FY2004 12/17/2003
DANNY L. KOLHAGE
CLERK OF THE CIRCUIT COURT
DATE:
January 9, 2004
TO:
Fire Chief Clark Martin
Fire-Rescue Department
ATTN:
FROM:
Darice Hayes
Administrative Assistant
Pamela G. Hanc~
Deputy Clerk ry
At the December 17, 2003, Board of County Commissioner's Meeting the Board granted
approval and authorized execution of the following:
./Resolution No. 525-2003 authorizing the Chairman to execute an EMS County Grant
Application and related request for grant distribution to the State of Florida Department of
Health, Bureau of Emergency Medical Services. Enclosed is a certified copy of the subject
Resolution and a duplicate original of the Grant Application.
Contract Amendment between Monroe County and Professional Emergency Services, Inc.
to extend the existing Agreement for two months, January 2,2004 through February 29,2004, to
allow parties sufficient time to determine the details of future operations. Enclosed is a duplicate
original.
Should you have any questions please do not hesitate to contact this office.
cc: County Administrator w/o documents
County Attorney
Finance
File........
Clark Martin
Fire Rescue
RESOLUTION NO. 525 -2003
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF MONROE COUNTY, FLORIDA,
AUTHORIZING CHAIRMAN TO EXECUTE AN EMS COUNTY
GRANT APPLICATION AND RELATED REQUEST FOR
GRANT DISTRIBUTION TO THE STATE OF FLORIDA
DEPARTMENT OF HEALTH, BUREAU OF EMERGENCY
MEDICAL SERVICES
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, as follows:
1. The Chairman is hereby authorized to execute an EMS County Grant
Application and related Request for Grant Distribution to the State of Florida Department of
Health, Bureau of Emergency Medical Services, and copies of same being attached hereto.
2. The monies from the EMS County Grant will improve and expand the
County's pre-hospital EMS system to include the area municipal fire rescue systems.
3. The grant monies will not be used to supplant existing County EMS
budget allocations.
PASSED AND ADOPTED by the Board of County Commissioners of Monroe County,
Florida, at a regular meeting of said Board held on the 17 th day of December , 2003.
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,Attest: [>ANNY L.
Mayor Nelson
Mayor Pro Tern Rice
Commissioner Spehar
Commissioner Neugent
Commissioner McCoy
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BOARD OF COUNTY COMMISSIONERS
OF MO~07'~~UN1.Y.. FLORIDj ~
By: "/~/u- /7? ~~
Mayor/Chairman
By.
MONROE COUNTY ATTORNEY
~~M
ROBE . OLFE
CHIEF ff~TbtT.?_~~TTORNEY
Date .
EMS COUNTY GRANT ApPLlCA TION
FLORIDA DEPARTMENT OF HEAL TH
Bureau of Emergency Medical Services
Complete all items
ID. Code (The State Bureau of EMS will assign the ID Code - leave this blank) C
1. Coun Name: Monroe County onroe County Board of County Commissioner)
Business Address: 490 63rd Street, Suite 160
Marathon, FL 33050
Tele hone:
Federal Tax ID Number (Nine Di
9
2. Certification: (The applicant signatory who has authority to sign contracts, grants, and other legal
documents for the county) I certify that all information and data in this EMS county grant application and
its attachments are true and correct. My signature acknowledges and assures that the County shall
comply fully with the ~ itions outlined in the Florida _,*"S CJ)Unty Grant Application.
Si nature: t:.. 7~~ Date: I 4 0'1
Printed Name: Murra E. N
Position Title: Ma or
3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and has
responsibility for the implementation of the grant activities. This person is authorized to sign project
reports and may request project changes. The signer and the contact person may be the same.)
Name: Clark o. Martin, Jr.
Position Title: .t'1re l;n1er
Address: 490 63rd Street, Suite 160
Marathon, FL 33050
Telephone: (305) 289-6004 1 Fax Number: (305) 289-6336
E-mail Address: martin-clark@monroecountv-fl.gov
4. Resolution: Attach a current resolution from the Board of County Commissioners certifying the grant
funds will improve and expand the county pre-hospital EMS system and will not be used to supplant
current levels of county expenditures.
5. Budget: Complete a budget page(s) for each organization to which you shall provide funds.
List the organization(s) below. (Use additional pages if necessary)
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~y Larg9;Volunteer Ambulance Corps.
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Oo;an~_e~ Public Safety (ORPS)
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MONROE COUNTY ATTORNEY
6t?~RM
RO ERT . WOLFE
CHIEF I\SSISTANT qqu~ ATTORNEY
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BUDGET PAGE 1 OF 2 (KLVAC)
A. Salaries and Benefits:
For each position title, provide the amount of salary per hour, FICA per
hour, other fringe benefits, and the total number of hours. Amount
TOTAL Salaries
TOTAL FICA
Grand total Salaries and FICA
B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an
agency. such as, commodities and supplies of a consumable nature excludinq expenditures classified as
operatinq capital outlav (see next cateaory).
List the item and, if applicable, the quantity Amount
Training which would include salary reimbursement
for employees 12,600.00
TOTAL $ 12,600.00
C. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other
tangible personal property of a non consumable and non expendable nature with a normal expected life
of one (1) year or more.
List the item and, if applicable, the quantity Amount
'P<>n..},<I,,<>rl RMC:: fi<>lrl rl<lj-~ ,,~11 <lnrl renortincr
system 79,433.26
TOTAL $ 79,433.26
Grand Total $ 92,033. 26
**
DH Form 1684, Rev. June 2002
4
BUDGET PAGE 2 OF 2 (ORPS)
A. Salaries and Benefits:
For each position titl.e, provide the amount of salary per hour, FICA per
hour, other fringe benefits, and the total number of hours. Amount
TOTAL Salaries
TOTAL FICA
Grand total Salaries and FICA
B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an
agency, such as, commodities and supplies of a consumable nature excludinq expenditures classified
as operatinq capital outlay (see next cateaorvt
List the item and, if applicable, the quantity Amount
Training which would include salarv reimbursement
for employees 8,400.00
TOTAL $ 8,400.00
C. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other
tangible personal property of a non consumable and non expendable nature with a normal expected life
of one (1) vear or more.
List the item and, if applicable, the quantity Amount
Pen-based EMS data collection and renorting
system 52,955.50
TOTAL $ 52,955.50
Grand Total $ 61,355.50
**
DH Form 1684, Rev. June 2002
** $92,033.26 + 61,355.50 = $153,388.76; broke down as follows: Includes roll-over
funds of $63,007.63 with accrued interest of $2,580.41 through September 30, 2003, in
the amount of $65,588.04, and FY 2004 share of $87,800.72 - TOTAL: $153,388.76.
4 ===
FLORIDA DEPARTMENT OF HEAL TH
EMS GRANT PROGRAM
REQUEST FOR GRANT FUND DISTRIBUTION
In accordance with the provisions of Section 401.113(2)(a), F. S., the undersigned hereby
requests an EMS grant fund distribution for the improvement and expansion of pre-hospital
EMS.
DOH Remit Payment To:
Name of Agency: Board of County Commissioners, Monroe County, FL
Mailing Address: 490 63rd Street
Marathon, FL 33050
Federal Identification number 59-6000-749
Authorized Official: ~~
Signatut/"
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1-4- bLf
Date
Murray E. Nelson, Mayor
Type Name and Title
Sign and return this page with your application to:
Florida Department of Health
BEMS Grant Program
4052 Bald Cypress Way, Bin C18
Tallahassee, Florida 32399-1738
Do not write below this line. For use by Bureau of Emergency Medical Services personnel only
Grant Amount For State To Pay: $
Grant 10: Code:
Approved By
Signature of EMS Grant Officer
Date
State Fiscal Year:
Oroanization Code
64-25-60-00-000
E.O.
N
OCA
N2000
Obiect Code
7
Fed~ral Tax JD:
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Gra'h~,~~~)~ Date: October 1,
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DHForit';'\tWP. ~v; June 2002
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Grant Ending Date: September 30,
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MONROE COUNTY J.\fl0t1NEY
~ APPROVED A~l;(iM:
~~~
ROB R . WOLFE
O;t~IEi~S~~A~~U~Y~TTORNE~