Loading...
HomeMy WebLinkAboutAgreement A-22-547 w California Emergency Medical Services Authority.pdf sco ID: 4120-C22013 Agreement No. 22-547 STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES STANDARD AGREEMENT AGREEMENTNUMBER PURCHASING AUTHORITY NUMBER(If Applicable) STD 213(Rev.03/2019) C22-013 EMSA-4120 1.This Agreement is entered into between the Contracting Agency and the Contractor named below: CONTRACTING AGENCY NAME Emergency Medical Services Authority(EMSA CONTRACTOR NAME County of Fresno,acting as the Central California EMS Agency 2.The term of this Agreement is: START DATE July 1,2022 THROUGH END DATE June 30,2023 3.The maximum amount of this Agreement is: $959,900.00(Nine Hundred Fifty Nine Thousand Nine Hundred Dollars and Zero Cents) 4.The parties agree to comply with the terms and conditions of the following exhibits,which are by this reference made a part of the Agreement. Exhibits Title Pages Exhibit A Scope of Work 8 Attachment Funding Application 13 1 Exhibit B Budget Detail and Payment Provisions 2 + Exhibit C* General Terms and Conditions GT 017 Exhibit D Special Terms and Conditions 4 Exhibit E Sample Invoice 1 tems shown with an asters ,are ere y incorporated by reference and made part o t is agreement as ifattached hereto. These documents can be viewed at https://www.dqs.co,00vIOLS/Resources IN WITNESS WHEREOF,THIS AGREEMENT HAS BEEN EXECUTED BY THE PARTIES HERETO. CONTRACTOR CONTRACTOR NAME(if other than an individual,state whether a corporation,partnership,etc.) County of Fresno,acting as the Central California EMS Agency CONTRACTOR BUSINESS ADDRESS CITY STATE ZIP PO Box 11867 Fresno CA 193775 PRINTED NAME OF PERSON SIGNING TITLE Brian Pacheco Chairman,Board of Supervisors County of Fresno CO TRA OR AUTHORIZED SIGNATURE DATE SIGNED A.,., 11/zq/Z2 ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors Cou�����_Deputy ia By Page 1 of 2 SCo ID: 4120-C22013 STATE OF CALIFORNIA-DEPARTMENT OF GENERAL SERVICES STANDARD AGREEMENT AGREEMENT NUMBER PURCHASING AUTHORITY NUMBER(if Applicable) STD 213(Rev.03/2019) C22-013 EMSA-4120 STATE OF CALIFORNIA CONTRACTING AGENCY NAME Emergency Medical Services Authority(EMSA) CONTRACTING AGENCY ADDRESS CITY STATE ZIP 10901 Gold Center Drive,Suite 400 Rancho Cordovas CA 95670 PRINTED NAME OF PERSON SIGNING TITLE Elizabeth Basnett Acting Director CONTRACTING AGENCY AUTHORIZED SIGNATURE — DATE SIGNED 12/1/2022 CALIFORNIA DEPARTMENT OF GENERAL SERVICES APPROVAL EXEMPTION(If Applicable) Exempt per: SCM Vol 1,4.04(A)(4) Page 2 of 2 Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 1 of 8 EXHIBIT A Scope of Work 1. The Contractor (Central California EMS Agency) shall operate and manage a regional EMS system, and report on accomplished works and duties to Emergency Medical Services Authority (EMSA), in accordance with Division 2.5 of the Health and Safety Code and Title 22, CCR, Division 9 as described herein. 2. The Contractor shall refer to the EMSA publication #104, "Funding Multicounty EMS Agencies with State General Funds" to assist in the administration of this contract. The EMSA#104 can be found at http://www.emsa.ca.gov/Guidelines. 3. The Contractor requesting funding shall have on file a current EMS Plan/Annual update approved by EMSA. 4. This Agreement shall begin on July 1, 2022, or upon approval by EMSA, whichever is later, and no work shall begin before that time. This Agreement is of no effect unless approved by EMSA. The Contractor shall not receive payment for work performed prior to approval of the Agreement and before receipt of notice to proceed by the EMSA Contract Manager. This Agreement shall expire on June 30, 2023. The parties may amend this Agreement as permitted by law. 5. Representatives All inquiries related to and during the term of this Agreement shall be addressed to the authorized representatives listed below: Agency: Contractor: Emergency Medical Services Authority Central California Emergency Medical Services Agency Name: Angela Wise Name: Daniel Lynch Title: Assistant Chief, EMS Systems Title: Director Phone: (916) 431-3708 Phone: (559) 600-3387 Fax: Fax: (559) 600-7691 E-Mail: Angela.wise@emsa.ca.gov Email: dlynch@fresnocountyca.gov Direct all administrative inquiries to this agreement to: Agency: Contractor: Emergency Medical Services Authority Central California Emergency Medical Services Agency Name: Daniel Campbell Name: Daniel Lynch Title: Contract Analyst Title: Director Phone: 916-591-2047 Phone: (559) 600-3387 Fax: (916) 322-1441 Fax: (559) 600-7691 Email: Daniel.campbell@emsa.ca.gov Email: dlynch@fresnocountyca.gov Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 2 of 8 EXHIBIT A Scope of Work 6. Plan/Data Submission A. The Contractor shall complete and submit an EMS Plan/update annually to EMSA in compliance with Sections 1797.250 and 1797.254 of the Health and Safety Code. The annual update shall be determined by EMSA in the agency's last EMS Plan decision. B. The Contractor that has implemented a specialty care system shall complete and submit a trauma care system, STEMI/Stroke system, and EMS for Children program plan and annual updates to EMSA in compliance with Sections 1797.257, 1797.258, and 1799.205 of the Health and Safety Code, and Chapters 7, 7.1, 7.2, and 14 of Title 22, CCR, Division 9. C. The Contractor shall complete and submit a Quality Improvement program and annual updates to EMSA in compliance with Chapter 12 of Title 22, CCR, Division 9. D. The Contractor shall regularly provide to EMSA, data it receives consistent with Section 1797.227 of the Health and Safety Code that conforms to EMSA's California EMS Information System Standards, National EMS Information System, and the California State EMS Data Set. 7. Audit A. The Contractor shall have an annual financial audit conducted by an independent or county auditor covering the fiscal year in which funds were allocated. The copy of the audit must be received by EMSA by December 31 st. (See EMSA publication #104, "Funding Multicounty EMS Agencies with State General Funds" Section 6.1 - Audit). B. The final audit shall determine: 1. All costs incurred have been in accordance with the contract and See EMSA publication #104, "Funding Multicounty EMS Agencies with State General Funds". 2. Proper accounting records have been maintained for the administration of the multicounty EMS agency and source documents have been filed. 3. All reimbursements have been proper and reflect actual and allowable costs. 4. Physical inventory has been taken of all equipment/property purchased with State General Fund money. (See EMSA publication #104, "Funding Multicounty EMS Agencies with State General Funds" See Sections 3.4 and 5.3). 5. Provisions have been made to retain source documents supporting costs incurred for at least three years after the applicant agency has received final payment or until any audit exceptions are resolved. 8. Quarterly Reporting A. First through Fourth Quarter Task Reporting 1. The Contractor shall provide Quarterly Reports to EMSA by the 15th calendar day of the month following the end of each quarter. The fourth quarter report is due by August 1 and must include a Supplemental Year-End Data Report. 2. Quarterly Reports must contain a detailed description of work performed, the duties of all parties, and a summary of activities that have been accomplished during the quarter to meet the following eight EMS system components. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 3 of 8 EXHIBIT A Scope of Work B. Component 1 — System Organization and Management 1. Objective - To develop and maintain an effective management system to meet the emergency medical needs and expectations of the total population served. 2. Tasks: The responsibilities of the Contractor shall include, at a minimum: A. Staff development, training, and, management. B. Allocating and maintaining office space, office equipment, and office supplies. C. Executing and maintaining contracts with member counties, service providers, consultants, and contractual staff. D. Attending or participating in a minimum of 3 EMSA/LEMSA meetings annually (following advance notice and reasonable justification provided by the LEMSA, EMSA will make a determination on the flexibility of the attendance requirement on a case-by-case basis, and in the event the quarterly EMSA/LEMSA meeting is canceled, attendance at the meeting will not be counted for/against the LEMSA). C. Component 2— System Organization and Management 1. Objective -To ensure LEMSA authorized personnel functioning within the EMS system are properly trained, licensed/certified/authorized and/or accredited to safely provide medical care to the public. 2. Tasks: The responsibilities of the Contractor shall include, at a minimum: A. Ongoing assessment of local training program needs. B. Authorizing and approving training programs and curriculum for all certification levels. C. Providing training programs and classes as needed. D. Providing ongoing certification/authorization/accreditation or personnel approval of local scope of practice for all certification levels. E. Developing and maintaining treatment protocols for all certification levels. F. Maintaining communication link with Quality Improvement program to assess performance of field personnel. G. Conducting investigations and taking action against certification when indicated. H. Authorizing, maintaining, and evaluating EMS continuing education programs. D. Component 3— Communications 1. Objective -To develop and maintain an effective communications system that meets the needs of the EMS system. 2. Tasks: The responsibilities of the Contractor shall include, at a minimum: A. On-going assessment of communications status and needs. B. Assuring appropriate maintenance of EMS related communications systems. C. Approving ambulance dispatch centers. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 4 of 8 EXHIBIT A Scope of Work D. Providing acceptable procedures and communications for the purpose of dispatch and on-line medical control. E. Approving emergency medical dispatch (EMD) training and/or operational programs. E. Component 4— Response and Transportation 1. Objective - To develop and maintain an effective EMS response and ambulance transportation system that meets the needs of the population served. 2. Tasks: The responsibilities of the Contractor shall include, at a minimum: A. Designating EMS responders including first responders, Limited Advanced Life Support (LALS)/Advanced Life Support (ALS) providers, ambulance providers, and Prehospital EMS Aircraft providers. B. Monitoring local ordinances related to EMS. C. Establishing policies and procedures to the system for the transportation of patients to trauma centers and/or specialty care hospitals as needed. D. Implementing and maintaining contracts with providers. E. Creating exclusive operating areas F. Component 5— Facilities and Critical Care 1. Objective - To establish and/or identify appropriate facilities to provide for the standards and care required by a dynamic EMS patient care delivery system. 2. Tasks: The responsibilities of the Contractor shall include, at a minimum: A. Designating base hospital(s) or alternate base stations for on-line medical control and direction. B. Identifying ambulance receiving centers including hospitals and alternative receiving facilities in rural areas. C. Identifying and designating, as needed, trauma centers and other specialty care facilities. D. Periodically assessing trauma system and plan as needed. E. Coordinating trauma patients to appropriate trauma center(s) or approved receiving hospitals. F. Periodically assessing hospitals (e.g., pediatric critical care centers, emergency departments approved for pediatrics, other specialty care centers). G. Completing hospital closure impact reports. G. Component 6— Data Collection and System Evaluation 1. Objective - To provide for appropriate system evaluation through the use of quality data collection and other methods to improve system performance and evaluation. 2. Tasks: The responsibilities of the Contractor shall include, at a minimum: A. Reviewing reportable incidents. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 5 of 8 EXHIBIT A Scope of Work B. Reviewing prehospital care reports including Automated External Defibrillators (AED) reports. C. Processing and investigating quality assurance/improvement incident reports. D. Monitoring and reporting on EMS System Core Measures by March 31s' each year and acknowledging completion of the monitoring and reporting as of March 31st each year. E. Providing data to CEMSIS monthly. F. Implementing Health and Safety Code Section 1797.227, including providing data using the current versions of NEMSIS and CEMSIS standards from Electronic Health Records (EHR). G. Engaging healthcare partners and Health Information Organizations in your jurisdiction in discussions and planning efforts to integrate EMS into developing health information exchange networks that promote interoperability and the use of the Search, Alert, File, Reconcile Model. H. Component 7 — Public Information and Education 1. Objective - To provide programs to establish an awareness of the EMS system, how to access and use the system and provide programs to train members of the public in first-aid and CPR. 2. Tasks: The responsibilities of the Contractor shall include, at a minimum: A. Information and/or access to CPR and first-aid courses taught within the EMS system. B. Involvement in public service announcements involving prevention or EMS related issues. C. Availability of information to assist the population in catastrophic events, as appropriate. D. Participating in public speaking events and representing the EMS Agency during news events and incidents. E. Seeking opportunities to collaborate with key partners, including local public health and other community organizations, to promote healthcare and injury prevention activities I. Component 8 — Disaster Medical Response 1. Objective -To collaborate with the Office of Emergency Services, Public Health and EMS responders in the preparedness and response of the region's EMS systems in the event of a disaster or catastrophic event within the regions or a neighboring jurisdiction. 2. Tasks: The responsibilities of the Contractor shall include, at a minimum: A. Participating in disaster planning, training, and exercises as needed. B. Identifying disaster preparedness, mitigation, response and recovery needs, as requested. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 6 of 8 EXHIBIT A Scope of Work C. Coordinating the Medical Health Operational Area Coordination (MHOAC) Program or coordinating with the MHOAC Program of the affected county/counties, as appropriate. D. Coordinating the Regional Disaster Medical Health Coordinator (RDMHC) Program or coordinating with the RDMHC Program within the member county/county's California Office of Emergency Services mutual aid region. E. Developing policies and procedures for EMS personnel in response to a multi- casualty or disaster incident. F. Participating in the development of mutual aid agreements, as requested. G. Collaborating with EMS providers on Incident Command Systems (ICS) and Standardized Emergency Management System (SEMS) training as requested. H. Providing opportunities/exercises for Ambulance Strike Team Leader Trainees to complete their Position Task Books (PTB), as available. 9. Supplemental Year End Data Reporting A. The Supplemental Year-End Data Report is due to EMSA by August 1, and must be submitted with the 4th Quarter Task Report. B. The Supplemental Year-End Data Report must include year-end data for the individual workload indicators. C. Component 1 — System Organization and Management 1. Objective -To develop and maintain an effective management system to meet the emergency medical needs and expectations of the total population served. 2. Workload indicators shall include: A. Total static population served (Determined by DOF estimates). B. Total annual tourism population (Determined by identified sources). C. Number of counties. D. Geographic size of region (in square miles). D. Component 2— Staffing and Training 1. Objective -To ensure LEMSA authorized personnel functioning within the EMS system are properly trained, licensed/certified/authorized and/or accredited to safely provide medical care to the public. 2. Workload indicators shall include: A. Total number of personnel certified/authorized/accredited by EMS agency. B. Total number and type of training programs approved by EMS agency C. Total number and type of training programs conducted by EMS agency. D. Total number of continuing education providers authorized by EMS agency. E. Component 3— Communications 1. Objective -To develop and maintain an effective communications system that meets the needs of the EMS system. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 7 of 8 EXHIBIT A Scope of Work 2. Workload indicators shall include: A. Total number of primary and secondary Public Safety Answering Points. B. Total number of EMS responses. C. Total number of EMD training programs approved by EMS agency. D. Total number and type of EMD programs authorized by EMS agency. F. Component 4— Response and Transportation 1. Objective -To develop and maintain an effective EMS response and ambulance transportation system that meets the needs of the population served. 2. Workload indicators shall include: A. Total ambulance response vehicles. B. Total first responder agencies. C. Total patients transported. D. Total patients not transported (e.g., treated and released, total dry runs). E. Total number of LALS/ALS providers authorized by EMS agency. F. Total number of transport providers in region. G. Component 5— Facilities and Critical Care 1. Objective -To establish and/or identify appropriate facilities to provide for the standards and care required by a dynamic EMS patient care delivery system. 2. Workload indicators shall include: A. Total patients received. B. Total number of hospitals designated by EMS agency (e.g., base, receiving, trauma, STEMI, stroke, PCCC, EDAP/(PedRC), and PICU). H. Component 6 — Data Collection and System Evaluation 1. Objective -To provide for appropriate system evaluation through the use of quality data collection and other methods to improve system performance and evaluation. 2. Workload indicators shall include: A. Total patient care reports generated. B. Total trauma patients. C. Total cardiac patients D. Total medical patients. E. Total pediatric patients. F. Total number of situational/unusual occurrence reports processed by EMS agency. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 8 of 8 EXHIBIT A Scope of Work G. Component 7— Public Information and Education 1. Objective -To provide programs to establish an awareness of the EMS system, how to access and use the system and provide programs to train members of the public in first-aid and CPR. 2. Workload indicators shall include: A. Total number of public information and education courses approved by EMS agency. B. Total number of public information and education courses conducted by EMS agency. C. Total number of public information and education events involving EMS agency. H. Component 8— Disaster Medical Response 1. Objective -To collaborate with the Office of Emergency Services, Public Health and EMS responders in the preparedness and response of the region's EMS systems in the event of a disaster or catastrophic event within the regions or a neighboring jurisdiction. 2. Workload indicators shall include: A. Total number of Disaster/Multiple Casualty Incident (MCI) Responses (response with 5 or more victims). B. Total number of disaster drills involving staff. C. Total disaster-related meetings attended by staff. Central California Emergency Medical Services Agency Agreement Number: 1 Funding Application: Attachment 1 '.•- 1 of a � Uj N O � v d w H 4 m � O � V w v % 01 � C 0 W 'a O Q Application c• FRESNO o���v of x�AcSTATE GENERAL FUND ALLOCATION FOR REGIONAL EMS AGENCIES FY 2022/23 KINGS MADERA TULARE Daniel J Lynch EMS Director James Andrews,M.D. EMS Medical Director Fresno County Dept of Public Health 1221 Fulton Mall P.O.Box 11867 Fresno CA 93775 (559)600-3387 Fax(559)600-7691 www.ccemsa.org Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 2 of 13 EMS AGENCY MISSION STATEMENT The EMS Agency is committed to the needs of the multicounty pre-hospital environment. Our mission is to inspire, educate, evaluate, direct, provide resources, and ensure that each citizen receives the highest level of care. Our goals are to facilitate an environment of collaboration among all providers and agencies in which there is innovation, purpose, standardized care, proactive technologies, preparedness, coordination, and integration. Our values are honesty, loyalty, equality, originality, integrity, and communication. Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 1 of 13 The impact that the COVI pandemic has had on the health care systems has created challenges to EMS systems that will mandate changes in how the delivery of emergency care is provided. Daniel J. Lynch This application to the State of California focus of trying to keep paramedic ambulances Emergency Medical Services Authority is for the available to the EMS system. This includes continuation of State General Fund assistance furthering the use of Basic Life Support for the planning, implementation, and ambulances to handle prehospital requests for maintenance of a multi-county EMS system. The behavioral health incidents (i.e. 5150) and many Fresno County Department of Public Health is non-emergency requests for ambulance service the designated local EMS Agency for the that data has shown not to require the use of an Counties of Fresno, Kings, Madera and Tulare paramedic ambulance. In recent years, the EMS Counties. Through specific agreements Agency reduced code 3 responses by nearly between each County, this integrated EMS 30% by conducting an in-depth study of system provides 100% paramedic coverage with responses, which resulted in reducing many consolidated resources of both public and lights and sirens responses to non-lights and private provider agencies. The development of sirens responses. Today, only 51% of EMS calls regional policies and procedures assures that are dispatched with red lights and sirens, which out of hospital care and procedures are is significantly below the industry averages. consistent and that patients throughout the region are receiving quality patient care. The EMS agency's continuing challenge is to assure that the integrity of the EMS System Significant changes are occurring in healthcare remains intact. The EMS system continues to and the Emergency Medical Services has an move forward and plans are in place to further increasing role in the delivery of prehospital and enhance the quality level of care provided "out-of-hospital" care. The response to the throughout the EMS region. The funding COVID19 pandemic has tested the strength and provided by the State of California greatly flexibility of the EMS system and the region has assists the EMS Agency in maintaining this level responded very well. As the pandemic lessons of commitment to each of these counties and its impact on our healthcare systems, EMS provides a standard level of care that may not agencies are challenged with returning to be possible without this assistance. "normal", which is a "new Normal since the impact that the COVID pandemic has had on the The Central California EMS Agency is prepared health care systems has created challenges to to meet the challenges of the coming year. With EMS systems that will mandate changes in how the challenges come opportunities and the the delivery of emergency care is provided in the CCEMSA will be aggressively pursuing any future. EMS systems still continue to find changes that will continue to protect the citizens, themselves in an awkward position of continue the provision of excellent prehospital developing changes in the delivery model of care, and expand the development of out-of- prehospital care, while at the same time trying to hospital care. protect the EMS system from expansion of traditional services and roles that are no longer needed. EMS systems are looking towards healthcare models that further decrease the number of patients accessing emergency Daniel J. Lynch departments. The CCEMSA has implemented EMS Director several changes this past year with the sole CCEMSA— I22/23 Regional Fundingpp Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 2 of 13 SCOPE OF WORK The multicounty EMS agency shall operate and manage a regional EMS system, and report on accomplished work and duties to EMSA, in accordance with Division 2.5 of the Health and Safety Code and Title 22, CCR, Division 9. Refer to EMSA#104 "Funding Assistance Manual: Multicounty EMS Agencies Using State General Funds" for funding criteria and requirements. EMSA#104 can be accessed at https:Hemsa.ca.gov/multicounty-info/. PLAN/DATA SUBMISSION The multicounty EMS agency must complete and submit an EMS Plan/update annually to EMSA in compliance with Sections 1797.250 and 1797.254 of the Health and Safety Code. The annual update is determined by EMSA in the agency's last EMS Plan decision. A multicounty EMS agency that has implemented a specialty care system must complete and submit a trauma care system, STEMI/Stroke system, and EMS for Children program plan and annual updates to EMSA in compliance with Sections 1797.257, 1797.258, and 1799.205 of the Health and Safety Code, and Chapters 7, 7.1, 7.2, and 14 of Title 22, CCR, Division 9. The multicounty EMS agency must complete and submit a Quality Improvement program and annual updates to EMSA in compliance with Chapter 12 of Title 22, CCR, Division 9. The multicounty EMS agency shall regularly provide to EMSA, data it receives consistent with Section 1797.227 of the Health and Safety Code that conforms to EMSA's California EMS Information System Standards, National EMS Information System, and the California State EMS Data Set. AUDIT The multicounty EMS agency shall have an annual financial audit conducted by an independent or county auditor covering the fiscal year in which funds were allocated. The copy of the audit must be received by EMSA by December 31 st. (See Section 6.1 -Audit) The final audit shall determine: • All costs incurred have been in accordance with the contract and EMSA#104. • Proper accounting records have been maintained for the administration of the multicounty EMS agency and source documents have been filed. • All reimbursements have been proper and reflect actual and allowable costs. • Physical inventory has been taken of all equipment/property purchased with State General Fund money. (See Sections 3.4 and 5.3) • Provisions have been made to retain source documents supporting costs incurred for at least three years after the applicant agency has received final payment or until any audit exceptions are resolved. 2022/23 Regional Funding Application Page 2 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 3 of 13 QUARTERLY REPORTING - 1st THROUGH 4th QUARTER TASK REPORTS Quarterly Reports are due to EMSA by the 15th calendar day of the month following the end of each quarter. The fourth quarter report is due by August 1 st, and must include a Supplemental Year-End Data Report. Quarterly Reports must contain a detailed description of work performed, the duties of all parties, and a summary of activities that have been accomplished during the quarter to meet the following eight EMS system components. Component 1 -System Organization and Management Objective - To develop and maintain an effective management system to meet the emergency medical needs and expectations of the total population served. Tasks: The responsibilities of the EMS agency, at a minimum, include: • Staff development, training, and, management • Allocating and maintaining office space, office equipment, and office supplies • Executing and maintaining contracts with member counties, service providers, consultants, and contractual staff • Attending or participating in a minimum of 3 EMSA/LEMSA meetings annually (following advance notice and reasonable justification provided by the LEMSA, EMSA will make a determination on the flexibility of the attendance requirement on a case-by-case basis, and in the event the quarterly EMSA/LEMSA meeting is canceled, attendance at the meeting will not be counted for/against the LEMSA) Component 2 - Staffing and Training Objective - To ensure LEMSA authorized personnel functioning within the EMS system are properly trained, licensed/certified/authorized and/or accredited to safely provide medical care to the public. Tasks: The responsibilities of the EMS agency, at a minimum, include: • Ongoing assessment of local training program needs • Authorizing and approving training programs and curriculum for all certification levels • Providing training programs and classes as needed • Providing ongoing certification/authorization/accreditation or personnel approval of local scope of practice for all certification levels • Developing and maintaining treatment protocols for all certification levels • Maintaining communication link with Quality Improvement program to assess performance of field personnel • Conducting investigations and taking action against certification when indicated • Authorizing, maintaining, and evaluating EMS continuing education programs 2022/23 Regional Funding Application Page 3 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 4 of 13 Continued on Next Page Component 3 - Communications Objective - To develop and maintain an effective communications system that meets the needs of the EMS system. Tasks: The responsibilities of the EMS agency, at a minimum, include: • On-going assessment of communications status and needs • Assuring appropriate maintenance of EMS related communications systems • Approving ambulance dispatch centers • Providing acceptable procedures and communications for the purpose of dispatch and on-line medical control • Approving emergency medical dispatch (EMD) training and/or operational programs Component 4 - Response and Transportation Objective - To develop and maintain an effective EMS response and ambulance transportation system that meets the needs of the population served. Tasks: The responsibilities of the EMS agency, at a minimum, include: • Designating EMS responders including first responders, Limited Advanced Life Support (LALS)/Advanced Life Support (ALS) providers, ambulance providers, and Prehospital EMS Aircraft providers • Monitoring local ordinances related to EMS • Establishing policies and procedures to the system for the transportation of patients to trauma centers and/or specialty care hospitals as needed • Implementing and maintaining contracts with providers • Creating exclusive operating areas • Inspecting ambulance or LALS/ALS providers • Developing and enforcing performance standards as needed Component 5 - Facilities and Critical Care Objective - To establish and/or identify appropriate facilities to provide for the standards and care required by a dynamic EMS patient care delivery system. Tasks: The responsibilities of the EMS agency, at a minimum, include: • Designating base hospital(s) or alternate base stations for on-line medical control and direction • Identifying ambulance receiving centers including hospitals and alternative receiving facilities in rural areas • Identifying and designating, as needed, trauma centers and other specialty care facilities • Periodically assessing specialty care system and plan(s) as needed 2022/23 Regional Funding Application Page 4 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 5 of 13 • Coordinating specialty care patients to appropriate specialty care center(s) or approved receiving hospitals • Periodically assessing hospitals (e.g., trauma centers, STEMI centers, stroke centers, pediatric critical care centers (PCCC), emergency departments approved for pediatrics (EDAP)/pediatric receiving centers (PedRC), pediatric intensive care unit (PICU) • Completing hospital closure impact reports Component 6 - Data Collection and System Evaluation Objective - To provide for appropriate system evaluation through the use of quality data collection and other methods to improve system performance and evaluation. Tasks: The responsibilities of the EMS agency, at a minimum, include: • Reviewing reportable incidents • Reviewing prehospital care reports including Automated External Defibrillator (AED) reports • Processing and investigating quality assurance/improvement incident reports • Monitoring and reporting on EMS System Core Measures by March 31 st each year, and acknowledging completion of the monitoring and reporting as of March 31 st each year • Providing near real time data to CEMSIS, or at no less than monthly intervals • Implementing Health and Safety Code Section 1797.227, including providing data from Electronic Health Records (EHR) using the current NEMSIS and CEMSIS version standards • Engaging healthcare partners and Health Information Organizations in your jurisdiction in discussions and planning efforts to integrate EMS into developing health information exchange networks that promote interoperability and the use of the Search, Alert, File, Reconcile Model Component 7 - Public Information and Education Objective - To provide programs to establish an awareness of the EMS system, how to access and use the system, and provide programs to train members of the public in first-aid and CPR. Tasks: The responsibilities of the EMS agency, at a minimum, include: • Information and/or access to CPR and first-aid courses taught within the EMS system • Involvement in public service announcements involving prevention or EMS related issues • Availability of information to assist the population in catastrophic events, as appropriate • Participating in public speaking events and representing the EMS agency during news events and incidents • Seeking opportunities to collaborate with key partners, including local public health and other community organizations, to promote healthcare and injury prevention activities Component 8 - Disaster Medical Response Objective - To collaborate with the affected county/county's Office of Emergency Services, public health department(s), and EMS responders in the preparedness and response of the region's EMS system in the event of a disaster or catastrophic event within the affected operational area, region, or neighboring jurisdictions. Tasks: The responsibilities of the EMS agency, at a minimum, include: 2022/23 Regional Funding Application Page 5 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 6 of 13 • Participating in disaster planning, training, and exercises, as needed • Identifying medical disaster preparedness, mitigation, response, and recovery needs, as requested • Coordinating the Medical Health Operational Area Coordination (MHOAC) Program or coordinating with the MHOAC Program of the affected county/counties, as appropriate • Coordinating the Regional Disaster Medical Health Coordination (RDMHC) Program or coordinating with the RDMHC Program within the member county/county's California Office of Emergency Services mutual aid region • Developing policies and procedures for EMS personnel in response to multicasualty or disaster incidents • Participating in the development of mutual aid agreements, as requested • Collaborating with EMS providers on Incident Command Systems (ICS) and Standardized Emergency Management System (SEMS) training, as requested • Providing opportunities/exercises for Ambulance Strike Team Leader Trainees to complete their Position Task Books (PTB), as available SUPPLEMENTAL YEAR-END DATA REPORT The Supplemental Year-End Data Report is due to EMSA by August 1st, and must be submitted with the 4th Quarter Task Report. The Supplemental Year-End Data Report must include year-end data for the individual workload indicators. Component 1 - System Organization and Management Objective - To develop and maintain an effective management system to meet the emergency medical needs and expectations of the total population served. Workload Indicators: • Total static population served (Determined by DOF estimates) • Total annual tourism population (Determined by identified sources) • Number of counties • Geographic size of region (in square miles) Component 2 - Staffing and Training Objective - To ensure LEMSA authorized personnel functioning within the EMS system are properly trained, licensed/certified/authorized and/or accredited to safely provide medical care to the public. Workload Indicators: • Total number of personnel certified/authorized/accredited by EMS agency • Total number and type of training programs approved by EMS agency • Total number and type of training programs conducted by EMS agency Total number of continuing education providers authorized by EMS agency 2022/23 Regional Funding Application Page 6 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 7 of 13 Continued on Next Page Component 3 - Communications Objective - To develop and maintain an effective communications system that meets the needs of the EMS system. Workload Indicators: • Total number of primary and secondary Public Safety Answering Points • Total number of EMS responses • Total number of EMD training programs approved by EMS agency • Total number and type of EMD programs authorized by EMS agency Component 4 - Response and Transportation Objective - To develop and maintain an effective EMS response and ambulance transportation system that meets the needs of the population served. Workload Indicators: • Total ambulance response vehicles • Total first responder agencies • Total patients transported • Total patients not transported (e.g., treated and released, total dry runs) • Total number of LALS/ALS providers authorized by EMS agency • Total number of transport providers in region Component 5 - Facilities and Critical Care Objective - To establish and/or identify appropriate facilities to provide for the standards and care required by a dynamic EMS patient care delivery system. Workload Indicators: • Total patients received • Total number of hospitals designated by EMS agency (e.g., base, receiving, trauma, STEMI, stroke, PCCC, EDAP/(PedRC), and PICU) Component 6 - Data Collection and System Evaluation Objective - To provide for appropriate system evaluation through the use of quality data collection and other methods to improve system performance and evaluation. Workload Indicators: 2022/23 Regional Funding Application Page 7 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 8 of 13 • Total patient care reports generated • Total trauma patients • Total cardiac patients • Total medical patients • Total pediatric patients • Total number of situational/unusual occurrence reports processed by EMS agency Component 7 - Public Information and Education Objective - To provide programs to establish an awareness of the EMS system, how to access and use the system, and provide programs to train members of the public in first-aid and CPR. Workload Indicators: • Total number of public information and education courses approved by EMS agency • Total number of public information and education courses conducted by EMS agency • Total number of public information and education events involving EMS agency Component 8 - Disaster Medical Response Objective - To collaborate with the affected county/county's Office of Emergency Services, public health department(s), and EMS responders in the preparedness and response of the region's EMS system in the event of a disaster or catastrophic event within the affected operational area, region, or neighboring jurisdictions. Workload Indicators: • Total number of Disaster/Multiple Casualty Incident (MCI) Responses (response with 5 or more victims) • Total number of disaster drills involving staff • Total disaster-related meetings attended by staff 2022/23 Regional Funding Application Page 8 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 9 of 13 BUDGET BUDGET STATE GENERAL FUND BUDGET CATEGORIES LOCAL FUNDS TOTAL Base ENY 2022 BCP Personnel $282,614 $153,386 $760,453 $1,196,453 *Fringe Benefits $104,567 $56,753 $719,629 $880,949 Professional Services $0 $0 $0 $0 Communications $0 $41,194 $505,596 $546,790 Materials & Supplies $0 $0 $0 $0 Space $0 $0 $0 $0 Software/Software Maintenance $0 $234,122.50 $95,881 $330,004 Total Direct Costs $387,182 $485,455 $2,0811559 $2,954,196 Administrative/Indirect 10% of Total Direct $38,718 $48,545 $0 $87,264 Costs **Unreimbursed Indirect Cost (Local funding includes $76,931 unreimbursable $0 $0 $76,931 $76,931 indirect cost for the portion of 8.816% over the allowable 10% from State General Fund) $0 $0 $391,666 $391,666 TOTAL COSTS $425,900 $534,000 $2,550,156 $3,510,056 Fringe benefits are reimbursable at maximum of 37%on personnel costs from State and the exceeded costs are funded by local fund. -Currently, Indirect cost applied in Fresno County is 18.816%. PROGRAM FUNDING STATE GENERAL FUND PROGRAM FUNDING LOCAL FUNDS TOTAL Base ENY 2022 BCP State General Fund $425,900 $534,000 $0 $959,900 Kings County $0 $0 $53,874 $53,874 Madera County $0 $0 $53,874 $53,874 Tulare County $0 $0 $53,874 $53,874 Fresno County $0 $0 $2,388,534 $2,388,534 TOTALS $425,900 $534,000 $2,550,156 $3,510,056 2022/23 Regional Funding Application Page 9 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 10 of 13 Budget Detail/Narrative Personnel: The following positions are funded under this agreement. Dale Dotson, EMS Coordinator 1.0 FTE 2080 hours $38.5986 1 $80,285 Responsible for overall supervision of Operations in Fresno, Kings, Madera and Tulare Counties. Responsibilities include implementation and enforcement of policy and procedures, investigation of incidents, coordination between agencies and the EMS agency, first responder liaison, hospital and base hospital coordination, and attendance at EMS related meetings. 100% of his salary is paid for with State GF. Mato Parker, EMS Coordinator 1.0 FTE 2080 Hours @$38.5986 $80,285 Responsible for overall management of continuous quality improvement in Fresno, Kings, Madera, and Tulare Counties. Responsibilities include oversight of data collection and evaluation, quality assurance reporting, and monitoring of specialty care centers trauma, STEMI, stroke Curtis Jack, EMS Coordinator 0.4015 FTE 835.16 hours @ 38.5986 $32,234 Responsible for Disaster Medical Services for the EMS region, which includes coordination with ambulance providers, hospitals and allied agencies in disaster response and preparedness. Doug Loera, Staff Analyst 1.0 FTE 2080 hours @ $32.913 $68,459 Responsible for administrative functions of the EMS agency. John Cardona, EMS Specialist 1.0 FTE 2080 hours @ $35.1447 $73,101 Responsible for Tulare operations and oversight, which includes ambulance inspections, performance reviews, contract compliance evaluations, performance and appeal investigation, Tulare County Ambulance Commission preparation, system performance reports, and attendance at EMS related meetings. 100% of his salary is paid for with State GF. Luis Barrera, EMS Specialist 1.0 FTE 2080 Hours @ $35.1447 $73,101 Responsible for Kings/Madera operations and oversight, which includes ambulance inspections, performance reviews, contract compliance evaluations, performance and appeal investigation, EMCC preparation, system performance reports, and attendance at EMS related meetings. 100% of his salary is paid for with State GF. Gina Alonso , Office Assistant III 0.75 FTE 1560 hours @ $18.2916 $28,535 Responsible for clerical support for the operations division, which includes miscellaneous administrative support, meeting minutes, purchasing and inventory, requisition management, and correspondence materials. 75% of this salary is paid for with State GF. Note: Personnel listed above are funded through the funds listed in Program Funding i10 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 11 of 13 Personnel Classification Staff State General Fund Local Funds Total %of State General Fund Local Personnel Person % of Pay % of Time Funds Time Rate* Time Pay Rate* Local/State Base BCP Manager Lynch 100% $56.7019 100% 0 0 $117,940 Senior Specialist Buehler 100% $38.5942 100% 0 0 $80,276 Senior Specialist Dotson 100% $38.5986 100% $80,285 0 0 Senior Specialist Myers 100% $38.5986 100% 0 0 $80,285 Senior Specialist Parker 100% $38.5986 100% 0 $80,285 0 Senior Specialist Jack 40.15% $38.5986 40.15% $32,234 0 $48,051 Systems Program Deaver 100% ° Analyst $40.6841 100/° 0 0 $84,623 EMS Specialist Barrera 100% $35.1447 100% 0 $73,101 0 EMS Specialist Cardona 100% $35.1447 100% $73,101 0 0 EMS Specialist Rodriguez 100% $35.1447 100% 0 0 $73,101 EMS Specialist Whitaker 100% $34.7875 100% 0 0 $72,358 EMS Specialist Lakela 100% $35.1447 100% 0 0 $73,101 EMS Specialist Part-time 61.3743 $28.23 61.3743 0 0 $36,038 Staff Analyst Loera 100% $32.913 100% $68,459 0 0 Administrative Assistant Yang 50% $19.0135 5% 0 0 $19,774 Office Assistant III Alonso 75% $18.2904 75% $28,535 0 0 Program Technician Bautista 100% 20.0125 100% 0 0 $41,626 Stand-by Pay Officers Du 1 h3s 6 100% 0 0 $33,280 'Salaries are based upon 2080 hours per year. Hourly rates are also rounded to the nearest cents. Total $282,614 $153,386 $760,453 2022/23 Regional Funding Application Page 11 Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 12 of 13 FrInge Benefits: Benefit Amount Percent Unemployment Insurance $459 0.11% Retirement $276,925 63.52% OASDI contribution $37,030 7.650% Workers Compensation $3,625 Flat Rate* Health Insurance $81,027 Flat Rate** Benefits Administration $932 Flat Rate *** Total ****399,998 Workers Compensation is estimated at a flat rate of$537 per FTE. **Health Insurance is estimated at a flat rate of$10,409 per FTE.Employees with dependent coverage is$13,280 and is based on annual open enrollment information. Benefit administration is$138 per FTE. ****The Actual cost of fringe benefits is$399,998.The State Agreement limits fringe benefit costs to 37%(or$161,319)of total personnel costs.The remaining difference will be covered by local funds. Budget Detail At the time that this new funding is approved by the Fresno County Board of Supervisors, the EMS agency will be into the 2"d quarter of the fiscal year. Funding in this initial year will be allocated to the justified areas, however, priority areas will be targeted with funding allocations that may change in the subsequent years. Communications—This cost represents the current county cost for radio access charges for EMS Communications. This amount accounts for approx. 40 radios used in the rural and partner counties at a rate of $85.82 per radio/per month. Software/ Software Maintenance -This cost represents a portion of the ongoing computer aided dispatch software and software annual maintenance costs for partner counties and rural communities. The budgeted cost represents the EMS Communications Center annual software maintenance cost for the Central Square Dispatch System and software, which provides the primary dispatch for the EMS Region. Data Collection and Evaluation software is currently in the process of being purchased through one-time grant funds. The pursuit of grant funds for this item was initiated once it was verified that the BCP funds would be approved. The BCP funding will be used to provide support costs for the new data collection and evaluation software. Administrative/Indirect Cost: Fresno County has chosen to claim the 10% overhead/indirect cost allowed by the State. The 18.816% of indirect cost rates are currently applied in Fresno County, and the cost includes administrative support, departmental support and county overhead. Since the agreement is limited to 10% indirect cost, Fresno County will assume the responsibilities of the unreimburseable 8.816% indirect costs. I Application Central California Emergency Medical Services Agency Agreement Number: C22-013 Funding Application: Attachment 1 Page 13 of 13 Central California EMS Agency Division Manager DANIEL LYNCH EMS Medical Director JIM ANDREWS,M.D. Staff Anah st ( Administrative AssistanR DOL G LOERA 1 JULIE YANG Asst EMS Medical Director CQI GEOFF STROH,M.D. E%IERGE-\CY MEDICAL SERVICES Communications Operations Disaster Sen-ices Education Specialty Services Coordinator Coordinator Coordinator Coordinator Coordinator \LATT MYER.S DALE DOTSON CURTIS JACK JESSICA BUEBLER MATO PARKER EMS COMMUNICATIONS REGION PARAMEDIC TRAINING SPECIALTY CONT1:17UOUS CENTER OPERATIONS CERTIFICATION DISASTER TRAINING PROGRAMS CARE QUALITY COURSE I PROGRAMS IMPROVEhIENT Systems Procedure EMS Specialist EMS Specialist Eme Afemt Specialist EMS Specialist LENL pecialistEZviS SpecialistAnalyst pJEFFDEAD EROFIN CARDONA LLIS BARRERA VACANT RICK LAKELA HITAKER SAL RODRIGUEZ Program Technician MONICA BAUTISTA sEbIS Specialist *EMS Specialist Dan Ashenbrenner Kurt Kindie sEMS Specialist 'ELLS Specialist EMS AGENCY Taylor Spierling Shellia Alaniz SUPPORT STAFF •EMS Specialist "EMS Specialist X17hitney Rodriguez Vacant Office Assistant Office Assistant *EMS Specialist sEMS Specialist GINA ALONSO VACANT Lonnie Taylor Vacant -Extra-help pact-time instructors I22/23 Regional Funding Application Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 1 of 2 EXHIBIT B Budget Details and Provisions 1. Invoicing and Payment A. For services satisfactorily rendered and approved by the EMSA Contract Manager, and upon receipt and approval of the invoices, EMSA agrees to compensate the Contractor in accordance with the Funding Application, Attachment 1 and this Exhibit B. Incomplete or disputed invoices shall be returned to the Contractor, unpaid, for correction. B. Invoices shall be itemized in accordance with the Funding Application, Attachment 1, and shall be signed and submitted on company letterhead in triplicate not more frequently than monthly in arrears of the service. C. Each invoice shall include: 1) Agreement Number 2) Time Period Covered 3) Invoice Number 4) Bill to Address 5) Remit to Address 6) Sufficient scope and detail to define the actual work performed and specific milestones completed, including a description of the activities of the Contractor and Subcontractor, the hours allocated to those activities, the locations where work was performed, the expenses claimed, and any required reports. D. Invoices shall be submitted in triplicate to: Emergency Medical Services Authority Attn: Angela Wise Agreement Number:C22-013 10901 Gold Center Drive, Suite 400 Rancho Cordova, CA 95670 Final Invoices must be submitted no later than sixty (60) days after the end date of this agreement. Payment will be for actual services provided or actual costs. If EMSA does not approve the invoice in accordance with identified general tasks or deliverables in this contract, payment of the invoice will be withheld by EMSA and the Contractor will be notified. The Contractor must take timely and appropriate measures to correct or remedy the reason(s) for non- acceptance and demonstrate to EMSA that the Contractor has successfully completed the scheduled work for each general task or deliverable before payment will be made. 2. Budget Contingency Clause A. It is mutually understood between the parties that this Agreement may have been written before ascertaining the availability of congressional or legislative appropriation of funds, for the mutual benefit of both parties in order to avoid program and fiscal delays that would occur if the Agreement were executed after that determination was made. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 2 of 2 EXHIBIT B Budget Details and Provisions B. This Agreement is valid and enforceable only if sufficient funds are made available to the State of California by the United States Government or the California State Legislature for the purpose of this program. In addition, this Agreement is subject to any additional restrictions, limitations, conditions, or any statute enacted by the Congress or the State Legislature that may affect the provisions, terms or funding of this Agreement in any manner. C. It is mutually agreed that if the Congress or the State Legislature does not appropriate sufficient funds for the program, this Agreement shall be amended to reflect any reduction in funds. D. Pursuant to Government Code, Section 927.13, no late payment penalty shall accrue during any time period for which there is no Budget Act in effect, nor on any payment or refund that is the result of a federally mandated program or that is directly dependent upon the receipt of federal funds by a state agency. E. In accordance with Health and Safety Code Section 1797.110, the Emergency Medical Services Authority may provide advance payment to the Contractor. An advance payment shall not exceed 25 percent of the total annual contract amount. 3. Prompt Payment Clause Payment will be made in accordance with, and within the time specified in, Government Code Chapter 4.5, commencing with Section 927. 4. Cost Limitation Total amount of this Agreement shall not exceed $959,900.00 5. Rates Rates for these services may be found on Funding Application, Attachment 1 of this document. 6. Excise Tax The State of California is exempt from federal excise taxes, and no payment will be made for any taxes levied on employees' wages. EMSA will pay for any applicable State or local sales or use taxes on the services rendered or equipment or parts supplied pursuant to this Agreement. EMSA may pay any applicable sales and use tax imposed by another state. 7. Cost Principles A. The Contractor agrees that the Cost Principles and Procedures in 48 Code of Federal Regulations (CFR), Part 31, and the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, in 2 CFR, Part 200, shall be used to determine the allowable individual items of cost. B. Any costs for which payment has been made to the Contractor that are determined by subsequent audit to be unallowable under 48 CFR, Part 31 or 2 CFR, Part 200 are subject to repayment by Contractor to EMSA. C. Any subcontract entered into as a result of this Agreement shall contain all of the provisions of this Section. General Terms and Conditions (GTC 04/2017) EXHIBIT C 1. APPROVAL: This Agreement is of no force or effect until signed by both parties and approved by the Department of General Services, if required. Contractor may not commence performance until such approval has been obtained. 2. AMENDMENT: No amendment or variation of the terms of this Agreement shall be valid unless made in writing, signed by the parties and approved as required. No oral understanding or Agreement not incorporated in the Agreement is binding on any of the parties. 3. ASSIGNMENT: This Agreement is not assignable by the Contractor, either in whole or in part, without the consent of the State in the form of a formal written amendment. 4. AUDIT: Contractor agrees that the awarding department, the Department of General Services, the Bureau of State Audits, or their designated representative shall have the right to review and to copy any records and supporting documentation pertaining to the performance of this Agreement. Contractor agrees to maintain such records for possible audit for a minimum of three (3) years after final payment, unless a longer period of records retention is stipulated. Contractor agrees to allow the auditor(s) access to such records during normal business hours and to allow interviews of any employees who might reasonably have information related to such records. Further, Contractor agrees to include a similar right of the State to audit records and interview staff in any subcontract related to performance of this Agreement. (Gov. Code §8546.7, Pub. Contract Code §10115 et seq., CCR Title 2, Section 1896). 5. INDEMNIFICATION: Contractor agrees to indemnify, defend and save harmless the State, its officers, agents and employees from any and all claims and losses accruing or resulting to any and all contractors, subcontractors, suppliers, laborers, and any other person, firm or corporation furnishing or supplying work services, materials, or supplies in connection with the performance of this Agreement, and from any and all claims and losses accruing or resulting to any person, firm or corporation who may be injured or damaged by Contractor in the performance of this Agreement. 6. DISPUTES: Contractor shall continue with the responsibilities under this Agreement during any dispute. 7. TERMINATION FOR CAUSE: The State may terminate this Agreement and be relieved of any payments should the Contractor fail to perform the requirements of this Agreement at the time and in the manner herein provided. In the event of such termination the State may proceed with the work in any manner deemed proper by the State. All costs to the State shall be deducted from any sum due the Contractor under this Agreement and the balance, if any, shall be paid to the Contractor upon demand. 8. INDEPENDENT CONTRACTOR: Contractor, and the agents and employees of Contractor, in the performance of this Agreement, shall act in an independent capacity and not as officers or employees or agents of the State. 9. RECYCLING CERTIFICATION: The Contractor shall certify in writing under penalty of perjury, the minimum, if not exact, percentage of post-consumer material as defined in the Public Contract Code Section 12200, in products, materials, goods, or supplies offered or sold to the State regardless of whether the product meets the requirements of Public Contract Code Section 12209. With respect to printer or duplication cartridges that comply with the requirements of Section 12156(e), the certification required by this subdivision shall specify that the cartridges so comply (Pub. Contract Code §12205). 10. NON-DISCRIMINATION CLAUSE: During the performance of this Agreement, Contractor and its subcontractors shall not deny the contract's benefits to any person on the basis of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military and veteran status, nor shall they discriminate unlawfully against any employee or applicant for employment because of race, religious creed, color, national origin, ancestry, physical disability, mental disability, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, or military and veteran status. Contractor shall insure that the evaluation and treatment of employees and applicants for employment are free of such discrimination. Contractor and subcontractors shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code §12900 et seq.), the regulations promulgated thereunder (Cal. Code Regs., tit. 2, §11000 et seq.), the provisions of Article 9.5, Chapter 1, Part 1, Division 3, Title 2 of the Government Code (Gov. Code §§11135-11139.5), and the regulations or standards adopted by the awarding state agency to implement such article. Contractor shall permit access by representatives of the Department of Fair Employment and Housing and the awarding state agency upon reasonable notice at any time during the normal business hours, but in no case less than 24 hours' notice, to such of its books, records, accounts, and all other sources of information and its facilities as said Department or Agency shall require to ascertain compliance with this clause. Contractor and its subcontractors shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other agreement. (See Cal. Code Regs., tit. 2, §11105.) Contractor shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to perform work under the Agreement. 11. CERTIFICATION CLAUSES: The CONTRACTOR CERTIFICATION CLAUSES contained in the document CCC 04/2017 are hereby incorporated by reference and made a part of this Agreement by this reference as if attached hereto. 12. TIMELINESS: Time is of the essence in this Agreement. 13. COMPENSATION: The consideration to be paid Contractor, as provided herein, shall be in compensation for all of Contractor's expenses incurred in the performance hereof, including travel, per diem, and taxes, unless otherwise expressly so provided. 14. GOVERNING LAW: This contract is governed by and shall be interpreted in accordance with the laws of the State of California. 15. ANTITRUST CLAIMS: The Contractor by signing this agreement hereby certifies that if these services or goods are obtained by means of a competitive bid, the Contractor shall comply with the requirements of the Government Codes Sections set out below. a. The Government Code Chapter on Antitrust claims contains the following definitions: 1) "Public purchase" means a purchase by means of competitive bids of goods, services, or materials by the State or any of its political subdivisions or public agencies on whose behalf the Attorney General may bring an action pursuant to subdivision (c) of Section 16750 of the Business and Professions Code. 2) "Public purchasing body" means the State or the subdivision or agency making a public purchase. Government Code Section 4550. b. In submitting a bid to a public purchasing body, the bidder offers and agrees that if the bid is accepted, it will assign to the purchasing body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. Sec. 15) or under the Cartwright Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, materials, or services by the bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and become effective at the time the purchasing body tenders final payment to the bidder. Government Code Section 4552. C. If an awarding body or public purchasing body receives, either through judgment or settlement, a monetary recovery for a cause of action assigned under this chapter, the assignor shall be entitled to receive reimbursement for actual legal costs incurred and may, upon demand, recover from the public body any portion of the recovery, including treble damages, attributable to overcharges that were paid by the assignor but were not paid by the public body as part of the bid price, less the expenses incurred in obtaining that portion of the recovery. Government Code Section 4553. d. Upon demand in writing by the assignor, the assignee shall, within one year from such demand, reassign the cause of action assigned under this part if the assignor has been or may have been injured by the violation of law for which the cause of action arose and (a) the assignee has not been injured thereby, or (b) the assignee declines to file a court action for the cause of action. See Government Code Section 4554. 16. CHILD SUPPORT COMPLIANCE ACT: For any Agreement in excess of $100,000, the contractor acknowledges in accordance with Public Contract Code 7110, that: a. The contractor recognizes the importance of child and family support obligations and shall fully comply with all applicable state and federal laws relating to child and family support enforcement, including, but not limited to, disclosure of information and compliance with earnings assignment orders, as provided in Chapter 8 (commencing with section 5200) of Part 5 of Division 9 of the Family Code; and b. The contractor, to the best of its knowledge is fully complying with the earnings assignment orders of all employees and is providing the names of all new employees to the New Hire Registry maintained by the California Employment Development Department. 17. UNENFORCEABLE PROVISION: In the event that any provision of this Agreement is unenforceable or held to be unenforceable, then the parties agree that all other provisions of this Agreement have force and effect and shall not be affected thereby. 18. PRIORITY HIRING CONSIDERATIONS: If this Contract includes services in excess of $200,000, the Contractor shall give priority consideration in filling vacancies in positions funded by the Contract to qualified recipients of aid under Welfare and Institutions Code Section 11200 in accordance with Pub. Contract Code §10353. 19. SMALL BUSINESS PARTICIPATION AND DVBE PARTICIPATION REPORTING REQUIREMENTS: a. If for this Contract Contractor made a commitment to achieve small business participation, then Contractor must within 60 days of receiving final payment under this Contract (or within such other time period as may be specified elsewhere in this Contract) report to the awarding department the actual percentage of small business participation that was achieved. (Govt. Code § 14841.) b. If for this Contract Contractor made a commitment to achieve disabled veteran business enterprise (DVBE) participation, then Contractor must within 60 days of receiving final payment under this Contract (or within such other time period as may be specified elsewhere in this Contract) certify in a report to the awarding department: (1) the total amount the prime Contractor received under the Contract; (2) the name and address of the DVBE(s) that participated in the performance of the Contract; (3) the amount each DVBE received from the prime Contractor; (4) that all payments under the Contract have been made to the DVBE; and (5) the actual percentage of DVBE participation that was achieved. A person or entity that knowingly provides false information shall be subject to a civil penalty for each violation. (Mil. & Vets. Code § 999.5(d); Govt. Code § 14841.) 20. LOSS LEADER: If this contract involves the furnishing of equipment, materials, or supplies then the following statement is incorporated: It is unlawful for any person engaged in business within this state to sell or use any article or product as a "loss leader" as defined in Section 17030 of the Business and Professions Code. (PCC 10344(e).) Contractor Certification Clauses CCC 04/2017 CERTIFICATION I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly authorized to legally bind the prospective Contractor to the clause(s) listed below. This certification is made under the laws of the State of California. Contractor/Bidder Firm Name (Printed) Federal ID Number County of Fresno By (Authorized Signature) ATTEST: BERNICE E.SEIDEL Clerk of the Board of Supervisors Count of Fre no,State of California Printed Name and Title of Person Signing By. Deputy Brian Pacheco, Chairman of the Board of Supervisors of the County of Fresno Date Executed Executed in the County of 1 I /Zq/Z Z- Fresno CONITRACTOR CERTIFICATION CLAUSES 1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with the nondiscrimination program requirements. (Gov. Code §12990 (a-f) and CCR, Title 2, Section 11102) (Not applicable to public entities.) 2. DRUG-FREE WORKPLACE REQUIREMENTS: Contractor will comply with the requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free workplace by taking the following actions: a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. b. Establish a Drug-Free Awareness Program to inform employees about: 1) the dangers of drug abuse in the workplace; 2) the person's or organization's policy of maintaining a drug-free workplace; 3) any available counseling, rehabilitation and employee assistance programs; and, 4) penalties that may be imposed upon employees for drug abuse violations. c. Every employee who works on the proposed Agreement will: 1) receive a copy of the company's drug-free workplace policy statement; and, 2) agree to abide by the terms of the company's statement as a condition of employment on the Agreement. Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement or both and Contractor may be ineligible for award of any future State agreements if the department determines that any of the following has occurred: the Contractor has made false certification, or violated the certification by failing to carry out the requirements as noted above. (Gov. Code §8350 et seq.) 3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION: Contractor certifies that no more than one (1) final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two-year period because of Contractor's failure to comply with an order of a Federal court, which orders Contractor to comply with an order of the National Labor Relations Board. (Pub. Contract Code §10296) (Not applicable to public entities.) 4. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE- PRO BONO REQUIREMENT: Contractor hereby certifies that Contractor will comply with the requirements of Section 6072 of the Business and Professions Code, effective January 1, 2003. Contractor agrees to make a good faith effort to provide a minimum number of hours of pro bono legal services during each year of the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm's offices in the State, with the number of hours prorated on an actual day basis for any contract period of less than a full year or 10% of its contract with the State. Failure to make a good faith effort may be cause for non-renewal of a state contract for legal services, and may be taken into account when determining the award of future contracts with the State for legal services. 5. EXPATRIATE CORPORATIONS: Contractor hereby declares that it is not an expatriate corporation or subsidiary of an expatriate corporation within the meaning of Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the State of California. 6. SWEATFREE CODE OF CONDUCT: a. All Contractors contracting for the procurement or laundering of apparel, garments or corresponding accessories, or the procurement of equipment, materials, or supplies, other than procurement related to a public works contract, declare under penalty of perjury that no apparel, garments or corresponding accessories, equipment, materials, or supplies furnished to the state pursuant to the contract have been laundered or produced in whole or in part by sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor, or with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under penal sanction, abusive forms of child labor or exploitation of children in sweatshop labor. The contractor further declares under penalty of perjury that they adhere to the Sweatfree Code of Conduct as set forth on the California Department of Industrial Relations website located at www.dir.ca.gov, and Public Contract Code Section 6108. b. The contractor agrees to cooperate fully in providing reasonable access to the contractor's records, documents, agents or employees, or premises if reasonably required by authorized officials of the contracting agency, the Department of Industrial Relations, or the Department of Justice to determine the contractor's compliance with the requirements under paragraph (a). 7. DOMESTIC PARTNERS: For contracts of$100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.3. 8. GENDER IDENTITY: For contracts of$100,000 or more, Contractor certifies that Contractor is in compliance with Public Contract Code section 10295.35. DOING BUSINESS WITH THE STATE OF CALIFORNIA The following laws apply to persons or entities doing business with the State of California. 1. CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions regarding current or former state employees. If Contractor has any questions on the status of any person rendering services or involved with the Agreement, the awarding agency must be contacted immediately for clarification. Current State Employees (Pub. Contract Code §10410): 1). No officer or employee shall engage in any employment, activity or enterprise from which the officer or employee receives compensation or has a financial interest and which is sponsored or funded by any state agency, unless the employment, activity or enterprise is required as a condition of regular state employment. 2). No officer or employee shall contract on his or her own behalf as an independent contractor with any state agency to provide goods or services. Former State Employees (Pub. Contract Code §10411): 1). For the two-year period from the date he or she left state employment, no former state officer or employee may enter into a contract in which he or she engaged in any of the negotiations, transactions, planning, arrangements or any part of the decision-making process relevant to the contract while employed in any capacity by any state agency. 2). For the twelve-month period from the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was employed by that state agency in a policy-making position in the same general subject area as the proposed contract within the 12-month period prior to his or her leaving state service. If Contractor violates any provisions of above paragraphs, such action by Contractor shall render this Agreement void. (Pub. Contract Code §10420) Members of boards and commissions are exempt from this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (Pub. Contract Code §10430 (e)) 2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of the provisions which require every employer to be insured against liability for Worker's Compensation or to undertake self-insurance in accordance with the provisions, and Contractor affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code Section 3700) 3. AMERICANS WITH DISABILITIES ACT: Contractor assures the State that it complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.) 4. CONTRACTOR NAME CHANGE: An amendment is required to change the Contractor's name as listed on this Agreement. Upon receipt of legal documentation of the name change the State will process the amendment. Payment of invoices presented with a new name cannot be paid prior to approval of said amendment. 5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA: a. When agreements are to be performed in the state by corporations, the contracting agencies will be verifying that the contractor is currently qualified to do business in California in order to ensure that all obligations due to the state are fulfilled. b. "Doing business" is defined in R&TC Section 23101 as actively engaging in any transaction for the purpose of financial or pecuniary gain or profit. Although there are some statutory exceptions to taxation, rarely will a corporate contractor performing within the state not be subject to the franchise tax. c. Both domestic and foreign corporations (those incorporated outside of California) must be in good standing in order to be qualified to do business in California. Agencies will determine whether a corporation is in good standing by calling the Office of the Secretary of State. 6. RESOLUTION: A county, city, district, or other local public body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body which by law has authority to enter into an agreement, authorizing execution of the agreement. 7. AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor shall not be: (1) in violation of any order or resolution not subject to review promulgated by the State Air Resources Board or an air pollution control district; (2) subject to cease and desist order not subject to review issued pursuant to Section 13301 of the Water Code for violation of waste discharge requirements or discharge prohibitions; or (3) finally determined to be in violation of provisions of federal law relating to air or water pollution. 8. PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 1 of 4 EXHIBIT D Special Terms and Conditions 1. Settlement of Disputes A. Any dispute arising under this Agreement that is not disposed of by Agreement shall be decided by the EMSA Contract Officer, who may consider any written or verbal evidence submitted by the Contractor. The decision of the Contract Officer, issued in writing, shall be EMSA' final decision on the dispute. B. Neither the pendency of a dispute nor its consideration by the Contract Officer will excuse the Contractor from full and timely performance in accordance with the terms of the Agreement. 2. Termination A. If, after award and execution of the Agreement, the Contractor's performance is unsatisfactory, the Agreement may be terminated for default. Additionally, the Contractor may be liable to EMSA for damages including the difference between the Contractor's original bid price and the actual cost of performing the work by another Contractor. Default is defined as the Contractor failing to perform services required by the Agreement in a satisfactory manner. B. EMSA reserves the right to terminate this Agreement for any or no cause upon 30 days written notice to the Contractor or immediately in the event of default or material breach by the Contractor. C. The State may terminate this Agreement immediately for good cause. The term "good cause" may be defined as "impossibility of performance" or "frustration of purpose," but does not include material breach, default, or termination without cause. In this instance, the Agreement termination shall be effective as of the date indicated on the State's notification to the Contractor. D. In the event that the total Agreement amount is expended prior to the expiration date, EMSA may, at its discretion, terminate this Agreement with thirty (30) days' notice to Contractor. 3. Subcontractors The Contractor shall perform the work contemplated with resources available within its own organization and no portion of the work shall be subcontracted. 4. Retention of Records/Audits A. For the purpose of determining compliance with Government Code Section 8546.7, the Contractor and Subcontractors shall maintain all books, documents, papers, accounting records, and other evidence pertaining to the performance of the Agreement, including but not limited to, the costs of administering the Agreement. All parties shall make such materials available at their respective offices at all reasonable times during the Agreement period and for three years from the date of final payment under the Agreement. The State, the State Auditor, or any duly authorized representative of the Federal government having jurisdiction under Federal laws or regulations (including the basis of Federal funding in whole or in part) shall have access to any books, records, and documents of the Contractor that are pertinent to the Agreement for audits, examinations, excerpts, and transactions, and copies thereof shall be furnished if requested. B. Any subcontract entered into as a result of this Agreement shall contain all the provisions of this clause. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 2 of 4 EXHIBIT D Special Terms and Conditions 5. Assumption of Risk and Indemnifications Regarding Exposure to Environmental Health Hazards In addition to and not a limitation of the Contractor's indemnification obligations contained elsewhere in this Agreement, the Contractor hereby assumes all risks of the consequences of exposure of Contractor's employees, agents, Subcontractors, Subcontractors' employees, and any other person, firm, or corporation furnishing or supplying work services, materials, or supplies in connection with the performance of this Agreement, to any and all environmental health hazards, local and otherwise, in connection with the performance of this Agreement. Such hazards include, but are not limited to, bodily injury and/or death resulting in whole or in part from exposure to infectious agents and/or pathogens of any type, kind, or origin. Contractor also agrees to take all appropriate safety precautions to prevent any such exposure to Contractor's employees, agents, Subcontractors, Subcontractors' employees, and any other person, firm, or corporation furnishing or supplying work services, materials, or supplies in connection with the performance of this Agreement. Contractor also agrees to indemnify and hold harmless EMSA, the State of California, and each and all of their officers, agents, and employees, from any and all claims and/or losses accruing or resulting from such exposure. Except as provided by law, Contractor also agrees that the provisions of this paragraph shall apply regardless of the existence or degree of negligence or fault on the part of EMSA, the State of California, and/or any of their officers, agents and/or employees. 6. Mandatory Organic Waste Recycling It is understood and agreed that pursuant to Public Resources Code 42649.8 et. seq., if Contractor generates four (4) cubic yards or more of organic waste or commercial solid waste per week, the Contractor shall arrange for organic waste or commercial waste recycling services that separate/source organic waste for organic waste recycling. Contractor shall provide proof of compliance, i.e. organic waste recycling services or commercial waste recycling services that separate/source organic waste recycling, upon request from the EMSA Contract Manager 7. Force Majeure Except for defaults of Subcontractors, neither party shall be responsible for delays or failures in performance resulting from acts beyond the control of the offending party. Such acts shall include but shall not be limited to acts of God, fire, flood, earthquake, other natural disaster, nuclear accident, strike, lockout, riot, freight embargo, public regulated utility, or governmental statutes or regulations superimposed after the fact. If a delay or failure in performance by the Contractor arises out of a default of its Subcontractor, and if such default of its Subcontractor, arises out of causes beyond the control of both the Contractor and Subcontractor, and without the fault or negligence of either of them, the Contractor shall not be liable for damages of such delay or failure, unless the supplies or services to be furnished by the Subcontractor were obtainable from other sources in sufficient time to permit the Contractor to meet the required performance schedule. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 3 of 4 EXHIBIT D Special Terms and Conditions 8. Employment of Undocumented Workers By signing this contract, the Contractor swears or affirms that it has not, in the preceding five years, been convicted of violating a State or Federal law relative to the employment of undocumented workers 9. General Provisions Required in all Insurance Polices A. Deductible: Contractor is responsible for any deductible or self-insured retention contained within the insurance program. B. Coverage Term: Coverage must be in force for the complete term of this Agreement. If insurance expires during the term of this Agreement, a new certificate must be received by the EMSA Contract Manager at least ten (10) days prior to the expiration of the insurance. Any new insurance must continue to comply with the original terms of this Agreement. C. Policy Cancellation or Termination and Notice of Non-Renewal: Contractor shall provide, to the EMSA Contract Manager within five (5) business days, following receipt by Contactor, a copy of any cancellation or non-renewal of insurance required by this Agreement. In the event Contractor fails to keep, in effect at all times, the specified insurance coverage, the State may, in addition to any other remedies it may have, terminate this Agreement upon the occurrence of such event, subject to the provisions of this Agreement. D. Primary Clause: Any required insurance contained in this Agreement shall be primary, and not excess or contributory, to any other insurance carried by the State. E. Inadequate Insurance: Inadequate or lack of insurance does not negate the Contractor's obligations under this Agreement. F. Endorsements: Any required endorsements requested by the State must be physically attached to all requested certificates of insurance and not substituted by referring to such coverage on the certificate of insurance. G. Insurance Carrier Required Rating: All insurance companies must carry a rating acceptable to the DGS, Office of Risk and Insurance Management (GRIM). If the Contractor is self-insured for a portion or all of its insurance, review of financial information including a letter of credit may be required. DGS, ORIM Website: https://www.dgs.ca.gov/ORIM. H. Contractor shall include all of its subcontractors as insureds under Contractor's insurance or supply evidence of insurance to the State equal to the policies, coverages and limits required of Contractor. I. The State will not be responsible for any premiums or assessments on the policy. 10. Insurance Requirements A. Commercial General Liability 1) Contractor shall maintain general liability on an occurrence form with limits not less than $1,000,000 per occurrence and $2,000,000 aggregate for bodily injury and property damage liability. The policy shall include coverage for liabilities arising out of premises, operations, independent contractors, products, completed operations, personal and advertising injury, and liability assumed under an insured Agreement. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 4 of 4 EXHIBIT D Special Terms and Conditions This insurance shall apply separately to each insured against whom claim is made or suit is brought subject to the Contractor's limit of liability. The policy must include: EMSA, State of California, its officers, agents, employees and servants are included as additional insured but only with respect to work performed under this Agreement. 2) This endorsement must be supplied under form acceptable to DGS, ORIM. 11. Licenses and Permits A. The Contractor shall be an individual or firm qualified to do business in California and shall obtain at its expense all license(s) and permit(s) required by law for any work under this Agreement. B. If Contractor is a California or foreign corporation, Contractor must be registered and active/in good standing with the California Secretary of State. C. If the Contractor is any other business entity, Contractor must be registered and active/in good standing with the California Secretary of State, to the extent applicable. D. In the event any license(s) and/or permit(s) expire at any time during the term of this Agreement, Contractor agrees to provide EMSA Contract Manager a copy of the renewed license(s) and/or permit(s) within thirty (30) days following the expiration date. In the event the Contractor fails to keep in effect at all times all required license(s) and permit(s), the State may, in addition to any other remedies it may have, terminate this Agreement upon occurrence of such event. 12. Prohibition of Delinquent Taxpayers Public Contract Code Section 10295.4 prohibits the State from entering into an Agreement for goods or services with any taxpayer, whose name appears on either list maintained by the State Board of Equalization or the Franchise Tax Board pursuant to Revenue and Taxation Code sections 7063 and 19195, respectively, of the 500 largest tax delinquencies. Public Contract Code Section 10295.4 provides no exceptions to these prohibitions. Central California Emergency Medical Services Agency Agreement Number: C22-013 Page 1 of 1 EXHIBIT E Sample Invoice 1TA'[a-AUPORMA W O►][Ai•MCACAL WROZ42 AL7WArT` STAR a WANCOW `�.' ereftiae+cr�L�MII1�1r r /70RTI11YCTM IIa�IAUI��NT NMOC! T: OAR: XIDOU60X Aar.ir:Wa".a. CONTRACT Nlal\�1: XXXXXVIX 4 wj-0.W C.~Dr+",f1r.M go" pwwmo IRa1N�1: XXIODUOUI Ra—� Cord&"CA N!f MACt/fM00: XAXXl00lX If VMG AMOUNT: ! - F—.X100U0UOUL" fto""of w onwlm is is robM,rr OW W&C r far&Cf 48Pa.0an.a a.A~.hOO O Me&Wk46m&Ward Won r Caftrrra 41000800 Ilfrar rfootf0uotfL r MArMM AW of MWAwf d rWaOWWW rrt rA Oa peNaae Won•a rt —-.-I rd R..fp•[C aa.pulaa o �allr• Yrn.q C.p� ��� Cp<rl+p[aa.na.. f 4 Taw Lw AOaans•If aM4ue.; 1 . Taut R.r.c.f--t R-wi :arTq 7�1;an>ti sy.fscrwa.ro.cary oM-OZ .v..n aaaw p•r f ar.l Mr a.rrfr A.iy M.<u0 a.rM<.n<�N/Mp.:O v. :u..:4 .tea,<.ccaer��.tn S1.cc.Vact l &—.,atrrWi..r.a�a+a.!n•aaJPrOa►.w'tar a..rac�.raa;a.!>ti aw.c...r ai.lr•w4 Mcr•n•. .•n ar...a..y�....nr.a a ar n.eera.a tf�bT..y..c f Y..4cr:...�o..�►.M.fy. A•Y.aa A.rM Lr ..a Ap.Auu.pcv.ry.f.c�i.•.<.a.r n.r.[f.riOrti.a b paV.•r t Lr7<ea - - --- 'i' ------------- Om wd N.a.a :w• Agreement between the County of Fresno, Acting as the Central California EMS Agency, and the California Emergency Medical Services Authority (EMSA) Name/No.: Central California EMS Agency Grant (State Agreement No. C22-013) Fund/Subclass: 0001/10000 Organization #: 56201692 Revenue Account #: 3503