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HomeMy WebLinkAboutCity of Tamarac Resolution R-2010-110TR11915 August 9, 2010 Page 1 CITY OF TAMARAC, FLORIDA RESOLUTION NO. R-2010 -__` 1L_ A RESOLUTION OF THE CITY COMMISSION OF THE CITY OF TAMARAC, FLORIDA ACCEPTING AN EMERGENCY MEDICAL SERVICES GRANT IN THE AMOUNT OF $45,000 FROM THE FLORIDA DEPARTMENT OF HEALTH, BUREAU OF EMERGENCY MEDICAL SERVICES FOR CARDIAC MONITOR/DEFIBRILLATORS AND AUTHORIZING THE APPROPRIATE CITY OFFICIALS TO EXECUTE AN AGREEMENT FOR PURCHASE OF TWO (2) LIFEPAK 15 CARDIAC MONITORS AND DEFIBRILLATORS WITH RELATED ACCESSORIES FROM PHYSIO-CONTROL, A DIVISION OF MEDTRONIC, INC., A SOLE SOURCE PROVIDER NOT TO EXCEED A TOTAL AMOUNT OF $60,000 IN GRANT FUNDING AND CITY MATCH; AUTHORIZING THE DISPOSAL OF TWO (2) OUTDATED CARDIAC MONITORS AND DEFIBRILLATTRS; PROVIDING FOR CONFLICTS; PROVIDING FOR SEVERABILITY; AND PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, the State of Florida requires a Cardiac Defibrillator/Monitor on every licensed Advanced Life Support (ALS) vehicle; and WHEREAS, upgrading Cardiac Defibrillator/Monitors on City of Tamarac Fire Rescue ALS vehicles maintains the Department's emergency and operational readiness; and WHEREAS, the City applied and was awarded a Florida Department of Health, Bureau of Emergency Medical Services matching grant to purchase two (2) cardiac monitors and defibrillators (attached hereto as Exhibit A and B); and WHEREAS, acceptance of these grant funds require the amending of estimated revenues and expenditures within the Department's Fund Budget; and WHEREAS, funding for cardiac monitors and defibrillators has been provided for in the Fire Rescue FY10 budget; and WHEREAS, the City Commission of the City of Tamarac deems it to be in the best interest of the citizens and residents of the City of Tamarac to accept this grant funding for the provision of cardiac monitors and defibrillators, and to execute the Florida Department of TR11915 August 9, 2010 Page 2 Health Project Agreement in the amount of $45,000 with a City match of $15,000 from the Fire -Rescue FY10 budget, for a total grant amount of $60,000; and WHEREAS, the Fire Chief and the Purchasing and Contracts Manager recommend acceptance of these grant funds and execution of the project Agreement between the Florida Department of Health and the City of Tamarac, and to enter into the necessary agreements with Physio-Control, a division of Medtronics, Inc., for the purchase of two (2) LifePak 15 cardiac monitors and defibrillators, in a total grant amount not to exceed $60,000, pending legal review and approval (attached hereto as Exhibit C); and WHEREAS, Physio-Control, a division of Medtronic, Inc. does not utilize a dealer network, and markets all products directly; and WHEREAS, as a result of standardization and the lack of dealers, Physio-Control, a division of Medtronic, Inc. is a sole source provider (letter attached hereto as Exhibit D); and WHEREAS, the Fire Chief and the Purchasing and Contracts Manager furthermore recommend disposing of two (2) LifePak 11 cardiac monitors and defibrillators; and WHEREAS, City Code §6-153 permits the disposal of Surplus Stock. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF TAMARAC, FLORIDA: SECTION 1: The foregoing "WHEREAS" clauses are hereby ratified and confirmed as being true and correct and are hereby made a specific part of this Resolution. All Exhibits attached hereto are expressly incorporated herein and made a part hereof. SECTION 2: The City Commission of the City of Tamarac hereby accepts the award of $45,000 from the Florida Department of Health. SECTION 3: The appropriate City Officials are HEREBY authorized to accept the Grant Agreement between the City of Tamarac and the Florida Department of Health for grant funding in the amount of $45,000 with a 25% match in City funds or $15,000, for a total project cost of $60,000 (attached hereto as Exhibit A), approval letter (attached hereto as Exhibit B), vendor quotation (attached hereto as Exhibit C), sole source letter (attached hereto as Exhibit 1 C n TR11915 August 9, 2010 Page 3 D) and to enter into the necessary agreements pending legal review and approval between the City of Tamarac and Physio-Control for cardiac monitors and defibrillators. SECTION 4: The LifePak 11 monitors and defibrillators are outdated for use by Tamarac, are considered surplus stock, and are available for trade-in toward the purchase of LikePak 15 machines and accessories. SECTION 5: All Resolutions or parts of Resolutions in conflict herewith are hereby repealed to the extent of such conflict. SECTION 6: If any clause, section, other part or application of this Resolution is held by any court of competent jurisdiction to be unconstitutional or invalid, in part or application, it shall not affect the validity of the remaining portions or applications of this Resolution. SECTION 7: This Resolution shall become effective immediately upon its passage and adoption. PASSED, ADOPTED AND APPROVED this ATTEST: MARION SWENSON, CMC CITY CLERK I HEREBY CERTIFY that I have approved this RESOLUTION as to form. '/'� A _" ,,, SAM L S. OIL N CITY ATTORNEY cK day of , 2010. BETH TALABISCO MAYOR Record of COMMISSION MAYOR TALABISCO DIST 1: COMM BUSHNE DIST 2: COMM GOMEZ DIST 3: COMM GLASSE DIST 4: VM DRESSLER TR11915 - EXHIBIT A EMS MATCHING GRANT APPLICATION FLORIDA DEPARTMENT OF HEALTH Bureau of Emergency Medical Services Complete all items unless instructed differently within the application Type of Grant Requested: ❑ Rural ® Matching ID. Code The State Bureau of EMS will assign the ID Code — leave this blank 1. Or anization Name: City of Tamarac Fire Rescue 2. Grant Signer: (The applicant signatory who has authority to sign contracts, grants, and other legal documents. This individual must also sign this application) Name: Jeffrey L. Miller Position Title: City Manager Address: 7525 NW 88 Avenue City: Tamarac County: Broward State: Florida Zip Code: 33321 Telephone: 954-597-3510 Fax Number: 954-597-3520 E-Mail Address: jeffm@tamarac.org 3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and responsibility for the implementation of the grant activities. This person may sign project reports and may request project changes. The signer and the contact person may be the same.) Name: Thomas Sheridan Position Title: EMS Division Chief Address: Tamarac Fire Rescue 6000 Hiatus Road Ci Tamarac County: Broward State: Florida Zip Code: 33321 Telephone: 954-597-3800 Fax Number: 954-597-3810 E-mail Address: tomsh tamarac.or DH Form 1767, Rev. June 2002 TR11915 - EXHIBIT A 4. Legal Status of Applicant Organization (Check only one response): (1) ❑ Private Not for Profit [Attach documentation-501 (3) ©] (2) ❑ Private For Profit (3) ❑x City/Municipality/TownNillage (4) ❑ County (5) ❑ State (6) ❑ Other (specify): 5. Federal Tax ID Number (Nine Digit Number). VF 5 9 —1 0 3 9 5 5 2 6. EMS License Number: 0636 Type: ❑x Transport ❑Non -transport ❑Both 7. Number of permitted vehicles by type: BLS GALS Transport r_ALS non -transport. 8. Type of Service (check one): ❑Rescue ❑x Fire ❑Third Service (County or City Government, nonfire) ❑Air ambulance: ❑Fixed wing ❑Rotowing ❑Both ❑Other (specify) 9. Medical Director of licensed EMS provider: If this project is approved, I agree by signing below that I will affirm my authority and responsibility for the use of all medical equipment and/or the provision of all continuina EMS education in this project. [No signature is needed if medical equipment and professional EMS education are not in this project.] Signature: Date: Print/Type: Name of Director L. Scott Ulin, MD. FACEP FL Med. Lic. No. ME 40245 Note: All organizations that are not licensed EMS providers must obtain the signature of the medical director of the licensed EMS provider responsible for EMS services in their area of operation for projects that involve medical equipment and/or continuing EMS education. If your activity Is a research or evaluation project, omit Items 10, 11, 12, 13, and skip to Item Number 14. Otherwise, proceed to Item 10 and the following items. 10. Justification Summa : Provide on no more than three one sided, double spaced pages a summary addressing this project, covering each topic listed below. A) Problem description (Provide a narrative of the problem or need); B) Present situation (Describe how the situation is being handled now); C) The proposed solution (Present your proposed solution); D) Consequences if not funded (Explain what will happen if this project is not funded); E) The geographic area to be addressed (Provide a narrative description of the geographic area); F) The proposed time frames (Provide a list of the time frame(s) for completing this project); G) Data Sources (Provide a complete description of data source(s) you cite); H) Statement attesting that the proposal is not a duplication of a previous effort (State that this project doesn't duplicate what you've done on other grant projects under this grant program). DH Form 1767, Rev. 2002 2 iliAIE'ZFM=0:1:11:311111 10. Justification Summary A) Problem Description: Cardiovascular disease (CVD) claims more lives each year than the next five leading causes of death combined.' An estimated 700,000 Americans will have a new coronary attack and about 500,000 will have a recurrent attack.2 Nearly 2,500 Americans die each day of CVD, an average of one death every 35 seconds .3 In surviving a heart attack, experts agree that "time is muscle" as the single most critical factor. When having a heart attack, the more time that lapses without definitive treatment, the greater the risk of long-term permanent disability or death. Therefore, the "full spectrum of personnel — physicians, nurses, emergency medical technicians, and all allied healthcare personnel — need to know the core principles of diagnosis and treatment of the acute coronary syndromes. ,4 From January 1, 2009 through December 31, 2009, the City of TFR responded to 7,562 EMS -type calls and 6,086 required transport to the emergency department. Of those patients transported to the emergency department, 69% required the use of a cardiac monitor/defibrillator, and 27% were confirmed with a cardiac dysrhythmia.5 The ability to monitor and transmit data to the appropriate hospital was hindered by the limited capability of the monitors. B) Present Situation: Currently, Tamarac Fire Rescue (TFR) has a monitor/defibrillator capable of acquiring a 12-lead ECG on each primary ALS unit. However, five City machines are between 11-14 years old, using outdated technology and are not able to transmit ECG findings. These units are some of the oldest units in Broward County according to our Physio-Control purchase sheets. These monitors continue to require software upgrades in order to transmit the necessary data to the Emergency Department, C) Proposed Solution: Our proposed solution would replace four of the five outdated monitor/defibrillators units with new industry standard monitor/defibrillators with a more capable, multifunctional cardiac monitor and defibrillation system. Modern cardiac monitors can trim minutes from the diagnosis and treatment of heart attacks and other diseases requiring constant patient monitoring. The new LifePak system provides a multitude of cutting edge capabilities including: 12-lead ECG analysis using industry standard interpretation to immediately recognize and treat myocardial infarction for both men and women. In addition, the system has the ability to transmit diagnostic quality 12-lead ECG to the hospital, automatic defibrillation through biphasic wave form technology at the recommended energy levels with shock advisory system, non-invasive cardiac pacing, non-invasive blood pressure monitoring with artifact rejection and automatic measurement modes, 3 TR11915 - EXHIBIT A Masimo pulse CO-oximetry with a finger probe, offering accurate and reliable oxygen saturation, met hemoglobin and carbon monoxide detection, CPR metronome to ensure 100 compression per minute, lithium ion batteries, end -tidal capnography for both intubated and non-intubated patients, extensive data storage, transmission and retrievable capabilities, large color coded and SunVue display for enhanced ECG viewing, and patient trending of vital signs and 50mm / 100mm printers to record ECGs and patient care. D) Consequences if not funded: If the grant is not funded, the current technological standard of care would not be available to all patients experiencing a coronary event. Due to economic conditions that has affected our capital improvement plan, the associated cost to purchase the system would over -burden the City and is presently not fiscally possible. Based on equipment age, the likelihood of potential equipment failure is inevitable and it will not be possible for immediate replacement even under service contracts. Finally, these monitors would be slowly phased in over the next few years under our capital equipment plan, when economic conditions improve. However, due to the economic climate, TFR believes these funds may be several years away. E) The geographic area to be addressed: This grant will serve the entire 12 square miles of the City of Tamarac, located in west Broward County. TFR has three fire stations and uses a minimum of four Advanced Life Support (ALS) rescues and three ALS engines serving a population of 60,000, as well as 2,500 seasonal residents and an estimated daily transient population of 10,000 (City of Tamarac, Community Development, 2009). In addition, the City has agreements such as automatic and/or mutual aid agreements with border cities, encompassing approximately 25 square miles including the cities of North Lauderdale, Oakland Park and Lauderhill that we respond to assist with patient care. F) Proposed Project Time Frames: TFR expects to select a vendor within 30-60 days of receiving the grant monies and receiving purchase approval by the City Commission. The Department will order the four cardiac monitor/defibrillators and expects delivery in approximately three weeks. Training on the devices will begin within 30 days of receipt, with devices placed on specified vehicles for use within the same time period as the training. Please see # 16 for timeframes. G) Data sources: , 1) National Heart Attack Alert Program Coordinating Access to Care Subcommittee, 1995. "Staffing and Equipping Emergency Medical Services System: Rapid Identification and Treatment of Acute Myocardial Infarction." American Journal of Emergency Medicine. Volume 18: Pages 806-811. 2) 4 TR71915 - EXHIBIT A Atherosclerosis Risk in Commities (ARIL, 1987-2000, NHLBI). 3) American Heart Association, Inc. 2006. Heart Disease and Stroke Statistics 2006 update, page 10. 4)American Heart Assoication, Inc. 1997. "Advanced Cardiac life Support" Textbook of Advanced Cardiac Life Support, Chapter 9, pages 9-14. 5) City of Tamarac Fire Rescue, State Aggregate Data 2009. H) Statement attesting to no duplication: The City of Tamarac project for requested Cardiac equipment is not a duplication of a previous grant effort or involved in any other grant project. 5 TR11915 - EXHIBIT A Next, only complete one of the following: Items 11, 12, or 13. Read all three and then select and complete the one that pertains the most to the preceding Justification Summary. 11. Outcome For Projects That Provide or Effect Direct Services To Emergency Victims: This may include vehicles, medical and rescue equipment, communications, navigation, dispatch, and all other things that impact upon on -site treatment, rescue, and benefit of emergency victims at the emergency scene. Use no more than two additional one sided, double-spaced pages for your response. Include the following. A) Quantify what the situation has been in the most recent 12 months for which you have data (include the dates). The strongest data will include numbers of deaths and injuries during this time. B) In the 12 months after this project's resources are on-line, estimate what the numbers you provided under the preceding "(A)" should become. C) Justify and explain how you derived the numbers in (A) and (B), above. D) What other outcome of this project do you expect? Be quantitative and explain the derivation of your figures. E) How does this integrate into your agency's five year plan? 12. Outcome For Training Projects: This includes training of all types for the public, first responders, law enforcement personnel, EMS and other healthcare staff. Use no more than two additional one sided, double-spaced pages for your response. Include the following: A) How many people received the training this project proposes in the most recent 12 month time period for which you have data (include the dates). B) How many people do you estimate will successfully complete this training in the 12 months after training begins? C) If this training is designed to have an impact on injuries, deaths, or other emergency victim data, provide the impact data for the 12 months before the training and project what the data should be in the 12 months after the training. D) Explain the derivation of all figures. E) How does this integrate into your agency's five year plan? 13. Outcome For Other Projects: This includes quality assurance, management, administrative, and other. Provide numeric data in your responses, if possible, that bear directly upon the project and emergency victim deaths, injuries, and/or other data. Use no more than two additional one sided, double- spaced pages for your response. Include the following. A) What has the situation been in the most recent 12 months for which you have data (include the dates)? B) What will the situation be in the 12 months after the project services are on-line? C) Explain the derivation of all numbers. D) How does this integrate into your agency's five year plan? DH Form 1767, Rev. 2002 5 TR11915 - EXHIBIT A 11. Outcome for Projects that Provide or Effect Direct, Services to Emergency Victims A) 12-Month Situation — In 2009, TFR responded to 7,562 EMS -related calls and transported 6,086 patients or 80.5 %. Of those calls, 4,190 or 69% involved patients with conditions requiring the non- invasive use of cardiac monitoring. Overall, in the period covering the year 2009, data showed that 471 or 11.24% of all patients were experiencing either chest pain or cardiac related problems. Although the City's call volume has been relatively consistent over the past several years, 68% of patients receiving a 4- lead ECG received a 12-lead ECG and less than 0.5% might have been transmitted to the emergency department due to technology downfalls. Firefighter rehabilitation has also been difficult due to the limited ability of CO monitoring. With the primary CO monitors in the City located on the command and rescue unit, the CO monitor is not utilized if a separate unit is used for firefighter rehabilitation on a fire scene. Command vehicles are not equipped with any ECG monitors, although staffed by paramedics. The acquisition of the new machines will allow the previous monitors to be placed on command vehicles to be used as needed. B) Projected Outcomes — In recently published literature, the implementation of the new cardiac monitor/defibrillators in all AILS vehicles will allow our services to run and transmit 12-lead data on 100% of patients presenting cardiac symptoms, keeping pace with the County focus for a STEMI network. The transmission would enable the receiving facility to be alerted to potential ACS patients 100% of the time as opposed to receiving the ECG upon crew arrival. The City of Tamarac should decrease the door to balloon time for our patients at interventional facilities or other invasive procedures by 10-15 minutes. Also, in the case of firefighter rehabilitation, the new cardiac monitor/defibrillator with CO monitoring would be present on all fire ground operations, not only for our personnel but for structure fire victims. C) Justification for 11A and 116 - The data numbers in Part A above were derived from Florida Aggregate Data and are the actual figures for that year. The data presented and estimates in Part Beare derived from Florida Aggregate Data for those years cited and from studies/results detailed in a variety of sources that are listed in the justification section of this proposal. All figures are conservative estimates with the exception of transmission capabilities that do not reliably exist. There is also mounting evidence in studies and actual incidences throughout EMS that indicate additional measures should be taken for cardiac patients in the field in regard to their appropriate intervention and cardiac catheter times based on North Shore Medical Center -Florida Medical Center, Holy Cross Hospital, Cleveland Clinic as well as interfacility transports to Westside Regional Medical Center. N. ki:-;IPI Wn=0:1:11:1�ffA D) Other Possible Outcomes — Other outcomes of this project would be the additions of available ECG machines is one is being used at the hospital for patient pacing or monitoring. Currently, if a patient is being paced, the local hospital does not have a "transition" cable in order to continue cardiac pacing without interruption while transferring patient care. The urgency of placing units back in service has caused unnecessary interruption of pacing by the hospital. E) Integration into 5-Year Plan - This project integrates into our 5 year plan by improving and expanding EMS within the community. This includes the incorporation of 12-lead transmission and hypothermia treatment based on updated ACLS algorithms. The new ECG machines allow paramedica access several monitoring devices in one unit as opposed to having several separate pieces of equipment to accomplish the same task. As the plan to provide the most up-to-date technology for our patients, this project will assist in fulfilling these requirements. TRI1915 - EXHIBIT A Skip Item 14 and go to Item 15, unless your project is research and evaluation and you have not completed the preceding Justification Summary and one outcome item. 14. Research and Evaluation Justification Summary. and Outcome: You may use no more than three additional one sided, double spaced pages for this item. A) Justify the need for this project as it relates to EMS. B) Identify (1) location and (2) population to which this research pertains. C) Among population identified in 14(B) above, specify a past time frame, and provide the number of deaths, injuries, or other adverse conditions during this time that you estimate the practical application of this research will reduce (or positive effect that it will increase). D) (1) Provide the expected numeric change when the anticipated findings of this project are placed into practical use. (2) Explain the basis for your estimates. E) State your hypothesis. F) Provide the method and design for this project. G) Attach any questionnaires or involved documents that will be used. H) If human or other living subjects are involved in this research, provide documentation that you will comply with all applicable federal and state laws regarding research subjects. 1) Describe how you will collect and analyze the data. 15. Statuto Considerations and Criteria: The following are based on s. 401.113(2)(b) and 401.117, F.S. Use no more than one additional double spaced page to complete this item. Write N/A for those things in this section that do not pertain to this project. Respond to all others. Justify that this project will: A) Serve the requirements of the population upon which it will impact. B) Enable emergency vehicles and their staff to conform to state standards established by law or rule of the department. C) Enable the vehicles of your organization to contain at least the minimum equipment and supplies as required by law, rule or regulation of the department. D) Enable the vehicles of your organization to have, at a minimum, a direct communications linkup with the operating base and hospital designated as the primary receiving facility. E) Enable your organization to improve or expand the provision of: 1) EMS services on a county, multi county, or area wide basis. 2) Single EMS provider or coordinated methods of delivering services. 3) Coordination of all EMS communication links, with police, fire, emergency vehicles, and other related services. DH Form 1767. Rev. 2002 C] TR71915 - EXHIBIT A 15. Statutory Considerations and Criteria A) Serve the population: This grant would provide the needed risk protection to all cardiac -related type patients in the City as well as Broward County. It also will assist our system to respond faster and more efficiently to those patients that require interventional cardiac procedures. B) Conform to State Standards: This project specifically helps TFR to address Objective 5.4 and 5.5, 2010 - 2012 Statewide EMS Goals and Objectives (draft), which aims to "measure and identify opporunitities for improvement of on -site EMS treatment ... [and] appropriate transport destination" under the % of time a 12-lead was captured and transmitted, % using capnography and % of AMI victims to interventional facilities." C) Minimum equipment and supplies: Yes. Currently, under Chapter 64J these cardiac monitor/defibrillators will meet all state and local requirements for ECG printout and electronic waveform capnography capable of real-time monitoring and printing. D) Communications: These monitors will transmitting technology that will be used to reduce door to balloon time at our receiving cardiac interventional facilities. E) Enable your organization to improve or expand: This project improves the provision of EMS services within the city and countywide primarily through a single EMS provider. However, through our Automatic Aid agreements, several surrounding cities would benefit from this project as well. These cities include the Cities of North Lauderdale, Oakland Park, Lauderhill and occasionally Coral Springs and Sunrise. N TR11915 - EXHIBIT A 16. Work activities and time frames: Indicate the major activities for completing the project (use only the space provided). Be reasonable, most projects cannot be completed in less than six months and if it is a communications project, it will take about a year. Also, if you are purchasing certain makes of ambulances, it takes at least nine months for them to be delivered after the bid is let. Work Activity Number of Months After Grant Starts Begin End Select stretcher and patient lift device vendor Month 0 Month 2 Purchase ECG Monitor/defibrillator Month 2 Month 3 Receive machines and train personnel Month 3 Month 4 Place ECG machines on response units Immediately after training. 17. CountyGovernments: If this application is being submitted by a county agency, describe in the space below why this request cannot be paid for out of funds awarded under the state EMS county grant program. Include in the explanation why any unspent county grant funds, which are now in your county accounts, cannot be allocated in whole or part for the costs herein. N/A DH Form 1767, Rev. 2002 10 Till 1915 - EXHIBIT A 18. Bud et: Salaries and Benefits: For each position title, provide the amount of salary per hour, FICA per hour, fringe benefits, and the total number of hours. Costs Justification: Provide a brief justification why each of the positions and the numbers of hours are necessary for this project. N/A TOTAL: Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an agency, such as, commodities and supplies of a consumable nature, excluding expenditures classified as operating capital outlay (see next cate o Costs: List the price and source(s) of the price identified. Justification: Justify why each of the expense items and quantities are necessary to this project. N/A TOTAL: $ DM Form 1767, Rev. 2002 11 TR11915 - EXHIBIT A Vehicles, equipment, and other Costs: List the price Justification: State why each of the items operating capital outlay means of the item and the and quantities listed is a necessary equipment, fixtures, and other source(s) used to component of this project. tangible personal property of a non identify the price. consumable and non expendable nature, and the normal expected life of which is 1 year or more. (4) ECG Monitors/Defibrillators $ 30,000 per unit Actual placement of equipment on 4 ALS based on units to respond within City jurisdiction and manufacturers sales surrounding areas. department to include unit case, batteries and chargers TOTAL: $ 120,000 State Amount (Check applicable program) El Matching: 75 Percent $ 90,000 ❑ Rural: 90 Percent $ Local Match Amount (Check applicable program) © Matching: 25 Percent $ 30,000 ❑ Rural: 10 Percent $ Grand Total $ 120.000 UH Form 1767, Rev. 2002 12 TR11915 - EXHIBIT A 19. Certification: My signature below certifies the following. I am aware that any omissions, falsifications, misstatements, or misrepresentations in this application may disqualify me for this grant and, if funded, may be grounds for termination at a later date. I understand that any information I give may be investigated as allowed by law. I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith. agree that any and all information submitted in this application will become a public document pursuant to Section 119.07, F.S. when received by the Florida Bureau of EMS. This includes material which the applicant might consider to be confidential or a trade secret. Any claim of confidentiality is waived by the applicant upon submission of this application pursuant to Section 119.07,F.S., effective after opening by the Florida Bureau of EMS. I accept that in the best interests of the State, the Florida Bureau of EMS reserves the right to reject or revise any and all grant proposals or waive any minor irregularity or technicality in proposals received, and can exercise that right. I, the undersigned, understand and accept that the Notice of Matching Grant Awards will be advertised in the Florida Administrative Weekly, and that 21 days after this advertisement is published I waive any right to challenge or protest the awards pursuant to Chapter 120, F.S. I certify that the cash match will be expended between the beginning and ending dates of the rant and will be used in strict accordance with the content of the application and approved budget for the activities identified. In addition, the budget shall not exceed, the department, approved funds for those activities identified in the notification letter. No funds count towards atisfying this grant if the funds were also used to satisfy a matching requirement of another tate grant. All cash, salaries, fringe benefits, expenses, equipment, and other expenses as listed in this application shall be committed and used for the activities approved as a part of this rant. cceptance of Terms and Conditions: If awarded a grant, I certify that I will comply with all of the bove and also accept the attached grant terms and conditions and acknowledge this by signing below. Signature of Authorized Grant Signer MM / DID / YY Individual Identified in Item 2 DH Form 1767, Rev. June 2002 13 TR11915 - EXHIBIT A FLOR/DA DEPARTMENT OF HEALTH EMS GRANT PROGRAM REQUEST FOR GRANT FUND DISTRIBUTION In accordance with the provisions of Section 401.113(2) (b), F. S., the undersigned hereby requests an EMS grant fund distribution for the improvement and expansion or continuation of pre -hospital EMS. IDOH Remit Payment To: Name of Agency: City of Tamarac Fire Rescue Department Mailing Address: 6000 Hiatus Rd, Tamarac, FL 33321 Federal Identification Number 5 9 —1 0 3 9 5 5 2 Authorized Agency Official: Signature Date Jeff Miller, City Manager Type Name and Title Sign and return this page with your application to: Florida Department of Health BEMS Grant Program 4052 Bald Cypress Way, Bin C18 Tallahassee, Florida 32399-1738 Do not write below this line. For use by Bureau of E'-mernencv Medical Services Dersonnel Grant Amount For State To Pay: $ Approved By: Signature of EMS Grant Officer State Fiscal Year: - O0r anizatipn Code E.Q. 64-25-60-00-000 N N2000 Federal Tax ID: VF Grant ID Code: Object Code 7 Grant Beginning Date: Grant Ending Date: DH Form 1767P, Rev. June 2002 14 uuti� FH"DEEARETMENfT�Of TR71 915 - EXHIBIT B Charlie Crist Ana M. Viamonte Ras, M.D., M.P.H. Governor State Surgeon General June 18, 2010 Mr. Jeffrey L. Miller, City Manager City of Tamarac Fire Rescue 7526 Northwest 88th Avenue Tamarac, Florida 33321 Dear Mr. Miller: I am pleased to award an emergency medical services (EMS) matching grant to Tamarac Fire Rescue in the amount of $45,000.00, which is 75 percent of the total project costs. The grant ID code is M9303. In accordance with section 401.113(b)1, Florida Statutes, the grant budget is 75 percent state funds and 25 percent matching funds. Your required local cash match for this grant is $15,000.00. The purpose of this grant is to improve and expand EMS by assisting your organization in the purchase of two ECG monitor/defibrillators. This grant program is number 64.003 in the Florida Catalog of State Financial Assistance, object code 750000. The state money is paid from the Department of Health's EMS Trust Fund, and there are no federal funds involved. Acceptance of the grant terms and conditions is acknowledged when you draw or otherwise obtain funds from the grant payment system. Your signed grant application acknowledges you have read, understood, and will comply with all terms and conditions of the approved grant and Departmental rules. You may place these funds in any type of bank account you choose; however, all interest earned on these funds must be returned to the Department. The Bureau of Emergency Medical Services will provide, by separate letter, a copy of the approved grant budget, details about obtaining state funds, and the due dates of the required grant reports. This matching grant begins on the date of this letter and will end June 30, 2011. Thank you for your participation in this state EMS grant program. If you need assistance, please feel free to contact Mr. Alan Van Lewen, Health Services and Facilities Consultant in the Bureau of EMS, at (850) 245-4440, extension *2734. Sincerely, Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General AVR/avl cc: Mr. Thomas Sheridan, EMS Division Chief DOH Bureau of Emergency Medical Services 4052 Bald Cypress Way, Bin C18 • Tallahassee, Florida 32399-1738 ii:Zipltm4:/:11-1Yte3 "ySr)-F.;anlrol, Inc. i 1811 '4 �,,ii:W,4. P;,ac.J NE, Fy,OI 50A Tel '".Z55%,r;,.;,(_li? Tuh-tree R("'j.,14::.11.4 , www.physic-control.com August 6, 2010 Chief Tom Sheridan City of Tamarac Fire Rescue 6000 Hiatus Road Tamarac, FL 33321 Dear Chief Sheridan: In response to your recent request, I am writing to confirm that Physio-Control, Inc. is the sole source provider for the LIFEPAK® defibrillator, defibrillator/monitor, and monitor/defibrillator family of products in your marketplace; including, LIFENET", Data Management Solutions, LIFEPAK brand accessories, repair parts, upgrades, and factory authorized services. Physio-Control does not utilize the services of any authorized distributors in the sale of our products in your marketplace. Best regards, anne Maschal .. Finance Manager Physio Control, Inc. 11811 Willows Road NE Redmond, WA 98052-2003 To: Chief Tom Sheridan City of Tamarac Fire Rescue 6000 Hiatus Road TAMARAC, FL 33321 Phone: (954) 597-3804 Fax: (954) 724-2438 tomsh@tamarac.org LIFEPAK 11 TRADE-IN SERIAL NUMBERS: 003821;003407 Contract: None Physio-Control, Inc. 11811 Willows Road NE P.O. Box 97023 Redmond, WA 98073-9723 U.S.A www.physio-control.com www.medtronic.com tel 800.442.1142 fax 800.732.0956 Quote#: 1-160263496 Rev#: 1 Quote Date: 08/05/2010 Sales Consultant: Debbi Stanfield 800-442-1142 x 72305 FOB: Redmond, WA Terms: Net 30, all quotes subject to credit approval and the following terms & conditions Exp Date: 10104/2010 1 99577-000046 - LP15 MONITOR/DEFIS, CPR, 2 $32,995.00 $5,609.15 $1,000.00 $26,385.85 $52,771.70 Pace, to 360J, SPO2/CO, 12L GL, NIBP, CO2, Trend, ST 2 41577-000007 - LP15 SHIP KIT 2 $0.00 $0.00 $0.00 $0.00 $0.00 3 11577-000011 - MOBILE BATTERY CHARGER 2 $1,625.00 $243.75 $0.00 $1,381.25 $2,762.50 DC AND AC OPERATION FOR MOBILE TRANSPORT APPLICATIONS, FOR USE WITH THE LI-ION 5.7AMP BATTERY. INCLUDES AC AND DC POWER CORDS, MOUNTING BRACKET AND OPERATING INSTRUCTIONS. 4 21330-001176 - LI-ION BATTERY 5.7 AMP 10 $379.00 $56.85 $0.00 $322.15 $3,221.50 HOUR CAPACITY RECHARGEABLE LITHIUM -ION, WITH FUEL GAUGE 5 11577-000002 - KIT - CARRY BAG, MAIN BAG 2 $250.00 $37.50 $0.00 $212,50 $425.00 ACCESSORY 11577-000002 LP15 KIT CRY BAG 6 11260-000039 - KIT - CARRY BAG, REAR 2 $65.00 $9.75 $0.00 $55.25 $110.50 POUCH KIT - CARRY BAG, REAR POUCH 7 11577-000001 - KIT - CARRY BAG, 2 $28.00 $28.00 $0.00 $0.00 $0.00 SHOULDER STRAP ACCESSORY 11577-000001 LP15 KIT CRY BAG 8 11220-000028 - Top Pouch 2 $46.00 $6.90 $0.00 $39.10 $78.20 Storage for sensors and electrodes. Insert in place of standard paddles. 9 11996-000091 -ELECTRODE ASSY-ADULT,QC 4 $37.00 $37.00 $0.00 $0.00 $0.00 STD,WORLDWIDE ACCESSORY 11996-000091OEM ELCTD 14 LANG 10 11996-000323 - MASIMO SET RED LNCS 2 $147.00 $22.05 $0.00 $124.95 $249.90 PATIENT CABLE - 4 FEET RED LNC-04,PATIENT CABLE,4FT,REF 2055 11 21330-001365 - TEST LOAD 2 $84.00 $84.00 $0.00 $0.00 $0.00 ASSY - TEST LOAD, ENGLISH 2 TR11915 - EXHIBIT D Quote#: a 1-160263496 Rev#: 1 Quote Products (continued) Quote Date: 08/05/2010 12 11996-000022 - CHILD CUFF (PEDIATRIC), 2 $21.00 $3.15 $0.00 $17.85 $35.70 9X27CM REUSABLE NIBP CUFF-REUSABLE,CHILD,9X27CM 13 11996-000025 - LARGE ADULT CUFF, 2 $29.00 $4.35 $0.00 $24.65 $49.30 16X42CM REUSABLE NIBP CUFF-REUSABLE,LARGE ADULT 16X24CM GRAND TOTAL $59,704.30 Trade-in Detail Product Qty Unit Value Total Value Pricing Summary Totals List Price: $74,518.00 Trade-ins: - $2,000.00 Cash Discounts: $12,813.70 GRAND TOTAL FOR THIS QUOTE $59,704.30' TO PLACE AN ORDER, PLEASE FAX A COPY OF THE QUOTE AND PURCHASE ORDER TO: # 500-732-0956, ATTN: REP SUPPORT "Ask your sales representative how to get 25% or more off list price on your LIFEPAK disposables by signing up for a disposables agreement" PHYSIO-CONTROL, INC. REQUIRES WRITTEN VERIFICATION OF THIS ORDER.A PURCHASE ORDER IS REQUIRED ON ALL ORDERS $10,000 OR GREATER BEFORE APPLICABLE FREIGHT AND TAXES.THE UNDERSIGNED IS AUTHORIZED TO ACCEPT THIS ORDER IN ACCORDANCE WITH THE TERMS AND PRICES DENOTED HEREIN. SIGN TO THE RIGHT: Ref. Code: JE/10308205/1-2NF039 CUSTOMER APPROVAL (AUTHORIZED SIGNATURE) NAME TITLE DATE Notes: TAXES, FREIGHTAND HANDLING FEES WILL BE ADDED ATTIME OF SHIPMENT, IF APPLICABLE. ABOVE PRICING VALID ONLY IF QUOTE IS PURCHASED IN ITS ENTIRETY. (OPTIONAL ITEMS NOT REQUIRED). IF QUOTE REFLECTS TRADE-IN VALUES,CUSTOMER ASSUMES RESPONSIBILITY FOR SHIPMENT OF TRADE-IN UNITS TO PHYSIO-CONTROL, INC. ITEMS LISTED ABOVE AT NO CHARGE ARE INCLUDED AS PART OF A PACKAGE DISCOUNT THAT INVOLVES THE PURCHASE OF A BUNDLE OF ITEMS. CUSTOMER IS SOLELY RESPONSIBLE FOR APPROPRIATELY ALLOCATING THE DISCOUNT EXTENDED ON THE BUNDLE WHEN FULFILLING ANY REPORTING OBLIGATIONS IT MIGHT HAVE. 3 TR11915 - EXHIBIT D TERMS OF SALE General Terms Physio-Control, Inc.'s acceptance of the Buyer's order is expressly conditioned on product availability and the Buyer's assent to the terms set forth in this document and its attachments. Physio-Control, Inc. agrees to furnish the goods and services ordered by the Buyer only on these terms, and the Buyer's acceptance of any portion of the goods and services covered by this document shall confirm their acceptance by the Buyer. These terms constitute the complete agreement between the parties and they shall govern any conflicting or ambiguous terms on the Buyer's purchase order or on other documents submitted to Physio-Control, Inc. by the Buyer. These terms may only be revised or amended by a written agreement signed by an authorized representative of both parties. Pricing Unless otherwise indicated in this document, prices of goods and services covered by this document shall be Physio-Control, Inc. standard prices in effect at the time of delivery. Prices do not include freight insurance, freight forwarding fees, taxes, duties, import or export permit fees, or any other similar charge of any kind applicable to the goods and services covered by this document. Sales or use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services covered by this document unless Physio-Control, Inc. receives a copy of a valid an exemption certificate prior to delivery. Please forward your tax exemption certificate to the Physio-Control, Inc. Tax Department, P.O. Box 97006, Redmond, Washington 98073-9706. Payment Unless otherwise indicated in this document or otherwise confirmed by Physio-Control, Inc. in writing, payment for goods and services supplied by Physio-Control, Inc. shall be subject to the following terms: Domestic (USA) Sales - Upon approval of credit by Physio-Control, Inc., 100% of invoice due thirty (30) days after invoice date. International Sales - Sight draft or acceptable (confirmed) irrevocable letter of credit. Physio-Control, Inc. may change the terms of payment at any time prior to delivery by providing written notice to the Buyer. Physio-Control, Inc. reserves the right to charge a 15% restocking fee for returns. Delivery Unless otherwise indicated in this document, delivery shall be FOB Physio-Control, Inc. point of shipment and title and risk of loss shall pass to the Buyer at that point. Partial deliveries may be made and partial invoices shall be permitted and shall become due in accordance with the payment terms. In the absence of shipping instructions from the Buyer, Physio-Control, Inc. will obtain transportation on the Buyer's behalf and for the Buyers account. Delays Delivery dates are approximate. Physio-Control, Inc. will not be liable for any loss or damage of any kind due to delays in delivery or non -delivery resulting from any cause beyond its reasonable control, including but not limited to, acts of God, labor disputes. the requirements of any governmental authority, war, civil unrest, terrorist acts, delays in manufacture, obtaining any required license or permit, and Physio-Control, Inc. inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio-Control, Inc. and the Buyer's agreement and the delivery dates shall be extended for the length of such delay. Inspections Claims by the Buyer for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physic - Control, Inc. with written notice of any deficiency. Payment is not contingent upon immediate correction of any deficiencies and Physio-Control, Inc. prior approval is required before the return of any goods to Physio-Control, Inc.. Warranty Physio-Control, Inc. warrants its products in accordance with the terms of the standard Physio-Control, Inc. product warranty applicable to the product to be supplied, and the remedies provided under such warranty shall be the Buyers sole and exclusive remedies. Physio-Control, Inc. makes no other warranties, express or implied, Including, without limitation, NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, AND IN NO EVENT SHALL PHYSIO-CONTROL, INC. BE LIABLE FOR INCIDENTAL, CONSEQUENTIAL, SPECIAL OR OTHER DAMAGES. Patent & Indemnity Upon receipt of prompt notice from the Buyer and with the Buyer's authority and assistance, Physio-Control, Inc. agrees to defend, indemnify and hold the Buyer harmless against any claim that the Physio-Control, Inc. products covered by this document directly infringe any United States of America patent. Miscellaneous a) The Buyer agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. b) Through The purchase of Physio-Control, Inc. products, the Buyer does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products, and the Buyer expressly agrees not to reverse engineer or decompile such products or related software and information. c) The rights and obligations of Physio-Control, Inc. and the Buyer related to the purchase and sale of products and services described in this document shall be governed by the laws of the State of Washington, United States of America. All costs and expenses incurred by the prevailing party related to enforcement of its rights under this document, including reasonable attorneys fees, shall be reimbursed by the other party.