary to ensure reliable E
service delivery in the fire rescue System and excellence in patient care.
4.18.6.1
In conducting the review, MEDICAL DIRECTOR shall take into consideration the results of -12
Quality .Assurance Reviews, review of medical literature, input from interested physicians, and
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MCFR personnel.
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4.1.8.6.2
MEDICAL DIRECTOR, in conjunction with MCFR, shall complete the comprehensive review
of all EMS System medical supplies and equipment and present the proposed changes to the Fire
Chief for approval prior to the end of each Fiscal Year.
4.18.7
MEDICAL DIRECTOR shall ensure that the following criteria are met prior to activating new �
medical equipment or supplies within the EMS System.
4.18.7.I
N
Proposed medical equipment or ;supplies have been thoroughly researched, supported by medical
literature, a field evaluation completed when applicable, and the analysis of available system
data; ca
4.18.7.2
All Protocols related to the medical equipment or supplies have been evaluated and updated as �
appropriate, to ensure consistency and accuracy; and
4.18.7.3
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Protocols, supporting documents and implementation instructions are distributed to MCFR.
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personnel prior to training or implementation, and training has been completed, if necessary prior
to implementation.
4.19 Infectious Disease Control Policy
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4.1 .1
MEDICAL DIRECTOR shall formulate, monitor, evaluate and update as necessary, a policy
complying with all applicable laws and rules necessary to control exposure of MCFR personnel
to infectious diseases. This policy shall cover protective measures to be taken on incidents,
inoculation procedures and recommendations, record keeping, follow up care recommendations
as well as storage and disposal policies for contaminated materials.
4.1 q.
MEDICAL DIRECTOR shall be available, in conjunction with the MCFR Infection Control �
Officer, for consultation from field personnel to determine the significance of ally body fluid y
exposure and suggest appropriate action for such an exposure in accordance with Monroe
County Fire Rescue's existing Workers' Compensation policies and procedures.
4.20
This Contract is a personal services contract based on the qualifications of Dr. Sandra �
Schwemmer and the services required hereunder shall be performed by Professional Emergency �
Services Inc. or under his/her supervision. Any additional personnel necessary for the
fulfillment of the services required under this Contract shall be secured at MEDICAL
DIRECTOR's sole expense and such personnel shall be fully qualified and, if required,
authorized or permitted under State and local law to perform such services.. �
0
. Insurance CL
COUNTY shall maintain in full force: and effect for the terra of this Contract, and any ry
subsequent renewals, professional and General Liability Insurance with minimum limits of
$1,000,000.00 per occurrence. The Professional and General Liability certificate will specify
coverage for"EMS oversight/medical direction".
COUNTY will provide certificate or proof of such insurance to MEDICAL DIRECTOR on an
annual basis. Medical Director will be provided thirty (30) days notice of cancellation, change in
policy limits, and/or any restrictions placed on coverage of the insurance provided by COUNTY �
during the term of this Contract. COUNTY will be responsible for the payment of any deductible
and/or self--insured retention in the:event of a claim,
N
The Contractor- shall be responsible for all necessary Workers' Compensation and Vehicle
Liability insurance coverage. Certificates of Insurance must be provided to Monroe County �
within fifteen (1.5) days, after award of contract, with Monroe County BOCC listed as additional
insurer/ as indicated. Policies shall be written by insurers admitted and licensed to do business in
the Mate of Florida and having an agent for service of process in the Mate of Florida.
Companies :shall have an A.M. Best rating of VI or better, The required insurance shall be �
maintained at all times while Respondent is providing service to County. �
Prior to commencement of work governed by this contract, the CONTRACTOR must obtain:
1
Packet Pg. 2071
Worker's Compensation Insurance with limits sufficient to respond to applicable state
statutes. In addition, the Respondent must obtain Employer's Liability insurance with limits of
not less than:
$500,000 Bodily Injury by accident,
$500,000 Bodily Injury by Disease policy limits,
and $500,000 Bodily Injury by Disease, each employee. �
Coverage must be maintained throughout the entire terra of the contract,
0
Prior to commencement of work governed by this contract,. the CONTRACTOR must obtain:
Vehicle Liabili!y Insurance which shall cover owned, non-owned and hired vehicles. The
minimum acceptable limits shall be $300,000 Combined Single Limit (CSL). If split limits are ca
provided, the rninimurn limits acceptable shall be:
$100,000 per Person E
$300,000 per Occurrence 2
$50,000 Property Damage
Monroe County hoard of County Commissioners shall be named as an Additional insured
on Vehicle Liability policies. )
6. Termination �
6.1 Early termination may occur as follows:
A. This Contract may be terminated by MEDICAL DIRECTOR, with or without cause,
upon not less than ninety (90) days written notice delivered to COUNTY.
B. COUNTY may terminate this Contract in whole or in part and without cause, upon not
less than ninety (90) days written notice, delivered to MEDICAL DIRECTOR. ,
C. COUNTY may terminate this Contract intermediately in the event that MEDICAL ry
DIRECTOR fails to fulfill any of the terms, understandings or covenants,of this Contract.
6.2 At such time as this. Contract is terminated, whether at the natural ending date or at an
earlier time, MEDICAL DIRECTOR shall:
A. Stop work on the date and to the extent specified.
B. Terminate and settle all orders and subcontracts relating to the performance of the work,
C. Transfer all work in process, completed work, and other materials related to the
terminated work to COUNTY.
D. Continue and complete all parts of that work which have not been terminated, if any,
7. Payments
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Payments shall be made by COUNTY pursuant to the Florida Local Government Prompt
Payment Act after the completion of the rendered services and proper invoicing by MEDICAL c
DIRECTOR.
8. Contin envy
COLlNTY`s performance and obligation to pay under this Contract is contingent upon an annual
appropriation by the Board of County Commissioners.
L)
9. Section Headings
Section headings have been inserted in this Contract as a matter of convenience of reference
only, and it is agreed that such section headings are not a part of this Contract and will not be E
used in the interpretation of any provision of this Contract. 2
10. {ownership of the Pr ieef Document �
Any documents submitted by MEDICAL DIRECTOR for this RFP belong to COUNTY and )
may be reproduced and copied without acknowledgement or permission of MEDICAL
DIRECTOR. �
1.1. Successors and A ssi ns
MEDICAL, DIRECTOR shall not assign its right hereunder, except its right to payment, nor shall
it delegate any of its duties hereunder without the written consent of COUNTY. Subject to the �
provisions of the immediately preceding sentence, each party hereto binds itself, its successors,
assigns and legal representatives to the other and to the successors, assigns and legal CL
,
representatives of such either party. ry
12. No Third Party Beneficiaries
Nothing contained herein shall create any relationship, contractual or otherwise, with or any
rights in favor of, any third party.
13. Public Entities Crimes �
1 .1 �-
A person or affiliate who has been placed on the convicted vendor list following a conviction for cv
public entity crime may not submit a bid on contracts to provide any goods or services to a '
public entity, may not submit a bid on a contract with a public entity for the construction or
repair of a public building or public work, may not submit bids on leases of real property to U
public entity, may not be awarded or perform work as a contractor, supplier, subcontractor,or
MEDICAL DIRECTOR under a contract with any public entity, and may not transact business
with any public entity in excess of the threshold amount provided in Section 287.017 of the F.S., E
for CATEGORY TWO for a period of 36 months from the date of being placed on the convicted �
vendor list.
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13.2
By signing this Contract, MEDICAL DIRECTOR represents that the execution of this Contract
will not violate the Public Entity Crimes Act (Section 287.133, F. .). Violation of this section �
shall result in termination of this Contract and recovery of all monies paid hereto, and may result
in debarment From COUNTY's competitive procurement activities. �
13.3
In addition to the foregoing, MEDICAL DIRECTOR further represents that there has been no
determination, based on an audit, that it or any SUBCONTRACTOR has committed an act
defined by Section 287.133, F.S., as a "public entity crime", and that it has not been formally
charged with committing an act defined as a `;public entity crime" regardless of the amount of �
money involved or whether CC)NUSULTANT has been placed on the convicted vendor list. E
13.4
MEDICAL DIRECTOR will promptly notify COUNTY if MEDICAL DIRECTOR or any �
subcontractor is formally charged with an act defined as a"public entity crime" or has been
placed on the convicted vendor- list.
1 . Records
MEDICAL DIRECTOR shall maintain all books, records, and documents directly pertinent to
performance under this Contract in accordance with generally accepted accounting principles.
Upon ten (10) business days written notice to the other party, representatives of either party shall
have access, at all reasonable times, to all the other party's books, records, correspondence,
instructions, receipts, vouchers and memoranda (excluding computer software) pertaining to
work under this Contract for the purpose of conducting a complete independent Fiscal audit. ,
MEDICAL DIRECTOR shall retain all records required to be kept under this Contract For a ry
minimum of Five years, and for at least four years after the termination of this Contract. Storage
of medical records required by Federal or Mate statute in excess of the times stated herein and
subsequent to the termination of this Contract shall be revisited by the parties at such time as any
transition period is established to accommodate the termination of this Contrast. MEDICAL
DIRECTOR shall keep such records as are necessary to document the provision of services
under this contract and expenses as incurred, and give access to these records at the request of
COUNTY, the Mate of Florida or authorized agents and representatives of said government �
bodies. It is the responsibility of MEDICAL DIRECTOR to maintain appropriate records to
insure a proper accounting of all collections and remittances. MEDICAL, DIRECTOR shall be
responsible For repayment of any and all audit exceptions which are identified by the Auditor- cv
General for the Mate of Florida, the Clerk of Court for Monroe County, the Board of County '
Commissioners for Monroe County, or their agents and representatives.
15. Governing Law, Venue, Inter retation, Costs, and Fee
This Contract shall be governed by and construed in accordance with the laws of the Mate of E
Florida applicable to contracts made and to be performed entirely in the State.
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In the event that any cause of action or administrative proceeding is instituted for the
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enforcement or interpretation of this Contract, COUNTY and MEDICAL DIRECTOR agree that
venue shall lie in Monroe County, Florida, in the appropriate court or before the appropriate
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administrative body.. The Parties waive their rights to a trial by jury. This Contract is not subject r_
to arbitration.
16. Severabilit
0
It' any term, covenant, condition or provision of this Contract (or the application thereof to any
circumstance or person) shall be declared invalid or unenforceable to any extent by a court of
competent jurisdiction, the remaining terms, covenants, conditions and provisions of this
Contract, shall not be affected thereby, and each remaining term, covenant, condition and
provision of this Contract shall be valid and shall be enforceable to the fullest extent permitted E
by law unless the enforcement of the remaining terms, covenants, conditions and provisions of 2
this Contract would prevent the accomplishment of the original intent of this Contract.
COUNTY and MEDICAL DIRECTOR agree to reform the Contract to replace any stricken
provision with a valid provision that comes as close as possible to the intent of the stricken
provision.
17. Attorney's Fees and Costs
COUNTY and MEDICAL DIRECTOR agree that in the event any cause of action or
administrative proceeding is initiated or defended by any party relative to the enforcement or
interpretation of this Contract, the prevailing party shall be entitled to reasonable attorneys fees, N
court costs, investigative, and out-of-pocket expenses, as an award against the non-prevailing
party, and shall include attorney's fees, courts costs, investigative, and out-of-pocket expenses in
appellate proceedings. Mediation proceedings initiated and conducted pursuant to this Contract ,
shall be in accordance with the Florida Rules of Civil Procedure and usual and customary ry
procedures rewired by the circuit court of Monroe County.
18. Binding Effect
U
The terms, covenants, conditions, and provisions of this Contract shall hind and inure to the
benefit of COUNTY and MEDICAL DIRECTOR and their respective legal representatives,
successors, and assigns.
19. Authority
cv
Each party represents and warrants to the other that the execution, delivery and performance of
this Contract have been duly authorized by all necessary County and corporate action, as
rewired by law.
0. Claims for Federal or State Aid
MEDICAL DIRECTOR and COUNTY agree that each shall be, and is, empowered to apply for, �
seek, and obtain federal and state Funds to further the purpose of this Contract, provided that all
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applications, requests, grant proposals, and funding solicitations shall be approved by each party c
prier to submission.
21. Adjudication of Disputes
X
COUNTY and MEDICAL DIRECTOR agree that all disputes shall be attempted to be resolved �
by meet and confer sessions between representatives of each of the parties. If the issue or issues
are still not resolved to the satisfaction of the parties, then any party shall have the right to seek
such relief or remedy as may be provided by this Conti-act or by Florida law.
22. CooReratjvn
In the event any administrative or legal proceeding is instituted against either party relating to the 0)
formation, execution, performance, or breach of this Contract, COUNTY and MEDICAL 2
DIRECTOR agree to participate,. to the extent required by the other party, in all proceedings,
hearings, processes, meetings, and other activities related to the substance of this Contract or
provision of the services under- this Contract. COUNTY and MEDICAL DIRECTOR
specifically agree that no party to this Contract shall be required to enter into any arbitration
proceedings related to this Contract.
23. Nondiscrimination �
MEDICAL DIRECTOR and COUNTY agree that there will be no discrirrtination against any
person, and it is expressly understood that upon a determination by a court of competent
jurisdiction that discrimination has occurred, this Contract automatically terminates without any
further action on the part of any party, effective the date of the court order. MEDICAL
DIRECTOR and COUNTY agree to comply with all Federal and F.S., and all local ordinances, CL
as applicable, relating to nondiscrimination. These include but are not limited to: 1 Title III of "!
the Civil Rights Act of 1964 (PL 88-352), which prohibits discrimination on the basis of race,.
color or national origin; 2) Title IX of the Education Amendment of 1972, as amended (20 USC
§§ 161-1683, and 1685 1686), which prohibits discrimination on the basis of sex; 3) Section
504 of the Rehabilitation Act of 1973, as amended (20 USC § 794), which prohibits
discrimination on the basis of handicaps; 4) The Age Discrimination Act of 1975, as amended
(42 USC §§ 61 1-6107), which prohibits discrimination on the basis of age; 5) The Drug Abuse
Office and.Treatment Act of 1972 (PL 92-255), as amended, relating to nondiscrimination on the: �
basis of drug abuse; 6) The Comprehensive Alcohol Abuse and Alcoholism Prevention,
Treatment and Rehabilitation. Act of 1970 (PL 91-616), as amended,. relating to
nondiscrimination on the basis of alcohol abuse or alcoholism; 7) The Public Health Service Act
of 1912,. §§ 523 and 527 (42 USC §§ 690dd-3 and 290ee-3), as amended, relating to '
confidentiality of alcohol and drug abuse patent records; 8) Title YIII of the Civil Rights Act of
1968 (42 USC §§ 3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or
financing of housing; 9) The Americans with Disabilities Act of 1990 (42 USC §§ 1201), as ca
amended from time to time, relating to nondiscrimination in employment on the basis of
disability; 10) Monroe County Code Chapter 13, Article VI, which prohibits discrimination on E
the basis of race, color, sex, religion, national origin, ancestry, sexual orientation, gender identity �
17
Packet Pg. 2076
or expression, familial status or age; and 11 any other nondiscrimination. provisions in any c
federal or state statutes which may apply to the parties to, or the subject utter of, this Contract.
4, Covenant of No Interest a
X
METRICAL DIRECTOR and COUNTY covenant that neither presently has any interest, and �
shall not acquire any interest, which would conflict in any manner or degree with its performance
under this Contract, and that only interest of each is to perform and receive benefits as recited in
this Contract.
. Cade of Ethics
MEDICAL DIRECTOR agrees that officers and employees of COUNTY recognize and will be E
required to comply with the standards of conduct for public officers and employees as delineated 2
in Section 1 12.313, F.S., regarding, but not limited to, solicitation or acceptance of gifts; doing
business with one's agency; unauthorized compensation; misuse of public position, conflicting
employment or contractual relationship; and disclosure or use of certain information.
26. No Sollicitatiopyayment �
METRICAL DIRECTOR and COUNTY warrant that, in respect to itself, it has neither employed �
nor retained any company or person, rather than a bona fide employee working stalely for it, to Lu
solicit or secure this Contract and that it has not paid or agreed to pay any person, company,
corporation, individual, or firm, other than a bona fide employee working solely for it, any fee,
commission, percentage, gift, or rather consideration contingent upon or resulting from the award
or making of this Contract. For the breach or violation of the provision„ MEDICAL DIRECTOR
agrees that COUNTY shall have the right to terminate this Contract without liability and, at its CL
,
discretion, to offset from monies sawed, or otherwise recover, the full amount of such fee, ry
commission, percentage, gift, or consideration.
7. Public Access
U
METRICAL DIRECTOR and COUNTY shall allow and permit reasonable access to, and
inspection of, all documents, papers, letters or rather materials in its possession or under its
control subject to the provisions of Chapter 119, F.S., and made or received by METRICAL
DIRECTOR and COUNTY in connection with this Contract; and COUNTY shall have the right
to unilaterally cancel this Contract upon violation of this provision by MEDICAL DIRECTOR.
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28. Non-waiver of Immunity
Notwithstanding the provisions of Section 768.28, F.S., the participation of METRICAL
DIRECTOR and COUNTY in this Contract and the acquisition of any commercial liability
insurance coverage, self-insurance coverage, or local government liability insurance pool
coverage shall not be deemed a waiver of immunity to the extent of liability coverage, near shall
any contract entered into by COUNTY be required to contain any provision for waiver. �
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29. Privileges and Immunities c
All of the privileges and immunities from liability, exemptions from laws, ordinances, and rules.and pensions and relief, disability, workers' compensation, and other-benefits which apply to the
activity of officers, agents, or employees of any public agents or employees of COUNTY, when
performing their respective functions under this Contract within the territorial limits of
COUNTY shall apply to the same degree and extent to the performance of such functions and
duties of such officers, agents, volunteers, or employees outside the territorial limits of
COUNTY.
0. Legal Obligations and Responsibilities
This Contract is not intended to, nor shall it be construed as, relieving any participating entity CD
from an obligation or responsibility imposed upon the entity b law except to the extent of 2
y g` P y Ta P y y pCD
actual and timely performance thereof by any participating entity, in which case the performance
may be offered in satisfaction of the obligation or responsibility. Further, this Contract is not
intended to, nor shall it be construed as, authorizing the delegation of the constitutional or �
statutory duties of COUNTY, except to the extent permitted by the Florida constitution, state.
statute, and case law,
31. Non-Reliance by Nan-Parties �
No person or entity shall be entitled to rely upon the terms, or any of there, of this Contract to
enforce or attempt to enforce any third-party claim or entitlement to or benefit of any service or y
prograrn contemplated hereunder, and MEDICAL DIRECTOR MEDICAL DIRECTOR and
COUNTY agree that neither .MEDICAL DIRECTOR near COUNTY or any agent, officer, or
CL
employee of either shall have the authority to inform, counsel, or otherwise indicate that any
particular individual or group of individuals, entity or entities, have entitlements or benefits
under this Contract separate and apart, inferior to, or superior to the community in general or for
the purposes contemplated in this Contract.
2. Attestations,and Truth in Negotiation
MEDICAL DIRECTOR agrees to execute such documents as COUNTY may reasonably require,
including a Public Entity Crime Statement, an Ethics Statement, and a Drug-Free Workplace
Statement. Signature of this Contract by MEDICAL. DIRECTOR shall act as the execution of a
truth in negotiation certificate stating that wage rates and ether factual unit costs supporting the
compensation pursuant to the Contract are accurate, complete, and current at the time of
contracting.
33. No Personal Liability
No covenant or Contract contained herein shall be deemed to be a covenant or Contract of any
member, officer, agent or employee of COUNTY in his or her individual capacity, and no E
member,officer, agent or employee of COUNTY shall be liable personally on this Contract or be �
subject to any personal liability or accountability by reason of the execution of this Contract.
19
Packet Pg. 2078
0
34. Execution of Counterparts
Ch
This Contract may be executed in any number of counterparts, each of which shall be regarded r-
as an original, all of which taken together shall constitute one and the same instrument and any
of the parties hereto may execute this Contract by signing any such counterpart. �
5.. Amendments and Assignments.
No amendment or assignment of this Contract shall be valid without the prior written consent
from COUNTY.
3+6. Independent Contractor. E
2
At all times and for all purposes hereunder, MEDICAL DIRECTOR is an independent
contractor and not an employee of the Board of County Commissioners of Monroe County. No
statement contained in this Contract shall be construed as to find MEDICAL DIRECTOR or any
of its employees, contractors, servants or agents to the employees of the Board of County
Commissioners of Monroe County, and they shall be entitled to none of the rights, privileges or
benefits of employees of Monroe County.
37. Compliance with Lair.
In carrying out its obligations under this Contract, MEDICAL DIRECTOR shall abide by all
statutes, ordinances, rules and regulations pertaining to or regulating the provisions of this
Contract, including those now in effect and hereafter adopted. Any violation of said statutes,
ordinances, rules or regulations :shall constitute a material breach of this Contract and shall ,
entitle COUNTY to terminate this Contract immediately upon delivery of written notice of ry
termination to MEDICAL DIRECTOR.
38. Licensing and. Permits.
U
MEDICAL DIRECTOR shall have, prior to commencement of work under this Contract and at
all times during ;said work, all required licenses and permits whether federat, state, county or
municipal.
39. Signatures of Parties Required
N
THIS CONTRACT SHALL NOT BE EFFECTIVE UNTIL EXECUTED BY BOTH PARTIES
AND RECEIVED IN FINAL EXECUTED FORM BY AN AUTHORIZED
REPRESENTATIVE OF MEDICAL DIRECTOR AT ITS PRINCIPAL PLACE OF
BUSINESS.
40. Count' Authority �
0
Packet Pg. 2079
y execution hereof the signer below hereby certifies that signer is duly authorized to execute
c
this Contract on behalf of the COUNTY.
41. +ederal and State Tax.
X
COUNTY is exempt from payment of Florida Mate Use and Sales Taxes, COUNTY will sign an
U
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exemption certificate submitted by MEDICAL DIRECTOR. MEDICAL DIRECTOR will not
be exempted from paying state sales tax to its suppliers for materials used to fulfill contractual
obligations with COUNTY, nor is MEDICAL DIRECTOR authorized to use C UNTY's Tax
Exemption Number in securing such materials.
IN WITNESS WHEREOF, each party hereto has caused this contract to be executed by its duly �
authorized representative.
BOARD OF COUNTY COMMISSIONERS y
OF MONROE COUNTY, FL �
Y L. KOLHA E, CLERK
A
By: �
x Deputy Clerk Mayo r/Cy1f,rm
. .
BOARD OF GOVERNORS OF N
FIRE AND AMBULANCE DISTRICT 1, �
M ROE COUNTY ATTORNEY OF MONROE COUNTY, FLORIDA
PROV Q, A T FCL
YNTH1 L� SAL- _.
Aa l NT t U T`Y ATTORNEY Mayor/Chairman �
Dare " ;.01d
CD
Name and Address of Respondent:
Professional Emergency Services, Inc.
Dr. Sandra Schwemrner
10 High Point Road
PO Box 37
Tavernier, Fl 3 O
B J . By; cV
Lsu* Gt Signature of. espondent '
' c
Print Name and Title ca
Date; _ E
Approved by MON OE COUNTY can 1 2011, Item#� � 3
21
Packet Pg. 2080
SECTION TWO
FORM
Attachment A Submission Response Form from Request for Proposal.
Attachment B Non-Collusion Affidavit
Attachment C Public Entity Crime Statement
Attachment D Drug Free Workplace Form
Attachment E Lobbying cc Conflict of Interest Clause Sworn Statement under Ordinance m
No, 10-1990 (Ethics Clauses
Attachment F Indemnification and Hold Harmless
Attachment G Insurance Documents �
Attachment H Local Preference Form
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Packet Pg. 2081
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SUBMISSION PROPOSAL RESPONSE FORM
MEDICAL DIRECTOR for M+f NROE COUNTY FIRE RESCUE �+
}N
f
Respondent's Name and Address.
J
Telephone Numbers:
All amounts must be written AND in number format. In case of a conflict between �
the amount in words and the amount in numbers,the amount in words shall �
control,
Annual fee to provide medical direction for ground ambulance service �
.,,J-, i.L.. '.i•Y:P.e f�A� ti i�s�f.-�'r-TMI F`R
Annual fee to provit e medical direction for air ambulance service:
..fit: r cr4ar _t.. .U•
Miscellaneous charges(speclf,,whether the chases ar, p-r year, or one-time only): �
}Yt. of`E j 4ef1 1 k, Wlltt [ i Coto l ' L lei
t' ""s[-'t� t8
1 have included: / yM1kq d I i!. "Y c !�c'P 1+ �• l�st�d Y:®� b 4 i1�R �. € c's t r`P
* Proposal �i; `c ;eT ,
* Submission Response Form �
* Non Collusion Affidavit 0
CL
Public Entity Crime Statement
Lobbying and Conflict of Interest Clause l~orni i
Drug Free, Workplace Form
Indemnification and hold harmless
Local Preference Form t
(Check mark items above, as a reminder-that ihey are inclacieci).
I state deal I am authorized to submit this proposal. E
j
STATF.OF t a llf
} (Signature pf Respondent) �
Date
PERSONALLY APPEARED BEFORE ME, the undersigned
authority,L�P g,'lr1j't 6.d i i� if -- who,after first being sworn by me,{name of
individual sign-n ) affixed his!hcrsignature in the space provided above:on this
,+rw day of ._. _ ' t 70 1
Div commission expires
t)3tRY l'IJfL1C r Mkt LOWNE
My GOWSS04 9 EE 067841 �
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Packet Pg. 2082
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NON-COLLUSION AFFIDAVIT
'� t ,E' c ,ct t`pr I'f t the
city ofL5o7 accor tre
g to law on y oath,
and under penalty of erj ury,depose and say that-,
1) lam Dc 'Sn t, C" C t .r` the respondent
making the Proposal for the project described as follows.
r -cam - L
Z) The prices in this proposal have been arrived at independently without E
collusion, consultation,communication or Contract for the purpose of restricting
competition, as to any matter relating to such prices with any other respondent or with
any competitor;
3) Unless otherwise rewired by law,the prices which have been quoted in this �
proposal have not been knowingly disclosed by the respondent and will not knowingly be
disclosed by the respondent prior to proposal opening,directly or indirectly,to any other
respondent or to any competitor; and
4) No attempt has been made or will be made by the respondent to induce any
other person,partnership or corporation to submit,or not to submit,a proposal for the
purpose of restricting competition;and
) The statements contained in this affidavit are true and correct,and made with
full knowledge that Monroe County relies upon the truth of the risen contained in CL
this affidavit in awarding contracts for said project. ry
STATE LAP 1J)r I
�� (Signature of Despondent)
�i
COUNTY CI ' ++ �' � 6 t � I
Date
PERSONALLY APPEARED BEFORE ME,the undersigned authority,
t, 1° " 7f who,after first being sworn by me,(name of r�
individual signing) affixed his/her signature in the space provided above on this
day of,.___ . 20 r®
f ,
My commission expires- # .� USA kL LOWRE
NOTARY PUBLIC #_ : 2 b
Attachment
rs-
Packet Pg. 2083
0
PUBLIC ENTITY CRIME STATEMENT
x
"A. person or affiliate who has been placed on the convicted vendor list following a
conviction for public entity crime may not submit a proposal on a contract to provide any
goods or services to a public entity,may not submit a proposal on a contract with a public
entity for the construction or repair of public building or public work, may not submit
proposals on leases of real property to public entity,may not be awarded or perform work
as a bidder, supplier,subbidder,or RESPONDENT under a contract with any public
entity,and may not transact business with any public entity in excess of the threshold
amount provided in Section 287.017, Florida Statutes,for CATEGORY TWO for a �
period of 36 months from the date of being placed on the convicted vendor list." E
By executing this form, l acknowledge that I/my company is in compliance with the
above.
STATE OF f �
(Signature of Respondent)
COUNTY OF v
Bate
PERSONALLY APPEARED BEFORE ME,the undersigned authority, �
0
� - - . G . t S0XV&-y))T)6r who,after first being sworn by me,(name of CL
individual signing)affixed his/her signature in the space provided above on this
_!r _ Clay of 20 P
E
My commission expires: ) / 3 MyWAWwM#EEWW1
NOTARY PUBLIC '' EXPM.Mwub=20i5PUM
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Attachment C'
Packet Pg. 2084
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DRUG-FREE WORKPLACE FORM
x
The undersigned Respondent in accordance with Florida Statute 287.087 hereby certifies
that.-
f 0
(f
(Name d Business) e-
0
1. Publishes a statement notifying employees that the UnlaWfUl n1antiftiCnIFC, distribution.
dispensing, possess-Ion, Or use of a controlled substance is prohibited in the workplace
.arid specifying the actions that will be taken avainst employees for violations Of such E
Prohibition.
2 Informs employees about the dangers ofdru- abuse in the workplace, tile business's
policy of maintaining a drug-free workplace, any available dnig counseling .2
rehabilitation, and employee assistance pro yarns, and the penalties that may be imposed
U)
upon employees for drug abuse violations.
3. Gives each employee engaged in providing the commodities or contractual services
that are under proposal a copy of the statement specified in subsection (I
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4. In the statement specified in subsection (1), notifies the ernployees that, as a condition C
of working on the commodities or contractual services that are under proposal, the .2
employee will abide by the ten-ns of the statement and will notify the employer of any
conviction of, or plea of guilty or solo contendre to, any violation of Chapter 893 0
(Florida Statutes)or of any controlled substance law of the United States or any state, for CL
a violation occurring in the workplace no later than five (5) days after such conviction. N
5. Imposes a sanction on, or require the satisfactory participation in a drug abuse
assistance or rehabilitation program if such is available in the employee's cormliunity, or
any employee who is so convicted, U T�
E
6� Makes a good faith effort to continue to maintain a drug-free workplace through
implementation of this section.
As the person authorized to sigi ill Statement, I certify that this firril complies fully with
the above requirenlents.
C44
Respond nts Signature
"Wo 0
Date
OMB NWII FORM t�5 E
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Packet Pg. 2085
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LOBBYING AND CONFLICT OF INTEREST CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
ONROE COUNTY, FLORIDA
ETHICS CLAUSE
PE( 5 �j c _'f V 11 e c warrants that he/it has not employed,
retained or otherwise had ct olits behalf any former County officer or employee in
violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in
violation of Section 3 of Ordinance No, 10-1990. For breach or violation of this
provision the County may, in its discretion,terminate this contract without liability and E
may also, in its discretion,deduct from the contract or purchase price,or otherwise
recover, the hufy
t of y fee,commission, percentage, gift,car consideration paid to
the former Co er employee.
(Signature)
Date:
STATE OF I
COUNTY CIF ( 1`
0
PERSONALLY APPEARED BEFORE ME, the undersigned authority, CL
or. G1 c
.ht, - t'`n fY1Z,r who,after first being swain by me, affnted
1ais[her
Signature (name of individual signing) in the space provided above on this ' day
�i
of
,201
-MIUMTM
L _ My tEE 1
NOTARY PUBLIC PM MaO 2,2015 r�
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vly corn-nission expires: c f
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OMB MCP FORM#4
Attachment E
Packet Pg. 2086
0
0
MONROE COUNTY, FLORIDA
RISK MANAGEMENT
POLICY AND PROCEDURES
CONTRACT ADMILNISTRATION
MANUAL
0
Indemnification and Hold harmless
for
Other Bidders and Subbidders
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The Bidder covenants and.agrees to i.ndenznify and bold harmless Monroe Board of
CD
County Commissioners, its servants,agents and employees from any and all claims for
bodily injury(including death),personal injury, and property damage(including property cn
owned by Monroe County)and any other losses,damages,and expenses(including 2
attorney's fees) which arise:out of, in connection with,or by reason of services provided �
by the Bidder or any of its Subbidder(s)in any tier,occasioned by the negligence, errors,
or ether wrongful act or omission of The Bidder or its Subbidders in any tier„their
employees,or agents.
In the event the completion of the project(to include the work of others) is delayed or �
suspended as a result of the Bidder's failure to purchase or maintain the required Lu
insurance,the Respondent shall indemnify the County from any and all increased
expenses resulting from such delay.
The first ten dollars( 10.00)of remuneration paid to the Respondent is for the
indemnification provided for above.
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The extent of liability is in no way limited to,reduced,or lessened by the insurance
requirements contained elsewhere within this Contract.
�f
1eondent's Signature
Date
N
'I 'S
Atfachment f
Packet Pg. 2087
0
VEHICLE LIABILITY
INSURANCE REQUIREMENTS
FOR
CONTRACT MEDICAL DIRECTOR
BETWEEN
MC NROE COUNTY,FLORIDA
AND
0)
Recognizing that the work governed by this contract requires the use of vehicles,the
CD
Contractor,prior to the com encernent of work, shall obtain Vehicle Liability Insurance.
Coverage shall be maintained throughout the life of the contract and include,as a
minimum,liability coverage for:
• Owned,Non-Owned,and Hired Vehicles
The minimum limits acceptable shall be: �
$300,000 Combined.Single Limit(C L.)
If split limits are provided,the minimum limits acceptable shall be:
$100,000 per Person
$300,000 per Occurrence
CL
$50,000 Property Damage
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The Monroe County Board of County Commissioners shall be named as Additional
Insured on all policies issued to satisfy the above requirements..
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L2
Attachment G(I of 2) �
Packet Pg. 2088
0
WO R t CO NSATICIN
INSURANCE REQUIREMENTS
FOR
CONTRACT MEDICAL DIRECTOR
BETWEEN
MONROE COUNTY, FLORIDA
AND
0)
Prior to the commencement of work governed by this contract, the Contractor shall obtain
Workers"Compensation Insurance with limits sufficient to respond to the applicable state
statutes. y
In addition, the Contractor shall obtain Employers° Liability Insurance with limits of not
less than:
$ 00,000 Bodily Injury by Accident
$ 00,000 Bodily Injury by Disease,policy limits
$ 00,000 Bodily Injury by Disease, each employee
Coverage shall be maintained throughout the entire term of the contract.
Coverage shall be provided by a company or companies authorized to transact business i N
the state of Florida.
0
If the Contractor has been approved by the Florida's Department of Labor,as an
authorized self-insurer,the County shall recognize and honor the Contractor's status. The
Contractor may be required to submit a Letter of Authorization issued by the Department
of Labor and a Certificate of Insurance,providing details on the Contractor's Excess
Insurance Program.
If the Contractor participates in a self-insurance fund,a Certificate of Insurance will be
rewired.. In addition,the Contractor may be required to submit updated financial.
statements from the fund upon request from the County.
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Attuchmew G(2 of 2)
Packet Pg. 2089
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0
ALLSTATE FIRE AND CASUALTY INSURANCE COMPANY Calendar Date'
05/16/2011
HD Office Number. 941938561 09 7 1 �
Nort br o , Illinois
Insured: SANDRA SCE ER Address, 160 KEY HGHTS OR
City: TAVERNIER St; FL Zip; 33070 Home. 305 - 85 - 9778 U
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ADD ITEM INTERESTED PARTY
Item Interested Party n 00B R 4DDH T I§l31UgS 86 55 Iair Cade:
MCBUCC
1100 SIMONTON STREET CD
KEY NEST FL 33048 2
THIS REQUEST IS SUBJECT TO POLICY TERMS AND IS EFFECTIVE ONLY IF THE POLICY y
NOTED ABOVE IS CURRENTLY IN FORCE �
Effective Off. : 54 PM 05 16 l2011 E
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051833 07D 385- 45-8 88
gen s ign a Agent Location Agent's Phone N
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Packet Pg. 2090
MAY-16- 11 16:51 From: To 61 999 1273 P .
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Print Key Output Page 1
5751SS1 V5RIMO 080215 A4000038 05/16/11 17:09:42Lu
Display Device QPADEV012Z
User . . . . . . . .. S303393
Insured: SAI+IEIRA SC�4EMMER Pol . No. : 941938561. 09/14
Hone: ( 00 ) 852 - 9778 ITEM COVERAGES
08 R 400H ._
AA Bodily Injury S 250/50u 5 2 0/500 250/500 2501500
8I1 Property Damage 100 100 00 100 �
ST UMJIIIM Bodily Injur 5 100/300 100/300 1 0/300 100/300 E
SV LIM10IM Non-Stacking
CC Medical Payments
DD Collision (Ded) S 500 S 500 500 500
HH Comprehensive (Ded) 250 250 250 250
HC Eire/Eight/Trap/The
JJ Towing, Later (Dcc) )
UD Rental Reim.. (Day) 5 30 S 30 30 30
ZA Sound System (Occ)
VA PIP (Ded)
PIP Plan 2 2 2 2
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Make All Physical Damage Limits Consistent. II Add other Misc. Coverages: M �
(ENTER) CONTINUE (F1) HELP (E3) QUIT
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Packet Pg. 2091
0
LOCAL PREFERENCE FORM
Vendors claiming a local Preference according to Ordinance 023-2009 must mplete this form. �
Narne of Bidder/Responder� t t7 r1 a _ 4 c Date: _y ------
l. Does the vendor have a valid receipt for the business tax paid to the Monroe County Tax Collector elated
at least one year prior to the notice or request for bid or proposal`? � w_{Please furnish copy. )
I Does the vendor have a physical business address located within Monroe County from which the vendor
operates or performs business on a clay to day basis that is a substantial component of the goods or services
being offered to Monroe County?
) (. '
Last.Address: w,— -•
-- --
Telephone Number:
B- Does the vendor/prime contractor intend to subcontract 50°lam or more of the goods,services of �
construction to local businesses tntefrng the criteria above as to licensing and location?
if yes,please provide:
1.Copy of Receipt of the business tax paid to the Monroe County Tax Collector by the subcontractor dated �
at least one year prior to the notice or request for bid or proposal.
2. Subcontractor Address within Monroe County from which the subcontractor operates:
Tel.Number--._
0
Print CL
Sim end sTitle of Authorised Sigxtatory for c r r -) it,t.'- t a c C.4 €'ct � r`c cv
Bidder/Responder
STATE Dl [ ®—r_ T�
U
COUNTY OF E
On this *`day of , 2011 before me, the undersigned notary public, personally appeared
() • L, r, known to me to be the rson whose name is subscribed above or who
produced _ as identification, and acknowledged that he/she is the person who
executed the above Local Preference Form for the purposes therein contained,
ram.
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My commission expires:
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