HomeMy WebLinkAboutAgreement A-15-275 with City of Sanger.pdfAgreement No. 15-275
1 EMERGENCY MEDICAL SERVICES AGREEMENT
2 THIS AGREEMENT is made and entered into this ji.ift-day of J~ '2015,
3 by and between the COUNTY OF FRESNO, a Political Subdivision of the State of California,
4 hereinafter referred to as "COUNTY," and the CITY OF SANGER, a Municipal Corporation, whose
5 address is 1700 Seventh Street, Sanger, California, 93657, hereinafter referred to as
6 "CONTRACTOR."
7 W I T N E S S E T H:
8 WHEREAS, COUNTY, through its Department of Public Health, has been designated as the
9 Local EMS Agency of the County of Fresno pursuant to California Health and Safety Code Section
1 o 1797 .200; and
11 WHEREAS, the CONTRACTOR desires to provide emergency ambulance services as
12 authorized by law within the incorporated boundaries of the City of Sanger and within the
13 unincorporated area of Fresno County, all as designated in Exhibit "A", attached hereto and by this
14 reference incorporated herein.
15 NOW, THEREFORE, the parties hereto agree as follows:
16 1. The parties acknowledge that the COUNTY's Department of Public Health has been
17 designated as the Local EMS Agency of the COUNTY with the authority to plan, administer,
18 implement and evaluate an emergency medical services system in Fresno County pursuant to
19 California Health and Safety Code Sections 1797.200 and 1797.204. The parties also acknowledge
2 0 that the Local EMS Agency has implemented COUNTY EMS Policy #200 (Authorization of
21 Ambulance Provider Agencies in Fresno County). The parties further acknowledge that the EMS
2 2 Medical Director of the COUNTY's Department of Public Health has the authority set forth in Health
2 3 and Safety Code Section 1798. CONTRACTOR shall operate its emergency medical care program in
2 4 conformity with the medical policies, procedures and standards issued and amended by the Local EMS
2 5 Agency (hereinafter collectively referred to as the "COUNTY EMS Policies and Procedures," and
2 6 individually referred to as "COUNTY EMS Policy #").
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1 2. DUTIES OF CONTRACTOR
2 A. CONTRACTOR shall be responsible for furnishing services, equipment and
3 materials as hereinafter set forth, in order to provide emergency medical services to persons in need
4 thereof within the incorporated boundaries of the City of Sanger and that certain portion of the
5 unincorporated area of Fresno County, which is all known as Ambulance Service Zone "I," all shown
6 on Exhibit "A."
7 Neither the fact that this Agreement is entered into nor anything contained in this
8 Agreement shall be construed as an admission by either party hereto regarding CONTRACTOR's
9 legal authority, if any, to plan, implement, and operate within or without its corporate boundaries a
1 0 system of emergency medical services (including, but not limited to, ambulance services) independent
11 of COUNTY's authorization or approval.
12 B. CONTRACTOR shall maintain automatic vehicle locators in each authorized
13 emergency ambulance unit and authorized disaster response unit.
14 3. DUTIES OF COUNTY
15 A. COUNTY shall operate a central dispatching facility and shall immediately refer
16 all calls for emergency medical care and ambulance services within the area set forth in Exhibit "A" to
17 · the Fire Department of the City of Sanger in accordance with COUNTY EMS Policies and
18 Procedures.
19 1) COUNTY will assist CONTRACTOR in developing, implementing, and
2 0 maintaining an internal field supervision system to provide evaluation of CONTRACTOR's personnel
21 providing service under this Agreement according to the standards established by the COUNTY EMS
2 2 Policies and Procedures.
23 2) COUNTY will do periodic and annual inspections of CONTRACTOR's
2 4 emergency ambulance services personnel certifications, records, vehicles, equipment, and facilities
2 5 required by law and this Agreement.
26 B. Notwithstanding the foregoing provisions of Subsection 3.A. of this Agreement,
2 7 COUNTY is not restricted by reason of this Agreement from entering into another agreement for
2 8 services that are the same as or similar to these provided by CONTRACTOR pursuant to this
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Agreement with an entity qther than CONTRACTOR for the provision of emergency medical services
within the same geographic area as described in Exhibit "A". COUNTY shall notify CONTRACTOR
of any proposal to enter into such an agreement with any other entity, at least thirty (30) days prior to
award of such agreement.
5 4. QUALIFICATION OF CONTRACTOR
6 CONTRACTOR shall at all times meet the requirements set forth by the California
7 Highway Patrol, the California Vehicle Code, the State Department of Health, the California Health
8 and Safety Code, the California Code of Regulations, the COUNTY's Department ofPublic Health
9 with respect to medical standards, and any other applicable statute or regulation with respect to the
1 0 services, equipment, and materials, which are the subject matter of this Agreement. In the event of
11 conflicting statutes or regulations, the statute or regulation setting forth the most stringent
12 requirements shall be adhered to by CONTRACTOR. In the event of a conflict between the terms of
13 this Agreement and any resolution or regulation of the COUNTY, the terms of this Agreement shall
14 prevail.
15 5. AREA SERVED
16 CONTRACTOR shall provide emergency medical services, on a non-exclusive basis,
17 upon dispatch by COUNTY and upon direct call to CONTRACTOR's Fire Department to any location
18 or incident within the territory of Fresno County Ambulance Service Zone Area "I" as described in
19 Exhibit "A." In addition, upon request of the COUNTY EMS Communications Center,
2 0 CONTRACTOR shall, to the extent consistent with its primary responsibility to provide emergency
21 medical services in the area of Exhibit "A," render all reasonable prehospital "mutual aid" to those
22 providers of emergency medical services operating within the adjacent Service Zone Areas in order to
2 3 ensure that timely emergency medical services are rendered to persons in need of such services within
2 4 those areas.
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1 6. SERVICES TO BE PROVIDED AND PERFORMANCE STANDARDS
2 A. CONTRACTOR shall provide appropriate ambulance, paramedic, and medical
3 equipment and personnel in order to furnish "Advanced Life Support" (ALS) and "Basic Life
4 Support" (BLS) services to persons within the area defmed in Exhibit "A" on a non-exclusive, on-call
5 basis, twenty-four (24) hours per day, seven (7) days per week.
6 "Advanced Life Support" services shall mean special services designed to
7 provide definitive emergency medical care, including, but not limited to, cardiopulmonary
8 resuscitation, cardiac monitoring, cardiac defibrillation, advanced airway management, intravenous
9 therapy, administration of specified drugs and other medical preparations, and other specified
1 0 techniques and procedures administered by authorized personnel under direct supervision of a base
11 station hospital or according to approved written protocols.
12 "Basic Life Support" services shall mean emergency first aid and
13 cardiopulmonary resuscitation procedures which, as a minimum, includes recognizing respiratory and
14 cardiac arrest and starting the proper application of cardiopulmonary resuscitation to maintain life
15 without invasive techniques until the patient may be transported or until advanced life support is
16 available.
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B. CONTRACTOR shall adhere to the following monthly standards of
1) Metropolitan Response Area
2 0 The Metropolitan Response Area is defined as that area within the
21 corporate limits of the City of Sanger plus an area within one (1) statutory mile of said corporate
22 limits, which is described in Exhibit "B", attached hereto and incorporated herein by reference.
23 a) For Priority 1 and 2 responses to locations within the
24 Metropolitan Response Area, CONTRACTOR shall arrive at scene within ten (10) minutes of the time
25 alerted by COUNTY or called directly on at least ninety-five percent (95%) of such responses.
26 b) For Priority 3 and 4 responses to locations within the
27 Metropolitan Response Area, CONTRACTOR shall arrive at scene within twenty (20) minutes ofthe
2 8 time alerted by COUNTY or called directly on at least ninety-five percent (95%) of such responses.
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1 c) For Priority 5 responses to locations within the Metropolitan
2 Response Area, CONTRACTOR shall arrive at scene within thirty (30)minutes of the scheduled pick-
3 up time on at least ninety-five percent (95%) of such responses.
4 2) Rural Response Area
5 The Rural Response Area is defined as that area beyond the metropolitan
6 response area limits, which is described in Exhibit "C", attached hereto and incorporated herein by
7 reference.
8 a) For Priority 1 and 2 responses to locations within the Rural
9 Response Area, CONTRACTOR shall arrive at scene within twenty (20) minutes of the time alerted
10 by COUNTY or called directly on at least ninety-five percent (95%) of such responses.
11 b) For Priority 3 and 4 responses to locations within the Rural
12 Response Area, CONTRACTOR shall arrive at scene within thirty (30) minutes of the time alerted by
13 COUNTY or called directly on at lease ninety-five percent (95%) of such responses.
14 c) For Priority 5 responses to locations within the Rural Response
15 Area, CONTRACTOR shall arrive at scene within thirty (30) minutes of the scheduled pick-up time
16 on at least ninety-five percent (95%) of such responses.
17 3) Wilderness Response Area
18 For each calendar month, and for calls dispatched to locations within the
19 area described in Exhibit "D", attached hereto and incorporated herein by this reference, and herein
2 0 collectively called the Wilderness Response Area, CONTRACTOR shall have an emergency
21 ambulance at scene within the appropriate response time requirements:
22 a) Priority 1 and 2 Responses
2 3 From the "unit alert" time, CONTRACTOR shall arrive at scene
2 4 within sixty ( 60) minutes on at least ninety-five percent (95%) of such responses.
25 b) Priority 3 and 4 Responses
2 6 From the "unit alert" time, CONTRACTOR shall arrive at scene
2 7 within ninety (90) minutes on at least ninety-five percent (95%) of such responses.
28 c). The EMS Agency may set standards for the measurement of
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response times where it is determined that such response time requirements are not appropriate due to
low call volume on a monthly basis. In such instances, COUNTY may establish criteria for evaluating
response time performance on a time period other than monthly.
4) The COUNTY Department of Public Health may, upon receipt of a
5 written request from the CONTRACTOR, exempt the CONTRACTOR from late responses for those
6 calls where geographical limitations exist when the CONTRACTOR responds from post locations
7 dictated by the CONTRACTOR's normal stationing of ambulances or system status plan so long as
8 the CONTRACTOR has otherwise adhered to operational and performance standards of the County
9 EMS Policy and Procedure Manual. Any calls so exempted shall be exempt from the inclusion of the
1 0 determination of compliance with response time requirements herein.
11 5) The required response times under this Agreement are measured from the
12 time CONTRACTOR is alerted for a response to the time that CONTRACTOR arrives at scene.
13 COUNTY provides CONTRACTOR with significant flexibility in CONTRACTOR's methods of
14 providing said services in order to achieve minimum results required under this Agreement. This is
15 based upon CONTRACTOR's commitment to perform to the response time standards required under
16 this Agreement. Therefore, a deficiency or an error by CONTRACTOR in one or more phases of its
1 7 operations shall not be the basis for the EMS Agency granting an exception to CONTRACTOR for its
18 performance in another phase of its operation (e.g., response time performance). Required response
19 times shall be measured in minutes and seconds, and shall be time stamped by the EMS Agency's
2 0 computer aided dispatch (CAD) system consistent with the requirements herein. COUNTY and the
21 EMS Agency recognizes that dispatch operations are not a responsibility or under the control of
22 CONTRACTOR. COUNTY and the EMS Agency acknowledge that CONTRACTOR is not to be
2 3 held responsible for delays that may occur due to dispatching, and the CONTRACTOR acknowledges
2 4 that the COUNTY EMS Communications Center requires adequate time to process each request (e.g.,
2 5 time from request received to the time of unit alert). COUNTY agrees to monitor the COUNTY EMS
2 6 Communications Center to ensure that its dispatch performance remains within the standards
2 7 developed by COUNTY and the local EMS Agency. The EMS Agency may grant exemptions from
2 8 response time performance requirements stated herein, on case-by-case basis, for calls where weather
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1 conditions, multi-casualty incidents, or other situations beyond the Contractor's control cause
2 unavoidable delay. All such calls shall be individually examined by the EMS Agency as to system status
3 plan and staffmg levels, dispatch and in-service times, and other influencing factors (e.g., weather
4 conditions), and if the circumstances warrant, the EMS Agency may authorize the exclusion of such
5 calls when measuring performance requirements. Exclusion of a call under this paragraph means that a
6 late call which has received approval for an appeal will not count as an on-time response. Therefore, it is
7 excluded from the database for the purpose of fractile performance calculation (i.e., performance
8 measured by fractions of a minute or hour).
9 In order to be eligible for such exemption, the Contractor shall notify the
1 0 EMS Agency within a reasonable amount of time of the occurrence. Equipment failure, personnel error,
11 or lack of a nearby ambulance does not constitute grounds for exemption from response time performance
12 requirements.
13 a) Required response times are measured from the time
14 CONTRACTOR is alerted for a response until a fully staffed and equipped emergency ambulance unit
15 arrives at the scene of the incident.
16 1) "Unit Alert"
1 7 Shall be defined as the moment the COUNTY EMS
18 Communications Center alerts CONTRACTOR's emergency ambulance unit for a response.
19 2) "At Scene"
2 0 Shall be defined as the moment when the assigned
21 emergency ambulance unit is physically at or within one hundred (1 00) feet of the scene. In instances
2 2 where the emergency ambulance unit responds to a location other than the scene (e.g., staging area),
2 3 arrival "at scene" shall be the time such unit arrives at, or within one hundred (1 00) feet of, the
2 4 designated staging location.
25 3) Failure to Report "At Scene"
2 6 In instances when emergency ambulance units fail to
2 7 report "at scene," the time of the next communications by those units with the COUNTY EMS
2 8 Communications Center shall be used as the "at scene" time. However, CONTRACTOR may appeal
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such instances when it can document the actual arrival time through another means (e.g., non-
CONTRACTOR first responder communication recording and automatic vehicle locator).
4) Unit Cancelled Prior to Arrival "At Scene"
Required response time standards do not apply to
instances where CONTRACTOR is cancelled prior to arrival "at scene".
6) Performance Indicators for Alerting and Initiating Response
The following performance indicators shall be used to evaluate the
timeliness of CONTRACTOR's field operations (from time of unit alert to time "at scene") in
response to requests that require an immediate dispatch (Priorities 1 and 2) or an urgent dispatch
(Priorities 3 and 4). Such performance indicators are not used as standards for enforcing
CONTRACTOR's compliance with required response time standards under this Agreement. Rather,
they are utilized as a means of determining whether CONTRACTOR meets the criteria for an
exception to response time standards and for evaluating the need for more in-depth Quality
Improvement review by the EMS Agency and/or CONTRACTOR of CONTRACTOR's services.
Crew Response Phase (Priorities 1, 2, 3 and 4)
For requests for immediate responses (Priorities 1 and 2) and urgent
responses (Priorities 3 and 4), the "Chute Time" is the measurement of elapsed time from "unit alert"
to the time that all crewmembers are in the ambulance unit, begin response, and report on radio to the
COUNTY EMS Communications Center of"unit enroute." For CONTRACTOR's primary
ambulance units, the maximum permissible Chute Time shall be one hundred twenty (120) seconds or
less. This performance indicator is a performance measurement of CONTRACTOR's performance
separate from any other performance standard in this Agreement.
7) CONTRACTOR shall at all times maintain as a minimum, one (1) person
who is certified and licensed as an Emergency Medical Technician Paramedic ("EMT-P") and one (1)
person who is certified and licensed as an Emergency Medical Techncian-I-A ("EMT-I-A"), as those
terms are defined in the California Health and Safety Code and the California Code of Regulations, on
the primary ambulance unit responding to emergency medical services calls. CONTRACTOR shall
also provide one back-up emergency ambulance, when available, staffed with a minimum of two (2)
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1 persons who are certified and licensed as EMT-I-As, or persons who are certified and licensed at a
2 higher level.
3 8) CONTRACTOR shall make (and shall maintain for 180 days) a tape
4 recorded copy of all requests for medical aid through the designated public safety answering point.
5 9) CONTRACTOR shall, consistent with the COUNTY EMS Policies and
6 Procedures, develop, collect, maintain and transmit data regarding its delivery of services hereunder.
7 10) CONTRACTOR shall notify the COUNTY EMS Communications
8 Center immediately upon receipt of calls for medical aid and/or transportation, and attempt to forward
9 medical 911 calls to the COUNTY EMS Communications Center to allow for telephone medical
1 0 prearrival instructions.
11 11) CONTRACTOR shall make and maintain radio contact with the
12 COUNTY EMS Communications Center on the COUNTY EMS Med-Net System for the purpose of
13 tracking, coordinating, and data collection.
14 12) CONTRACTOR agrees to provide an internal quality improvement
15 program, which adheres to the COUNTY EMS Policies and Procedures.
16 7. EQUIPMENT AND PERSONNEL
17 CONTRACTOR shall furnish, operate, maintain and replace, as necessary, any and all
18 items of equipment, apparatus and supplies, whether real, personal, or otherwise, and qualified
19 personnel as may be necessary to fulfill its obligations under this Agreement. As between the parties
2 0 hereto, title to all such equipment, apparatus and supplies furnished by CONTRACTOR, under this
21 Agreement shall remain at all times in CONTRACTOR, and personnel assigned by CONTRACTOR
22 to the performance of this Agreement are and shall remain employees or contractors of the
2 3 CONTRACTOR.
24 8. INDEPENDENT CONTRACTOR
2 5 In order to establish that COUNTY is not a co-employer of CONTRACTOR's officers,
26 agents or employees, the parties agree to the provisions ofthis Section 8.
27 In performance of the work, duties, and obligations assumed by CONTRACTOR under
28 this Agreement, it is mutually understood and agreed that CONTRACTOR, including any and all of
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1 CONTRACTOR's officers, agents, and employees, will at all times be acting and performing as an
2 independent contractor, and shall act in an independent capacity and not as an officer, agent, servant,
3 employee, joint venturer, partner, or associate of the COUNTY. COUNTY shall retain the right to
4 administer this Agreement so as to verify that CONTRACTOR is performing its obligations in
5 accordance with the terms and conditions thereof. CONTRACTOR and COUNTY shall comply with
6 all applicable provisions of law and the rules and regulations, if any, of governmental authorities
7 having jurisdiction over matters the subject thereof.
8 Because of its status as an independent contractor, CONTRACTOR shall have
9 absolutely no right to employment rights and benefits available to COUNTY employees.
1 0 CONTRACTOR shall be solely liable and responsible for providing to, or on behalf of, its employees
11 all legally-required employee benefits. In addition, CONTRACTOR shall be solely responsible and
12 save COUNTY harmless from all matters relating to payment of CONTRACTOR's employees,
13 including compliance with Social Security, withholding, and all other regulations governing such
14 matters. It is acknowledged that during the term of this Agreement, CONTRACTOR may be
15 providing services to others unrelated to the COUNTY or to this Agreement.
16 9. CONSIDERATION
17 A. COUNTY shall not be obligated to raise taxes, or to adopt or approve any tax
18 measures to provide funds, in order to compensate CONTRACTOR in connection with this
19 Agreement. The only compensation payable by COUNTY to CONTRACTOR for CONTRACTOR's
2 0 performance of its services under this Agreement is as follows:
21 B. COUNTY shall provide both monetary and non-monetary compensation to
2 2 CONTRACTOR for the satisfactory performance of its services as provided, herein.
23 I) Monetary Compensation
24 a) COUNTY shall pay to CONTRACTOR a monthly lump-payment
25 ofThree Thousand Seven Hundred Fifty and No/100 Dollars ($3,750.00) for estimated dry runs and
2 6 uncollectible charges. The foregoing compensation represents the parties' best estimate of
2 7 CONTRACTOR's monthly dry runs and uncollected charges for services provided under this
2 8 Agreement.
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1 b) The maximum monetary compensation payable under this
2 Agreement, for each period from July 1st through June 30th of each year, shall not exceed Forty Five
3 Thousand and Noll 00 Dollars ($45,000.00). Notwithstanding the provisions ofthis Section 9, the
4 total maximum monetary compensation payable to the CONTRACTOR by the COUNTY during the
5 term ofthis Agreement shall not exceed Ninety Thousand and NollOO Dollars ($90,000.00).
6 c) In consideration for such monetary compensation,
7 CONTRACTOR shall completely, unconditionally and irrevocably assign all of its "uncollectible
8 accounts" to COUNTY. "Uncollectible accounts" shall be defined as those accounts receivable for
9 authorized runs which CONTRACTOR has been unable to collect payment upon after they become
10 past due or delinquent in accordance with CONTRACTOR's customary andusual practices as set
11 forth in COUNTY EMS Policy #205, and which accounts came into existence due to
12 CONTRACTOR's performance of this Agreement or as a result of CONTRACTOR's rendering of
13 emergency ambulance service, or both.
14 COUNTY shall have the discretion to pursue any and all
15 collection efforts for the compromise and settlement of such accounts. COUNTY shall retain any and
16 all revenues it receives on such accounts and shall have no obligation to pay to CONTRACTOR any
1 7 portion of such revenues collected.
18 The parties agree that CONTRACTOR will follow the billings,
19 collections, and account write-off practices and procedures outlined in COUNTY EMS Policy #205,
2 0 for purposes of this Subsection 9 .B. of this Agreement.
21 2) Non-Monetary Compensation
22 The following are the forms of non-monetary compensation given by
2 3 COUNTY to CONTRACTOR:
24 a)
2 5 Med Channels, as provided herein.
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The use of COUNTY communications infrastructure for EMS
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1 b) For emergency ambulance units and disaster response vehicles
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approved by the EMS Agency, the provision, installation, and maintenance of the following
communications equipment. In the event equipment is lost or destroyed, CONTRACTOR shall be
responsible for replacement of such equipment:
5 i) One (1) UHF in-vehicle radio with front and rear control
6 points;
7 ii) One (1) UHF handheld radio;
8 C. COUNTY shall have no obligation to compensate CONTRACTOR for
9 services under this Agreement other than as stated above. The parties agree that the amounts stated
10 above are inclusive of and fulfill any obligation COUNTY may have, if any, presently or at any time
11 during the term of this Agreement, to compensate, reimburse, or otherwise pay CONTRACTOR for
12 emergency medical services provided to medically-indigent persons.
13 10. AUDITING
14 COUNTY shall have the right to review any and all books, accounts, fmancial and
15 accounting records, bills and the like of CONTRACTOR relating to services provided under this
16 Agreement, upon reasonable notice to CONTRACTOR. CONTRACTOR shall retain and make
17 available for inspection by COUNTY for at least a three (3) year period from final payment under this
18 Agreement, all of the documents and records described above.
19 Ifthis Agreement exceeds Ten Thousand and Nol100 Dollars ($10,000.00),
2 0 CONTRACTOR shall be subject to the examination and audit of the State Auditor for a period of
21 three (3) years after fmal payment under contract (Government Code Section 8546.7).
22 11. INSURANCE
2 3 Without limiting the COUNTY's right to obtain indemnification from CONTRACTOR
2 4 or any third parties, CONTRACTOR, at its sole expense, shall maintain in full force and effect the
2 5 following insurance policies or a program of self-insurance, including but not limited to, an insurance
2 6 pooling arrangement or Joint Powers Agreement (JP A) throughout the term of this Agreement:
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1 A. Commercial General Liability
2 Commercial General Liability Insurance with limits of not less than One Million
3 Dollars ($1,000,000) per occurrence and an annual aggregate of Two Million Dollars ($2,000,000).
4 This policy shall be issued on a per occurrence basis. County may require specific coverage including
5 completed operations, product liability, contractual liability, Explosion-Collapse-Underground (XCU),
6 fire legal liability or any other liability insurance deemed necessary because of the nature of the
7 contract.
8 B. Automobile Liability
9 Comprehensive Automobile Liability Insurance with a combined single limit of
10 not less One Million Dollars ($1,000,000) per accident. Coverage should include owned and non-
11 owned vehicles used in connection with this Agreement.
12 C. Professional Liability
13 Professional Liability Insurance (Errors and Omissions) with limits of not less
14 than One Million Dollars ($1,000,000) per occurrence, Three Million Dollars ($3,000,000) annual
15 aggregate.
16 D. Worker's Compensation
17 A policy of Worker's Compensation insurance as may be required by the
18 California Labor Code .
19 CONTRACTOR shall obtain endorsements to the Commercial General Liability
2 0 insurance naming the County of Fresno, its officers, agents, and employees, individually and
21 collectively, as additional insured, but only insofar as the operations under this Agreement are
2 2 concerned. Such coverage for additional insured shall apply as primary insurance and any other
2 3 insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be
2 4 excess only and not contributing with insurance provided under CONTRACTOR's policies herein.
2 5 This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance
2 6 written notice given to COUNTY.
2 7 Within thirty (30) days from the date CONTRACTOR signs this Agreement,
2 8 CONTRACTOR shall provide certificates of insurance and endorsement as stated above for all of the
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1 foregoing policies, as required herein, to the County of Fresno, Department ofPublic Health, P.O. Box
2 11867, Fresno, CA 93775, Attn: Contracts Sections-6th Floor, stating that such insurance coverage
3 have been obtained and are in full force; that the County of Fresno, its officers, agents and employees
4 will not be responsible for any premiums on the policies; that such Commercial General Liability
5 insurance names the County of Fresno, its officers, agents and employees, individually and
6 collectively, as additional insured, but only insofar as the operations under this Agreement are
7 concerned; that such coverage for additional insured shall apply as primary insurance and any other
8 insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees, shall be
9 excess only and not contributing with insurance provided under CONTRACTOR's policies herein; and
10 that this insurance shall not be cancelled or changed without a minimum of thirty (30) days advance,
11 written notice given to COUNTY.
12 In the event CONTRACTOR fails to keep in effect at all times insurance coverage as
13 herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate
14 this Agreement upon the occurrence of such event.
15 All policies shall be with admitted insurers licensed to do business in the State of
16 California. Insurance purchased shall be purchased from companies possessing a current A.M. Best,
1 7 Inc. rating of A FSC VII or better.
18 The insurance requirements of this Section 11 shall apply to CONTRACTOR's
19 personnel during their performance of any activity which is the subject of this Agreement, or any
2 0 amendment hereto, including, but not limited to, their participation in clinical education programs and
21 prehospital experience while assigned to a separate paramedic ground ambulance provider.
22 12. MUTUAL INDEMNIFICATION
23 A. CONTRACTOR agrees to protect, defend, indemnify and hold harmless
24 COUNTY, its elective and appointive boards, officers, agents, employees, local EMS Agency, and
25 EMS Medical Director(s), from any and all claims, suits, liabilities, expenses, costs, damages, and
2 6 judgments of any nature, including attorney fees and court costs, for injury to, and death of, any
2 7 person, and for injury to any property, including consequential damages of any nature resulting
2 8 therefrom, arising out of, or in any way connected with any acts or omissions by, or on behalf of
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1 CONTRACTOR, its officers, employees, agents or contractors in performing or failing to perform any
2 services or functions provided for or referred to or in any way connected with any work, services, or
3 functions to be performed by CONTRACTOR, its officers, employees, agents, or contractors under
4 this Agreement. The foregoing clause shall in no way obligate the CONTRACTOR to provide such
5 protection, indemnification, or defense to the extent of acts or omissions by the COUNTY, its officers,
6 employees, agents, or contractors.
7 B. COUNTY agrees to protect, defend, indemnify and hold harmless
8 CONTRACTOR, its elective and appointive boards, officers, agents and employees from any and all
9 claims, suits, liabilities, expenses, costs, damages, and judgments of any nature, including attorney's
1 0 fees and court costs, for injury to, and death of, any persons, and for injury to any property, including
11 consequential damages of any nature resulting therefrom, arising out of, or in any way connected with
12 the acts or omissions by, or on behalf of COUNTY, its officers, employees, agents or contractors in
13 performing or failing to perform any services or functions provided for or referred to or in any way
14 connected with any work, services, or functions to be performed by COUNTY, its officers, employees,
15 agents or contractors under this Agreement. The foregoing clause shall in no way obligate the
16 COUNTY to provide such protection, indemnification, or defense to the extent of acts or omissions by
17 the CONTRACTOR, its officers, employees, agents, or contractors.
18 c. The aforesaid indemnity and hold hamiless clauses by CONTRACTOR and
19 COUNTY shall apply to all damages and claims for damages of every kind suffered, or alleged to
2 0 have been suffered by the party to be indemnified, including but not limited to attorney fees and court
21 costs, by reason of the aforesaid operations of the indemnifying party, regardless of whether or not the
22 insurance policies or Central San Joaquin Valley Risk Management Authority (CSNRMA) Program
2 3 or self-insurance of the indemnifying party shall have been determined to be applicable to any such
2 4 damages or claims for damages.
25 13. TERM OF AGREEMENT
2 6 This Agreement shall become effective on the 1st day of July, 2015, and shall terminate
2 7 on the 30th day of June, 2017. Upon the mutual written agreement of the parties hereto, this
2 8 Agreement may be extended beyond that date.
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1 14. TERMINATION OF AGREEMENT
2 Either party hereto may terminate this Agreement at any time without cause upon ninety
3 (90) days written notice to the other party. Prior to giving such notice, the terminating party shall
4 notify the other party of its intention to terminate and shall allow the other party an opportunity to
5 appear before COUNTY's Board of Supervisors or CONTRACTOR's City Council concerning such
6 notice of termination.
7 The terms of this Agreement, and the services to be provided thereunder, are contingent
8 on the approval of funds by the COUNTY's Board of Supervisors. Should sufficient funds not be
9 allocated, the services provided may be modified, or this Agreement terminated at any time by giving
10 the CONTRACTOR thirty (30) days advance written notice.
11 Either party hereto may terminate this Agreement at any time for cause for the other
12 party's material breach of its obligations affecting the public health and safety if not less than ten (10)
13 days advance, written notice has been given to the other party and such breach remains uncured. The
14 party receiving said notice may respond to said notice and any charges contained therein within the ten
15 (10) day period.
16 In the event oftermination for cause, CONTRACTOR shall be paid pro rata for those
1 7 days of satisfactory service performed to the date of termination.
18 In the event of termination, each party shall be responsible for complying with all laws
19 applicable to them, if any, respecting reduction or termination of medical services.
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15. NON-DISCRIMINATION
During the performance of this Agreement, CONTRACTOR shall not unlawfully
discriminate against any employee or applicant for employment, or recipient of services, 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, military or veteran status, pursuant to all applicable State of California and Federal
statutes and regulations.
Ill
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-16 -COUNTY OF FRESNO
Fresno, CA
1 16. FORCE MAJEURE
2 A. If either party hereto is rendered unable, wholly or in part, by Force Majeure to
3 carry out its obligations under this Agreement, that party shall give to the other party hereto prompt
4 written notice of the Force Majeure with full particulars relating thereto. Thereupon, the obligation of
5 the party giving the notice, so far as they are affected by the Force Majeure, shall be suspended during,
6 but no longer than, the continuance of the Force Majeure, except for a reasonable time thereafter
7 required to resume performance.
8 B. During any period in which either party hereto is excused from performance by
9 reason ofthe occurrence of an event ofForce Majeure, the party so excused shall promptly, diligently,
1 0 and in good faith take all reasonable action required in order for it to be able to promptly commence or
11 resume performance of its obligations under this Agreement. Without limiting the generality ofthe
12 foregoing, the party so excused from performance shall, during any such period of Force Majeure, take
13 all reasonable action necessary to terminate any temporary restraining order or preliminary or
14 permanent injunctions to enable it to so commence or resume performance of its obligations under this
15 Agreement.
16 C. The party whose performance is excused due to the occurrence of an event of
17 Force Majeure shall, during such period, keep the other party hereto notified of all such actions
18 required in order for it to be able to commence or resume performance of its obligations under this
19 Agreement.
20 D. "Force Majeure" is defined as an Act of God, act of public enemy, war, and other
21 extraordinary causes not reasonably within the control of either of the parties hereto.
22 17. GOVERNING LAW
23 For purposes of venue, performance ofthis Agreement shall be in Fresno County,
24 California. The rights and obligations of the parties and all interpretations and performance ofthis
2 5 Agreement shall be governed in all respects by the laws of the State of California.
26 18. ENTIRE AGREEMENT
2 7 The parties agree that all of the terms of this Agreement shall be binding upon them, and
2 8 their successors-in-interest, assigns and legal representatives, and that together these terms constitute
-17 -COUNTY OF FRESNO
Fresno, CA
L
1 the entire agreement of the parties with respect to the subject matter hereof. This Agreement
2 supersedes all previous negotiations, proposals, commitments, writings, understandings and
3 agreements of any nature whatsoever concerning the subject matter hereof unless expressly included
4 in this Agreement. No variation or modification of this Agreement and no waiver of any of its
5 provisions or conditions shall be valid unless in writing and signed by an authorized agent or officer of
6 the parties. This Agreement may not be assigned by CONTRACTOR or COUNTY without the
7 written consent of the other party. CONTRACTOR shall not delegate, subcontract, assign, or transfer
8 any of its duties hereunder without the written consent of the COUNTY.
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-18 -COUNTY OF FRESNO
Fresno, CA
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement'as of the day and
year first hereinabove written.
COUNTY OF FRESNO:
By: ------------------------Chairman, Board of Supervisors
Dme: ____________ __
BERNICE E. SEIDEL, Clerk
Board of Supervisors
By: -----------------------
Date: ____________ __
APPROVED AS TO LEGAL FORM:
DANIEL C. CEDERBORG, C/TY CO~EL
By: (!~d/
APPROVED AS TO ACCOUNTING FORM:
VICKI CROW, CPA, AUDITOR-CONTROLLER/
TREAS~r-T~ ~R
By: -d i~
REVIEWED AND RECOMMENDED FOR ::PRo&ttU
David Pomaville
Director
Department of Public Health
as the designated EMS Agency
-19 -
CITY OF SANGER:
By:. _______________________ _
Mayor
Date: ---------------
City Clerk
By: _______________________ _
Date: ______________ _
APPROVED AS TO LEGAL FORM:
SANGER CITY ATTORNEY
By: _______________________ _
REVIEWED AND RECOMMENDED
FOR APPROVAL:
By: ______________________ _
City Manager
Mailing Address:
Attn.: Ambulance Billing
1700 7th Street
Sanger, CA 93657
Fund/Subclass:
Organization:
Account:
0001/10000
56201695
7295
COUNTY OF FRESNO
Fresno, CA
1 IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
2 year first hereinabove written.
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COUNTY OF FRESNO:
By:---'Po~-"--""'--'--"~--=--~----=-..:......::..::_....,"~
Chairman, Board of Supervisors
E. SEIDEL, Clerk
Board of Supervisors
By: Ci,)\1._. ~I G._y'-'-'ts
Date: \...o \ \I.()\\~
APPROVED AS TO LEGAL FORM:
DANIEL C. CEDERBORG, COUNTY COUNSEL
15
16 By: ___________ _
17
18 APPROVED AS TO ACCOUNTING FORM:
19 VICKI CROW, CPA, AUDITOR-CONTROLLER/
TREASURER-TAX COLLECTOR
20
21
By: ___________ _
22
REVIEWED AND RECOMMENDED FOR
23 APPROVAL:
24
25 By: ___________ _
David Pomaville
26
27
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Director
Department of Public Health
as the designated EMS Agency
-19 -
Date: 'Sf('-( ( cs=
I
City Clerk
By:~7ck~~
Date: Sf /.1. !J 5 r •
APPROVED AS TO LEGAL FORM:
SANGER CITY ATTORNEY
By:L-!/6-L
7
REVIEWED AND RECOMMENDED
FOR APPROVAL:
By:d ~
City Manager
Mailing Address:
Attn.: Ambulance Billing
1 700 7th Street
Sanger, CA 93657
Fund/Subclass:
Organization:
Account:
0001/10000
56201695
7295
COUNTY OF FRESNO
Fresno, CA
Exhibit A
Fresno County Ambulance Service Area
Zone I
Description
I. Beginning at the intersection ofN. McCall Avenue and Ashlan Avenue.
2. Proceed south along N. McCall Avenue to the intersection N. McCall Avenue and E.
Belmont Avenue.
3. Proceed west on E. Belmont Avenue to the intersection of E. Belmont Avenue and N.
De Wolf A venue.
4. Proceed south on N. DeWolf Avenue to the intersection ofS. DeWolf and the E.
American A venue.
5. Proceed east on E. American Avenue to the intersection of E. American Avenue and S.
McCall A venue.
6. Proceed south on S. McCall Avenue to the intersection ofS. McCall Avenue and E.
Jefferson Avenue.
7. Proceed east on E. Jefferson Avenue to the intersection of E. Jefferson Avenue and S.
Academy Avenue.
8. Proceed south on S. Academy Avenue to the intersection of S. Academy Avenue and E.
Adams Avenue.
9. Proceed east on E. Adams Avenue to the intersection of E. Adams Avenue and S.
Newmark A venue.
10. Proceed northeasterly in a straight line from the intersection ofE. Adams Avenue and S.
Newmark Avenue to the point where the Kings River and the Cameron Slough intersect.
11. Proceed north along the Cameron Slough to the point where the Reed A venue alignment
intersects with the Cameron Slough.
12. Proceed south along the Reed A venue alignment to the point where Reed A venue
intersects with Kings Canyon Road.
13. Proceed east along Kings Canyon Road to the Friant-Kern Canal.
14. Proceed northeasterly along a line extending from the intersection of Kings Canyon Road
and the Friant-Kern Canal to the southern side of the Pine Flat Dam until such line
intersects southwest of Elwood Road.
15. Proceed southeasterly in a straight line from a point southwest of Elwood Road to a point
where Palomino Road terminates west ofBellows Drive.
16. Proceed east to a point where Longhorn Drive terminates south of Elwood Road.
17. Proceed northeasterly in a straight line to a point such line intersects Mill Creek near
Elwood Road.
18. Proceed northeasterly along Mill Creek to the point where Mill Creek intersects with
White Deer Creek.
19. Proceed northeasterly along White Deer Creek to the point where White Deer Creek
intersects with Rancheria Creek.
20. Proceed north and east along Rancheria Creek to the point where Rancheria Creek turns
east towards its origin.
21. Proceed northeast along a straight line to the intersection of Mill Flat Creek and the
Kings River.
22. Proceed west along the Kings River to the intersection of the Kings River and the North
Fork of the Kings River.
23. Proceed north along a line extending from the west bank of the North Fork of the Kings
River to where such line intersects Trimmer Springs Road.
24. Proceed west along Trimmer Springs Road to a point Y4 mile past the intersection of
Trimmer Springs Road and Sunny Slope Drive.
25. Proceed southwest along a straight line to the point where Watts Valley Road intersects
the Friant Kern Canal.
26. Proceed southwest along Watts Valley Road to the point where Watts Valley Road
intersects Ashlan A venue.
27. Proceed West on Ashlan Avenue to the intersection of Ashlan Avenue and N. McCall
Avenue.
Exhibit A
Fresno County Ambulance Service Area
Zone I
N
A
Legend
0 Response Zone I
--Streets
Exhibit B
Fresno County Ambulance Service Area
Zone I
Metropolitan Response Area Description
1. 1 Beginning at the point where E. Kings Canyon Road and N. Del Rey A venue
intersect.
2. Proceed south along N. Del Rey Avenue to the intersection ofN. Del Rey Avenue
and E. Central A venue.
3. Proceed east along E. Central Avenue to the intersection of E. Central Avenue and S.
Bethel A venue.
4. Proceed south along S. Bethel Avenue to the intersection ofS. Bethel Avenue and the
E. American A venue.
5. Proceed east along E. American Avenue to the intersection ofthe E. American
Avenue alignment and the S. Riverbend Avenue alignment.
6. Proceed north along the S. Riverbend Avenue alignment to the intersection of S.
Riverbend A venue and E. Annadale A venue.
7. Proceed west along E. Annadale Avenue to the intersection ofE. Annadale Avenue
and the S. Zediker Avenue alignment.
8. Proceed north along the S. Zediker Avenue alignment to the intersection ofthe S.
Zediker A venue alignment and E. Kings Canyon Road.
9. Proceed west along E. Kings Canyon Road to the point of origin.
i __ _
_, _,
(3. ~ ~ENSEN ~
[
···-I
I
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0
0
CENT AL
Exhibit B
Fresno County Ambulance Service Area
Zone I
Metropolitan Response Area
N
A
ANN AD ALE /~··-·········--,~··-·---·--····----·-----
/' .
_,
w
F
~ 0
0
0
~ w
\
\
\. '• "-· .................. c FANTZ
'" .... ,
+----+----l-~····--····--·· ................................... _______ ., ...... :,..<.::··--····
/ .,/ I ""--------·---··--· )
(
el_;
Legend
---Streets
0 Zone I Metro Response
................................... \
Exhibit C
Fresno County Ambulance Service Area
Zone I
Rural Response Area Description
The Rural Response Area includes the area within the Fresno County Ambulance Service
Area Zone I (Exhibit A) west of an imaginary line that extends north to south at the
intersection of Piedra Road and Trimmer Springs Road, and excludes the areas identified as
the Metropolitan Response Area (Exhibit B).
Exhibit c
Fresno County Ambulance Service Area
Zone I
Rural Response Area
N
Zone I
-Zone I Metro Response Area
D Zone I Rural Response Area
.. Zone I Wilderness Response Area
--Streets
ExhibitD
Fresno County Ambulance Service Area
Zone I
Wilderness Response Area Description
The Wilderness Response Area includes the area within the Fresno County Ambulance
Service Area Zone I (Exhibit A) east of an imaginary line that extends north to south at the
intersection of Piedra Road and Trimmer Springs Road.
Exhibit D
Fresno County Ambulance Service Area
Zone I
Wilderness Response Area
N
A
Zone I
• Zone I Metro Response Area
• Zone I Rural Response Area
D Zone I \l\lilderness Response Area
··--··-· .. --Streets