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HomeMy WebLinkAboutItem #04 Approval to Accept an EMS Grant Provided by the Office of the Orange County Medical Director Ocoee florida AGENDA ITEM COVER SHEET Meeting Date: February 16, 2016 Item # 4- Reviewed By: Contact Name: John Miller, Fire Chief Department Director: John 'ller, F' hief Contact Number: 407-905-3140 City Manager: Rob Frank Subject: Approval to Accept an EMS Grant provided by the Office of e Orange County Medical Director. Background Summary: Currently, the Ocoee Fire Department has a half-body airway and CPR manikin, an IV simulation arm, and a cardiac rhythm generator. With only these items, our training has been limited and basic in nature. The acquisition of the SMART STAT simulation generator will allow the training department the opportunity to expand training to a whole new level. Advanced training in real-life scenarios will be available. Over the last several years, the number of EMS calls that the Ocoee Fire Department has responded to have been increasing. With the continued growth of the city, the increase in EMS calls is expected to continue. The use of this advance training equipment will help us become better prepared to meet these needs and our expectations. Issue: The Ocoee Fire Department has been searching for means to obtain realistic emergency medical training for their EMTs and Paramedics. Incorporating this SMART STAT simulator will help provide high quality training for all EMS personnel. Recommendations Staff recommends accepting this being awarded by the Orange County EMS Council through the Office of the Orange County Medical Director. Attachments: Attached are copies of the entire Orange County EMS Council Awards Program application, a copy of a letter from the Office of the Orange County Medical Director, stating the awarding of the grant, and copies of the (3) quotes for the product, as required in the grant. Financial Impact: The EMS Grant provided by the Office of the Orange County Medical Director are funds provided directly from the State of Florida to the Office of the Medical Director. The Office of the Medical Director will purchase directly from the vendor the SMART STAT simulator valued at $9968. Once the simulator is received at the Office of the Medical Director the Ocoee Fire Department will be notified to make arrangements to pick it up from their office with no financial obligation. Type of Item: (please mark with an '50 Public Hearing For Clerk's Dept Use: Ordinance First Reading X Consent Agenda Ordinance Second Reading Public Hearing Resolution Regular Agenda Commission Approval Discussion&Direction Original Document/Contract Attached for Execution by City Clerk Original Document/Contract Held by Department for Execution Reviewed by City Attorney N/A Reviewed by Finance Dept. N/A Reviewed by 0 N/A 2 C tEDfc g a,4k GECouNTY V 1L :NT A A . 1 , . ORANGE COUNTY EMS COUNCIL AWARDS PROGRAM APPLICATION MANUAL 1 Revised 09-2014 t.d. TABLE OF CONTENTS SECTION PAGE 1. INTRODUCTION 3 2. ELIGIBILITY 3 3. PROCESS FOR AWARD FUNDING 4 4. COMPLETING THE APPLICATION 4 5. FUNDING 5 6. PURCHASES 5 7. TERMS, CONDITIONS AND REQUIREMENTS 6 8. FINANCIAL 8 9. REVISIONS 8 10. EXTENSION OF AWARD ENDING DATE 8 APPLICATION FORM EMS AWARDS APPLICATION 9 - 14 APPENDICES A. MEDICAL DEVICE APPROVAL 15 B. RADIO EQUIPMENT WORKSHEET 16 C. APPLICATION SCORING SHEET 17 D. DISTRIBUTION AGREEMENT 18 E. EQUIPMENT RELEASE FORM 21 F. IMPLEMENTATION PROGRESS REPORT 22 2 Revised 09-2014 t.d. Orange County EMS Awards Program INTRODUCTION The Orange County Award program assists public and private organizations involved in EMS to improve and expand the countywide EMS system. To apply for Orange County EMS Council (EMSC) awards money, organizations must meet specific eligibility requirements. Applicants certify they will meet all the requirements in this manual when they sign the application. Retain this manual. It contains the forms for application, reports and budget changes. ELIGIBILITY To apply for funding under this program, the applicant must meet the following threshold criteria: 1. The requested award funds must be used for the improvement and expansion of services provided. 2. The requested award funds must be used for one or more of the following activities as stated in section 401.113 (2)(b), Florida Statutes (F.S.): A. INCREASING EXISTING LEVELS OF EMERGENCY MEDICAL SERVICES: Projects should be for activities or services to treat a sudden critical illness or injury and to provide emergency medical care and pre-hospital emergency medical transportation to sick, injured or otherwise incapacitated persons within the County. Funds cannot be used for land acquisition or construction projects. B. EVALUATION: Projects that directly evaluate the efficiency and effectiveness of EMS services. C. COMMUNITY EDUCATION: Activities must be for public (nonprofessional) education in injury prevention or accessing 9-1-1. D. TRAINING IN CPR AND OTHER LIFESAVING AND FIRST AID TECHNIQUES: Projects for public (nonprofessional) education are eligible. E. CONDUCTING RESEARCH: Projects should be designed to extend the level or scope of EMS knowledge, techniques and practices that will directly improve or expand patient care in the present or near future. 3. Projects will be considered "Existing Service" after two (2) years unless extended by a vote of the EMS Council. 3 Revised 09-2014 t.d. PROCESS FOR AWARDS FUNDING APPLICATION PACKAGE: To obtain an application package, contact the Orange County EMS Office of the Medical Director (OMD). FORM TO USE: Applicants must complete the form titled Orange County EMS Awards Program Application. Submit the completed original form to: ArrN: EMS AWARDS ORANGE COUNTY EMS OFFICE OF THE MEDICAL DIRECTOR 2002-A E. MICHIGAN STREET ORLANDO, FL 32806 PHONE: 407-836-8960 FAX: 407-836-7625 DEADLINE: The Finance Committee must receive EMS Awards application(s) no later than the deadline stated on the award announcement. The Finance Committee reserves the right to extend the deadline. MANDATORY CRITERIA: The Finance Committee shall review and determine if application(s) meet mandatory criteria on the application. Any application that does not meet the mandatory criteria may be rejected by the Finance Committee and not reviewed (Appendix D). COMPLETING THE APPLICATION ITEMS 1 &2 - NAMES: Legal name of organization and the applicant signatory who has authority to sign contracts, awards and other legal documents. The contact person (item 2) is the individual who will have direct knowledge of the project on a day-to-day basis. This person may sign project reports and request project changes. The signer and contact person may be the same or different individuals. ITEM 3 - LEGAL STATUS: Place a check mark beside only one of the choices. ITEM 4 - FEDERAL TAX IDENTIFICATION NUMBER: This is a nine digit number (required for non- profits and for-profits only). ITEM 5-MEDICAL DIRECTOR APPROVAL FOR MEDICAL EQUIPMENT AND CONTINUING EDUCATION ITEM 6 - RELATIONSHIP TO EMS STRATEGIC PLAN GOAL ITEM 7- PROJECT DESCRIPTION/JUSTIFICATION: This is the NEED STATEMENT. Describe and justify the project as noted on the application. Cite the source for all information, (e.g. run reports, 9-1-1 logs, or other specific sources). Data should be specific to the geographic area of the project. 4 Revised 09-2014 t.d. ITEM 8 - PROJECT OUTCOME: Measurable degree to which the need will be met or changed. ITEM 9-WORK ACTIVITIES AND TIME FRAMES: Indicate procedure for delivery of project. ITEM 10 - BUDGET: If the project involves agencies other than EMS, the budget should be for the proportion that EMS would use. • SALARIES: Payment for salaries must be for positions or staff over the level of current funding. • EXPENSES: Project expenses for EMS awards must be in direct support of the project. Indirect or general costs are not allowable. • EQUIPMENT: Cost for specific equipment is listed here: o Medical Devices require Medical Director's approval (Appendix A). o Radio Equipment worksheet for all communications projects (Appendix B). ITEM 11 -ASSURANCES: The authorized official identified in Item 1 signs and dates this page. FUNDING NOTICE OF AWARD: The OMD will send a Notice of Award letter to each successful award applicant. This letter is the official notification by the EMS Council that the project will be funded. It will specify the amount of the award, the beginning and ending dates of the award and any possible limitations on execution of the award. UNSUCCESSFUL APPLICATIONS: On behalf of the EMS Council, OMD will also notify all unsuccessful applicants. FINAL AUTHORITY: The Orange County EMS Council has final authority for all EMS Award funding decisions. PURCHASES All purchases will be through the Orange County procurement process and coordinated by OMD. For purchases up to $1,500 one quote is required; over $1,500 to $33,999 requires three quotes; $34,000 to $100,000 requires RFP or sole source justification and greater than $100,000 requires RFP or sole source justification and Board of County Commissioners approval. All other expenditures must follow Orange County purchasing policies. 5 Revised 09-2014 t.d. Terms, Conditions and Requirements GENERAL The awardee hereby agrees to: ♦ Improve the quality of existing pre-hospital EMS activities. ♦ Expand the extent, size or number of existing pre-hospital EMS activities or services. 1. Statutes and Rules: The recipient agrees to implement all provisions of the award in accordance with federal, state, and local laws, rules, regulations and policies. 2. Confidentiality: The recipient shall not use or disclose any client/patient information under this award for any purpose not in conformity with state and federal regulations (45 CFR, Part 205.50) except upon written consent of the client/patient or his/her responsible parent or guardian as authorized by law. 3. Vehicles and Equipment: The recipient shall own all items, including vehicles and equipment purchased with Orange County awards money, unless otherwise described in the award application. The award recipient shall clearly document the assignment of equipment ownership and usage, and maintain these documents so they are available to the EMS Office of the Medical Director. The owner of vehicles shall be responsible for its proper insurance, licensing, permitting, and maintenance. All equipment purchased with award funds shall continue to be used for pre-hospital EMS or the purpose for which it was purchased throughout its useful life. Useful life is determined by Orange County's Procurement Division. When any award funded equipment is no longer usable, it may be sold for scrap or disposed of in the customary way that the agency disposes of equipment that has no further functional use. 4. Availability of Funds: Orange County EMS awards are subject to the availability of funds. 5. Medical Devices: All medical devices must have the approval of the EMS Medical Director. If the device has not previously received approval, Medical Director's Approval of Medical Device (Appendix A) must be attached. 6. Radio Equipment: The recipient agrees to have all radio activities, services and equipment approved in writing by the Orange County EMS Office of Medical Director. Radio Equipment Worksheet (Appendix B) must be attached. 7. Transfer of Property: If, for whatever reason, the owner of any equipment funded in whole or part by Orange County EMS award funds is compelled to transfer ownership of that equipment before the end of its useful life, OMD shall be that recipient. 8. Supplanting Funds: The applicant cannot propose to use award funds to supplant or replace any county or other funding source. Funds received under the county award program cannot be used to fulfill the matching requirement for the matching award program. 6 Revised 09-2014 t.d. 9. Notice of Award: The Notice of Award letter and the contents of this manual contain by reference, all regulations, rules and other conditions governing this award. 10. Use of Award Funds: All money awarded by the EMS Council shall be used between the beginning and ending dates of the award. 11. Reports and Documentation: The Orange County EMS Office of the Medical Director will maintain all records for auditing purposes. To remain eligible for future awards, the recipient agrees to submit a completed Implementation Progress Report (Appendix E) to the Orange County EMS Office of the Medical Director prior to the end of the current award cycle. If a recipient was awarded more than one award, a separate sheet must be submitted for each. The OMD will submit a final expenditure and narrative report to the EMS Council after the ending date of the award cycle. 12.Travel Costs: Travel and per diem expenses shall be in compliance with section 112.061, F.S. and Orange County Purchasing and Contracts policy. The award recipient shall be solely responsible for all costs: a. Which the award recipient pays prior to the beginning date of the project. b. Which the award recipient does not encumber before the ending date of the award. c. Which the award recipient encumbered before the ending date of the award but pays 40 or more days after the ending date of the grant. 13. Sponsorship Statement: The recipient ensures that where activities supported by this award produce original writing, sound recording, pictorial reproductions, drawings or other graphic representations and works of any other nature, notices, informational pamphlets, press releases, advertisements, descriptions of the sponsorship of the program, research reports, and similar public notices prepared and released by the provider shall include the statement: "Sponsored by the Orange County Emergency Medical Services System and the State of Florida, Department of Health, Bureau of Emergency Medical Services". If the sponsorship reference is in written or other visual material, the words "Sponsored by the Orange County Emergency Medical Services System and the State of Florida, Department of Health, Bureau of Emergency Medical Services" shall appear in the same size letter or type as the name of the recipient's organization. A copy of materials shall be sent to the OMD within three weeks of reproduction and delivery to the award recipient Failure to comply with this requirement will result in disallowance of the expenditure. 14. Permanence of Agreement: The recipient agrees that compliance with this assurance constitutes a condition of continued receipt of, or benefit from EMS Awards funds, and that it is binding upon the recipient and assignees for the period during which such assistance is provided. In the event of failure to comply, the recipient understands that the County may, at its discretion, seek a court order requiring compliance with the terms of this assurance or seek other appropriate judicial or administrative relief. 15. Orange County Held Harmless: Orange County Government shall not be liable for violations by recipients of any laws, rules, ordinances, regulations, or guidelines. 7 Revised 09-2014 t.d. FINANCIAL 1. Termination by the EMS Council: Failure to meet the financial, activity, reporting, performance, or other obligations under this award may result in termination of the award. 2. Termination by the Recipient: Recipients desiring to terminate the award must notify the EMS Council in writing. The EMS Council must receive notice of termination before any funds are expended and agree to the termination. 3. Termination by Sale Transfer: Responsibility for an award cannot be transferred to another agency or organization without written authorization from the Orange County EMS Office of the Medical Director. REVISIONS The recipient shall obtain written approval from the Orange County EMS Office of the Medical Director for any substantive change to award proposal. EXTENSION OF PROJECT TIMELINE No project timelines will be extended without prior approval. All extensions must be requested in writing and approved by the Orange County EMS Office of the Medical Director at least 45 days prior to the award's ending date. Extensions will not be given for avoidable delays. 8 Revised 09-2014 t.d. C� �IEDjC� cr,/ ,, F. ,tt,i, w �` w (7 —, I :, cow Orange County EMS Council EMS AWARDS PROGRAM APPLICATION YEAR 2015 9 Revised 09-2014 t.d. ORANGE COUNTY EMS COUNCIL EMS AWARDS APPLICATION (FOR OFFICE USE ONLY) EMSO ID. Code Total Award Amount $9,968 1. Organization Name Ocoee Fire Department Authorized Official John M. Miller Title Fire Chief Mailing Address 563 S. Bluford Ave City Ocoee State FL Zip 34761 Telephone 407-905-3140 Email Address jmiller @ci.ocoee.fl.us 2. Contact Person Corey Bowles Title Lieutenant Mailing Address 563 S. Bluford Ave City Ocoee State FL Zip 34761 Telephone 407-905-3140 Email Address cbowles @ci.ocoee.fl.us 3. Legal Status of EMS Organization (Check only one response). Private Not For-Profit (attach copy of IRS's 501(c)(3)letter or other legal documentation of this status) Private For-Profit x City/Municipality County State 4. Federal Tax ID No. V F 5 9 6 0 1 9 7 6 4 5. Medical Director 1 hereby affirm my authority and responsibility for the use of all medical equipment and continuing Education awards projects. SIGNATURE DATE PRINTED NAME MEDICAL LICENSE NO. 10 Revised 09-2014 t.d. PROJECT DESCRIPTION AND JUSTIFICATION A 12 POINT FONT MUST BE USED OR LEGIBLE HAND PRINTING 6. Project Description/Justification: This is the NEED STATEMENT. Describe and justify the project. Include: (1) all available numerical data, time frames for the data, data source; (2) number of people directly impacted by the award(s); (3) whether the project will serve single municipality, county, multi-county, or regional area; and, (4) whether the project will coordinate with other EMS organizations. (Use only space provided). In 2007 the Ocoee Fire Department(Ocoee FD) increased its clinical capabilities to provide advanced life support (ALS) services to the citizens of west Orange County. At the time the main focus was to reduce the delay between the 911 call for service and ALS intervention. In 2016, the Ocoee FD is looking to take another step in increasing the efficiency of the emergency medical services provided. While the Ocoee FD continues to maintain a positive relationship with Rural Metro Ambulance, the goal is to increase the transport capabilities from the scene of emergencies to the hospital. This will help provide a more consistent and efficient service from the time of call to the arrival at the emergency room. With this strategic plan in mind the future will provide Ocoee paramedics an opportunity to provide transport services. This will be a new venture for almost all of the paramedics within the Ocoee FD organization. It is critical that the Ocoee FD training department provide the paramedics with the knowledge, skills, and abilities required to provide transport services. Paramedics will encounter increased patient interaction and progression of illness/injuries which they may not readily see with our current two tiered transport system. Currently the Ocoee FD training department only has a half body airway/CPR manikin, an IV simulation arm, and cardiac rhythm generator. OCFRD has been gracious enough to allow our organization access to their training site which is located 19 miles away from Ocoee FD jurisdiction. Unfortunately due to the distance to the training site and the size of the Ocoee FD operation it is impossible to provide Ocoee paramedics with adequate hands-on time. There are currently no advanced training simulators in the west Orange County region accessible to EMS providers. This SMART STAT simulator is transportable and will be accessible to all west OCEMS organizations for their training/research needs. The Ocoee FD is requesting $9,968 in funding for the acquisition of the SMART STAT Basic simulator. The simulator will provide paramedics with the tools needed to increase the existing levels of EMS by providing the knowledge, skills, and abilities to treat sudden critical illnesses/injury and effectively provide emergency medical transportation. As an American Heart Association training site, the Ocoee FD will be able to enhance community education programs with the use of the SMART STAT basic simulator. The technology incorporated into the SMART STAT basic simulator will also enable the Ocoee FD to collect and analyze data for the purpose of research in hopes to optimize patient outcomes. 11 Revised 09-2014 t.d. 7. Orange County Strategic Plan: If applicable, specifically reference Orange County EMS Strategic Plan goal(s) and explain relationship to the project. In relation to the Orange County EMS Strategic Plan goal(s) the acquisition of the SMART STAT simulator will support prehospital providers in achieving national training level while improving Ocoee FD paramedic's clinical capacities for integration with the EMS transport system. The simulator features allow instructors to ascertain the diagnostic abilities of the paramedic at the same time capturing performance data for future evaluation. The SMART STAT simulator will provide quantitative data to support future research projects. The data collected by the simulator will utilize an evidence-based approach to creating training programs in an effort to optimize patient outcomes. 8. Outcome measurability: Degree to which the need will be met or changed (Use only the space provided). The Ocoee FD training department will initially focus on evaluating the confidence of the organizations paramedics to recognize and treat patients through customized scenarios. A survey will indicate the level of benefit that the simulator has on the training program. In addition to qualitative data collected through the survey process, the SMART STAT simulator will allow for capture of quantitative data that can then be utilized for operational review and scientific research that improves EMS performance. The Ocoee FD has 45 healthcare providers which provide OCEMS-OMD with an appropriate scale of the OCEMS system for future studies. An example is the addition of King Vision device to Ocoee FD units. With the simulator Ocoee FD will be able to provide scientific data to support the utilization of camera assisted intubation in the field. The goal will be to repeat similar studies to capture measureable outcomes. 9. Work activities and time frames: Indicate procedure for delivery of project (Use only the space provided). Within thirty days of receiving the SMART STAT simulator the Ocoee FD training department will dedicate the first month (minimum of 32 hours) to programing the system to match the OCMD protocol. In addition the training department will focus on creating customized respiratory and cardiac arrest scenarios. Within sixty days the organization will place all of their personnel through baseline scenarios focusing on airway emergencies and cardiac arrest scenarios. Based on the data collected from this exercise, a training regimen will be created. At this point the simulator will also become available for use during all AHA training or any other associated medical training for OCEMS personnel and the public. On a monthly basis the Ocoee FD will provide continuing training in both airway emergencies and cardiac arrest in order to track and collect data on the progress of the medical personnel and adjust training accordingly. 12 Revised 09-2014 t.d. BUDGET CATEGORIES ORANGE AGENCY TOTAL COUNTY FUNDS FUNDS Expenditures: Shipping $0 $0 $0 TOTAL EXPENDITURES $0 $0 $0 Equipment: SMART STAT Basic w/ iPAD $9,968 $0 $9,968 TOTAL EQUIPMENT COSTS $9,968 $0 $9,968 GRAND TOTAL $9,968 $0 $9,968 13 Revised 09-2014 t.d. ASSURANCES ACCEPTANCE OF TERMS AND CONDITIONS: The recipient accepts the award terms and conditions in the "Orange County EMS Awards Program Application Manual", and acknowledges this when funds are expended from the award payment system. EXECUTION OF EMS AGREEMENT: The recipient agrees to abide by the Agreement with Orange County EMS Office of the Medical Director. DISCLAIMER: The recipient certifies that the facts and information contained in this application and any attached documents are true and correct. A violation of this requirement may result in revocation of the award. SIGNATURE OF AUTHORIZED OFFICIAL (Individual Identified in Item 1) DATE John M. Miller TITLE 14 Revised 09-2014 t.d. APPENDIX A MEDICAL DIRECTOR APPROVAL OF MEDICAL DEVICE THE FOLLOWING MEDICAL DEVICE HAS BEEN EVALUATED AND APPROVED FOR USE IN THE ORANGE COUNTY EMS SYSTEM UNDER MY DIRECTION: DEVICE SMART STAT Basic Simulator GEORGE RALLS,MD DATE ORANGE COUNTY MEDICAL DIRECTOR 15 Revised 09-2014 t.d. APPENDIX B RADIO EQUIPMENT WORKSHEET EMS Radio equipment Unit Cost Quanti Subtotal I. Mobile Radios: A. VHF Hi•h Band (or Low Band) B. UHF C. 800 MHz D. Ancillary equipment 11. Portable Radios: A. VHF Hish Band (or Low Band) B. UHF C. 800 MHz D. Accessories: Charger(sin•le or multiple) Remote microphone (speaker/microphone/antenna) Additional batte (two per portable radio) Car ing case E. Ancillary equipment III. Base Stations: A. VHF Hi•h Band (or Low Band) B. UHF C. 800 MHz D. Duplexers and/or Filters (as required) E. Ancilla equipment IV. Communications Center: A. Dispatch Consoles B. Recorders (logging and/or instant recall) C. Computer Aided Dispatch (CAD) system D. Automatic Vehicle Location (AVL) E. RF Control Stations (FX1) F. Ancillary equipment V. Pagers: A. Encoders B. Ancillary equipment Equipment Subtotal VI. Miscellaneous [Award Evaluation: 10% of Equipment Total] Equipment Subtotal VII. Installation, Optimization and First Year Warranty [Award Evaluation: 15% of Equipment Total] VIII. Desi.n and/orEn•ineering Fees Bottom Line Total Pricing should include antennas and associated hardware. 2 Dual Control Head required if radio is utilized for Local Medical Coordination. s Required in all licensed EMS vehicles(MED-8). 16 Revised 09-2014 t.d. APPENDIX C Application Scoring Sheet Evaluator Date Please answer the screening questions first. Screening Questions(If a proposal receives a "YES"it is disqualified). A. Is the proposal cost prohibitive? Yes No B. Is the proposal unreasonable? Yes No C. Is the proposal potentially illegal? Yes No D. Failed to submit Appendix E for award(s)approved the previous year? Yes No Score each remaining application based on the following criteria: • Each application should be scored on its own merits and not compared to another application or other criteria. If there are issues related to the proposal note these in the comments. • The score for each element can be between the score levels. For example,for Overall Merit the score is 8 • This is higher than"good" but not"excellent". • Total the points and record the score at the bottom of the form and on the accompanying composite sheet. 1. Overall merit of the application 10-Excellent proposal 5-Good proposal 1 - Fair proposal 0-No merit 2. Meeting goal or objective of the Current EMS Strategic Plan 10-Completely meets 5-Partially meets 1 -Minimal meets 0-Doesn't meet 3. Value or benefit to the Countywide EMS system 6-Excellent benefit 3-Good benefit 1 -Fair benefit 0-No benefit 4. Cost 3-Low cost < 1,500 2-Medium cost<34,000 1 -High cost >34,000 5. Ease of implementation 3-Easy to implement 2-Moderately easy to implement 1 -Hard to implement TOTAL SCORE 17 Revised 09-2014 t.d. APPENDIX D DISTRIBUTION AGREEMENT BETWEEN ORANGE COUNTY EMS OFFICE OF THE MEDICAL DIRECTOR AND THIS ORANGE COUNTY EMS OFFICE OF THE MEDICAL DIRECTOR AGREEMENT is entered into this day of by and between Orange County, a political subdivision of the State of Florida, hereinafter referred to as the "COUNTY", and to the , hereinafter referred to as the "OWNER". WHEREAS, under Section 401.113(2), Florida Statutes, the Department of Health: Bureau of Emergency Medical Services, hereinafter referred to as the "DEPARTMENT" shall annually dispense funds contained in the Emergency Medical Services Trust Fund; and WHEREAS, the COUNTY has applied for its proportion of funds from said Trust Fund; and WHEREAS, Section 401.113(2)(a), Florida Statutes (hereinafter the "Statute"), provides that an individual Board of County Commissioners may distribute funds received under the Statute to licensed Emergency Medical Services Providers within the County as designated by the Emergency Medical Service (EMS) grant award; and WHEREAS, such grant money shall be used solely to improve and expand pre-hospital Emergency Medical Services and will not be used to supplant or replace any other funds; and WHEREAS, the Board of County Commissioners of Orange County, Florida, has agreed to purchase and distribute equipment and/or services or both, pursuant to grant award to the Owner NOW, THEREFORE, the parties hereto agree as follows: 18 Revised 09-2014 t.d. Section 1 - Term and Termination: The term of this agreement shall begin on the day referenced above and shall continue until five years from that date. However, either party may terminate this agreement without cause upon no less than ten (10) days written notice to the other party. Any notice of termination shall be delivered by certified mail or in person to the business address of the party upon whom such notice is served as set forth on page 3 of this agreement. Section 2 -The Owner's Obligations: The Owner shall: a. Use the equipment for pre-hospital and lifesaving purposes throughout its useful life. Said equipment shall be specifically described and set forth in the "Equipment Release Form" (Appendix E). Failure to use the equipment for pre-hospital and lifesaving purposes will result in: 1) Termination of this agreement. 2) Items being returned to the EMS Office of the Medical Director. 3) Possible restrictions on future Orange County EMS awards allocations. b. Accept full title to all designated equipment purchased with EMS awards funds upon distribution of equipment as noted on "Distribution Agreement" (Appendix D). c. Be responsible for properly insuring, licensing and maintaining equipment purchased with County EMS grant funds for the useful life of the equipment. d. Notify the COUNTY upon the loss, destruction, or theft of the equipment. e. Agree not to sell, lease, rent, lend, encumber or dispose of said equipment without written permission from the COUNTY. f. Submit an "Implementation Progress Report" (Appendix F) to the Office of the Medical Director prior to the end of the current grant cycle. g. Be duly authorized by law to provide pre-hospital Emergency Medical Services and shall maintain all licenses and approvals required by any law, rule or regulation of the State of Florida required for the rendering of pre-hospital Emergency Medical Services. Section 3 -The County's Obligation: Orange County shall: a. Comply with all terms and conditions as "Grantee" of the grant award. b. Purchase and distribute, through the Orange County EMS Office of the Medical Director; the designated equipment and/or services or both, pursuant to the grant award. Section 4 - Entire Agreement: This Agreement contains the entire agreement between the parties. No promises, representations, warranties or covenants not included herein has been or shall be relied upon by either party. Any modifications, additions, or amendments hereto must be in writing, and signed by all parties. 19 Revised 09-2014 t.d. IN WITNESS WHEREOF, the parties hereto have caused this EMS Agreement to be executed by their undersigned officials as duly authorized. BY: SIGNATURE TITLE: FIRE CHIEF AGENCY: Ocoee Fire Department ADDRESS: 563 S. Bluford Ave Ocoee, FL 34761 DATE: TELEPHONE: 407-905-3140 BY: Todd Stalbaum SIGNATURE TITLE: Disaster Health & Medical Manager AGENCY: Orange County Office of the EMS Medical Director ADDRESS: 2002-A E. Michigan Street Orlando, FL 32806 DATE: TELEPHONE: 407-836-6515 STATE OF FLORIDA COUNTY OF ORANGE The foregoing instrument was acknowledged before me this day of by who is personally known to me or has produced identification. WITNESS my hand and official seal in the County and State aforesaid this day of NOTARY PUBLIC: SIGNATURE MY COMMISSION EXPIRES: 20 Revised 09-2014 t.d. APPENDIX E EQUIPMENT RELEASE FORM Office of the Medical Director 2002-A E. Michigan St., Orlando, Florida 32806 Telephone (407) 836-8960 * Fax (407) 836-7625 EMS COUNTY AWARD No. YEAR 20 RECIPIENT AGENCY: Description Model No. Qty PO Number EQUIPMENT RECEIVED BY: 4 SIGNATURE4 DATE OMD REPRESENTATIVE: 4 SIGNATURE4 DATE 21 Revised 09-2014 t.d. APPENDIX F Implementation Progress Report To remain eligible for award funds, Appendix F must be completed and submitted to the Office of the EMS Medical Director before the end of the current award cycle. PROJECT OUTCOME: The measurable degree to which the project needs have been met. SUBMITTED BY: SIGNATURE DATE: 22 Revised 09-2014 t.d. Office of Medical Director, Orange County EMS iOg-4,1 2002-A East Mkkigan Street,Orlando,Florida 32806 1 Telephone(407)836-8960 o Fat(407)836-7625 �J - iuiY GOVERNMENT January 13,2016 F L O R I D A Chief John Miller Ocoee Fire Department 563 S.Bluford Avenue Ocoee,FL 34761 Dear Chief Miller: The Orange County EMS Council and the EMS Finance Committee would like to congratulate you on the award of the EMS County Grant in the amount of$9,968.00 for the SMART STAT Basic simulator for the Ocoee Fire Department and the County-wide EMS system. The decision was based on a standard criteria and scoring process that was applied equally to all applicants. The Orange County EMS Finance Committee will oversee the grant awards and expects quarterly updates on costs and progress. The purchasing process will begin on February 1, 2016. All goods and services must be purchased by September 30, 2016 the end of the grant. You will need to provide our office with three current quotes made out to the Office of the Medical Director for the educational materials and/or equipment to be purchased. Please send all information to Crystal Ford at Crystal.Beattyaocfl.net or you may contact her for additional information at 407-836-9392. . Please feel free to contact our office at 407-836-8960 for any questions regarding the grant money or the process of selection. Sincerely, i N E Christopher Hunter,M.D., Pb Associate Medical Director l Orange County EMS System On behalf of the Orange County EMS Council Board I Shop Anatomical, Inc. Quote PO Box 1320 SHOP NA M.I CAI Lexington, SC 29071 Date Quote# 800-528-4059 9/21/2015 1006180 Name/Address Fax# Ocoee Fire Department 888-357-3231 Corey Bowles 563 S Bluford Ave Ocoee,FL 34761 Terms Net 30 Item Description Qty Price Total SU-8002 SMART STAT Basic with iPad Simulator Manikin 1 9,968.00 9,968.00T Fedex Shipping and Handling***FREE Freight Delivery 0.00 0.00 included We look forward to working with you. Subtotal $9.968.00 Sales Tax (0.0%) $0.00 E-mail Web Site quotes a shopanatomical.com www.ShopAnatomical.com Total $9,968.00 Channing South Deerfield,MA 01373-0200 QUOTE DATE PAGE k�\��/X Bete 1-800-322-3564 . 1-413-665-7611 09/16/15 1 C O M P A N Y' custsvcs @channing-bete.com Mr. Corey Bowles, LT/PM QUOTE SHIP TO Firefighter/Paramedic ■ CUSTOMER REFERENCE NO. Ocoee Fire Department 563 S Bluford Ave TERMS Ocoee FL 34761 Net 30 Days ■ J Mr. Corey Bowles, LT/PM Customer: 11987382 QUOTEDTO Firefighter/Paramedic QuoteNbr: 30767822 SQ Ocoee Fire Department 563 S Bluford Ave HASTI_M Ocoee FL 34761 r QUANTITY I DESCRIPTION I ITEM NO. I UNIT PRICE I EXTENSION 1 1 SMART STAT BASIC WITH iPAD 8002 12240 . 000 12, 240 . 00 1- Price Discount - AHA Products 1652 .400 1, 652 .40- Subtotal 10, 587 . 60 Sales Tax . 00 Total Amount Due 10, 587 .60 N. Channing Bete Company, Inc. Taxpayer ID#04-2041237 r , TAX EXEMPT/RESALE NO. 58-00-094593-54C i QUOTE TOTAL ■ . $ 10, 587 .60 ■ Ocoee Fire Department I0 000000000000010587608 CHANNING BETE COMPANY, INC. QUOTE TERMS SHIPPING: Unless previously noted, shipment will be made within 30 days from receipt of order and/or approval of imprint proof. F.O.B. South Deerfield, MA. (GSA-F.O.B. Destination). Pricing assumes that one shipment, to one location, will be made for this order. Should additional shipments be required, the order will be subject to further quotation. Shipping charges are additional and will be added to the invoice as a separate line item for non-GSA orders. Drop shipping charges and other special transportation charges are additional. TERMS: 1% Prepayment discount (with check). Net 30 days. NOTES: Prices are guaranteed for 30 days unless otherwise noted and are based on a total quantity within each pricing category. Please do not fax or e-mail your credit card information. Credit card information should only be shared via mail, telephone, or our secure Web site. SALES TAX: Included unless tax exempt identification number or a copy of a tax exempt certificate is provided. ADDRESS: Unless instructed otherwise, please send all correspondence to: Channing Bete Company, Inc. One Community Place South Deerfield, MA 01373-7328 Please contact me if you have any questions or concerns regarding this quote. Meghan Hastings AHA Senior Account Manager Phone: 1-888-834-6640 Fax: 1-800-329-2939 Email: mhastings @channing-bete.com Web site: www.aha.channing-bete.com QUOTE Simulaids I I ' PO Box 1289- 16 Simulaids Dr Quote NO. 2922 Saugerties NY 12477 DATE September 15, 2015 [Phone 800-431-4310] CUSTOMER# [Fax 845-679-2344] EXPIRATION DATE October 15, 2015 TO OCOEE FIRE DEPARTMENT ATTN: COREY BOWLES 563 5 BLUFORD AVE OCOEE, FL 34761 phone:407-760-8423 Quoted By Extension 'Email Address PAT SHAW 108 infoasimulaids.com UNIT PRICE LINE TOTAL QUANTITY 1.00 ITEM#8002 SMART STAT BASIC WITH'pad $12,240.00 $12,240.00 CON-WAY QTE#22829093 104.49 Please note:The quote is an estimate of charges based on the information you supplied. We will do our best to honor the quote,but once in a while,the service may be beyond our control. Modifications must be agreed in writing or the quote is void in its entirety. Quotes that include LTL(less then a truckload)services are valid for a period of 30 days; TOTAL $12,344.49 all other quotes are valid for 90 days. Contact customer service for Terms and conditions before placing your order. Payment terms:Visa, MasterCard, Prepay,and Net 30 days with approved credit. ss with you.we IooK rorwara to completing tnis oraer to your satisraction.