HomeMy WebLinkAboutAgreement A-16-394 with KWPH Enterprises d.b.a. American Ambulance Riverdale Fire Dept.pdf Agreement No. 16-394
1 AGREEMENT
2 THIS AGREEMENT is made and entered into this 21st day of June , 2016,
3 by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California,
4 hereinafter referred to as "COUNTY," and K.W.P.H. ENTERPRISES, doing business as
5 AMERICAN AMBULANCE,a California Corporation, whose address is 2911 East Tulare
6 Street, Fresno, California 93721,hereinafter referred to as"CONTRACTOR."
7 WITNESSETH:
8 WHEREAS, COUNTY's Emergency Medical Services ("EMS") Communications
9 Center is staffed and operated by CONTRACTOR through that certain Emergency Medical
10 Services Provider Agreement for Emergency Ambulance Service and Advanced Life Support
1 l (Paramedic) Ambulance Service dated July 10, 2007 (COUNTY Agreement No. A-07-292, the
12 "EMS PROVIDER Agreement"), by and between COUNTY and PROVIDER; and
13 WHEREAS, Riverdale Public Utility District("DISTRICT")desires to receive
14 dispatching services for fire suppression calls, which may include dispatching of non-transport
15 first responder services,(collectively, "FIRE Dispatching Services") from COUNTY's EMS
16 Communications Center; and
17 WHEREAS, CONTRACTOR desires to provide dispatching services for DISTRICT; and
18 WHEREAS, it is to the mutual benefit and in the best interest of the DISTRICT and
19 COUNTY,and the parties hereto, to combine EMS dispatching services and FIRE Dispatching
20 Services for the purpose of providing improved services to the public; and
21 WHEREAS, CONTRACTOR and COUNTY developed an original Agreement on June 18,
22 2013 (COUNTY Agreement No. A-13-462) beginning August 2, 2013 through June 30, 2016;
23 and
24 WHEREAS, it is a goal of COUNTY and DISTRICT to consolidate dispatching services
25 in Fresno County; and
26 WHEREAS, it has been determined by DISTRICT and COUNTY that there is a need to
27 provide EMS dispatching services and FIRE Dispatching Services through a centralized and
28 combined effort by COUNTY's EMS Communications Center; and
COUNTY OF FRESNO
I WHEREAS, DISTRICT and COUNTY intend to enter into an agreement which will
2 continue the provision of FIRE Dispatching Services by COUNTY (the "DISTRICT-COUNTY
3 Agreement"); and
4 WHEREAS, CONTRACTOR is willing to facilitate the DISTRICT-COUNTY
5 Agreement by entering into this Agreement.
6 NOW, THEREFORE, in consideration of their mutual covenants and conditions,the
7 parties hereto agree as follows:
8 1. SERVICES
9 A. Subject to DISTRICT timely paying COUNTY for FIRE Dispatching
10 Services(defined in Section 4.A. of the DISTRICT-COUNTY Agreement) under the
11 DISTRICT-COUNTY Agreement:
12 (1) COUNTY shall obtain and maintain dispatching equipment,
13 hardware, software (including software licenses), and other technologies, which will be utilized
14 for the triage and entry of information for FIRE Dispatching Services in COUNTY's EMS
15 Communications Center computer aided dispatch("CAD") system, in connection with
16 CONTRACTOR's performance of FIRE Dispatching Services under this Agreement; and
17 (2) COUNTY shall be responsible for selection, configuration,
18 installation, and maintenance of all dispatching equipment, hardware, software and other
19 technologies associated with this Agreement. All dispatching equipment, hardware, software
20 (including software licenses), and other technologies purchased and/or obtained through this
21 Agreement shall be the sole property of COUNTY.
22 (3) CONTRACTOR, shall provide FIRE Dispatching Services
23 requiring responses by DISTRICT apparatuses as follows:
24 (a) CONTRACTOR shall provide all FIRE Dispatching
25 Services in accordance with DISTRICT's Policies and Procedures ("DISTRICT's Policies and
26 Procedures"), which shall be approved by COUNTY's EMS Director, or his or her designee
27 (the "COUNTY's Representative").
28 (b) CONTRACTOR shall dispatch DISTRICT's apparatuses
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I through DISTRICT's radios and electronic communications, and in accordance with
2 DISTRICT's Policies and Procedures approved by COUNTY's Representative.
3 (c) CONTRACTOR shall provide pre-arrival instructions to
4 callers requesting fire suppression service responses in accordance with DISTRICT's Policies
5 and Procedures approved by COUNTY's Representative.
6 (d) CONTRACTOR shall provide inter-agency coordination
7 regarding requests for fire suppression service, mutual aid and instant aid services, and order
8 specialized fire equipment from DISTRICT or other agencies(e.g., hazardous materials
9 equipment, or"jaws of life") which may be needed to handle an incident, and perform other
10 related duties in accordance with DISTRICT's Policies and Procedures approved by
I 1 COUNTY's Representative.
12 (e) CONTRACTOR shall track all activity of DISTRICT's
13 apparatuses responses utilizing the COUNTY's EMS Communications Center CAD system.
14 (f) COUNTY shall provide one (1) radio operator for
15 dispatching of DISTRICT'S apparatuses twenty-four(24) hours a day, seven (7) days a week.
16 DISTRICT understands that the radio operator is not dedicated for the sole purpose of
17 DISTRICT and that the radio operator may be dispatching other fire and EMS providers.
18 (g) CONTRACTOR shall provide that a minimum of one (1)
19 dispatch supervisor shall be on duty at COUNTY's EMS Communications Center twenty-four
20 (24)hours a day, seven(7)days a week. The supervisor shall be available to DISTRICT's on-
21 duty fire administration as needed.
22 (h) CONTRACTOR shall maintain an up-to-date manual of
23 DISTRICT's Policies and Procedures (approved by COUNTY's Representative, as provided
24 herein) for all dispatch staff, and shall provide for training and continuing education of dispatch
25 staff as needed.
26 (i) The goal for the immediate dispatch of a fire apparatus, in
27 accordance with DISTRICT approved dispatch protocols, and excluding multiple unit responses,
28 1 reassigned responses and other situations beyond the COUNTY's EMS Communications Center
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1 control; shall be sixty (60) seconds. The dispatch time will be measured from the time the
2 telephone is answered by the call taker to the time the first fire apparatus is alerted to the incident
3 either by radio, telephone, pager, or station alerting device. A review shall occur for all cases in
4 which dispatches are over ninety (90) seconds and results will be evaluated for improvement
5 opportunities by the Fire Dispatch Continuous Quality Improvement(CQI)Committee.
6 It is understood, because of the dynamic nature of emergency services, there are
7 situations when the sixty (60) second dispatch goal may not be achieved. Examples of these
8 situations include,but are not limited to:
9 1. Calls not received through the 9-1-1 telephone
10 system.
11 2. Calls that do not immediately geo-verify in the CAD.
12 3. Calls in which the public safety answering points
13 (PSAP) dispatcher does not immediately transfer the
14 calling party.
15 4. Calls in which the reporting party is either unable or
16 unwilling to immediately provide all required
17 information as part of the call taking process (i.e.,
18 non-English speaking,hysterical, or uncooperative).
19 5. Calls not meeting Priority I medical-aid criteria
20 during initial questioning.
21 B. It is understood by the parties hereto that(i) CONTRACTOR's provision
22 of FIRE Dispatching Services herein does not include any CONTRACTOR or COUNTY
23 provision of fire suppression services, (ii) all fire suppression services for all fire suppression
24 calls to be dispatched by CONTRACTOR are to be provided by DISTRICT pursuant to the
25 DISTRICT-COUNTY Agreement, (iii) CONTRACTOR is providing FIRE Dispatching
26 Services herein on a non-exclusive basis, (iv) COUNTY's compensation paid to
27 CONTRACTOR for its performance of FIRE Dispatching Services herein is for supplemental
28 services that are in addition to any other services that CONTRACTOR provides, and for which
COUNTY OFFRESNO
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I CONTRACTOR acknowledges that CONTRACTOR is paid in accordance with the EMS
2 PROVIDER Agreement, and (v) CONTRACTOR shall first obtain COUNTY's written
3 permission to provide any other dispatching services through the COUNTY's EMS
4 Communications Center. Notwithstanding anything stated to the contrary herein,
5 CONTRACTOR covenants, warrants, and represents to COUNTY that (i) Any funds that
6 COUNTY may pay to CONTRACTOR, or that CONTRACTOR otherwise may collect from
7 performing service in connection with the EMS PROVIDER Agreement, including, but not
8 limited to, COUNTY compensation and CONTRACTOR's fees and charges for services
9 rendered to patients, shall not be diverted or otherwise used, either directly or indirectly, by
10 CONTRACTOR to subsidize CONTRACTOR's performance of this Agreement, and(ii)
I I CONTRACTOR shall not directly or indirectly charge any costs or expenses incurred in
12 connection with the performance of this Agreement to any of CONTRACTOR's other
13 operations for or approved by COUNTY, including but not limited to CONTRACTOR's
14 operations in the COUNTY's EMS Communications Center for COUNTY under the EMS
15 PROVIDER Agreement and/or for other COUNTY-approved agencies (e.g., agencies that may
16 be outside of Fresno County such as the County of Kings or cities or special districts, if any,
17 within Fresno County).
18 C. CONTRACTOR's performance of FIRE Dispatching Services herein shall
19 enhance CONTRACTOR's peak load capacity, disaster readiness and overall efficiency in
20 providing dispatching services in COUNTY's EMS Communications Center, and shall not
21 detract from CONTRACTOR's performance of its obligations under the EMS PROVIDER
22 Agreement, or any other agreement, if any, entered into or authorized by COUNTY.
23 D. COUNTY shall perform the following functions:
24 (1) COUNTY shall provide COUNTY-approved DISTRICT Policies
25 and Procedures to CONTRACTOR.
26 (2) COUNTY shall assure that all calls to DISTRICT for EMS and fire
27 suppression services are immediately transferred to COUNTY's EMS Communications Center.
28 (3) COUNTY agrees to provide for an internal quality improvement
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I program, which includes the participation of CONTRACTOR and DISTRICT.
2 2. TERM
3 This Agreement shall become effective on the I" day of July, 2016 and terminate
4 on the 31 st day of December, 2017, unless sooner terminated as provided herein.
5 Notwithstanding anything stated to the contrary herein,this Agreement shall
6 automatically terminate on any earlier date that the DISTRICT-COUNTY Agreement
7 terminates.
8 3. TERMINATION
9 A. Non-Allocation of Funds - The terms of this Agreement, and the services
10 to be provided hereunder, are contingent on the approval of funds by the appropriating
11 governmental agency, provided however, should sufficient funds not be allocated, (i) the
12 services provided may be modified at any time upon the parties' mutual written agreement, or
13 (ii)this Agreement may be terminated at any time by the COUNTY giving at least sixty(60)
14 days' advance written notice of an intention to terminate to the CONTRACTOR.
15 B. Without Cause - Under circumstances other than those set forth above,
16 this Agreement may be terminated by CONTRACTOR or COUNTY upon the giving of at least
17 sixty(60) days' advance written notice of an intention to terminate to the other party.
18 C. Material Breach- Either party may terminate this Agreement at any time
19 for cause for the other party's material breach of its obligations herein if not less than seven(7)
20 days' advance, written notice has been given to the other party and such breach remains uncured
21 within that seven(7) day period. The party receiving such notice may respond to said notice and
22 any charges contained therein within that seven(7) day period. A "Material Breach"by
23 CONTRACTOR, as that term is defined by and used in the EMS PROVIDER Agreement, also
24 shall be deemed to be a material breach by CONTRACTOR under this Agreement. Any notice
25 by COUNTY to CONTRACTOR of CONTRACTOR's Material Breach under the EMS
26 Provider Agreement shall satisfy the requirement of COUNTY giving notice to CONTRACTOR
27 of a material breach under this Agreement without the necessity of such notice referring to
28 CONTRACTROR's performance under this Agreement.
COUNTY OF FRESNO
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I D. COUNTY shall compensate or provide funding to CONTRACTOR for
2 any services performed under this Agreement prior to any termination of this Agreement.
3 4. COMPENSATION FOR SERVICES
4 A. For CONTRACTOR'S performance of FIRE Dispatching Services herein,
5 COUNTY agrees to pay CONTRACTOR and CONTRACTOR agrees to receive a quarterly
6 lump-sum payment of Four Hundred Sixty-Eight and 50/100 Dollars ($468.50)pursuant to
7 Exhibit A, attached hereto and incorporated herein by this reference. The quarterly lump-sum
8 payment shall be paid for the performance of services as stated in this contract only while the
9 Agreement with American Ambulance(Agreement No. A-07-292) is still in effect. In no event
10 shall compensation for CONTRACTORS performance of FIRE Dispatching Services under this
I I Agreement be in excess Two Thousand Eight Hundred Eleven and No/100 Dollars ($2,811.00)
12 B. COUNTY's obligation to compensate CONTRACTOR herein is subject to
13 COUNTY receiving sufficient and timely payments of funds from DISTRICT under the
14 DISTRICT-COUNTY Agreement. Subject to the foregoing sentence, COUNTY, promptly
15 following COUNTY's receipt of such DISTRICT funds, shall pay CONTRACTOR no later than
16 the fifteenth (151h) day of the month in which the services are provided by CONTRACTOR
17 without the necessity of CONTRACTOR submitting invoices to COUNTY. All payments shall
18 be remitted to CONTRACTOR at the following address: American Ambulance, 2911 East
19 Tulare Street, Fresno, CA 93721.
20 5. INDEPENDENT CONTRACTOR
21 A. In performance of the work,duties, and obligations assumed by
22 CONTRACTOR under this Agreement, it is mutually understood and agreed that
23 CONTRACTOR, including any and all of CONTRACTOR's officers, agents, and employees
24 will at all times be acting and performing as an independent contractor, and shall act in an
25 independent capacity and not as an officer, agent, servant, employee,joint venture,partner, or
26 associate of COUNTY. Furthermore, COUNTY shall have no right to control or supervise or
27 direct the manner or method by which CONTRACTOR shall perform its work and function,
28 except for CONTRACTOR's compliance with DISTRICT's Policies and Procedures,herein.
COU OF FRESNO
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I However, COUNTY shall retain the right to administer this Agreement so as to verify that
2 CONTRACTOR is performing its obligations in accordance with the terms and conditions
3 thereof. CONTRACTOR and COUNTY shall comply with all applicable provisions of law and
4 the rules and regulations, if any, of governmental authorities having jurisdiction over matters
5 which are directly or indirectly the subject of this Agreement.
6 B. Because of its status as an independent contractor, CONTRACTOR shall
7 have absolutely no right to employment rights and benefits available to COUNTY employees.
8 CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its
9 employees all legally-required employee benefits. In addition, CONTRACTOR shall be solely
10 responsible and save COUNTY harmless from all matters relating to payment of
I I CONTRACTOR's employees, including compliance with Social Security, withholding, and all
12 other regulations governing such matters. It is acknowledged that during the term of this
13 Agreement, CONTRACTOR may be providing services to others unrelated to COUNTY or to
14 this Agreement.
15 6. MODIFICATION
16 Any matters of this Agreement may be modified from time to time by the written
17 consent of all the parties hereto without, in any way, affecting the remainder.
18 7. HOLD-HARMLESS
19 A. CONTRACTOR agrees to indemnify, save, hold harmless, and at
20 COUNTY's request, defend COUNTY and DISTRICT, including their respective officers,
21 agents, and employees from any and all costs and expenses(including attorneys' fees and costs),
22 damages, liabilities,claims,and losses occurring or resulting to COUNTY or DISTRICT(as
23 applicable) in connection with the performance, or failure to perform, by CONTRACTOR,
24 including its officers, agents,or employees under this Agreement, and from any and all costs and
25 expenses(including attorneys' fees and costs), damages, liabilities, claims, and losses occurring
26 or resulting to any person, firm,or corporation who may be injured or damaged by the
27 performance, or failure to perform,of CONTRACTOR, including its officers, agents, or
28 employees under this Agreement.
COU Y OF FP ESNO
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I B. COUNTY agrees to indemnify, save, hold harmless, and at
2 CONTRACTOR's request, defend CONTRACTOR, including its officers, agents, and
3 employees from any and all costs and expenses (including attorneys' fees and costs), damages,
4 liabilities, claims, and losses occurring or resulting to CONTRACTOR in connection with the
5 performance, or failure to perform, by COUNTY or DISTRICT, including their respective
6 officers, agents, or employees under this Agreement or under the DISTRICT-COUNTY
7 Agreement(as applicable), and from any and all costs and expenses (including attorneys' fees
8 and costs),damages, liabilities,claims, and losses occurring or resulting to any person, firm, or
9 corporation who may be injured or damaged by the performance, or failure to perform, of
to COUNTY or DISTRICT, including their respective officers, agents, or employees under this
11 Agreement or under the DISTRICT-COUNTY Agreement.
12 C. In the event of concurrent negligence on the part of CONTRACTOR or
13 any of its officers,agents or employees, and of COUNTY or DISTRICT or any of their
14 respective officers,agents, or employees, the liability for any and all such claims, demands and
15 actions in law or equity for such costs and expenses(including attorneys' fees and costs),
16 damages, and losses shall be apportioned under the State of California's theory of comparative
17 negligence as presently established or as may be modified hereafter.
18 D. This Section 7 shall survive termination or expiration of this Agreement.
19 8. INSURANCE
20 CONTRACTOR shall obtain and maintain,at all times, insurance coverages, with
21 such policies, and in such amounts, as are provided in the EMS Provider Agreement. The
22 parties hereto agree that the provisions of the EMS Provider Agreement (including any future
23 amendments thereto) shall and will be incorporated herein by this reference, as though each and
24 every of such terms are set forth herein below. CONTRACTOR's failure to maintain all such
25 insurance coverages shall be deemed to be a material breach of this Agreement.
26 HI
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1 9. CONFIDENTIALITY
2 All services performed by CONTRACTOR under this Agreement shall be in strict
3 conformance with all applicable Federal, State of California and/or local laws and regulations
4 relating to confidentiality.
5 10. NON-DISCRIMINATION
6 During the performance of this Agreement, CONTRACTOR shall not unlawfully
7 discriminate against any employee or applicant for employment, or recipient of services,
8 because of race, religion, color, national origin,ancestry, physical disability, medical condition,
9 marital status, age or gender,pursuant to all applicable State of California and Federal statutes
to and regulations.
11 11. DISCLOSURE OF SELF-DEALING TRANSACTIONS
12 This provision is only applicable if the CONTRACTOR is operating as a
13 corporation (a for-profit or non-profit corporation) or if during the term of this agreement,the
14 CONTRACTOR changes its status to operate as a corporation.
15 Members of the CONTRACTOR's Board of Directors shall disclose any
16 self-dealing transactions that they are a party to while CONTRACTOR is providing goods or
17 performing services under this agreement. A self-dealing transaction shall mean a transaction to
18 which the CONTRACTOR is a party and in which one or more of its directors has a material
19 financial interest. Members of the Board of Directors shall disclose any self-dealing transactions
20 that they are a party to by completing and signing a Self-Dealing Transaction Disclosure Form,
21 attached hereto as Exhibit B and incorporated herein by reference, and submitting it to the
22 COUNTY prior to commencing with the self-dealing transaction or immediately thereafter.
23 12. RECORDS
24 A. Each party shall maintain its books, accounts and records in connection
25 with the respective services referred to under this Agreement. CONTRACTOR's books,
26 accounts and records of such services shall be kept separate and apart from CONTRACTOR's
27 other books,accounts and records of services kept in connection with the EMS PROVIDER
28 Agreement, and any other agreement entered into or approved by COUNTY. All of such
COUNTY OF FRESNO
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I CONTRACTOR's books, accounts, and records shall be prepared and kept by CONTRACTOR
2 in an organized manner that facilitates an efficient review of the costs incurred and funds
3 received in order to give COUNTY a complete and clear understanding of the accounting
4 thereof. All of such CONTRACTOR's books, accounts and records shall be subject to public
5 disclosure as provided in the EMS PROVIDER Agreement(including any future amendments
6 thereto), which shall and will be incorporated herein by this reference, as though each and every
7 of such terms are set forth herein below.
8 B. Each of the parties' books,accounts and records must be maintained for a
9 minimum of three(3) years. Such books,accounts and records must also be maintained a
10 minimum of three (3) years after the termination of this Agreement. The party generating the
11 books, accounts and records shall maintain ownership thereof upon termination of this
12 Agreement.
13 13. AUDITS AND INSPECTIONS
14 A. Each party shall at any time during business hours, and as often as the
15 other party may deem necessary, make available to the other party for examination all of the
16 former party's records and data with respect to the matters covered by this Agreement. Each
17 party shall,upon request by the other party,permit the other party to audit and inspect all such
18 records and data necessary to ensure the former party's compliance with the terms of this
19 Agreement.
20 B. If this Agreement exceeds Ten Thousand and No/100 Dollars
21 ($10,000.00), CONTRACTOR shall be subject to the examination and audit of the State
22 Auditor for a period of three(3) years after final payment under contract(Government Code
23 Section 8546.7).
24 14. FORCE MAJEURE
25 A. If either party hereto is rendered unable, wholly or in part, by Force
26 Majeure to carry out its obligations under this Agreement, that party shall give to the other
27 party hereto prompt written notice of the Force Majeure with full particulars relating thereto.
28 Thereupon, the obligations of the party giving the notice, so far as they are affected by the
COU Y OF FRESNO
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I Force Majeure, shall be suspended during, but no longer than, the continuance of the Force
2 Majeure, except for a reasonable time thereafter required to resume performance.
3 B. During any period in which either party hereto is excused from
4 performance by reason of the occurrence of an event of Force Majeure, the party so excused
5 shall promptly, diligently,and in good faith take all reasonable action required in order for it to
6 be able to promptly commence or resume performance of its obligations under this Agreement.
7 Without limiting the generality of the foregoing, the party so excused from performance shall,
8 during any such period of Force Majeure, take all reasonable action necessary to terminate any
9 temporary restraining order or preliminary or permanent injunctions to enable it to so
Io commence or resume performance of its obligations under this Agreement.
I I C. The party whose performance is excused due to the occurrence of an
12 event of Force Majeure shall, during such period, keep the other party hereto notified of all
13 such actions required in order for it to be able to commence or resume performance of its
14 obligations under this Agreement.
15 D. "Force Majeure" is defined as an Act of God, act of public enemy, war,
16 and other extraordinary causes not reasonably within the control of either of the parties hereto.
17 15. NOTICES
18 A. The persons having authority to give and receive notices under this
19 Agreement and their addresses include the following:
20 COUNTY CONTRACTOR
21 Director, County of Fresno American Ambulance
22 Department of Public Health Attn: President
23 P.O. Box 11867 2911 East Tulare Street
24 Fresno, CA 93775 Fresno, CA 93721
25 B. Any and all notices between COUNTY and CONTRACTOR provided for
26 or permitted under this Agreement or by law shall be in writing and shall be deemed duly served
27 when personally delivered to one of the parties hereto, or in lieu of such personal service, when
28 deposited in the United States Mail, postage prepaid, addressed to such party, except for notices
COU Y OF FR£SNO
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1 of termination, which are effective upon receipt. Notices under this Agreement are not
2 modifications to this Agreement.
3 16. GOVERNING LAW
4 A. The parties hereto agree, that for the purposes of venue, performance
5 under this Agreement is to be in Fresno County,California.
6 B. The rights and obligations of the parties hereto and all interpretation and
7 performance of this Agreement shall be governed in all respects by the laws of the State of
8 California.
9 17. SEVERABILITY
10 The provisions of this Agreement are severable. The invalidity or
I 1 unenforceability of any one provision in the Agreement shall not affect the other provisions.
12 18. ENTIRE AGREEMENT
13 This Agreement constitutes the entire agreement between COUNTY and
14 CONTRACTOR with respect to the subject matter hereof and supersedes all previous
15 agreement negotiations, proposals, commitments, writings, advertisements, publications, and
16 understandings of any nature whatsoever unless expressly included in this Agreement.
17 CONTRACTOR acknowledges that COUNTY detrimentally relies upon each and every of
18 CONTRACTOR's covenants, warranties and representations made herein to COUNTY. This
19 Agreement may be executed in several counterparts by the parties hereto, in which case, all of
20 such executed duplicate counterpart originals thereof,taken together, shall be deemed to be one
21 and the same legal instrument.
22 19. NO THIRD PARTY BENEFICIARIES
23 Notwithstanding anything stated to the contrary in this Agreement, there shall not
24 be any intended third party beneficiaries to this Agreement.
25 ///
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COU Y OF FRESNO
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I IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the
2 day and year first hereinabove written.
3
4 CONTRACTOR: COUNTY OF FRESNO:
5 K.W.P.H. ENTEPRISES,dba
AMERIC N AMBULANCE
6 c -
By3q�o�
ByG
7 Chairman, Board of Supervisors
8 Print Name:'VI 4;N C l
9 Title: Date: — a 14,
President, K.W.P.H. Enterprises
10
11 Date: `J BERNICE E. SEIDEL, Clerk
Board of Supervisors
12
By
13 t
14 Print Name: By
15 Title: �r - �,iG�•�// Date: ��
Chief Financial Officer or Corporate
16 Secretary to K.W.P.H. Enterprises
17 d.b.a. American Ambulance,
a California Corporation
18
Date: 6 PLEASE SEE ADDITIONAL
19 SIGNATURE PAGE ATTACHED
20
21
22
23 Mailing Address:
2911 E. Tulare St.
24 Fresno,CA 93721
25
26
27
28
14 - COUNTY Or M- ESNO
I,resno,CA
I AGREEMENT BETWEEN COUNTY OF FRESNO AND
2 K.W.P.H. ENTERPRISES, DBA AMERICAN AMBULANCE
3
4 APPROVED AS TO LEGAL FORM:
5 DANIEL C. CEDERBORG, COUNTY COUNSEL
b
-.
7 By
8
9 APPROVED AS TO ACCOUNTING FORM:
10 VICKI CROW, C.P.A., AUDITOR-CONTROLLER/
I i TREASURER-TAX COLLECTOR
12 /
13 By
14
15 REVIEWED AND RECOMMENDED FOR APPROVAL:
16
17 By
_ IJ/�Zz
18 David Pomaville
19 Director
20 Department of Public Health
21
22
23 Fund/Subclass: 0001/10000
24 Organization#: 56201693
25 Account#: 7295
26
27
28
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COU ry OF FRESNO
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EXHIBIT A
Qtr Date Due Amount
1 10/01/2016 $468.50
2 01/01/2017 $468.50
3 04/01/2017 $468.50
4 07/01/2017 $468.50
5 10/01/2017 $468.50
6 01/01/2018 $468.50
COUNTY OF FRESNO
Exhibit B
SELF-DEALING TRANSACTION DISCLOSURE FORM
In order to conduct business with the County of Fresno (hereinafter referred to as "County"),
members of a contractor's board of directors (hereinafter referred to as "County Contractor"), must
disclose any self-dealing transactions that they are a party to while providing goods, performing
services, or both for the County. A self-dealing transaction is defined below:
"A self-dealing transaction means a transaction to which the corporation is a party and in which one
or more of its directors has a material financial interest."
The definition above will be utilized for purposes of completing this disclosure form.
INSTRUCTIONS
(1) Enter board member's name,job title (if applicable), and date this disclosure is being made.
(2) Enter the board member's company/agency name and address.
(3) Describe in detail the nature of the self-dealing transaction that is being disclosed to the
County. At a minimum, include a description of the following:
a. The name of the agency/company with which the Corporation has the transaction;
and
b. The nature of the material financial interest in the Corporation's transaction that the
board member has.
(4) Describe in detail why the self-dealing transaction is appropriate based on applicable
provisions of the Corporations Code.
(5) Form must be signed by the board member that is involved in the self-dealing transaction
described in Sections (3) and (4).
Page [ of 2
Exhibit B
(1)Company Board Member Information:
Name: Date:
Job Title:
(2)Company/Agency Name and Address:
(3) Disclosure(Please describe the nature of the self-dealing transaction you are a party to):
(4)Explain why this self-dealing transaction is consistent with the requirements of Corporations Code 5233(a):
(5)Authorized Signature
Signature: Date:
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