HomeMy WebLinkAboutItem 7.1 Emergency Ambulance Service .... .....�� may: ...., !
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AGENDA STATEMENT
Meeting Date: September 27, 1982
SUBJECT : Emergency Ambulance Service Program Agreement
EXHIBITS ATTACHED : Letter from Ben H. Mathew, County EMS, dated September 7, 1982
Agreement
Resolution
RECOMMENDATION • Adopt reso lution Approving agreement
FINANCIAL STATEMENT: Estimated Cost - $5,000
Amount Budgeted - $5,000
DESCRIPTION The City has been notified by Alameda County that the Board of
Supervisors has approved the renewal of the Emergency Ambulance
Agreement with Fremont/Tri-Cities Ambulance Service, Inc. , for
• a three-year term beginning July 1 , 1982 and ending June 30, 1985.
The Agreement provides emergency ambulance service to Zone IX,
which.includes Dublin, Pleasanton, Livermore and the surrounding
unincorporated areas of the County.
Under the terms of the agreement, the City would be required to reimburse the County
for all dry run services rendered by the ambulance provider within the City of Dublin,
and all standby services requested by either Dublin Police or the Dublin San Ramon Services
District Fire Department.
There are approximately 450 ambulance calls per year in the City of Dublin. Of those calls,
approximately 160 result in dry runs (no transport). Standby services are seldom ever used
within the City of Dublin.
The cost to the City is $31 .50 per run or approximately $5,000 per year.
All cities in the County with the exception of Piedmont and Albany contract with the
County for ambulance service. The fire service provides ambulance services in Piedmont
and Albany. The cost to the City of contracting with the County for emergency ambulance
services is reduced to the extent that the County subsidizes the service by paying the
ambulance company for all uncollectibles. By contracting with the County the City becomes
part of an existing system with standards of performance, methods of handling complaints
and mechanisms for insuring adequate coverage.
Other alternatives available to the City include:
1 ) City independently contracts with the private ambulance company. This would probably
cost the City more and the City would lose the expertise and manpower available to
assure adequate standards of performance.
COPIES TO: Art Lathrop
ITEM NO. '• I
AGENDA STATEMENT: Emergen'e' Ambulance Service Program Agre`' nt
Page 2
2) City provides its own ambulance service. Not recommended for reasons in #1 above.
3) City does not enter into any contract for ambulance service. Under this alternative
either no service would be provided or the County and the City could become involved
in a lawsuit over responsibility for the service.
4) . Contract with Dublin San Ramon Services District to provide service. The District
might not be willing to enter into such an arrangement. Cost would be greater than
County contract.
Recommendation:
It is Staff's recommendation that the City Council adopt a resolution approving the attached
emergency ambulance service agreement.
ALAMEDA COUNTY 499-5th Street
HEALTH CARE SERVICES 41
4V Oakland, CA 94607
AGENCY 4
J. MICHAEL LEAHY, Agency Director
Telephone Number:(415)
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September 7, 1982 874-6828
Richard Ambrose, City Manager' •
City of Dublin
P.O. Box 2340
Dublin, CA 94566
Dear Mr. Ambrose:
On August 3, 1982 the Board of Supervisors approved the Agency's recommenda-
tion to renew the Emergency Ambulance Agreements with Fremont/Tri-Cities
Ambulance Service, Inc. for EMS Zones VIII (Fremont, Newark, Union City)
and IX (Dublin, Livermore, Pleasanton) for a three-year term commencing
July 1, 1982 through June 30, 1985.
Attached are four (4) copies of the proposed Emergency Ambulance Service
Agreement between the City of Dublin and Alameda County for the same
term, July 1, 1982 through June 30, 1985.
Please return four (4) copies signed according to your City's policy to
this office for transmittal to the Board of Supervisors. Please contact me
or Mr. Art Lathrop, Assistant Administrator, if you have any questions
regarding this matter.
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Sin y,
A7...!or,"%v —
Ben H. athews, Administrator
Emergency Medical Services
BHM/mb
Attachments
0
RESOLUTION No.
RESOLUTION OF THE CITY COUNCIL
OF THE
CITY OF DUBLIN
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APPROVING THE EMERGENCY AMBULANCE PROGRAM AGREEMENT
WITH ALAMEDA COUNTY
WHEREAS, the County of Alameda has entered into a contract agreement
with Fremont/Tri-Cities Ambulance Service, Inc. , for the provision of emergency
ambulance service; and '
WHEREAS, said agreement includes the provision of emergency ambulance
services to the City of Dublin.
NOW, THEREFORE, BE IT REVOLVED, that the Dublin City Council hereby
approves the Emergency Ambulance Service Program Agreement with Alameda County
for the term of July 1 , 1982 to June 30, 1985.
PASSED, APPROVED AND ADOPTED this day of 1982.
AYES:
NOES:
ABSENT:
Mayor
ATTEST:
City Clerk
EMERGENCY AMBULANCE SERVICE PROGRAM AGREEMENT
This Agreement, made and entered into this day of
, 19 ,. by and between the CITY OF DUBLIN
hereinafter referred to as "CITY and the COUNTY'OF ALAMEDA, hereinafter referred
to as "COUNTY."
WITNESSETH:
WHEREAS, the City finds it in the public interest to assure the
availability of emergency ambulance services within its jurisdiction, and
WHEREAS, the County is capable and willing to- arrange for and
coordinate the provision of such emergency ambulance services;
NOW, THEREFORE, LT IS HEREBY MUTUALLY AGREED .AS FOLLOWS:
Services
1. County shall secure the services of an ambulance contractor(s) to provide
emergency ambulance services within the City limits, in accordance with the
Emergency Ambulance Agreement, Exhibit A, attached hereto .and by reference
incorporated herein.
2. TheCounty Shall provide the services of the Central Medical Emergency
Dispatch (CMED) for dispatch and coordination of emergency ambulance
services.
3. The County shall' monitor the quality of ambulance services including
personnel, equipment, and procedures. •
4. The- County will review= and monitor all ambulance contractor billings.
5. The County will immediately notify the appropriate City public safety agency
of all emergency ambulance requests originating within the territory of the
City, which are reported to CMED.
Public Safety Agencies
6. The City shall relay all requests for emergency ambulance service received
by its public safety agencies to CMED or to such other- dispatch center as
may be mutually agreed to by City and County.
7. The City's Public Safety Agencies shall respond, according to their custom,
practice, and procedures, to assist as needed at the scene of a• medical
emergency when notified by CMED offsuch an emergency.
EMERGENCY AMBULANCE SERVO PROGRAM AGREEMENT
Page Two
Data Collection
8. The City shall make reasonable efforts to assist.the County in the collection
of pertinent data regarding public safety response to medical emergencies.
9. The County shall involve such designees of the City Manager any review of
Exhibit A regarding .(i) any complaints arising thereunder, .(iii) changes in
its operating procedures,. and (iii) contract administration policies relating
thereto..
• Payment
10.. City shall reimburse County for all payments made by County to ambulance
contractor(s) for ell• dry run services rendered within the jurisdiction
of City, regardless of the origin of the request, an CT standby services
requested by a City Public Safety' Agency. It is. expressly. agreed and
understood. by the parties: that City's obligation. to reimburse County for
dry run services shall not exceed. the amounts set forth.in the Reimbursement
Schedule (Exhibit "D"which is. a part of Exhibit "A') as said exhibit read
on. July 1, 1982
11. County shall submit claims for'paynient:to City' within 3a days after County's.
payment to the*ambulance contractor(s). pursuant:to Exhibit A'. Such claims
shall be. accompanied by supporting-ilocumentation as may be reasonably
• required. by' City.
,`12. The City shall reimburse the County within 3G days of the receipt of County's
claim for payment:.
13. City may, at City's option, bill the patient or other person responsible
.
for requesting emergency ambulance response when such a request terminates
as a dry run-.. County's Emergency Ambulance Contractor for EMS Zone IX _
shall provide to. City, when requested by City, information, reasonably
available for such Dry Runs necessary for City's billing-.
14. This Agreement may be modified in writing by mutual consent of the parties
hereto. County shall not enter into a modification of Exhibit A with an
ambulance contractor without the written consent of City thereto.
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EMERGENCY AMBULANCE SERA PROGRAM AGREEMENT 0
Page Three
Term
15. This Agreement shall commence on July 1, 1982 and shall terminate
on June 30, 1985 •
IN WITNESS.WHEREOF, the parties have executed this Agreement the
day and year first above written.
COUNTY OF ALAMEDA CITY OF DUBLIN
By By
Chairman of the Board of Supervisors
Title
Date
Date
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+44 o, 4( CONTRACT N0: 1 2 4 3 9
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C1trlpolo"
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097/C11 OF MIL •
:Ca. 4e44e N w•twv1Nws - 444f,
wit ten
Tri-Cities Ambulance, Inc. AUG 16 198 M.sgn�,lyH
37537 Glenmoor Drive '4110 3 M
0 r98
2
Fremont, CA 94536
Gentlemen:
SUBJECT: AGREEMENT/CONTRACT (or modification thereof) between the County of Alameda
and 4: rr _ ca . , 14 06 . • • �„ „•
within Worsoniy Mpdiral Services_ 7nne T
,r
the Chairman- of the Board of Supervisors of the County of Alameda was
authorized to execute said document by Resolution No. 1 9 4 2 1 0 •
adopted on. Aux 3. 1982 .. a copy of which is attached to each document.
Forwarded for further processing are the original and copy/copies
of subject document.
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Ng Forwarded for your files is a/are fully-executed copy/copies of subject
document.
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Forwarded for further distribution are copies of subject document. • -
Please return the original of the subject document, marked "Clerk's Tile
Copy," together with additional copy/copies of same, f].1L
executed, to:. Clerk of the Board of Supervisors, 1221 Oak Street, Oakland,
California 94612.
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xx We have retained the original of subject document for our files and have ,
forwarded a copy of same to the County Auditor-Controller and the Health
Care. Services Agency.
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• Other:
Very truly yours,
William Mehrvein, Clerk
WM:YQ:cc
Enclosures)
cc: County Auditor-Controller
>Health Care Services Agency
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RI CHARD Mved aS R to For t
:.. f��t'%..uunsei Co;
EMERGENCY AMBULANCE AGREEMENT ~ 1��' "'""-�-•.
EMS ZONE IX
This Agreement, made and entered into this . t ? day of
I9 , by and between the COUNTY OF ALAMEDA, f Cody corporate an&ggrolgoz&,
litic of the State of California, hereinafter referred to as "COUNTY,"
and Tri-Cities Ambulance, Inc. s hereinafter referred to as
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"CONTRACTOR."
• WITNESSETH:
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WHEREAS, .the County finds it in the public. interest to assure the
availability of efficient emergency ambulance services within the areas
• served by this Agreement, and
,WHEREAS, the Contractor 1s capable of and willing to provide such
emergency ambulances:
NOW, THEREFORE, rr IS HEREBY MUTUALLY AGREED as follows: t -
DEFINITIONS OF TERMS
I. The following definitions of terms shall apply throughout. this Agreement:
A. Ambulance - Any vehicle licensed as an ambulance by the fornia
Highway yWatroi.
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H. Ambulance Unit - An ambulance staffed with qualified personnel and
equipped with appropriate medical equipment and supplies.
C. Backup Service - The relocatiori'of an ambulance unit'ta a predesigna-
ted location from-whence it will be available for emergency calls to
serve the. Contractor's. Zone, as well as. an adjacent zone which
ambulance unit shall remain under the control of CMED.
Q. Contract Administrator - An agent of the County designated by the
director of the Health Care Services Agency.
E. CMED - The County of Alameda Central Medical Emergency Oispatch
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F flity.
F. CMED" Number (Code• I I) - A number issued by CMED indicating that the
emergency or non-emergency call was. dispatched or cleared through
G. Ory Run - Any trip made by an ambulance unit in rasoonsa to an
emergency call whereupon after responding to said call , it is found
that no ambulance is needed.
H. Emergency Any sudden or serious illness or injury requiring immediate
medical or psychiatric attention under circumstances such that delay
in providing such services may aggravate such medical condition or
cause the loss of life; further more, any case declared to be an
emergency by a physician.
I. ET erg pn_i Call - A call »e?;es`i ac an '?+-8ci=ta response :+�, an unit to an emergency. jr emergency call shall olute
both Code 3 (red lights and siren) , and Code Z ;expeditious response
without red light and siren) calls. •
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EME1GV= , 131 LANCZ AGREEMENT
PAGE TWO
Definitions of Terms, continued
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J. Mitease - Actual .mileage traveled when transporting a patient(s).
Mileage shall not be determined by a multiplier of the number of
patients carried over the distance traveled.
K. Non-Eneroencr Call - A request for an ambulance unit which request
does not require an immediate resccnse. won-eamersency calls may
be of private or public origin.
L. Public Safety Officer - Any person designated-as a public safety
officer by the. Taw of the State of California.
M. Ph f•fa - Any person duly licensed. to practice :medicine fn the.
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to California. t
N. Responsible Third-Party Paver - Any federal or state medical care
program under which a patient is eligible for benefits; also any
person, partnership, association, corporation, or other entity
under a contractual or iegal obligation to provide medical benefits
to. a patient, and which customarily makes direct payment to a
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provider of medical services including ambulance service. -
a. Standby Services - The dispatch dig an emergency ambulance unit(s)
at the request of a public safety agency to a-specific location
where it remains under the direction of the requesting public safety •
agency until released or put into service on an emergency basis. _
P. Void Call Any dry run of less than three (3) minutes duration
computed from time- of request by-COED or notification of intent to
respond. by Contractor to time of cancellation; or any ambulance
servict r'equest.whtch Contractor is unable to service due to deficiency
imr equipment, personnel, or location identification; or any ambulance
_'7servfc+t request cancelled by CMED prior to the contractor's ambulance
• Writ epor i ng. to CMEQ that it is underway (1.0-a).
SERtC • •
' Z- Contractor agrees to provide on a 14-hour basis all necessary ambulance
units, facilities and personnel form the purpose- of responding, to. em:ergency
calls. within the zone as described. in Exhibit A attached hereto and by
reference incorporated herein.
3. The- Contractor shall maintain the capability of responding to not less
than 97'percent of the emergency cails originating in his Zone as
measured by any 30-day period during the term of this Agreement. Ambulance
units will be stationed in such a manner so as to permit arrival at the
scene of an emergency (response time) within tan (:0) minutes from the
notification to the Contractor of such call, for not Tess than 90
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percent of all such calls as measured by any 30-day period.
. The Contractor shall not respond to any non-emergency request-when doing
so requires the use of the last or only ambulance unit available to
sane the Contractor's zone, or at any time backup services are being
provided to the Contractor's Z_'a� i , r a'- Contractor respond :
any emergency reolees t to a location outside the Contractor's :one wi
e::fi: prior w..�.
4. The Contract:~ shall; provide Standby Service at any location within his
zone Cr in another :one from a a^ up posture, when .
i r9tta! tr./ C.•tV,
u cn the moues: of a :ubl f c safety ofsi Car.
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EMERGENCY AMBULANCE AGREEMENT
PAGE THREE
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Services, continued •
5. Additionally, the Contractor shall provide Backup Services to adjacent
zones upon direction of CMED. During any period of time that ail of the• -
Contractor's ambulance units may be unavailable for service, the County
will make reasonable efforts to obtain backup services from adjacent
zones to provide coverage for Contractor's zone.
6. The Contractor to the best of his ability shall assist in the provision
of ambulance services to any County zone in which emergency ambulance
services pursuant to a contract with the County have been suspended or •
terminated. •
• 7. The Contractor agrees that the performance of work and services
pursuant to 'the requirements of this Agreement shall conform to high
professional standards and shall comply with Exhibit B, Operational
Procedures, attached hereto and by reference incorporated herein, and
such other protocols for patient. transport and treatment as may be
issued by Contract Administrator. .
8. It is agreed and understood that County desires to track all- of
Contractor's ambulance units which respond regularly or frequently to
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either- emergency or non-emergency calls originating within his zone.
- It is mutually agreed, therefore, that Contractor (i) shall keep CMED
informed on a current basis as to the status, availability-and location
of all such ambulance units and (ii) shall not respond to any emergency
or non-emergency call within his zone or which such an ambulance unit - -
without informing CMED of the type of call and destination, and without
receiving a 'CMED number therefor.
g. Notwithstanding paragraph 8, the Contract Administrator may from time
to. time dispense with the requirement that. Contractor notify CMED of
his ambulance units responding to non-emergency calls.
• 10. Contractor shall respond-to- aTT-calTs:wTth the ambulance unit(s) located.
nearest to the scene of the incident unless otherwise specifically
• directed by CMED.
11. Contractor's personnel shall provide such patient assessment and medical
treatment as may be appropriate.
PERSONNEL
12. When responding to any emergency call, the ambulance unit shall be
staffed with a minimum of two (2) personnel including (i) a driver, and
(ii) a patient attendant, both- of whom are certified as Emergency
Medical Technicians I-A. Ail ambulance personnel shall obtain an
identification card with photograph from the Contract Administrator and
shall' wear such card on the outside of the uniform and where easily
visible. Upon termination of an employee, and within fifteen. (1S)
days thereof, Contractor shall return employee's identification card to
the Contract. Administrator.
13. Emergency Medical Technician personnel shall comply with all training
requirements as established by the State of California including refresher
or certification renewal training. In addition, Contract Administrator,
may, from time to time, require such additional training as County may
arrange at County's own expense.
• 14. The County shall make reasonable efforts to make available Emergency
Medical Technician training, refresher courses, and challenge examinations
for EMT-IA certification.
15. Contractor shall not permit any employees, including di spatchers, to
;erfo^ any per'picas as contemplated hereunder while under the influence
o any alcoholic bevera_rn re.+;c.ticn narcotic, then substance that
Might impair their physical or mental performance.
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EMERGENCY AMBULANCE AGREEMENT
PAGE FOUR
Personnel, continued
16. Patient attendant and driver both shall be neat and clean, at least 18
years of age, and physicaliy capable of performing the duties required
of them. •
VEHICLES ANO EOUIPMIFKT •
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17. Ambulance vehicles shall' meet standards of Title XIII, Chapter 2,
California AdministrativeCode and each shall possess .a valid emergency
Vehicle Permit issued by the California Highway Patrol. A vehicle
identification number which meets State ambulance identification
regulations shall be displayed on each vehicle employed under the terms
of this Agreement. Contractor shall identify and utilize these ambulance
vehicles to be used for the provision of emergency services hereunder.
Only those ambulances identified in Exhibit F, attached hereto and by
reference incorporated herein, shall be used to provide such services.
Contractor may substitute another vehicie for the vehicie listed in
Exhibit F, only after receiving written permission from the Contract
Administrator; Vehicle MEDNET identification, as assigned by the
Contract Administrator, must be displayed on the roof of the vehicle
• lit lettering at least four inches in width, and at least 24 inches in
height. Each vehici •.must be identified.with the name of the
contractor as it appears in this Agreement. •
18. Each ambulance unit shall carry such'emergency supplies and equipment
as listed. in Exhibit C, attached hereto and by reference incorporated
herein. Vehicles, equipment, and supplies shall be maintained clean
and in sanitary and safe mechanical condition at all times.
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19. Contract Administrator or his agents may at any time without prior
notice inspect Contractor's ambulance units, in order to ascertain
Contractor's compliance with this Agreement in respect thereto. An
inspection mat be postponed if ft is shown that the inspection would
unduly—delay"aa embulance unit from responding to an emergency call.
A memorandums of the inspection specifying any deficiencies and stating
date, unit number, and. names of driver and attendant shall be provided
' to the Contractor. Contractor shall show proof of correction for'any
deficiencies noted in said inspections, within three (3) working days,
to the Contract Administrator.
COMMUNICATIONS
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20. County shall furnish to Contractor and maintain MEONET two-way radio
equipment in his. ambulance units for his use- under- this Agreement. Radio
equipment approved by the Contract Administrator must be installed prior
to assignment of a vehicle for zone coverage under the terms of this
Agreement.
21. Contract Administrator shall determine the number of Contractor's
ambulance units to be MEDNET equipped_
22. Such radio(s) shall remain the property of County and be subject to its `
control, supervision, and removal. Contractor shall pay the County the
cost of any repairs and maintenance over and above that caused by
ordinary wear and tear and shall return radio(s) to the County upon
completion or termination of this Agreement. Contractor shall be liable
for any loss or damage to County's radios while in the possession of
Contractor.
22. Contractor shall r..aintain at his expanse necessary communications between
his dispatch office(s) and all his ambulance units. Contractor's dispatch
office shall be available by telephone at all times to answer calls from
C,tEB.
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EMERGENCY AMBULANCE AGREEMENT
PAGE FIVE
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. PAYMENT,
24. For the performance of this Agreement, County shall pay, to Contractor
the amounts specified in Exhibit 0, attached hereto and by reference
incorporated herein, for the following only: •
A. Uncollectibie billings for emergency call services., .
H. Standby Services directed by CMEO. In the event that an emergency
transport is provided when an ambuiance unit is' "standing by",
reimbursement will be made in accordance with emergency rates., in
lieu of payment for Standby Services; provided, however, if standby
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. time exceeds 1/2 hour, than authorized waiting time shall be
reimbursed, for the period exceeding 1/2 hour.
C:. Response to emergency call requests which result in dry runs. Void
calls shall not be reimbursed.
0. Uncallectibte billings for emergency transfer services to or from
any County medical facility when authorized by appropriate County
medical personnel.
25. No {Wm for payment submitted to Coynty .by Contractor shall be paid in
the absence of.reasonable proof that the particular ambulance service
involved was in fact provided by the Contractor.. -
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25. Contractor's failure to comply with the requirements of this Agreement
including but not limited to his failure (i) to obtain i CMED number at
the time of service; (ii) to submit a ;
(iii) to respond with service within the required medical report form;
required time periods; (iv) to
follow approved protocol in selection of a receiving hospital; and
(v) to follow dispatch and communications procedures shali be
the basis for a rejection by County of Contractor's claims for payment.
In the event that service is provided without strictly meeting the
requirements of this Agreement,, the Contract Administrator may. neverthe-
less approve claims for payment upon determining that the service was
provided substantially in accordance with the intent of this Agreement.
27. The County shall not be obligated tb. pay Contractor for services provided
to any person eligible to receive benefits from any responsible third
party payor, unless such claims for payment are accompanied by written
notification of rejection of eligibility. County shall not be obligated
to pay Contractor for services for which payment in any amount is due
or has been received from any responsible third party payor. County
shall not be obligated. to pay for more. than one patient trip on any
particular emergency call service, nor shall County be obligated to
pay for any emergency cail service in which the Contractor receives
• payment from any one of multiple patients transported.
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28. All payments made to Contractor by a patient, patient's estate, responsible
relatives and friends, or- from any other source shall be credited to the
patient's account- and the- amount specified in Exhibit 0 claimed to be due
from County to Contractor shall be decreased by a like amount.
29. Contractor shall make every reasonable effort to collect payment for his
services from the patient, or a responsible relative or a responsible
third party payor, or any appropriate government agency. With 15 days
of rendering service, Contractor shali send the first of at least three
(3) separate billings to the patient which are spaced at least fifteen
(15) days apart; provided further, however, that responsible third party
payors may be billed only once within the same period. Each call shall
be separately billed by Contractor and all bills shall be rencerea in
the nave of the Contractor and shall request the patient to notify
Contractor of insurance c_verega, if :n:.
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EMERGENCY AMBULANCE AGREEMENT
PAGE SIX
30. Each claimable call or service shall be separately billed to County by
Contractor on forms provided or approved.by, and in such form, substance,
detail, and exhibits thereto as required. by Contract. Administrator.
Contractor shall submit bills to the Contract Administrator no sooner
than 90. days and no later than 150. days after the service was rendered,
and if Contractor does not bill County within this time frame, County
shall „not be obligated to pay Contractor for the particular service.-
However, claims for payment for dry runs, backup and standby services
may be submitted prior to 90 days, and said prior submittal may be
allowed for earlier payment within the discretion of the Contract
Administrator. Rejected responsible third party payor billings may
be submitted later than 150 days of the date of service, provided that
such claims are accompanied by written rejection of the billing by the
responsible third party payor. g y
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31. After payment to Contractor by County on a patient's account, the
Contract Administrator may direct and upon such direction Contractor
shall assign to. County all of Contractor's right, title., and interest
in and to any such account.
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In the event of such assignment, Contractor shall cease all further
attmapts et collection from the patient, the patient's .estate or
family, or from anyone else. Any and all payments Contractor may
receive frog a private party, insurance company, court settlement or
any government agency within thirty 00) days of assignment shall be
remitted to the County within thirty (30) days of receipt, but not
to exceed the amount paid to Contractor by County. Any and all payments
toward an assigned account which the Contractor may receive more than •thirty (30) days after assignment shall be submitted in full' to the -
County by Contractor. Contractor agrees to notify County in writing
within fourteen (14) days of all amounts received on assigned accounts
and to remit to the County all amounts due within thirty (30) days
of receipt of payment from any source. Date of assignment shall be•
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the date.on the County warrant making.payment on. assIgned-account.
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If Contract Administrator does not direct such an assignment, Contractor
shall continue to make reasonable efforts under the circumstances to
collect the account, and shall refund to County the collections not to •
exceed the amount paid to.Contractor by County. P. -
3Z. Within thirty (30) days after receipt by Contract Administrator of any
claim for payment, the County shall. make payment to the Contractor or
the Contract Administrator shall notify Contractor that such claim is
rejected by County and give the reasons therefor. Upon audit or
examination of Contractor's records, the Contract Administrator may
disallow invalid claims) for which payment to Contractor has been
made and may deduct the amount of disallowed claim(s) in following
payment(s) to Contractor-, or Contractor shall forthwith refund to
County said• disallowed amounts upon demand of Contract Administrator.
PRIVATE BILLINGS
33. All bills submitted by Contractor to any private party or third party
payor for emergency services rendered within the Zone shall not exceed
the rates listed in Exhibit E.
Contractor shall not bill any party for any service unlisted in
Exhibit E, except for approved specialized service above the level of
• service provided by EMT-IA or which require the use of equipment not
included in Exhibit C, subject to the approval of the Contract
Administrator.
Contractor may request modification of rates listed in Exhibit E after
the first year of this Agreere»t. Any s;;th -^difi ation ri rates t
�, tr5 sr�al ,
require the prior approval of the 4ounty ;,y re_olutin .f the !card of
Supervisors.
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EMERGENCY AMBULANCE AGREEMENT
PAGE SEVEN
PAYMENT FOR EXCESS BACKUP
34. Contract Administrator shall maintain records of backup service for _
each zone by each Emergency Ambulance Contractor. Upon receipt of
written complaint from any Emergency Ambulance Contractor that an
excessive amount of backup service has been provided by that Contractor
to an adjacent zone contractor, Contract. Administrator shall compile
data showing the backup time provided by each of the affected Contractors
to the other(s) and may direct a contractor found to be receiving excess
backup to reimburse the Contractor providing said backup an amount
based upon the rate specified in Exhibit 0 for Standby Services. In
determining an amount for excess backup reimbursement, consideration
shall be limited to a period beginning not more than 180 days prior
to the receipt of written compiaint.
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REPORTS AND RECORDS
3S. Contractor shall maintain complete financial records in auditabie
forarand content and according to good accounting practices for all
:a its, expenses, expenditures, revenues, accounts receivable, and
billings, pertinent to and during the performance of this Agreement.
36. Contractor shall maintain an active list of employee ambulance personnel
including their qualifications, driver's'certificate and licenses with
expiration dates. Contractor shall provide County with a list of all
ambulance personnel and shall notify'County within thirty (30) days of
any new ambulance employees or terminations.
37. Cbntractor shall maintain records of all calls including date and time
of service,. CMED number., type of service, response time, and traveling
code.
38. All records maintained pursuant to this. Agreement shall be available
for inspections, audit or examination by the Contract Administrator or~
other agents of the County and shall be preserved by Contractor for at _..
least three (3) years from the end of the contract year in which they
were made or if the term of this Agreement is less than one (1) year,
then three (3) years from the termination or completion of this
Agreement.
39. Upon request of Contract Administrator-, Contractor shall prepare and
submit reports providing justification, if any, for his failure to
respond within required time periods, his failure to obtain a CMED
number prior to an ambulance response or to submit an adequately
completed medical report form.
Contractor shall provide such additional information and reports as
the Contract Administrator may require from time to time to monitor
properly the performance of the Contractor under this Agreement.
INS _
40. Contractor shall at all times during the term of the Agreement with the
County, maintain in force those insurance policies and bonds as
designated in Exhibit H and will comply with all requirements thereof.
NO ADVERTISING
41. Contractor shall not advertise, promote, or endorse in any way any
emergency ambulance service telephone numbers except the "911" emergency
telephone number.
NO DISCRIMINATION
42. The Contractor shall be an equal opportunity/affirmative action
organization in all of its practices, policies, and procedures. The
Contractor shall not discriminate on the basis of race, color, national
origin, ancestry, religion, sex, marital status, age, physical or
mental disability in any matters related to access, provision of services,
or employment.
EMERGENCY Ai•SULANCE AG E_'IE::r
PAGE EIGHT
CCMPLIANCE, ! A'4
43. Con:rectcrshal; comply with all rules, regulations, laws, and codes of
federal, state, and local ;overnment in the performance of this
Agreement including, not iimited to: .article ?, Subcha,:t_r 5,
Chapter ?, California Administrative Code, Title XIi:. ,
PARENT CC PA•Y
44. Contractor agrees to keep the Contract Administrator advised at all
times of the name and location If ;.ie Contractor's parent ccrrany, if
any.
• I?IOI! •
45. The Contractor egress to defend, indemnify, and held harmless the
County of Alameda and the City(ies) of Dublin, Livermore, and
Pleasanton , and any all officers, employees, agents,
and servants of said County and City(ies) for any and all liability
caused by the negligence or wrongful act of the Contractor arising
out of the performance of this Agreement, and to pay all claims, damages,
Judgments, legal costs, adjuster fens, and attorney fees related thereto.
THIRD PARTY BENEFICIARY
46. This Agreement shall not be deemed to have been made for the expressed
or implied benefit of any person who is not a party hereto, except the
aforementioned Cities and any breach or violation of this Agreement
shall not be dewed to create or establish any claim or cause of action
in behalf of any such person.
ASSIGNMENT
47. Neither County nor Contractor shall assign this Agreement-•to* a third
Party without written consent of the other party to this Agreement; nor
shall Contractor assign any monies due from County under this Agreement
to any third party without consent of the County. In the event of
attempted assignment in violation of this Agreement, the non-consenting
party may declare this contract to 'be null and void in regard to the
attempted assignor.
?ONE EXCLUSIYtTY
'48. Excepting the provision of Saccup Services, or the suspension of .his
Agreement, the County shall not enter into any Agreement with any other
Contractor for the provision of emergency ambulance services within the
Contractor's zone during the term of this Agreement.
I'A3IL:i f iC ?:.?FOP:'
4g. Should Contractor be unable to perform services under this Agreement as
result of circumstances beyond his control , the County shall be
a^
title the possession and use of Contractor' s a'-::i ancas are_
of :he e_:y:tan: tprt taime.t therein :r a eri-o ru: :o ax eo :h'
cn � c=--
aura:i of saga C T.s zancos, a: 7:11 art e ::!1T c.`. : e sal .-t.
neasc''4a5r. _a oar a^:: Z:r ::cr a: a::: 3 ::. r.76. __ a_
r_�. a Sc: er. a:cc=__:et. - v.inty oral i tai to :t :racttr
e: :h in s:cht it -, attache_ .sere:: an:: ,, r'-fc arcc
1rcorrcrete_ ^eereeir, :sr eduidoed amtulance so uset. shall a .._e
all l ia:11!- �oL'ttt! 5„� 55.... _
�y arisinc tut of .:s '153 a,^.,r. :c5ess':n .. the Irtu'a^:ns
i '.
0
EMERGENCY AMBULANCE AGREEMENT
PAGE NINE
DEFAULT
50. In the event that the Contractor defaults in the performance of the
terms of this Agreement, the Contract Administrator shall so notify
Contractor in writing specifying the nature of the default and the
amount of time within which the Contractor shall have'to remedy such
default. If after receipt of such notice the Contractor shall fail •
to remedy such default within the time period specified, the Contract
Administrator may forthwith suspend this Agreement in,whole or in
part and the County may terminate the Agreement in whole or in part.
INDEPENDENT CONTRACTOR
51. This Agreement is an agreement by and between two (2) independent
contractors and is not intended to and shall not be construed to create
the relationship of agency, servant, employee, partnership, joint
venture, or association.
MODIFICATION. OF AGREEMENT
52. From time to time, amendments or modifications to the text of the
Agreement may be initiated by either party hereto and may be incorporated
into this Agreement by mutual consent and in writing as evidenced by
resolution of the Board of Supervisors approving such modification.
•
TERM OF AGREEMENT
53. This Agreement shall commence on July 1, 1982, and shall terminate on
June 30, 1985, provided, however, this Agreement shall remain in force
after said termination date to the extent necessary to process claims
for payment which may become due and payable for services rendered by
Contractor prior to said termination date.
TERMINATION FOR CONVENIENCE
54. This Agreement may be terminated by either party for any reason such
party shall determine that such termination is in the best interest.
• Such termination shall he effective. at the end of the contract year
upon 120 days prior written notice thereof. The period from January 1
to December 31 constitutes a contract year.
WAIVER
55. The failure of either party to insist upon strict performance of any
of the terms, convenants or conditions of this Agreement in any one
or more instances shall not be construed as a waiver or relinquishment
for the future of any such tests, convenants, or conditions, but all
of the same shall be and remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have executed
Agreement the day and year first above written. i
COUNTY OF CONTnAC R (7, /
BY ,/
BY
Title R.- //- cfa- e-si c(eN
AFFIDAVIT
I, Yvonne Quan, Administrative Assistant, Clerk, Board of Supervisors
County, do hereby certify under penalty that copy attached
document has been delivered to the Chairman, Alameda County of the atBoard of Supervisors
as provided in Section 25103 of the Government Code.
wli,L Dated• ``�` _ AUG 0 31982
''ONNE QUAN, Administrative oAssistant
sors
********************
0
EXHIBIT ^.
Zone IX - This tone will include the unincorporated territories of
Pleasanton and Murray Townships and the Cities of.Dublin,
Livermore, and Pleasanton.
• mania
ft
.
•
•
EXHIBIT B
CPERATIONAL. PRCCEDURES
I. AVAILABILITY
• A. Contractor shall keep CMED informed at all times of the number,
location, and status of ali ambulance units utilized in serving the
zone at any time. Contractor shall not respond to any call, nor
take an ambulance out of service without immediately notifying CMED.
Contractor's dispatch office(s) shall be available by telephone at
all times to respond to calls from CMED.
II. COIWMUNICATIONS
A. Contractor shall operate MEDNET radios 'in conformance with all
applicable rules and regulations of the Federal Communications
Commission and in conformance with all applicable County procedures
and protocols.
8. Contractor's ambulance units shall maintain continuous radio
communications with CMED at all times when ambulance is on any
call requested by C''iED and when providing backup or standby
services.
•
III. PERSONNEL
A. The ambulance driver shall have in his possession at ail times a
valid California Driver's License and current Ambulance Driver's
Certificate issued by the California Department of Motor Vehicles.
8. For the health, safety, and comfort of both patient and ambulance
personnel, smoking shall not be permitted in the patient•compart-
ment of any ambulance at any time by either ambulance personnel ,
patients, or passengers. Smoking shall not be permitted in the
driver's compartment when any patient or other non-ambulance
•
personnel are located in same, or at any time the ambulance is
traveling Code 3. Smoking is ndt permitted at the scene of any
emergency when it may in any way endanger the safety or health of
any individual.
IV. REQUESTS FOR SERVICE
A. Requests received by CMED: Upon receipt of a request for emergency
ambulance originating within the designated zone of responsibility,
CMED wili immediately contact Contractor and provide the following
information: Location and nature of the incident, CMED number, and
traveling code. CMED will also inform the appropriate public safety
agencies serving the location of the incident.
3. Requests received by Contractor: Upon receipt of a request for
emergency ambulance service, Contractor shall immediately contact
CMED and provide the foilo:ving information: Location and nature cf
the incident and traveling code. CMED will than contact the
Contractor Servirc the zone in which the incident
provide the following information: Location, natureoofYincident,,l
traveling code and Code 11 number. CMED shall contact the appropriate
public safety agencies serving the location of the incident.
V. ?ESPO^SSE C _'•'_7Gc"C`( r=,.
A. Upon receipt of request
shall immediately •'ee� .aOr response :^C .�'SJ ^'..�.ucY', c:i}j:'"3C:ir
unit _ per.. and as soon as ,r der. ay. the 1,-2.
` - : a� ': is
.�rree'., .;j
.OU t^ an no Ci "= s tan C es shall ..*s r=:crt :e 'Pr_ than ,❑inu from i- cation the ^ .he call .
•
EXHIBIT Es
PAGE TWO
OPERATIONAL PROCEDURES
V. Resoonse to Ebner e= Calls continued
8• Under no circumstances shall Contractor respond to any requests
for emergency service originating in another zone of responsibility
without the specific prior approval of CMED. If such a request
is placed by a physician, the name of the physician shall be
provided to CMED.
C. CMED may assign ambulance to cross zone lines when deemed
necessary for the most efficient response to an emergency call.
0. Upon arrival at the location to which the ambulance has been
dispatched, ambulance personnel shall notify CMED, and again when
departing the location with a patient to a hospital.
E. While at the emergency scene or immediately upon departing,
ambulance personnel shall notify the receiving hospital via MEDNET
radio of the anticipated delivery of patient(s), a description of
the possible iniury(ies) or Illness with appropriate vital signs,
and the expected time of arrival at the hospital emergency department.
F. Upon arrival at the hospital, MD shall be notified.
G. Upon becoming again available for 'service, CMED shall be notified.
VI. NON•EyERGEHCY CALLS
•
A. Prior to responding any ambulance unit previously reported to CMED
as available for emergency response, to any non-emergency request,
the Contractor shall contact CMED and inform CUED of the intent to
respond, and the destination. Upon returning to the zone of
responsibility and available for service, the ambulance unit shall
contact CMED to inform CMED of availability. The Contractor shall
not respond to any non-emergency request when by doing so requires -
the use of the last or only ambulance units available to serve the
zone, or at any time the Contractor's zone is being provided backup
service.
VII. STANDBY SERVICE
A. Upon receipt of a request for standby service originating within
Contractor's zone of responsibility, CMED shall contact Contractor
and provide information regarding the location and nature of the
incident for which standby services have been
a CMED number. Standby services ahll be provideduonlydinnresponse
to requests from officials of public safety agencies. Contractor
shall immediately respond and as soon as it is underway, the
. ambulance unit shall again .notify CMED upon arrival at the scene.
The ambulance personnei shall report to the public safety official
In charge of the scene and shall serve under his or her supervision
while on standby.
B. In the event that standby service should result in the transport of
a patient, Contractor shall immediately inform C;4ED and shall
follow procedures established herein for response to emergency calls.
C. When released from service by the official in charge, the ambulance
unit shall inform CMED of such.
•
Q £
EXHIBIT B
PAGE THREE
OPERATIONAL PROCEDURES
VIII. BACKUP SERVICE
A. When any Contractor does not-have an ambulance unit available to
respond, CMED shall request backup coverage from an available
ambulance from an adjacent zone. In the instance that the
Contractor is providing service to two adjacent zones, CMED will
first attempt to obtain backup coverage from the same Contractor,
However, no ambulance shall be used to provide covera�
than two zones of responsibility at any one time. �e to more
8. The backup ambulance will be reiocated to a pre-designated
location. Such locations will be designated within each zone to
cover each adjacent zone. Such locations will be mutually agreed
upon by the Contractors involved and the Contract Administrator.
C. Contractor agrees to respond to request from CMED to relocate any
available ambulance to the pre-designated backup location.
0• CMED will dispatch the backup ambulance to any immediate response
call in the vacant zone and immediately notify the''ambuiance
Contractor providing backup service.
.IX. PROCEDURES AT THE SCENE OF AN EMERGENCY
•
A. Upon arrival at the scene of an emergency, Contractor's ambulance
personnel shall assess the condition of the patient(s) and provide
the appropriate medical treatment. A medical report form shall be
completed for each patient to whom treatment is provided.
8. Prior to transporting or i
• ambulance personnel shall co�ntactetheureceivingnhopitaleand
provide the following information about the patient: Age, sex,
primary complaint, level of consciousness, and vital signs, as
well as any additional information which may be requested. If
the patient has a personal physician and requests that he or she
be informed, this information shall also be provided to the
hospital.
C. The selection of appropriate receiving facility and traveling
code shall be made in compliance with protocols estabished b
Alameda County and provided to Contractor by the Contract
Administrator,
•
0. The transport of any patient to a facility when selection of the
facility is not in compliance with established protocols shall not
be reimbursable under the terms of this Agreement.
E. Should any patient refuse transport, ambulance personnel shall
complete a medical report form so indicating and shall offer a copy
of the medical report to the patient or 'responsible relative. Should
any patient refuse alt service, the ambulance personnel shall notify _ _
CMED of the refusal and shall complete a medical report form with
whatever Information is available to the ambulance
X. RECEIVI"!G HOSPiTgL personnel .
A. Before leaving the receiving facility, ambulance o
complete and submit a completed ambulance medical report form. In
the instance that an agent of the hospital requests the ambulance
unit to wait at the hospital in order to transfer the patient, the
ambulance personnel ::ill Immediately so inform
:V•
1.
- _
EXHIBIT 8
PAGE FOUR
OPERATIONAL PROCEDURES
XI. mum NS .
A. In the event that CMED is informed that an ambulance which is en
route to an emergency is no longer required, CMED shall immediately
contact the ambulance unit and inform them of such. In the event
that the ambulance unit arrives at the location and determines that
there is no need for emergency ambulance services, the ambulance .
personnel shall immediately contact CMED and inform CMED of the
nature of the incident or reason for not providing transport.
XII. OISASTER AND DISASTER DRILLS
A. In the event of a disaster or disaster drill, CMED will inform the
Contractor's office of such. The Contractor's office shall confirm
to CMED the location.and number of available units and the number
of units which may be made available upon request. Contractor's
office shall inform all ambulance units of the condition and all
units shall maintain continuous radio communications with CMED until
released from this requirement by CMED. , In the event of a disaster,
CMED will dispatch ambulances and no non-emergency service will be
provided without CMED approval.
•
,I
r
•
C
EXHIBIT C
STANDARDS FOR BASIC IFE SUPPORT AM LANCE EOUIPMENT. AND SUPPLIES
Standard Ambulance Specifications and Non-Medical Equipment for all 6LS and
ALS Mobile Units:
Size
All ambulances will have adequate space in the patient care c
to accommodate one litter patient and two providers. There msttabe�nt
sufficient space to allow for patient care activities during transport.
I. Safety Eqp
uiment
Seat Belts (3) -- two in front compartment, one in rear compartment
Heating and Air Conditioning opartment
Approved Siren
Red Warning Lamp
Fire Extinguisher (I) Ory Chemical or Carbon Dioxide
Portable, battery operated light (1)
Spare Wheel with inflated tire
Jack and tools for wheel change-
Maps of Service Area
Flares
Floodlights
Patient compartment doors must be operable from .inside and outside
II. Patient Care Equipment
Stretcher - Collapsable and adjustable (1)
Able to elevate head and foot
Covered with non-permeable material
•
Ambulance Cot
(1)
(All stretchers must be equipped with straps to secure patient to
stretcher and a means of securing stretcher in the vehicle.)
Linens - sheets (4 sets), pillow cases (4), blankets (3), pillows (3)
III. Basic Life Su000rt Medical Eauioment and Supplies
Inservice
I= - Suggested Required
Quantity (ISR)
Ace bandages, 4"
2 0
Airways: Nasopharvngeal (soft rubber)
30 Fr.
32 Fr. 2 1
34 Fr. 2 2
2
1
Orapharyngeal (sizes 0 through 6) 2 each i each
0
O.
B:(HIBIT C
PAGE TWO
STANDARDS FOR BLS AMBULANCE EQUIPMENT AND SUPPLIES
•
• Inservice
Item Suggested Required
uantit , (ISR)
Bandages and bandaging supplies**
12x4" sterile bandage compresses or
equivalent 1
3x3" sterile gauze pads I
2" or 3" roller bandages 4 `
40" triangular bandages 4 4
10x30" or larger universal dressings ' 4
's", 1", and 2" cloth adhesive tape i
Tourniquets (for hemorrhage control. 2.roiTs ea. 1 roll ea.
Bandage shears 2 1
•
Large safety pins 1 1
6
Vaseline gauze
2
4 L
Bedpan. =
e sticks, padded (commercial or homemade) 1 1
Bit
2 1
Blood-pressure cuffs
Adult (portable)
Large arm (obese I I
Pediatric I 0•
Burn sheets (sterile) 1 I
Cervical collars 2 1
Soft: Medium
Long • 2 I
. 1
Hard: Medium `
Large 2 L
Cold packs' 2 1
4 2
Emesis basins or
emesis bags with container • 2 I
Irrigation equipment and supplies
•
Tubing for irrigation
Saline, sterile: 1,000cc 1 1
2 1
Water, sterile: I,000cc
2 1
Obstetrical kit (sterile; pre-packaged to
include minimum of 2 umbilical cord clamps, 1 1 •
scissors or scapei, asp. bulb syringe,
gloves, drapes, antiseptic solution)
Oxygen equipment and supplies
•
Face masks for 02 administration (transparent)
Adu l t
Pediatric 3 3
Infant 2 2
Nasal cannula for 0 administration 2 3 •
02 humidification dAvices (sterile) 2 2
02 tanks 2 2
Fixed in vehicle
• Portable 1 1
Resuscitation equipment and su 1 1
CPR backboard ppites
1 1
Oemand-vaive resuscitator that meets the
requirement of Vehicle Code Section 2418.5 1 1
Face masks for resuscitation (clear)
Adult
Pediatric 2 2
?Doke: *ask 2 1
Resuscitation :a_-va'' '- _
?atilt /� with J2 ��5$t'IQ?
:ediatri`
r
Restraints, ankle and wrists (leather or
soft ties) 2 sets
•
1 sets
•
•
EXHIBIT C
•
PAGE THREE
STANDARDS fOR BLS AMBULANCE EQUIPMENT AND SUPPLIES
Inservice
Item Suggested Required
uantit1 ISR)
Sandbags, 10 lbs. each
Scoop stretcher - 4 2
Spineboa rds 1 1
Long with accessories 1
Short with accessories I
1
Splints • 1•
With a soft or cushioned surface or
equivalent padded board, wrap ladder, •
inflatable or cardboard splints**
Arm 3x15" 4
Leg 3X36" 4 2
Splints, traction (recommend Hare Traction 2
Splints)
Adult
Pediatric 1 I
Stethoscopes 1 0
Suction 2 I
equipment and supplies
Pharyngeal tonsil tip (rigid) for'
suctioning
2
• Suction apparatus (portable) 1
Suction catheters, No. 18 4
Trash bags 4 2
Paper
Plastic 3 0
Urinal 3 0
1 I
"Excerpt rpm Title Cali n i •.
•
•
EXHIBIT 0
REIMBURSEMENT SCHEDULE
July 1, 1982 - July 1, 1983 -
June 30, 1983 June 30, 1984 July 1, 1984 -
EMERGENCY CALL ---- .June e 30, 1988 5
Emergency Call Base Rate S63.50
Mileage
4.20;.
DRY RUN 31.50
STANDBY SERVICES
No transport provided:
First 30 minutes 31.50
•
Each additional 10-minute
period or portion thereof 3.00 •
t Transport provided: Emergency rate, plus standby rate for time exceeding
30 minutes
(Rates for July 1, 1983, through June 30, 1985, or'a,portion thereof, to
established by mutual agreement prior to July 1, 1983.T - be
•
•
• 0
•
EXHIBIT E
•
ALLOWABLE CHARGES FOR PRIVATE BILLING APPLICABLE
i � . •c Y ,LL V `
PRIVA July 1, 1982 -
June 30, 1983
Immediate Response (Code 3 or Code 2)
5IIO.00
Night Call (7:00 p.m. to 7:00 a.m.)
20.00
Mileage (Per Mile)
5.50
Oxygen (Includes Mask and Resuscitation)
18.00
Extra Handling (Unusual, dangerous, including restraints,
special loading or unloading)
' 25.00
Waiting Time (After 15 minutes; per 10 minute period)
11.00
•
1 .
DISPOSABLE SUPPLIES
As required to provide appropriate EMT-IA services and first-aid; not to
exceed a mark-up of 100 percent of over cost. No charges shall be added
for use of equipment required by this Agreement, or any services requirin
EMT-IA skills, except as provided for above. g
+;•
•
•
EXHIBIT G •
RENTAL RATES FOR AMBULANCE EQUIPMENT
Vehicle and Basic Ecuioment
3723.00 per month per unit
23.00 per day per unit
Above rates include mileage, normal wear and tear and equipment.
•
ii
•
E:(HISIT F
•
AMBULANCE VEHICLES
•
I. Vehicle License No. # 1734187
Make, Model , Year 198j. Van
2. Vehicle License No. # 1198963
Make, Model, Year 197$ Van
3. Vehicle .License No. -
Make, Model, Year 1979, Qzeyy Van
4. Vehicle License No. # 1R945O9
Make, Model, Year 1979, Chevy, Van
•
5. Vehicle License No. # 1P34065
Make, Model, Year 1979 (IC Hi Sierra Truck
6. Vehicle License No. # 2104828
Make, Model, Year 1981, (MC Van
7. Vehicle License No. # 1Z71490
Make, Model, Year 1981, (; , Van
8. Vehicle License No. # 1R95665
. Make, Model, Year 1979, (C, Van
9. Vehicle License ';o. # 1L98951
•
Make, Model , Year 1978 Chevy, Van
10. 'vehicle License !c.
�= . :te i , Year
•
f
0 - -- -- .----- •
•
-
' EXHIBIT 4 Page 1
•
Tri-Cities yulance Service Service Contract
Contractor:
•
Contract Tera:_7 _ 6/ 0/83 Health Care Services Agency
County Agency or Department
roliC?ia ,o s4oQRtere•�r ttEQliAaurwre
Contractor's polities or bonds shall be midorsee as follows:
�tes�Naive Alameda County. its 1 oof �v' >.s as
i i tt � In:wea. tars. oft1�. agents and �q►o
`a' •z7 ptin+uns. costs or aunsi try is net liable to-the insurance caoiny
a result of being an Additional Named Insured. Lien with Contractor's policy/bond. y .
Provide County 30 days advance wine notice of cancellation. non-renewal or
reeuctiot in limits or morays ine w:line the name of :he Contract. mailed to the
following adWass:
cities off Health Care Services
cities Cl �' irk. and Union City, to tr ar�palt to Receive iotic.isl
•
City Councils, officers. agents. and �eA 1"fa ews
oloyers also named IS Additional Ensured/ Z it 1 c4 dinating Obligees.
street
•
Oakland., a"'94607
city. State. lip
State the Contractor's policy/bond is preaary insurance to any other insurance
available ice County with meat to any Slate arising out of this contract.
Contractor is responsible for payee.* of insurance deductibles.
•
Insurgents Companies must have an •N.N. lest• rating of rd.s. better.
•l'l triTmtinl..Iri r.E.
a i. mortars. COMMlailtm • 0 State Compensation Insurance Fund
a. Statutory Compensation eevere � 8 l t: 10 (1/1/82-1/1/83))
b. Cmploy 's liability insurance with ' i roiicy Number s IIcy Free sates
not less thin sioa,o00 per
eaurrence. Signature of Ihdirtdaal althm•iaed by
Insurance Cowan, te'bind Co pa.y to
coverage sheen, and above endorsement
• lC srufo - District Representativ
Santa Clara Avenue
hand, CA 94610
Slate. city. 110 r _•
• Q Z. CamprtlNnsive General Liability
At a. �nimme Limits of Liability: S5.000.000 rNATI OVAL UNION INS . CO.
Par occurrence combined tingle limit irra�lsl /
4;101reperty bi =er!' ale orveurty o age. )elicy6� rt2 Polic�r/Plerrieo (at si ".i lodily Injury Signature of indtrid aa5�l authorised b amage Insurance Company to bins Camay to
IMP stanaet Contractual cover shove. above endorsement
grersanal Injury f roducts/Completed Oberations 'i •
rma form Property Damage lame "�"f
__Irma Damage Legal Liability 330 4 19th Street A
e. Oeductib le net to exceed Si.000 Address lc d CA 9461_2
per mamma. tity State. tip
=Cross Liability or Severab i l i ty of '
Interests Ciase in policy
3. Comprehensive AYtdmebil. Liability
NATIONAL In ( ZUNION INS . CO.
4. a. Minimum Limits of Liability:
Insurance 905ti�09 /
•_,
SS,000.000 per Dew Policy ounce-to) Poii ► iao costal)
''rants comoi ned 6/1/82 — 6/1/83
single limit Bodily Injury and Signature of lndtviduai authorised by
Property Omega. Insurance Company to bind company to
Assigned risk insurance at available roves s above endorsement
:Lace financial responsibility limits. "om'G
O. Coverages: '
330 19th Street -
Owned Autaeobiles. if amp ebsakland , CA 94612
h-ownee Autzsobiies City. State. Zip
go a Mired Au mOwoni t es
•= Cross Liability or Severabtiity of
Interests clause in ;allay
•
EXHIBIT M Page 2
Service Contract
e c
4. Fnfessianal Liability NATIONAL UNION INS .
trauranc
I�t.. I. for all Profess+coal we l oyes% l i canted F s P 981 4182 •
at a condition of e,eelopeent at the Policy izeberu7 POT icy-P t Ioates)
beginning of Contract turn or hired 0/ 1/52 6/1
i 3
daring the contract turns, in$urinq 'Signature of rndleii5t authorized by
against error or omission in rendering or Insurance Camay to bid Canpany to
failing ins render Professional services. coverage em
shown, above endtaeet
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1 tat It
i, minima Limits of Liability: l USSEY CANTOR & T PLETT INC.
Or $5,000.000 per Claim looms 39 19th Street
exceed. V. Deductible not tb exceed $1,000 Ztty, State, io
per claw. Oakland, CA 94612
CI Cross Liability or Severaolllty of
Interests Clause it Policy ($j 3. One of the following must be checked:
=2. Contractor certifies there are no II- [i Professional liability is on an
canted or certified professional employees 'occurrence' basis.
at eatradt effective date and will notify 0 Professional liability is on a
' Caenty and comely wia this professional ii. 'claims made" basis contains,
ability insureaq prevision if professional pravlsloe for an extended discovery
employees are Mred dbrtng contract tarn. mod of five veers.
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Signature •
Prtntee lee Title •
• S. IOOOS/Ol1j DORM=
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C:11. Fidelity Insurance loud '
• Insurance Canesny(s)
a. Faithful Performance Coverage of all
offsets's, agents, and employees with Nolo *worts) Policy Period (dates)
access to funds received by Contractor. •
Signature Of Individual authorized by
b. Limits shall at least be equal to Insurance Company to bind Company to
masiam Sam funds in contractor's coverage shave, and above eidersament
padessta or control during contract requirements.
UM,
Acme
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Address
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ate. t y. o •
Q 2. Money and Securities Policy
a. laureate against the disappearance,
destruction or wrongful abstraction Insurance Company(%)
of fumes on and off premises of contractor.
Policy Miwoer(%) Policy Period (ates'
b. limits shall be at least equal to the
sedum Spiaz funds in contractor's Signature of lndlvloear authorized by
peseesstem or control during contract tarn. Insurance Company to bind Comm to
coverage shave, mil above endorsement
requirements.
lame
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Address
City, Rau. Lip
f$$5. Other (Describe below) NATIONAL UNION INS .
Umbrella Insurance T°n n"1.31PdTbtd
Dol1CGy1 i 1 geras) Policy /Period (dates'
Limit : $ 2,000,000. per occurrent or Tno,v,dua/>�wcnar,:ea or •
Insurance Company to bind Company to
Limit to be increased to $5 ,000,000.00veraq s `'"• above endorsement
requir +r :
as of 7/1/82. 5�•
Mt BUS S EY-CANTOR TRIPLET IN
• Address
330 19th Street Lip
Lley, state k'land , CA 94612
* Comprehensive General Liability , Automobile Liability and
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Professional Liability policies are to be issued with a
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limit of $500,000. Combined Single Limit . A separate
Umbrella policy is to be issue3 as noted or�ain ad3lional - 1
limit of liability $5 ,000, 000. as of 7/1/82 .
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=...titan Page
Service C ntruc:
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7. SILf•ixS101.=
`Caotraessrs self-tnsurss fs any risks snows to Sealons agave snail st:ata m lentrac: wt-
ein= satisfae:ay ;s :away al Contractors financial utility (suss as a Current financial
Statement: to reticle I tosses to ammntS time Mee. fir bet rift selt.insorsd.
Cantrae;st• snail camtets and OP.:Me foltm.tne stetaftwt and aloes to
floe .anerae:or ft selt.tnseres far txte felftieg Cewrsges will resat: to :kis contract:
C meter's Cementation
C Caernbenstve general Lia0111ty is :ne !Mt of S _
3/city tnlery
lii.'S et CCantrractuat
formal insury
P*vas:s/ais i eted aerations
—lbwr omgt llog�ltasii1iitty
1.., Caleraensive Auto I.tassitty to the limit of $
+wee Auteneeiles
30'01wee luteseellq
`lime aatbsetiles
R 'refessieul Liability m as legit of Ste_
!en. ff ascots insurance is needed O meet t:te iMtts rtevirsd'far insurances in Exhibit C.
tlif-antheritem rserstencattw of as excess insurance Many(s) must sign tile eertitittta in
itltt C pertaining to the necessary overages.
f:n
Signature of autnontao title Dau
reeresentattve of Contraessr
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August 3, 1982
Approved as to Form
REEL i`.i,�c:l: RICHARD j. M00RE, County Counsel
Br. ... . . ..... .. Deputy.
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THE BOARD OF SUPERVISORS OF THE COUNTY OF ALA/VEDA, STATE OF CALIFORNIA'
On motion of Supervisor Chairman Bort Seconded by Supervisor George
d approved by the following vote,.
Ayes: Supervisors Cooper,..GeorSe.,... antana and Chairman Bort - 4
Noes: Supervisors None
Excused = 1i4Bid: Supervisory Excell - 1
cc'
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THE FOLLOWING RESOLUTION WAS ADOPTED: NUMBER 1 9 4 2 1 0
EXECUTE AGREEMENT
BE IT RESOLVED that Jpseph P. Bort, Chairman of .this Board of Supervisors,
be and he is hereby authorized and directed to execute on behalf of the County of
Alameda that certain Emergency Ambulance Agreement by and• between the County of
Alameda and TRI-CITIES AMBULANCE, -INC. , providing for emergency ambulance services
with EMS (Emergency Medical Services) Zone IX, which includes the unincorporated
territories of Pleasanton and Murray Townships and the Cities of Dublin, Livermore
and Pleasanton, covering the period July 1, 1982 through June 30, 1985; and
BE IT FURTHER RESOLVED that this Resolution supersedes Resolution No. 193902
(Contract No. 12295) adopted on June 29, 1982.
CONTRACT NO: 12439
1(.7.77:7•7v TWO'TH`FORE. 1t^ .., r•'
' -- " THE enAPu OF :•I IPC:;vl:.iir1
cO,JrsT\,C.ti:.IFOPt.;:A •1`:0J ,.� ►vv -
A T7EST: anG 1G 1982
WILLIAM MEHRWEIN. CLERK Of
74D OE SUPERVISORS BY - a,. , •
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