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Home My WebLink About981454.tiff RESOLUTION RE: APPROVE CONTRACT FOR EMERGENCY MEDICAL SERVICES GRANT AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with a Contract for the Emergency Medical Services Grant between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Ambulance Service, and the Colorado Department of Public Health and Environment, commencing August 30, 1998, and ending June 30, 1999, with further terms and conditions being as stated in said contract, and WHEREAS, after review, the Board deems it advisable to approve said contract, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Contract for the Emergency Medical Services Grant between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Ambulance Service, and the Colorado Department of Public Health and Environment be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said contract. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 17th day of August, A.D., 1998. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: Constince L. Harbert, Chair Weld County ' �.' {,ar._ p - W. H. Webster, Pro-Tem BY: G-rL Deputy Cle��1� � EXCUSED DATE OF SIGNING (AYE) irk George E. Baxter APP AST M: EXCUSED Dale K. Hall nt tt /17/4 Barbara J. Kirkmeyer 981454 47); AM0010 Cc P ;, , . . WELD COUNTY AMBULANCE SERVICE PHONE (970) 353-5700, EXT. 3200 FAX: (970) 353-5700, EXT. 3215 1121 M STREET GREELEY, COLORADO 80631 August 11, 1998 To: Vicky Sprague BOCC From: Gary McCabe (/\•'‘• RE: State EMS Grant Contract I believe the enclosed contracts must be signed by the chair of the BOCC. Please facilitate and advise. Thank you. 981454 APPROVED WAIVER FORM CONTRACT Department or Agency Name Grants Program-Single Agency COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Department or Agency Number FAA Contract Routing Number 9900536 CONTRACT This CONTRACT is made this IILh day of Aueust, 199a,by and between:the State of Colorado for the use and benefit of the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT,whose address or principal place of business is 4300 Cherry Creek Drive South.Denver.CO 80246,hereinafter referred to as "the State"; and,Weld County.Ambulance Service whose address or principal place of business is 1121 M Street.Greeley CO 80631,hereinafter referred to as"the Contractor". WHEREAS,as to the State,authority exists in the Law and Funds have been budgeted,appropriated and otherwise made available and a sufficient uncommitted balance thereof remains available for subsequent encumbering and payment in Fund Number 4Q9,Appropriation Code 4S ,and Organization Code 8300,under Contract Encumbrance Number FLA EMS 9900536; WHEREAS,the Emergency Medical Services and Prevention Division(EMSPD)was created to administer the Local Emergency Medical Services program created by Title 25,Article 3.5,Part 6, 8 C.R.S.,as amended; WHEREAS,the Emergency Medical Services Account within the Highway Users Tax Fund was created by section 25-3.5-603, 8 C.R.S.,as amended,to fund grants for the enhancement of statewide emergency medical services; WHEREAS,the Contractor is licensed,to the extent required by law,to provide emergency medical services in the State of Colorado; • WHEREAS,the State desires to grant funding to the Contractor to provide local emergency medical services; WHEREAS,as of the effective date of this Contract,the State has a currently effective Group II purchasing delegation agreement with the Division of Purchasing within the Colorado Department of Personnel; WHEREAS,the Contractor has submitted a grant application that has been approved by the State; WHEREAS,as of the effective date of this Contract,the Contractor meets all other qualifications for funding under the emergency medical services grants'program to provide local emergency medical services; WHEREAS,in accordance with EMSPD Rule,section 3.4.,the EMSPD deems the Contractor's application or request for use of grant funding as justified and an appropriate use of these grant funds;and, WHEREAS,all required approvals, clearances,and coordination have been accomplished from and with all appropriate agencies. Page 1 of 10 Pages NOW THEREFORE,in consideration of their mutual promises to each other,hereinafter stated,the parties hereto agree as follows: A. EFFECTIVE DATE AND TERM. The effective date of this Contract is August 30. 1998 or on such other date as the State Controller finally approves this Contract,whichever is later. The initial term of this Contract shall commence on August 30. 1998 and continue through and including dune 30, 1999. B. DUTIES AND OBLIGATIONS OF THE CONTRACTOR. 1. The Contractor shall use the funding granted to it under this Contract by the State to provide the emergency medical services project described in "Attachment A", "Colorado EMS Grant Application",which is incorporated herein by this reference,made a part hereof,and attached hereto. Grant funds related to these emergency medical services projects shall be used to upgrade the level of emergency medical services care offered in the State of Colorado. 2. If this Contract involves training or education services,then the Contractor shall submit written documentation of certification or other appropriate written documentation of satisfactory completion along with the invoice requesting reimbursement under this Contract. 3. If this Contract involves the acquisition of equipment,then the Contractor shall provide the State with written documentation of the purchase of the specified equipment,and shall comply with the following State requirements: A. All communications equipment shall be purchased from the State award for communications equipment or from another vendor for a comparable price and quality. If the Contractor desires to purchase communications equipment which is not listed on the State award,then Contractor must complete an informal competitive solicitation process before purchasing such equipment. If a competitive solicitation process is used, then the Contractor shall purchase the communications equipment from the lowest responsive and responsible bidder. B. If the Contractor desires to purchase emergency vehicles other than ambulances,then the Contractor must complete an informal competitive solicitation process before purchasing such equipment. The proposed specifications for these emergency vehicles must be approved by the State prior to the initiation of the informal competitive solicitation process. If a competitive solicitation process is used,then the Contractor shall purchase the emergency vehicles from the lowest responsive and responsible bidder. C. If the Contractor desires to purchase medical equipment,then the Contractor must complete an informal competitive solicitation process before purchasing such equipment. If a competitive solicitation process is used,then the Contractor shall purchase the medical equipment from the lowest responsive and responsible bidder. D. The Contractor shall maintain all purchased equipment in good working order,normal wear and tear excepted. The Contractor shall perform all necessary maintenance services for that equipment in a timely manner and in accordance with the manufacturer's specifications and any manufacturer's warranty requirements. The Contractor shall keep detailed and accurate records of all maintenance services performed on all purchased equipment. E. During the term of this Contract,and as may be required after its expiration,the Contractor shall acquire and maintain personal property casualty insurance for the replacement value of the purchased equipment for the useful life of the purchased equipment. F. The Contractor shall repair or replace all purchased equipment which is damaged, destroyed, lost,stolen, or involved in any other form of casualty. Page 2 of 10 Pages ggi1152/ G. The Contractor shall keep inventory control records on all purchased equipment. The Contractor shall obtain the prior,express,written consent of the State before relocating or reallocating any purchased equipment. H. The Contractor shall provide the State with a picture of each piece of purchased equipment. This picture must be submitted with the final program report. I. If the Contractor or its subcontractors cease to provide emergency medical services in the State of Colorado,then all equipment purchased under this Contract shall either be placed with another operating emergency medical services provider in the State of Colorado,or be sold at public auction for its then fair market value. That portion of the sale proceeds which equals the State's initial fmancial contribution towards the purchase of that equipment shall be refunded to the State by the Contractor. The Contractor shall obtain the prior,express written consent of the State prior to any relocation or sale of any purchased equipment. 4. Any training or education requirements which are identified in Attachment A are subject to the following terms and conditions: A. Reimbursement for all travel expenses associated with the training or education program shall be made in accordance with the then current State of Colorado reimbursement rates for travel as specified in the Fiscal Rules for the State of Colorado. B. If a Contractor provides a training or education program under this Contract,then the Contractor shall acknowledge the use of emergency medical services account grant funds,managed by the State,on all public service announcements,program announcements,or any other printed material used for the purpose of promoting or advertising the program. C. If a Contractor provides a training or education program under this Contract,then the Contractor shall develop and utilize a course evaluation tool to measure the effectiveness of the program. The Contractor shall submit a copy of the evaluation reports to the State upon completion of the program. 5. During the term of this Contract,the Contractor shall provide the State with quarterly progress reports for itself and its subcontractors in the format provided by the State. 6. Except for"public entities",which are described below,during the term of this Contract,and any renewal or extension thereof,the Contractor shall keep in force and effect a policy or policies of comprehensive general liability insurance,issued by a company authorized to do business in Colorado in an amount not less than$500,000 combined single limit for total injuries or damages arising from any one incident(for bodily injuries or damages). The Contractor shall provide the State with a certificate of insurance as evidence that such insurance coverage is in effect as of the effective date of this Contract. If the Contractor is a"public entity"within the meaning of the Colorado Governmental Immunity Act, C.R.S.24-10-101,et seq., 10 C.R.S.,as amended("Act"),then the Contractor shall at all times during the term of this Contract maintain such liability insurance,by commercial policy or self-insurance, as is necessary to meet its liabilities under the Act. The Contractor must provide the State with proof of such insurance. C. DUTIES AND OBLIGATIONS OF THE STATE. For and in consideration of the Contractor's satisfactory performance under this Contract,the State shall cause to be paid to the Contractor an amount not to exceed$21,500.Twenty One Thousand Five Hundred DOLLARS,as follows: 1. For equipment purchased under this Contract,the Contractor shall receive an 50%of the total Page 3 of 10 Pages 98igsz1 cost,an amount not to exceed$21,500. The Contractor shall provide matching funds in the amount of$21.500. Any costs in excess of$21.500(State Share)shall be the responsibility of the Contractor. 2. For training or education programs purchased under this Contract,the Contractor shall receive N/A%of the total cost,an amount not to exceed SN/A. The Contractor shall provide matching funds in the amount of$N/A. Any costs in excess of$N/A(State Share)shall be the responsibility of the Contractor. 3. For all other types of projects to be performed under this Contract,the Contractor shall receive an amount not to exceed SN/A (State Share). The Contractor shall provide matching funds in the amount of$N/A . Any costs in excess of the State's share of the project(s)shall be the responsibility of the Contractor. 4. Of the total financial obligation of the State to the Contractor under this Contract, $.00 dollars are identified as attributable to a funding source of the federal government and,$21,500 dollars are identified as attributable to a funding source of the state government. 5. Payments under this Contract shall be made upon the receipt of a signed request for reimbursement from the Contractor along with a copy of a paid invoice,submitted in duplicate. The State shall issue a warrant made payable to the Contractor. Payment shall be contingent upon the affirmation by the State of the Contractor's full and satisfactory compliance with the terms and conditions of this Contract. 6. The State may prospectively increase or decrease the amount payable under this Contract through a"Change Order Letter",a sample of which is incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment B". To be effective,the Change Order Letter must be: signed by the State and the Contractor;and,approved by the State Controller or an authorized designee thereof. Additionally,the Change Order Letter shall include the following information: A. Identification of this Contract by its contract number and affected paragraph number(s); B. The type(s)of service(s)or program(s)increased or decreased and the new level of each service or program; C. The amount of the increase or decrease in the level of funding for each service or program and the new total financial obligation; D. The intended effective date of the funding change;and, E. A provision stating that the Change Order Letter shall not be valid until approved y the State Controller or such assistant as he may designate. Upon proper execution and approval,the Change Order Letter shall become an amendment to this Contract. Except for the General and Special Provisions of this Contract,the Change Order Letter shall supersede this Contract in the event of a conflict between the two. It is expressly understood and agreed to by the parties that the change order letter process may be used only for increased or decreased levels of funding,corresponding adjustments to service or program levels,and any related budget line items. Any other changes to this Contract,other than those authorized by the contract renewal letter process described below, shall be made by a formal amendment to this Contract executed in accordance with the Fiscal Rules of the State of Colorado. If the Contractor agrees to and accepts the proposed change,then the Contractor shall execute and return the Change Order Letter to the State by the date indicated in the Change Order Letter. If the Contractor does not agree to and accept the proposed change,or fails to timely return the partially executed Change Order Letter by the date indicated in the Change Order Letter,then the State may,upon written notice to the Contractor,terminate this Contract twenty(20)calendar Page 4 of 10 Pages 9S.)yCl/ days after the return date indicated in the Change Order Letter has passed. Such written notice shall specify the effective date of termination of this Contract. In the event of termination under this clause,the parties shall not be relieved of their respective duties and obligations under this Contract until the effective date of termination has occurred. Increases or decreases in the level of contractual funding made through this change order letter process during the initial or renewal terms of this Contract may be made under the following circumstances: A. If necessary to fully utilize appropriations of the State of Colorado and/or non- appropriated federal grant awards; B. Adjustments to reflect current year expenditures; C. Supplemental appropriations,or non-appropriated federal funding changes resulting in an increase or decrease in the amounts originally budgeted and available for the purposes of this Contract; D. Closure of programs and/or termination of related contracts; E. Delay or difficulty in implementing new programs or services;and, F. Other special circumstances as deemed appropriate by the State. Page 5 of 10 Pages GENERAL PROVISIONS 1. The parties warrant that each possesses actual,legal authority to enter into this Contract. The parties further warrant that each has taken all actions required by its applicable law,procedures,rules,or by-laws to exercise that authority,and to lawfully authorize its undersigned signatory to execute this Contract and bind that party to its terms.The person or persons signing this Contract,or any attachments or amendments hereto,also warrant(s)that such person(s)possesses actual,legal authority to execute this Contract,and any attachments or amendments hereto,on behalf of that party. 2. THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND NOT AS AN EMPLOYEE OF THE STATE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR SHALL BE.OR SHALL BE DEEMED TO BE.AN AGENT OR EMPLOYEE OF THE STATE. THE CONTRACTQR SHALL PAY WHEN DUE ALL REOUIRED EMPLOYMENT TAXES AND INCOME TAX ANDJ.00AL HEAD TAX ONANY MONIEEPAID PURSUANT TO THIS CONTRACT. THE CONTRACTOR ACKNOWLEDGES THAT THE CONTRACTOR AND ITS EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE CONTRACTOR OR A THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE PROVIDE_SUCH COVERAGE. THE CONTRACTOR SHALL}IAVE NO AUTHORIZATION.EXPRESS OR IMPLIED.TO BIND THE STATEJ'O ANYAGREEMENTS,LIABILITY.OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH HEREIN. THE CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKERS'COMPENSATION(AND SHOW PROOF OF SUCH INSURANCE)AND UNEMPLOYMENT COMPENSATION INSURANCE IN AMOUNTS REQUIRED BY LAW.AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR,ITS EMPLOYEES AND AGENTS. 3. If this Contract is in the nature of personal/purchased services,then the State reserves the right to inspect services provided under this Contract at all reasonable times and places during the term of this Contract. "Services",as used in this clause,includes services performed or written work performed in the performance of services. If any of the services do not conform with the terms of this Contract,then the State may require the Contractor to perform the services again in conformity with the terms of this Contract,with no additional compensation to the Contractor for the reperformed services. When defects in the quality or quantity of the services cannot be corrected by reperformance,then the State may:require the Contractor to take all necessary action(s)to ensure that the future performance conforms to the terms of the Contract;and,equitably reduce the payments due to the Contractor under this Contract to reflect the reduced value of the services performed by the Contractor. These remedies in no way limit the other remedies available to the State as set forth in this Contract. 4. If,through any cause attributable to the Contractor's action(s)or inaction(s),the Contractor:fails to fulfill,in a timely and proper manner,its duties and obligations under this Contract;or,violates any of the agreements,covenants,provisions,stipulations,or terms of this Contract,then the State shall thereupon have the right to terminate this Contract for cause by giving written notice thereof to the Contractor. Such written notice shall be given at least ten(10) calendar days before the proposed termination date and shall afford the Contractor the opportunity to cure the default or state why termination is otherwise inappropriate. If this Contract is terminated for default,then all finished or unfinished data,documents,drawings,evaluations,hardware,maps,models, negatives,photographs,reports,software,studies,surveys,or any other material,medium or information,however constituted,which has been or is to be produced or prepared by the Contractor under this Contract shall,at the option of the State,become the property of the State. The Contractor shall be entitled to receive just and equitable compensation for any services or supplies delivered to,and accepted by,the State. If applicable,the Contractor shall return any unearned advance payment it received under this Contract to the State. Notwithstanding the above,the Contractor is not relieved of liability to the State for any damages sustained by the State because of the Contractor's breach of this Contract. The State may withhold any payment due to the Contractor under this Contract to mitigate the State's damages until such time as the exact amount of the State's damages from the Contractor's breach of this Contract is determined. If,after terminating this Contract for default,it is determined for any reason that the Contractor was not in default,or that the Contractor's action or inaction was excusable,then such termination shall be treated as a termination for convenience,and the rights and obligations of the parties shall be the same as if this Contract had been terminated for convenience,as described herein. 5. The State may,when the interests of the State so require,terminate this Contract in whole or in part,for the convenience of the State. The State shall give written notice of such termination to the other party specifying the part(s)of the Contract terminated. Such written notice shall be given to the other party at least thirty(30)calendar days before the effective date of termination. If this Contract is terminated for convenience,then all finished or unfinished data, documents,drawings,evaluations,hardware,maps,models,negatives,photographs,reports,software,studies,surveys,or any other material,medium or information,however constituted,which has been or is to be produced or prepared by the Contractor under this Contract shall,at the option of the State, become the property of the State. The Contractor shall be entitled to receive just and equitable compensation for any services or supplies delivered to,and accepted by,the State. If applicable,the Contractor shall return any unearned advance payment it received under this Contract to the State. This paragraph in no way implies that a party has breached this Contract by the exercise of this paragraph. If this Contract is terminated by the State as provided for herein,then the Contractor shall be paid an amount equal to the percentage of services actually performed for,or goods actually delivered to,the State,less any payments already made by the State to the Contractor for those services or goods. However,if less than sixty percent(60%)of the services or goods covered by this Contract have been performed or delivered as of the effective date of termination,then the Contractor shall also be reimbursed(in addition to the above payment)for that portion of those actual"out-of-pocket"expenses(not otherwise reimbursed under this Contract)incurred by the Contractor during the term of this Contract which are directly attributable to the uncompleted portion of the services,or the undelivered portion of the goods,covered by this Contract. In no event shall reimbursement under this clause exceed the total financial obligation of the State to the Contractor under this Contract. If this Contract is terminated for default because of the Contractor's breach of this Contract,then the provisions of paragraph 4 above shall apply. 6. The Contractor shall comply with the requirements of the following: A. Office of Management and Budget Circulars A-87,A-21,or A-122,and A-102 or A-110,as applicable; B. the"Hatch Act"(5 U.S.C. 1501-1508)and Public Law 95-454,Section 4728. These federal statutes declare that federal funds cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of federally-assisted programs; C. the"Davis-Bacon Act"(40 Stat.1494,Mar.3, 1921,Chap.411,40 U.S.C.276A-276A-5). This Act requires that all laborers and mechanics employed by contractors or sub-contractors to work on construction projects financed by federal assistance must be paid wages not less than those established for the locality of the project by the Secretary of Labor; D. 42 U.S.C.6101 et seq,42 U.S.C.2000d,29 U.S.C.794. These Acts mandate that no person shall,on the grounds of race,color,national origin, age,or handicap,be excluded from participation in or be subjected to discrimination in any program or activity funded,in whole or in part,by federal funds; Page 6 of 10 Pages 98iya21 E. the"Americans with Disabilities Act"(Public Law 101-336;42 U.S.C. 12101,12102,12111-12117,12131 -12134,12141-12150, 12161 - 12165, 12181 -12189, 12201 -12213 and 47 U.S.C.225 and 47 U.S.C.611); F. if the Contractor is acquiring an interest in real property and displacing households or businesses in the performance of this Contract,then the Contractor is in compliance with the"Uniform Relocation Assistance and Real Property Acquisition Policies Act",as amended(Public Law 91-646, as amended and Public Law 100-17,101 Stat.246-256);and, G. when applicable,the Contractor is in compliance with the provisions of the"Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments"(Common Rule). H. Section 2101 of the Federal Acquisition Streamlining Act of 1994,Public Law 103-355,which prohibits the use of federal money to lobby the legislative body of a political subdivision of the State. 7. By signing and submitting this Contract,the Contractor affirmatively avers that: A. the Contractor is in compliance with the requirements of the"Drug-Free Workplace Act"(Public Law 100-690 Title V,Subtitle D,41 U.S.C.701 et seq.);and, B. the Contractor hereby certifies that it is not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from covered transactions by any federal department or agency. The Contractor agrees to comply with all applicable regulations pursuant to Executive Order 12549,including,Debarment and Suspension and Participants'Responsibilities,29 C.F.R.98.510(1990). C. the Contractor shall comply with all applicable regulations pursuant to Section 319 of Public Law 101-121,Guidance for New Restrictions on Lobbying,including,Certification and Disclosure,29 C.F,R.93.110(1990). 8. If this Contract involves the expenditure of federal or state funds,then this Contract is subject to,and contingent upon,the continued availability of those funds for payment pursuant to the terms of this Contract. If those funds,or any part thereof,become unavailable as determined by the State,then the State may immediately terminate this Contract. 9. To be considered for payment,billings for payments pursuant to this Contract must be received within a reasonable time after the period for which payment is requested;but in no event no later than ninety(90)calendar days after the relevant performance period has passed. Final billings under this Contract must be received by the State within a reasonable time after the expiration or termination of this Contract;but in no event no later than ninety(90)calendar days from the effective expiration or termination date of this Contract. 10. Unless otherwise provided for in this Contract, "Local Match"shall be included on all billing statements,in the column provided therefor,as required by the funding source. 11. The Contractor shall not use federal funds to satisfy federal cost sharing and matching requirements unless approved in writing by the appropriate federal agency. 12. In accordance with Office of Management and Budget(OMB)Circular A-I33(Audits of States,Local Governments,and Non-Profit Organizations),if the Contractor receives federal funds from any source,including State pass through money,in an aggregate amount in excess of$300,000.00(June 24, 1997),in a State fiscal year(July 1 through June 30),then the Contractor shall have an annual audit performed by an independent certified public accountant which meets the requirements of OMB Circular A-133. If the Contractor is required to submit an annual indirect cost proposal to the State for review and approval,then the Contractor's auditor shall audit the proposal in accordance with the requirements of OMB Circulars A-21(Cost Principles for Educational Institutions),A-87(Cost Principles for State,Local and Tribal Governments),or A-122(Cost Principles for Non-Profit Organizations),whichever is applicable. The Contractor shall furnish one(I)copy of the audit report(s)to the State's Accounting Office within thirty(30)calendar days of issuance;but in no event later than nine(9)months after the end of the Contractor's fiscal year. If(an)instance(s)of noncompliance with federal laws and regulations occurs,then the Contractor shall take all appropriate corrective action(s)within six(6)months of the issuance of(a)report(s). The Contractor shall grant the State,or its authorized agents, access to the Contractor's relevant records and financial statements. The Contractor shall retain all such records and financial statements for a period of three(3)years after the date of issuance of a final audit report. This requirement is in addition to any other audit requirements contained in other paragraphs of this Contract. 13. Unless otherwise provided for in this Contract,for all contracts with terms longer than three(3)months,the Contractor shall submit a written progress report,if required by this Contract,specifying the progress made for each activity identified in this Contract. These progress reports shall be in accordance with the procedures developed and prescribed by the State. The preparation of progress reports in a timely manner is the responsibility of the Contractor. If the Contractor fails to comply with this provision,then such failure:may result in a delay of payment of funds;or,termination of this Contract. Progress reports shall be submitted to the State no later than the end of each calendar quarter,or at such other time as may otherwise be specified. 14. The Contractor shall maintain a complete file of all records,documents,communications,and other materials which pertain to this Contract. Such materials shall be sufficient to properly reflect all direct and indirect costs of labor,materials,equipment,supplies,and services,and other costs of whatever nature for which a contract payment was made. These records shall be maintained according to generally accepted accounting principles and shall be easily separable from other records of the Contractor. Copies of all such records,documents,communications,and other materials shall be the property of the State and shall be maintained by the Contractor,in a central location as custodian for the State,on behalf of the State,for a period of three(3)years from the date of final payment under this Contract,or for such further period as may be necessary to resolve any pending matters,including,but not limited to,audits performed by the federal government. 15. The Contractor authorizes the State,or its authorized agents or designees,to perform audits or make inspections of its records for the purpose of evaluating its performance under this Contract at any reasonable time during the term of this Contract and for a period of three(3)years following the termination of this Contract. As such,the Contractor shall permit the State,any appropriate federal agency or agencies,or any other duly authorized governmental agent or agency,to monitor all activities conducted by the Contractor pursuant to the terms of this Contract. Such monitoring may include,but is not limited to: internal evaluation procedures,examination of program data,special analyses,on-site checks,formal audit examinations,or any other reasonable procedures. All monitoring shall be performed by the State in such a manner that it shall not unduly interfere with the work of the Contractor. Page 7 of 10 Pages 99/1/61/ • 16. If the Contractor obtains access to any records,files,or information of the State in connection with,or during the performance of,this Contract,then the Contractor shall keep all such records,files,or information confidential and shall comply with all laws and regulations concerning the confidentiality of all such records,files,or information to the same extent as such laws and regulations apply to the State. Any breach of confidentiality by the Contractor or third party agents of the Contractor shall constitute good cause for the State to cancel this Contract,without liability to the State. Any State waiver of an alleged breach of confidentiality by the Contractor,or third party agents of the Contractor,does not constitute a waiver of any subsequent breach by the Contractor,or third party agents of the Contractor. 17. Unless otherwise agreed to in this Contract,or in a written amendment executed and approved pursuant to Fiscal Rules of the State of Colorado,the parties agree that all material,information,data,computer software,documentation,studies,and evaluations produced in the performance of this Contract for which the State has made a payment under this Contract are the sole property of the State. 18. If any copyrightable material is produced under this Contract,then the State,and any applicable federal funding entity,shall have a paid in full,irrevocable, royalty free,and non-exclusive license to reproduce,publish,or otherwise use,and authorize others to use,the copyrightable material for any purpose authorized by the Copyright Law of the United States as now or hereinafter enacted. Upon the written request of the Contractor shall provide the State with three(3)copies of all such copyrightable material. 19. If required by the terms and conditions of a federal or state grant,the Contractor shall obtain the prior approval of the State and all necessary third parties prior to publishing any materials produced under this Contract. If required by the terms and conditions of a federal or state grant the Contractor shall also credit the State and all necessary third parties with assisting in the publication of any materials produced under this Contract. 20. Neither the Contractor nor the State shall be liable to the other for any delay in,or failure of performance of,any covenantor promise contained in this Contract;nor shall any delay or failure constitute default or give rise to any liability for damages if,and only to the extent that,such delay or failure is caused by a supervening cause. As used in this Contract,"supervening cause"is defined to mean:an act of God,fire,explosion,action of the elements,strike, interruption of transportation,rationing,court action,illegality,unusually severe weather,war,or any other cause which is beyond the control of the affected party and which,by the exercise of reasonable diligence,could not have been prevented by the affected party. 21. It is expressly understood and agreed to between the parties that the enforcement of the terms and conditions of this Contract and all rights of action related to such enforcement,shall be strictly reserved to the State and the named Contractor. Nothing contained in this Contract shall give or allow any claim or right of action whatsoever to or by any third person. Nothing contained in this Contract shall be construed as a waiver of any provision of the Colorado Governmental Immunity Act,section 24-10-101 et sea.,C.R.S.,as amended. It is the express intent of the State and the named Contractor that any person or entity,other than the State or the named Contractor,receiving services or benefits under this Contract shall be deemed an incidental beneficiary only. 22. To the extent that this Contract may be executed and performance of the obligations of the parties may be accomplished within the intent of this Contract,the terms of this Contract are severable. If any term or provision of this Contract is declared invalid by a court of competent jurisdiction,or becomes inoperative for any other reason,then such invalidity or failure shall not affect the validity of any other term or provision of this Contract. 23. The waiver of a breach of a term or provision of this Contract shall not be construed as a waiver of a breach of any other term or provision of this Contract or, as a waiver of a breach of the same term or provision upon subsequent breach. - 24. If this Contract is in the nature of personal/purchased services,then,except for accounts receivable,the rights,duties,and obligations of the Contractor cannot be assigned,delegated,or otherwise transferred,except with the prior,express,written consent of the State. 25. Except as otherwise provided for herein,this Contract shall inure to the benefit of,and be binding upon,the parties hereto and their respective successors and assigns. 26. Unless otherwise provided for in this Contract,the Contractor shall notify the State,within five(5)working days after being served with a summons, complaint,or other pleading in a case which involves any services provided under this Contract and which has been filed in any federal or state court or administrative agency.The Contractor shall immediately deliver copies of any such documents to the State. 27. This Contract is subject to such modifications as may be required by changes in applicable federal or state law,or federal or state implementing rules, regulations,or procedures of that federal or state law. Any such required modification shall be automatically incorporated into,and be made a part of,this Contract as of the effective date of such change as if that change was fully set forth herein. Except as provided above,no modification of this Contract shall be effective unless such modification is agreed to in writing by both parties in an amendment to this Contract that has been previously executed and approved in accordance with applicable law. 28. Notwithstanding anything herein to the contrary,the parties understand and agree that all terms and conditions of this Contract,and the exhibits and attachments hereto,which may require continued performance or compliance beyond the termination date of this Contract shall survive such termination date and shall be enforceable as provided herein in the event of a failure to perform or comply by a parry to this Contract. 29. Notwithstanding any other provision of this Contract to the contrary,no term or condition of this Contract shall be construed or interpreted as a waiver,express or implied,of any of the immunities,rights,benefits,protections,or other provisions of the Colorado Governmental Immunity Act(CGIA),section 24-10-101, et sea.,C.R.S.,as now or hereafter amended. The parties understand and agree that liability for claims for injuries to persons or property arising out of the alleged negligence of the State of Colorado,its departments,institutions,agencies,boards,officials,and employees is controlled and limited by the provisions of section 24-10-101 et seq.,C.R.S.,as now or hereafter amended. 30. The captions and headings used in this Contract are for identification only,and shall be disregarded in any construction of the terms,provisions,and conditions of this Contract. 31. The parties hereto agree that venue for any action related to this Contract shall be in the City and County of Denver,Colorado. 32. All attachments to this Contract are incorporated herein by this reference and made a part hereof as if fully set forth herein. In the event of any conflict or inconsistency between the terms of this Contract and those of any attachment to this Contract,the terms and conditions of this Contract shall control. 33. This Contract is the complete integration of all understandings between the parties. No prior or contemporaneous addition,deletion,or other amendment hereto shall have any force or effect whatsoever,unless embodied herein in writing. No subsequent novation,renewal,addition,deletion,or other amendment hereto shall have any force or effect unless embodied in a written contract executed and approved pursuant to the Fiscal Rules of the State of Colorado. Page 8 of 10 Pages 9E1g3-2f SPECIAL PROVISIONS. CONTROLLER'S APPROVAL. 1. This contract shall not be deemed valid until it shall have been approved by the Controller of the State of Colorado or such assistant as he may designate. FUND AVAILABILITY. 2. Financial obligations of the State payable after the current fiscal year are contingent upon funds for that purpose being appropriated,budgeted,and otherwise made available. • BOND REQUIREMENT. 3. If this contract involves the payment of more than fifty thousand dollars for the construction,erection,repair,maintenance,or improvement of any building,road, bridge,viaduct,tunnel,excavation or other public work for this State,the contractor shall,before entering upon the performance of any such work included in this contract,duly execute and deliver to the State official who will sign the contract,a good and sufficient bond or other acceptable surety to be approved by said official in a penal sum not less than one-half of the total amount payable by the terms of this contract. Such bond shall be duly executed by a qualified corporate surety conditioned upon the faithful performance of the contract and in addition,shall provide that if the contractor or his subcontractors fail to duly pay for any labor,materials,team hire,sustenance,provisions, provendor or other supplies used or consumed by such contractor or his subcontractor in performance of the work contracted to be done or fails to pay any person who supplies rental machinery,tools,or equipment in the prosecution of the work the surety will pay the same in an amount not exceeding the sum specified in the bond,together with interest at the rate of eight per cent per annum. Unless such bond is executed,delivered and filed,no claim in favor of the contractor arising under such contract shall be audited,allowed or paid. A certified or cashier's check or a bank money order payable to the Treasurer of the State of Colorado may be accepted in lieu of a bond. This provision is in compliance with CRS 38-26-106. INDEMNIFICATION. 4. To the extent authorized by law,the contractor shall indemnify,save,and hold harmless the State,its employees and agents,against any and all claims,damages, liability and court awards including costs,expenses,and attorney fees incurred as a result of any act or omission by the contractor,or its employees,agents,subcontractors,or assignees pursuant to the terms of this contract. DISCRIMINATION AND AFFIRMATIVE ACTION. 5. The contractor agrees to comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957,as amended,and other applicable law respecting discrimination and unfair employment practices(CRS 24-34-402),and as required by Executive Order,Equal Opportunity and Affirmative Action,dated April 16,1975. Pursuant thereto, the following provisions shall be contained in all State contracts and subcontracts. During the performance of this contract,the contractor agrees as follows: (a) The contractor will not discriminate against any employee or applicant for employment because of race,creed,color,national origin,sex,marital status,religion, ancestry,mental or physical handicap,or age. The contractor will take affirmative action to insure that applicants are employed,and that employees are treated during employment,without regard to the above mentioned characteristics. Such action shall include,but not be limited to the following:employment upgrading,demotion,or transfer,recruitment or recruitment advertising;layoffs or terminations;rates of pay or other forms of compensation;and selection for training,including apprenticeship. The contractor agrees to post in conspicuous places,available to employees and applicants for employment,notices to be provided by the contracting officer setting forth provisions of this non-discrimination clause. (b) The contractor will,in all solicitations or advertisements for employees placed by or on behalf of the contractor,state that all qualified applicants will receive consideration for employment without regard to race,creed,color,national origin,sex,marital status,religion,ancestry,mental or physical handicap,or age. (c) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, notice to be provided by the contracting officer,advising the labor union or workers'representative of the contractor's commitment under the Executive Order,Equal Opportunity and Affirmative Action,dated April 16, 1975,and of the rules,regulations,and relevant Orders of the Governor. (d) The contractor and labor unions will furnish all information and reports required by Executive Order,Equal Opportunity and Affirmative Action,dated April 16, 1975,and by the rules,regulations and Orders of the Governor,or pursuant thereto,and will permit access to his books,records,and accounts by the contracting agency and the office of the Governor or his designee for purposes of investigation to ascertain compliance with such rules,regulations and orders. (e) A labor organization will not exclude any individual otherwise qualified from full membership rights in such labor organization,or expel any such individual from membership in such labor organization or discriminate against any of its members in the full enjoyment of work opportunity because of race,creed,color,sex,national origin,or ancestry. (f) A labor organization,or the employees or members thereof will not aid,abet,incite,compel or coerce the doing of any act defined in this contract to be discriminatory or obstruct or prevent any person from complying with the provisions of this contractor any order issued thereunder;or attempt,either directly or indirectly,to commit any act defined in this contract to be discriminatory. (g) In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such rules,regulations,or orders,this contract may be canceled,terminated or suspended in whole or in part and the contractor may be declared ineligible for further State contracts in accordance with procedures,authorized in Executive Order,Equal Opportunity and Affirmative Action,dated April 16,1975,and the rules,regulations,or orders promulgated in accordance therewith,and such other sanctions as may be imposed and remedies as may be invoked as provided in Executive Order,Equal Opportunity and Affirmative Action,dated April 16, 1975,or by rules, regulations,or orders promulgated in accordance therewith,or as otherwise provided by law. Page 9 of 10 Pages • • 9F/y5-41 (h) The contractor will include the provisions of paragraphs(a)through(h)in every subcontract and subcontractor purchase order unless exempted by rules,regulations, or orders issued pursuant to Executive Order,Equal Opportunity and Affirmative Action,dated April 16, 1975,so that such provisions will be binding upon each subcontractor or vendor.The contractor will take such action with respect to any sub-contracting or purchase order as the contracting agency may direct,as a means of enforcing such provisions,including sanctions for non-compliance;provided,however,that in the event the contractor becomes involved in,or is threatened with,litigation,with the subcontractor or vendor as a result of such direction by the contracting agency,the contractor may request the State of Colorado to enter into such litigation to protect the interest of the State of Colorado. COLORADO LABOR PREFERENCE. 6a. Provisions of CRS 8-17-101& 102 for Colorado labor are applicable to this contract if public works within the State are undertaken hereunder and are financed in whole or in part by State funds. b. When a construction contract for a public project is to be awarded to a bidder,a resident bidder shall be allowed a preference against a non-resident bidder from a state or foreign country equal to the preference given or required by the state or foreign country in which the non-resident bidder is a resident.If it is determined by the officer responsible for awarding the bid that compliance with this subsection.06 may cause denial of federal funds which would otherwise be available or would otherwise be inconsistent with requirements of Federal law,this subsection shall be suspended,but only to the extent necessary to prevent denial of the moneys or to eliminate the inconsistency with federal requirements.(CRS 8-19-101 and 102) GENERAL. 7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation,execution,and enforcement of this contract. Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any extra judicial body or person or which is otherwise in conflict with said laws,rules,and regulations shall be considered null and void. Nothing contained in any provision incorporated herein by reference which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether by way of complaint,defense,or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this contract to the extent that the contract is capable of execution. 8. At all times during the performance of this contract,the contractor shall strictly adhere to all applicable federal and state laws,rules and regulations that have been or may hereafter be established. 9. Pursuant to CRS 24-30-202.4(as amended),the state controller may withhold debts owed to state agencies under the vendor offset intercept system for:(a)unpaid child support debtor child support arrearages;(b)unpaid balance of tax,accrued interest,or other charges specified in Article 22,Title 39,CRS;(c)unpaid loans due to the student loan division of the department of higher education;(d)owed amounts required to be paid to the unemployment compensation fund;and(e)other unpaid debts owing to the state or any agency thereof,the amount of which is found to be owing as a result of final agency determination or reduced to judgment as certified by the controller. 10. The signatories aver that they are familiar with CRS 18-8-301,et.seq.,(Bribery and Corrupt Influences),and CRS 18-8-401,et.seq.,(Abuse of Public Office),and that no violation of such provisions is present. I I. The signatories aver that to their knowledge,no state employee has any personal or beneficial interest whatsoever in the service or property described herein. IN WITNESS WHEREOF,the parties hereto have executed this Contract as of the date and year first above written. CONTRACTOR: Weld County Board of STATE: Commissioners . (Full Legal Name) eld County,Ambulance Service STATE OF COLORADO Roy Romer,Governor' By: / By: Constance L. arber DEPARTMENT OF Position(Title) Chair (08/17/98) PUBLIC HEALTH AND ENVIRONMENT 84-6000813 - Social Security Number or Fey '�'+. Program Approval If Corporation,Town/t /County Iv r, Attest(Affix Seal) , ' i 1 -- B : . teputy Clerk to theij.� . I J( 1M1 APPROVALS: ATTORNEY GENERAL --- --- '-� CONTROLLER ^- -� By: By: l� Y Gale A.Norton )/Clifford W.H 11 Page 10 of 10 Pages (� L Attachment A kuixaA //c3/7K LEGAL NAME OF AGENCY FEDERAL TAX ID (read instructions carefully on this item) Weld County Ambulance Service py_., 84-6000813 A CONTACT PERSON PHONE (DAY) PHONE (NIGHT) Gary McCabe 970-353-5700 )( 3 .c Y} same AGENCY MAILING ADDRESS See below STREET CITY ZIP 1121 M Street Greeley, CO 80631 LEGAL STATUS OF AGENCY/ORGANIZATION(Mark all that apply): _PRIVATE NOT FOR PROFIT _PRIVATE FOR PROFIT X COUNTY/CITY GOVERNMENT _STATE AGENCY _SPECIAL DISTRICT OTHER PROJECT AREA (Mark all that apply): Communications _ Training Medical/Rescue Equipment _ Continuing Education Manual_ Automated Defibrillator _ Training Equipment Public Education _ Extrication X Other EMS Data Collection/Research _ PIER/Injury Prevention Programs Emergency Vehicle Ambulance_ Quick Response Rescue - County Wide Grant _ Regional Grant _ State-wide Grant _ Individual Agency Grant - 50% CASH MATCH REQUIREMENT MET _ WAIVER HAS BEEN REQUESTED • I,the undersigned,do hereby attest that the information contained within this application is true to the best of my knowledge. I also attest that the County Commissioners from the areas impacted by this project will be provided a copy of this application by no later than 9-i 3_Qg . I understand that my application will be disqualified should either of these statements be untrue. Gary M. McCabe Director PRINT NAME TITLE /1-'°\-r-N i 2-14-98 IGNATURE DATE I 9Y/45z/ WHY IS THIS PROJECT NEEDED In the space below, write a concise statement describing the need(s)addressed by this project. Uniform EMS data are not being defined, collected, and/or analyzed in our region. We have no centralized collection or reporting system. Consequently, there is no objective feedback or research method to convey useful information about our system's performance. This system will provide all that is lacking presently. We hope to initiate the project in March, and complete it by mid-year 1998. Priorities: 1. Complete the RFI/RFP currently in progress. 2. Purchase necessary hardware and software for input devices. 3. Begin input training for providers. 4. Purchase server hardware and software. 5. Contract interface technology. 6. Integrate with existing systems (dispatch, billings, etc.) . County Plan Reference: See pages 23 through 26 (Documentation 2.4A) of the Weld County Plan and Report on Emergency Medical Services (copies attached) , 2 DESCRIPTION OF THE PROJECT AND HOW YOUR PROJECT UPGRADES EMS In the space provided,please outline the project. Include planned expenditures,the time-frame,and any other information that will assist the committee in understanding the nature of the request. Weld County and the surrounding region does not have a shared data base at this time. All patient encounter reports are currently hand—written and archived in a paper (hard— copy) format. EMS dispatch and provider data are not integrated and are duplications of effort. Retrieval of information, Q.A. , and data comparisons are cumbersome, time- consuming, and very inefficient. In 1994, the Paramedic Division of the Denver Department of Health and Hospitals in- vited Weld County Ambulance Service to participate in a study of the Westech comput- erized trip reporting system. The Denver study continued into 1995, but WCAS removed itself from the project due to differences of opinion over the efficacy of the system. In 1996, WCAS initiated its own informal RFI on computerized trip reporting systems and budgeted for the actual project. In June 1997, WCAS proposed a formal RFI to the Weld County EMS Council. The RFI was adopted and expanded. It was included in the 1997 Weld County EMS Plan. The RFI is being converted to an RFP at this writing. In January 1998, the Northeast Colorado ATAC was advised by WCAS that WCAS was proceeding on the computerized trip reporting project, and that the file server could be upgraded to include all ATAC providers agencies. In February 1998, WCAS made the decision that it would purchase the necessary hardware, software, and technical support to: 1. Upgrade its existing LAN PC system. 2. Interface with the Weld County Regional Dispatch Center's computer system. 3. Interface with its own existing billing and reporting system. 4. Develop a network file server system. Total cost of this project is estimated ate $120,000. The File Server component is estimated at approximately $40,000 if it will be used to accept and manage data from all participating ATAC providers in our region. 3 9g/4/52/ How will the project provide for a long-term solution to the current problem? Our system will become a model for other providers to study and/or emulate. The file server will act as a repository for county-wide and regional EMS data. This, in turn, will allow for : 1. Comparative analysis (including QA) and 2. EMS research. The LAN part of the system will be maintained by WCAS. The cost of maintaining the File Server would be apportioned according to agency interface requirements and number of agency entries. WCAS would provide host site services (Housing, power, and telephone link capabilities) . If this project is funded,how will the project be sustained in subsequent years? See above. What other remedies to this have you explored to meet your need,and explain why this is the most cost-effective. Individually, some of the providers in our region have explored computerized trip reporting in concert with WCAS. Many have put their projects on hold because of funding and other resource limitations. Ambulance services in our region have utilized the State's Data Collection Program (Dot-to-Dots) to limited success. Provide dollar amounts of other options you have explored. WCAS is in the REP process. See estimates. 4 9S1t/521 EQUIPMENT LIST(Listing brands will not preclude applicant from having to obtain bids for the generic equipment types) In the space provided,please list the EMS equipment.communications,or training equipment for which funding is being requested..lnclude as much information as ?ossible. Priority Quantity Description Cost 1 9 Laptop/Penbased Computers $36,000 Ot- 1 2 Tabletop PCs 5,000 al<1 1 9 Portable Printers 2,000 O ki Other TOTALS 43, o do 5 • 9gjq zl TRAINING LIST Fill in this form if this application is requesting training. TITLE OF TRAINING COURSE: TYPE OF TRAINING: Has your agency been approved by the EMSP Division to conduct this program? Yes No If No,name the agency/training officer/coordinator who will conduct the training: COST OF PROJECT: How much of the total CASH cost of training project will be paid by: The EMS GRANT The Agency Cash Match The Studen Cash Match $ $ g for each training list the following information: Training #of Persons Course Cost Travel Cost Total Cost Type To be Per Person Per Person Per type of Trained course EMT Basic EMT-I EMT-P First Resp. Cont Ed. First Resp. List any training equipment on Equipment List on page 5. A DETAILED BUDGET BREAKDOWN IF THIS IS A MAJOR TRAINING PROJECT 6 COMMUNICATIONS IF YOUR APPLICATION IS REQUESTING RADIO EQUIPMENT,THIS SECTION MUST BE COMPLETED. LIST FREQUENCY AND RADIO SERVICE OF THE SYSTEM BEING DEVELOPED,MODIFIED OR UPGRADED. If frequencies are UHF MED channels,put"Med Channels". If repeater operation, list both frequencies. FREQUENCY RADIO SERVICE If the communications system is shared with other public safety services,please indicate which service(mark all that apply) Police_ Fire_ Highway Maintenance Other_ ON A SEPARATE SHEET OF PAPER, PROVIDE A FUNCTIONAL DIAGRAM OF THE PROPOSED SYSTEM IF A COMMUNICATIONS PLAN HAS BEEN DEVELOPED, PROVIDE A COPY OF THIS PLAN WITH flit APPLICATION(THE NEW SYSTEM MUST HAVE,AT A MINIMUM,A CONCEPTUAL PLAN PROVIDED WITH THIS APPLICATION) New or upgraded communications system must provide technical engineering information. 1.Name and telephone number of individual or agency providing technical specifications. I 1 Name Telephone 2.If technical engineering has not been completed,please provide the name,telephone and cost quoted for the individual or agency you will be using. I Name Telephone 3.Will you need to bid for development of technical specification for the system? Yes No_ Estimated Cost 7 ei /Liss'/ FILL IN THIS SECTION ONLY IF REQUESTING EXTRICATION EQUIPMENT Location and type(RS-10, Hurst,etc.)Of nearest extrication equipment(place, distance in miles,travel time): Do you have a written_or verbal_agreement to share extrication equipment? If so,name of agency with whom you share: Do any other agencies(i.e.,fire,police,rescue)plan to share in the use of equipment bought with funding from this grant? _Yes _No If Yes,please list names: How many of your agency's EMS runs required extrication equipment in the past year?_ Average time of extrication DEFIBRILLATION INFORMATION SECTION The following information should be available from your physician advisor. Number of EMS runs in the past 2 years that were cardiac arrests Number of EMS runs in the past 2 years that were witnessed arrests Number of CPR starts that took place on your EMS runs in the past 2 years_ BLS avg Response Time ALS Avg Response Time Telephone CPR Yes_ No_ Citizen CPR Program_ 8 niys7l PROJECT FUNDING A)EMS Fund Request SIIEW 0 0 B) Local Government Share-Cash $ 0 (List source)C)Other Cash $ _ oL``1 ,500 D)Total Cash Proj.Cost(A+B+C) E)Dollar Estimate of In-kind match $ 0 Lr F)Total Program Cost(D+E) Q Describe the in-kind match you can provide: 9 APPLICANT'S FINANCIAL INFORMATION Cash Flow Projection for Next Full Fiscal Year Year: 199ato 199_ See copy of Budget Unit Request Summary EMS Portion of Agency Projection Agency Projection Cash Balance at the start of year $ 83,868 $ Anticipated Revenues 0 Local Government $ $ Private Contributions $ 0 $ Investment Income $ 0 Other Fees $ 3,363,893 Anticipated Expenditures Salaries $ 1,601,400 $ Operating S 1,009,774 Capital Improvement $ 0 $ Loans $ 0 Other Bad Debt $ 752,719 $ Anticipated Cash Balance For the end of next FY $ 0 $ Additional Information: Explain the purpose of your cash balance (i.e.,reserve,building fund,etc.) Operating reserves Explain any loan payments you are currently making(i.e.,$ per month on a fire vehicle) None Explain any capital improvement purchases you intend to make None 10 98i1/5zl EMS PROVIDER INFORMATION All of the information in this section is mandatory for your application to be considered complete. Please list only the personnel that are trained or certified. Persons currently in training should not be listed in this section. If the number of persons currently in training is pertinent to your application,list them in the project description narrative. Years in Operation 22 TYPE OF SERVICE: X ALS(EMT-P& EMT-I) _BLS _Combination _Fire/Rescue service Transport Q_Non-transport _Other(i.e.,Air,etc.) Jim Campain, MD Name of physician advisor(if agency has one) PERSONNEL BY TRAINING LEVEL(number of each): Level of Training Number of Full Time Paid Number of Part Time Paid Number of Volunteers EMT-B 5 10 0 EMT-I 5 1 0 EMT-P 19 12 0 First Responder Cert. 0 0 0 CPR,Other,etc. ADMIN 5 PRIMARY Hospital transported to: North Colorado Medical. Center 0 to 80 Miles Distance to PRIMARY Hospital: Average number of EMS Runs Annually: 6,675 Average number of Runs Annually: 8,150 11 gg/4/31/ EMS Provider Information (cont'd) EMS Service Area and Geographic Description: (See Instructions) Weld County Ambulance Service is responsible for all of Weld County by County Charter. TriArea Ambulance Service covers a small area in southwest Weld. Mutual Aid Agreements are in effect with ambulance services on Weld's continguous borders. 12 • • 98/yszl EMS PROVIDER INFORMATION CONTINUED EMS VEHICLES OWNED BY YOUR AGENCY Write in the number of vehicles owned of each type in the age group. If your agency does not own vehicles please check here N/A Type of Vehicle Ito 3 yrs old 4 to 7 yrs old 8 to I I yrs old II years or>Number& Number& Mileage Number& Number& Mileage Mileage Mileage Type I 0 / 0 / 0 / 0 / Type II 0 / 0 / 0 / / 0 Type III 5 / 4 / 0 0 Rescue Vehicle 0 / 0 / 0 / 0 / First Response 0 / 0 / 0 / 0 Extrication Equipment Age #of RS 10 Kits # Spreaders #Cutters #Rains #Air Bags Ito5.yrs 0 0 0 0 0 6 yrs-older 0 0 0 0 0 EMERGENCY MEDICAL EQUIPMENT OWNED BY YOUR AGENCY Defibrillators: Manual 1-3 years old 8 4 years or older Semi-automatic or automatic L 1-2 years old _ 3 years or older Suction(electric./battery): 1 1.2 years old 8 3 years or older Back Boards(number owned): 250 (system wide) Snchers: Scoop _ Wire 13 98/y5-1/ • • it c 4 £A U L d `'s C F ,-.a _2n L i. w V a v c 2 ItR ° c 54 ,4,,)d 3s. ^el cir0o41 �1 o Y N. ti � ^ u dS / t u QQ L CJ- O f - gt x S tni .7 Z g w EC _la A d -6� Nl T • 2 c- C w 0-- iz) Q 501i) ,' n 1 s U C E Z 0: ice/' Q Q (1S r- e� g- _ • tq mV. T ( h - V1 C�$ .9 G a a' 0 A E c0 (0 �' r ©Cco VT 3 c c.;. „ m • C — N r Q in '0 l"- 00 C '�" N M R N 2r 00 a Q < a a a a a a a a a < a a a a a a a a a 1 '5 a- 9gl /5Z/ • COMMUNICATIONS EQUIPMENT Mobile Radios(VHF): Please check all agencies who use this equipment: _Fire X EMS _Police List the number of mobile radios(VHF)equipment you have in the correct aee group: 4 0-5 years old 12 6-10 years old II years or older Mobile Radios(UHF): Please check all aeencies who use this equipment: _Fire x EMS _Police List the number of mobile radios(UHF)equipment you have in the correct age group: 4 0-5 years old 12 6-10 years old II years or older Portables: Please check all agencies which use this equipment:_Fire Fire X EMS Police List the number of Portables you have in the correct age group: 4 12 _0-5 years old _6-10 years old _ 11 years or older Pagers: Please check all agencies this equipment is used by: Fire x EMS Police List the number of pagers you have in the correct age group: • 6Q1-5 years old _6-10 years old _11 years or older TRAINING EQUIPMENT OWNED BY YOUR AGENCY Please list the equipment on the following lines: None. Done by AIMS Community College FEE STRUCTURE INFORMATION Does your agency charge for services? Yesx_ No_ Please List Base Rates: Attached Do you charge for service when you provide treatment but do not transport? Yes No_ If the answer is yes, list basic charge see attached 14 9F iy571 EXHIBIT "B" 1998 WELD COUNTY AMBULANCE SERVICE FEES CODE AMBULANCES SERVICES: Charges are per person AMOUNT 51, 52, PRIMARY SERVICES SERVICES (TRANSPORT) $420 171, 172 54, 174 RETURN TRIP (TRANSPORT) 230 57, 177 AIR/GROUND AMBULANCE ASSIST (NO TRANSPORT) 420 57/177 PARAMEDIC ASSIST (TREATMENT, NO TRANSPORT) 230 56 PATIENT EVALUATION (NO TREATMENT OR 78 TRANSPORT) WHEELCHAIR TRANSPORT (SCHEDULED IN 39 DISTRICT, ONE WAY, NO EVALUATION OR TREATMENT) STANDBYS: Charges are per hour (One hour minimum) 55 ALS AMBULANCE (FULLY STAFFED; NO TRANSPORT) $78 53 ONE PERSON (NO TRANSPORT) 39 MILEAGE: Charges are per mile (Two mile minimum) one way 58 ONE PATIENT $10 58 MULTIPLE (N) PATIENTS 10/N ADDITIONAL ALS SERVICES: Charges are per procedure, item, or dose 69 ADVANCED AIRWAY CONTROL $140 60 OXYGEN AND PULSE OXIMETER 45 62 INTRAVENOUS THERAPY 60 65 MEDICATIONS 30 61 CARDIAC MONITORING 60 64 CARDIAC PACING 60 63 CARDIOVERSION 60 63 CARDIAC DEFIBFRILLATION 60 j "l 0., 9��ysz/ Attachment B STATE OF COLORADO Roy Romer,Governor ��of' Patti Shwayder,Executive Director H Dedicated to protecting and improving the health and environment of the people of Colorado 4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division «L Denver,Colorado 80246-1530 8100 Lowry Blvd. 'time• Phone(303)692-2000 Denver CO 80220-6928 Located in Glendale,Colorado (303)692-3090 Colorado Department of Public Health http://www.cdphestate.m.us - and Environment , 1997 State Fiscal Year 19_-_ Contract Routing Number Change Order Letter No. In accordance with paragraph_of the Original Contract with contract routing number and contract encumbrance number ,as amended by Change Order Letter routing number , and Renewal Letter routing number [strike if inapplicable] hereinafter referred to in total as"the Original Contract"(a copy of which is attached hereto and by this reference incorporated herein and made a part hereof)between the State of Colorado,Department of Public Health and - Environment, Division and, ,covering the period from , 199, through , 199,the parties agree that the maximum amount payable by the State for the eligible services in Paragraph_of the Original Contract is increased/decreased[strike inapplicable] by DOLLARS ($) _ for a new total of DOLLARS($ ). This funding change is in accordance with the revised work plan,which is incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment A" and,the revised budget,which is incorporated herein by this reference,made a part hereof,and attached hereto as"Attachment B" [strike inapplicable]. The first sentence in paragraph_of the Original Contract is hereby modified accordingly. All other terms of conditions of the Original Contract are hereby reaffirmed by the parties. This amendment to the Original Contract is intended to be effective as of 199_,but in no event shall it be deemed valid until it shall have been approved by the State Controller or such assistant as he may designate. Please sign, date and return all_originals of this letter as soon as possible to: at the Colorado Department of Public Health and Environment, Division,4300 Cherry Creek Drive South, Mail Code: Denver,CO 80246. One original of this letter will be returned to you when fully approved. Contractor: State of Colorado Full Contractor Name Roy Romer, Governor By: By: Signature For the Executive Director Colorado Department of Print Name: • PPublic Health and Environment Title: APPROVALS: PROGRAM CONTROLLER • By: By: yBJ�/Sy STATE OF COLORADO Roy Romer,Governor F-C Patti Shwayder,Executive Director Dedicated to protecting and improving the health and environment of the people of Colorado 'tee • �\ 4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division Denver,Colorado 80246-1530 8100 Lowry Blvd. A!1806 Phone(303)692-2000 Denver CO 80220-6928 Located in Glendale,Colorado (303)692-3090 Colorado Department http://www.cdphe.state.co.os of Public Health and Environment MEMORANDUM TO: Gary McCabe, Weld County Ambulance FROM: Arleen Way, Grants Manager EMS Division /�`r DATE: 10/28/98 C V RE: Approved Contract Your fully approved contract with the state is enclosed. Make copies of the forms attached to file progress reports and request payment on your grant. Remember that failure to submit progress reports as stipulated, is a violation of the contract and can result in cancellation of your contract, refusal to honor your request for payment, or denial of future grants from the EMS Division. Send your reports in promptly at the end of each of the following months or you will receive a notice of cancellation of your contract: 1st Report - Waived 2nd Report - Waived 3rd Report - March 4th Report - June In prior fiscal years I spent a great deal of time reminding grantees that their contract ended JUNE 30, and that all equipment needed to be received, training done, and projects completed by that date (there are no exceptions or extensions). Also, the contract states that any billing pursuant to this contract must be received by the State within 60 days of the expiration date which is June 30, 1998. I will send no further notices or reminders. I regret that I have to take this position with grantees,but in order to continue to operate this program with the least amount of staff, it is necessary. I am looking forward to the successful completion of your project. Please let me know if there is anything I can do to assist you in accomplishing this. If you have any questions, please contact me. STATE OF COLORADO Roy Romer,Governor Patti Shwayder,Executive Director Qq� Dedicated to protecting and improving the health and environment of the people of Colorado 4300 Cherry Creek Dr.S. Laboratory and Radiation Services Division \ `IP j*t Denver,Colorado 80246-1530 8100 Lowry Blvd. Phone(303)692-2000 Denver CO 80220-6928 76/ Located in Glendale,Colorado (303)692-3090 Colorado Department http://www.cdphe.state.co.us of Public Health and Environment August 3, 1998 Gary McCabe Weld County(Ambulance Service) 1121 M Street Greeley, CO 80631 Dear Gary: Enclosed are three(3)copies of a contract between your agency and the State. Please read the contract carefully before you have it signed by the legal signing authority for your agency. Please have all three copies signed and attested to(do not use a notary for the witness signature). Failure to have the contract signed correctly will create problems for both you and me and result in substantial delays in processing. Your agency signature on this contract does not mean that it is a fully executed contract. You will received a copy of the fully executed contract when the state controller or his designee has signed it. Please return all of the requested information to me within 15 working days. If you have any questions,please give me a call. Sinc rely, Arleen Way Grants Manager C \\\ Pre-Hospital Care Program , - \%(4 03 �0 199 %Li CZ" Hello