HomeMy WebLinkAboutAgreement A-19-388 with KWPH Enterprises dba American Ambulance.pdf1 Services (defined in Section 4 herein):
2 (1)COUNTY shall be responsible for the dispatching equipment, hardware,
3 software (including software licenses), and other technologies, which will be utilized for the triage and
4 entry of information for AMERICAN-KINGS's EMS dispatch services in COUNTY's EMS
5 Communications Center computer aided dispatch ("CAD") system, in connection with COUNTY's
6 performance of its EMS dispatch services for AMERICAN-KINGS under this Agreement. In the event
7 that AMERICAN-KINGS requests additional technologies, not currently available in COUNTY's EMS
8 Communications Center, AMERICAN-KINGS shall be solely responsible for all costs to purchase and
9 maintain said technology and/or equipment; and
10 (2)COUNTY shall be responsible for selection, configuration, installation,
11 and maintenance of all dispatching equipment, hardware, software and other technologies associated
12 with this Agreement. All dispatching equipment, hardware, software (including software licenses),
13 and other technologies purchased and/or obtained through this Agreement shall be the sole property
14 of COUNTY; and
15 (3)COUNTY shall provide EMS dispatch services requiring responses by
16 AMERICAN-KINGS as follows:
17 (a)COUNTY's EMS Communication Center shall provide all EMS
18 dispatch services in accordance with AMERICAN-KINGS's policies and procedures affecting
19 AMERICAN-KINGS under this Agreement (to the extent that they do not conflict with EMS Agency
2 o policy and procedures). AMERICAN-KINGS's policies and procedures shall be subject to review by
21 COUNTY's EMS Director, or his or her designee (the "COUNTY's Representative"), as provided in
2 2 Section 1. C. (2) herein.
23 (b)COUNTY's EMS Communication Center shall dispatch
2 4 AMERICAN-KINGS ambulances through radio and electronic communications, and in accordance
2 5 with AMERICAN-KINGS and EMS Agency policies and procedures. AMERICAN-KINGS shall work
2 6 collaboratively with COUNTY on policies and procedures that are consistent with other agencies that
2 7 are being dispatched in COUNTY's EMS Communications Center.
28 (c)COUNTY's EMS Communications Center shall provide pre-
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1 arrival instructions to callers requesting EMS dispatch services.
2 (d)COUNTY's EMS Communications Center shall provide inter-
3 agency coordination regarding requests for EMS and first responder services, mutual aid and auto
4 aid services, and order specialized EMS related equipment from AMERICAN-KINGS or other
5 agencies ( e.g., supervisor, rescue team, or "jaws of life") which may be needed to manage an
6 incident, and perform other related duties.
7 (e)COUNTY'S EMS Communications Center shall track all activity of
8 AMERICAN-KINGS's ambulances and supervisor vehicles utilizing the COUNTY's EMS
9 Communications Center CAD system.
10 (f)COUNTY shall record all telephone and radio transmissions and
11 provide instant playback as needed. COUNTY shall retain recordings for a minimum of one-hundred
12 eighty (180) days.
13 (g)COUNTY shall provide reports to AMERICAN-KINGS as
14 requested. COUNTY must be given sufficient time to develop custom adhoc reports or reports that
15 are not already developed.
16 (h)COUNTY shall provide one (1) radio operator for dispatching of
1 7 AMERICAN-KINGS's ambulances and equipment twenty-four (24) hours a day, seven (7) days a
18 week. AMERICAN-KINGS understands that the radio operator is not dedicated for the sole purpose
19 of AMERICAN-KINGS and that the radio operator may be dispatching other fire and EMS providers.
2 o COUNTY shall provide that dispatch staff shall be trained in emergency medical dispatch.
21 (i)COUNTY shall provide that a minimum of one (1) dispatch
22 supervisor shall be on duty at COUNTY's EMS Communications Center twenty-four (24) hours a day,
2 3 seven (7) days a week. The supervisor shall be available to AMERICAN-KINGS's administration as
24 needed.
25 (j)COUNTY shall maintain an up-to-date policies and procedures
2 6 for all dispatch staff, and shall provide for training and continuing education of dispatch staff as
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1 (k)The goal for the immediate dispatch of an ambulance, in
2 accordance with COUNTY's dispatch protocols, and excluding multiple unit responses, reassigned
3 responses and other situations beyond the COUNTY's EMS Communications Center control, shall be
4 sixty (60) seconds. The dispatch time will be measured from the time the telephone is answered by the
5 call taker to the time the first ambulance is alerted to the incident either by radio, telephone, pager or
6 station alerting device. A review shall occur for all cases in which dispatches are over ninety (90)
7 seconds, and results will be evaluated for improvement opportunities by the EMS Dispatch Continuous
8 Quality Improvement (CQI) Committee.
9 It is understood that because of the dynamic nature of emergency
1 o services, there are situations when the sixty (60) second dispatch goal may not be achieved. Examples
11 of these situations include, but are not limited to:
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Calls not received through the 9-1-1 telephone system.
Calls that do not immediately gee-verify in the CAD.
Calls in which the public safety answering points dispatcher
does not immediately transfer the calling party.
Calls in which the reporting party is either unable or unwilling
to immediately provide all required information as part of the
call taking process (i.e., non-English speaking, hysterical, or
uncooperative).
It is understood by the parties hereto that COUNTY's provision of EMS dispatch
21 services herein does not include any COUNTY provision of ambulance services, and that COUNTY is
2 2 providing EMS dispatch services herein to AMERICAN-KINGS on a non-exclusive basis.
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C.AMERICAN-KINGS shall perform the following functions:
(1)AMERICAN-KINGS shall provide ambulance services for all incidents
2 5 dispatched by COUNTY's EMS Communications Center that require the response of an ambulance.
26 (2)AMERICAN-KINGS shall consult with COUNTY's Representative in
2 7 developing AMERICAN-KINGS policies and procedures as it relates to EMS dispatching.
2 8 AMERICAN-KINGS shall not approve AMERICAN-KINGS policies and procedures relating to
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1 dispatch until first having conferred with COUNTY's Representative and such representative agrees
2 that such policies and procedures are not inconsistent with the COUNTY's EMS Communication
3 Center's Policies and Procedures, and that AMERICAN-KINGS's policies and procedures do not
4 create additional workload for staff or impact other programs in the COUNTY's EMS Communications
5 Center.
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(3)AMERICAN-KINGS shall provide continuing education and training to
COUNTY's EMS Communications Center radio operators and staff regarding the dispatching and
management of AMERICAN-KINGS resources, as needed.
(4)AMERICAN-KINGS shall assure that all calls to AMERICAN-KINGS for
ambulance service are immediately transferred to COUNTY's EMS Communications Center.
(5)AMERICAN-KINGS agrees to participate in an internal quality
improvement program, which includes the participation of COUNTY and PROVIDER.
(6)AMERICAN-KINGS shall be responsible for the provision and
maintenance of all radio and computer equipment in AMERICAN-KINGS ambulances and vehicles.
2.TERM
A.The term of this Agreement shall be for a period of sixteen months, commencing
17 on July 1, 2019 through October 31, 2020.
18 B.Upon the termination of this Agreement, COUNTY shall promptly provide
19 AMERICAN-KINGS with the data generated through the EMS dispatch services provided herein in a
2 O commonly usable electronic format.
3.TERMINATION21
22 A.Non-Allocation of Funds -The terms of this Agreement, and the services to be
2 3 provided hereunder, are contingent on the approval of funds by the appropriating governmental
2 4 agency, provided however, should sufficient funds not be allocated, (i) the services provided may be
2 5 modified at any time upon the parties' mutual written agreement, or (ii) this Agreement may be
2 6 terminated at any time by AMERICAN-KINGS giving at least ninety (30) days' advance written notice
2 7 of an intention to terminate to the other party.
28 B.Without Cause -Under circumstances other than those set forth above, this
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1 Agreement may be terminated by AMERICAN-KINGS or COUNTY upon the giving of at least ninety
2 (90)days' advance written notice of an intention to terminate to the other party.
3 C.Material Breach -Either party may terminate this Agreement at any time for
4 cause for the other party's material breach of its obligations herein if not less than thirty (30) days'
5 advance, written notice has been given to the other party and such breach remains uncured within
6 that thirty (30) day period. The party receiving such notice may respond to said notice and any
7 charges contained therein within that thirty (30) day period.
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D.AMERICAN-KINGS shall compensate or provide funding to COUNTY for any
1 o performed or costs incurred under this Agreement prior to any termination of this Agreement.
4.COMPENSATION FOR SERVICES11
12 A.For COUNTY's performance of EMS dispatch services herein, AMERICAN-
13 KINGS agrees to pay COUNTY and COUNTY agrees to receive compensation pursuant to Exhibit A,
14 attached hereto and incorporated herein by this reference. In no event shall compensation for
15 COUNTY's performance of EMS dispatch services under this Agreement be in excess of the amounts
16 listed as follows:
17 (1)For the period of July 1, 2019 through October 31, 2020, the amount of
18 this Agreement shall not exceed Fifty-Eight Thousand Fifty-Three and 00/100 Dollars ($58,053.00).
19 B.AMERICAN-KINGS shall pay COUNTY no late than the fifteenth (15th) day of
2 o the month in which payment is required pursuant to Schedule A, without the necessity of COUNTY
21 submitting invoices to AMERICAN-KINGS. All payments shall be remitted to COUNTY at the
22 following address: Department of Public Health-Emergency Medical Services Division, P.O. Box
2 3 11867, Fresno, CA 93775.
24 5.INVOICING
25 COUNTY shall invoice AMERICAN-KINGS monthly, addressed to American
2 6 Ambulance, 2911 Tulare Ave, Fresno, California 93721.
6.INDEPENDENT CONTRACTOR27
28 In performance of the work, duties, and obligations assumed by COUNTY under this
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1 Agreement, it is mutually understood and agreed that COUNTY, including any and all of COUNTY's
2 officers, agents, and employees will at all times be acting and performing as an independent
3 contractor, and shall act in an independent capacity and not as an officer, agent, servant, employee,
4 joint venture, partner, or associate of AMERICAN-KINGS. Furthermore, AMERICAN-KINGS shall
5 have no right to control or supervise or direct the manner or method by which COUNTY shall perform
6 its work and function, except for COUNTY's compliance with AMERICAN-KINGS policies and
7 procedures, herein. However, AMERICAN-KINGS shall retain the right to administer this Agreement
8 so as to verify that COUNTY is performing its obligations in accordance with the terms and conditions
9 thereof. COUNTY and AMERICAN-KINGS shall comply with all applicable provisions of law and the
1 o rules and regulations, if any, of governmental authorities having jurisdiction over matters which are
11 directly or indirectly the subject of this Agreement.
12 Because of its status as an independent contractor, COUNTY shall have absolutely no
13 right to employment rights and benefits available to AMERICAN-KINGS employees. COUNTY shall
14 be solely liable and responsible for providing to, or on behalf of, its employees all legally-required
15 employee benefits. In addition, COUNTY shall be solely responsible and save AMERICAN-KINGS
16 harmless from all matters relating to payment of COUNTY's employees, including compliance with
1 7 Social Security, withholding, and all other regulations governing such matters. It is acknowledged
18 that during the term of this Agreement, COUNTY may be providing services to others unrelated to
19 AMERICAN-KINGS or to this Agreement.
2 o In performance of the work, duties and obligations assumed by AMERICAN-KINGS under this
21 Agreement, it is mutually understood and agreed that AMERICAN-KINGS, including any and all of the
2 2 AMERICAN-KINGS'S officers, agents, and employees will at all times be acting and performing as an
23 independent contractor, and shall act in an independent capacity and not as an officer, agent, servant,
2 4 employee, joint venturer, partner, or associate of the COUNTY. Furthermore, COUNTY shall have no
2 5 right to control or supervise or direct the manner or method by which AMERICAN-KINGS shall perform
2 6 its work and function. However, COUNTY shall retain the right to administer this Agreement so as to
2 7 verify that AMERICAN-KINGS is performing its obligations in accordance with the terms and conditions
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Because of its status as an independent contractor, AMERICAN-KINGS shall have absolutely
no right to employment rights and benefits available to COUNTY employees. AMERICAN-KINGS
shall be solely liable and responsible for providing to, or on behalf of, its employees all
legally-required employee benefits. In addition, AMERICAN-KINGS shall be solely responsible and
save COUNTY harmless from all matters relating to payment of AMERICAN-KINGS' employees,
including compliance with Social Security withholding and all other regulations governing such
matters. It is acknowledged that during the term of this Agreement, AMERICAN-KINGS may be
providing services to others unrelated to the COUNTY or to this Agreement.
7.MODIFICATION
Any matters of this Agreement may be modified from time to time by the written consent
of all the parties hereto without, in any way, affecting the remainder.
8.HOLD-HARMLESS
A.AMERICAN-KINGS agrees to indemnify, save, hold harmless, and at
14 COUNTY's request, defend COUNTY, including its officers, agents, and employees, from any and all
15 costs and expenses (including attorneys' fees and costs), damages, liabilities, claims, and losses
16 occurring or resulting to COUNTY in connection with the performance, or failure to perform, by
1 7 AMERICAN-KINGS, including its officers, agents, or employees under this Agreement, and from any
18 and all costs and expenses (including attorneys' fees and costs), damages, liabilities, claims, and
19 losses occurring or resulting to any person, firm, or corporation who may be injured or damaged by
2 o the performance, or failure to perform, of AMERICAN-KINGS, including its officers, agents, or
21 employees under this Agreement.
22 B.COUNTY agrees to indemnify, save, hold harmless, and at AMERICAN-KINGS'
2 3 request, defend AMERICAN-KINGS, including its officers, agents, and employees from any and all
2 4 costs and expenses (including attorneys' fees and costs), damages, liabilities, claims, and losses
2 5 occurring or resulting to AMERICAN-KINGS in connection with the performance, or failure to perform,
26 by COUNTY, including its officers, agents, employees or PROVIDER, under this Agreement, and
2 7 from any and all costs and expenses (including attorneys' fees and costs), damages, liabilities,
2 8 claims, and losses occurring or resulting to any person, firm, or corporation who may be injured or
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1 damaged by the performance, or failure to perform, of COUNTY, including its officers, agents,
2 employees or PROVIDER under this Agreement.
3 C.In the event of concurrent negligence on the part of COUNTY or any of its
4 officers, agents, employees or PROVIDER, and of AMERICAN-KINGS or any of its officers, agents,
5 or employees, the liability for any and all such claims, demands and actions in law or equity for such
6 costs and expenses (including attorneys' fees and costs), damages, and losses shall be apportioned
7 under the State of California's theory of comparative negligence as presently established or as may
8 be modified hereafter.
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D.This Section 8 shall survive termination or expiration of this Agreement.
9.INSURANCE
Without limiting the indemnification of each party as stated in Section 8 above, it is understood
and agreed that AMERICAN-KINGS and COUNTY shall each maintain, at their sole expense, the
following insurance policies or self-insurance programs including, but not limited to, an insurance
pooling arrangement and/or Joint Powers Agreement to fund their respective liabilities throughout the
term of this agreement. Coverage shall be provided for comprehensive general liability, automobile
liability, and workers' compensation exposure. Each party will provide the other party with an
appropriate Commercial General Liability insurance certificate with limits of not less than Two Million
Dollars ($2,000,000) per occurrence and an annual aggregate of Four Million Dollars ($4,000,000)
along with an appropriate endorsement naming the other party as an additional insured on the
Commercial General Liability policy ..
Additional Requirements Relating to Insurance
AMERICAN-KINGS shall obtain endorsements to the Commercial General Liability
insurance naming the County of Fresno, its officers, agents, and employees, individually and
collectively, as additional insured, but only insofar as the operations under this Agreement are
concerned. Such coverage for additional insured shall apply as primary insurance and any other
insurance, or self-insurance, maintained by COUNTY, its officers, agents and employees shall be
excess only and not contributing with insurance provided under AMERICAN-KINGS' policies herein.
This insurance shall not be cancelled or changed without a minimum of thirty (30) days advance
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written notice given to COUNTY.
AMERICAN-KINGS hereby waives its right to recover from COUNTY, its officers,
agents, and employees any amounts paid by the policy of worker's compensation insurance required
by this Agreement. AMERICAN-KINGS is solely responsible to obtain any endorsement to such
policy that may be necessary to accomplish such waiver of subrogation, but AMERICAN-KINGS'
waiver of subrogation under this paragraph is effective whether or not AMERICAN-KINGS obtains
such an endorsement.
Within thirty (30) days from the date AMERICAN-KINGS signs this Agreement,
AMERICAN-KINGS shall provide certificates of insurance and endorsement as stated above for all of
the foregoing policies, as required herein, to the County of Fresno, Department of Public Health, P.O.
Box 11867, Fresno, CA 93775, Attn: Contracts Section -6th Floor, stating that such insurance
coverage have been obtained and are in full force; that the County of Fresno, its officers, agents and
employees will not be responsible for any premiums on the policies; that for such worker's
compensation insurance the AMERICAN-KINGS has waived its right to recover from the COUNTY,
its officers, agents, and employees any amounts paid under the insurance policy and that waiver
does not invalidate the insurance policy; that such Commercial General Liability insurance names the
County of Fresno, its officers, agents and employees, individually and collectively, as additional
insured, but only insofar as the operations under this Agreement are concerned; that such coverage
for additional insured shall apply as primary insurance and any other insurance, or self-insurance,
maintained by COUNTY, its officers, agents and employees, shall be excess only and not
contributing with insurance provided under AMERICAN-KINGS's policies herein; and that this
insurance shall not be cancelled or changed without a minimum of thirty (30) days advance, written
notice given to COUNTY.
In the event AMERICAN-KINGS fails to keep in effect at all times insurance coverage as
herein provided, the COUNTY may, in addition to other remedies it may have, suspend or terminate
this Agreement upon the occurrence of such event. All policies shall be with admitted insurers
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licensed to do business in the State of California. Insurance purchased shall be purchased from
companies possessing a current A.M. Best, Inc. rating of A FSC VII or better.
COUNTY shall cause AMERICAN-KINGS to maintain insurance coverage that is consistent with the
requirements of this Agreement, and COUNTY will cause PROVIDER to submit to AMERICAN
KINGS the necessary Certificates of Insurance and endorsements.
10.CONFIDENTIALITY
All services performed by COUNTY under this Agreement shall be in strict conformance
with all applicable Federal, State of California and/or local laws and regulations relating to
confidentiality.
11.NON-DISCRIMINATION
During the performance of this Agreement, neither party may unlawfully discriminate
against any employee or applicant for employment, or recipient of services, because of race, religion,
color, national origin, ancestry, physical disability, medical condition, sexual orientation, marital
status, age or gender, pursuant to all applicable State of California and Federal statutes and
regulations.
12.RECORDS
Each party shall maintain its records in connection with the respective services referred
to under this Agreement. Such records must be maintained for a minimum of three (3) years.
Records must also be maintained a minimum of three (3) years after the termination of this
Agreement. The party generating the records shall maintain ownership of the records upon
termination of this Agreement.
13.AUDITS AND INSPECTIONS
Each party shall at any time during business hours, and as often as the other party may
deem necessary, make available to the other party for examination all of the former party's records
and data with respect to the matters covered by this Agreement. Each party shall, upon request by
the other party, permit the other party to audit and inspect all such records and data necessary to
ensure the former party's compliance with the terms of this Agreement.
If this Agreement exceeds Ten Thousand and No/100 Dollars ($10,000.00), COUNTY
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1 shall be subject to the examination and audit of the State Auditor for a period of three (3) years after
2 final payment under contract (Government Code section 8546.7).
3 14.PROVIDER
4 The parties hereto acknowledge that PROVIDER, or its replacement, if any during the
5 term of the PROVIDER Agreement, will carry out COUNTY's provision of dispatching services herein.
6 In the event of any such replacement of PROVIDER, the replacement EMS Provider Agreement will
7 be on substantially the same terms as the EMS Provider Agreement to the extent that it concerns this
8 Agreement, as provided herein.
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15.FORCE MAJEURE
A.If either party hereto is rendered unable, wholly or in part, by Force Majeure to
11 carry out its obligations under this Agreement, that party shall give to the other party hereto prompt
12 written notice of the Force Majeure with full particulars relating thereto. Thereupon, the obligations
13 of the party giving the notice, so far as they are affected by the Force Majeure, shall be suspended
14 during, but no longer than, the continuance of the Force Majeure, except for a reasonable time
15 thereafter required to resume performance.
16 B.During any period in which either party hereto is excused from performance by
1 7 reason of the occurrence of an event of Force Majeure, the party so excused shall promptly,
18 diligently, and in good faith take all reasonable action required in order for it to be able to promptly
19 commence or resume performance of its obligations under this Agreement. Without limiting the
20 generality of the foregoing, the party so excused from performance shall, during any such period of
21 Force Majeure, take all reasonable action necessary to terminate any temporary restraining order
22 or preliminary or permanent injunctions to enable it to so commence or resume performance of its
2 3 obligations under this Agreement.
24 C.The party whose performance is excused due to the occurrence of an event of
2 5 Force Majeure shall, during such period, keep the other party hereto notified of all such actions
2 6 required in order for it to be able to commence or resume performance of its obligations under this
2 7 Agreement.
28 D."Force Majeure" is defined as an Act of God, act of public enemy, war, and
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other extraordinary causes not reasonably within the control of either of the parties hereto.
16.NOTICES
3 The persons having authority to give and receive notices under this Agreement and
4 their addresses include the following:
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COUNTY
Director, County of Fresno
Department of Public Health
P.O. Box 11867
Fresno, CA 93775
AMERICAN
American Ambulance
President
2911 E Tulare Street
Fresno, California 93721
Any and all notices between COUNTY and AMERICAN provided for or permitted under
this Agreement or by law shall be in writing and shall be deemed duly served when personally
delivered to one of the parties hereto, or in lieu of such personal service, when deposited in the
United States Mail, postage prepaid, addressed to such party, except for notices of termination, which
are effective upon receipt. Notices under this Agreement are not modifications to this Agreement.
17.GOVERNING LAW
The parties hereto agree, that for the purposes of venue, performance under this
Agreement is to be in Fresno County, California.
The rights and obligations of the parties hereto and all interpretation and performance
of this Agreement shall be governed in all respects by the laws of the State of California.
18.SEVERABILITY
The provisions of this Agreement are severable. The invalidity or unenforceability of
any one provision in the Agreement shall not affect the other provisions.
19.ENTIRE AGREEMENT
This Agreement constitutes the entire agreement between AMERICAN-KINGS and
COUNTY with respect to the subject matter hereof and supersedes all previous agreement
negotiations, proposals, commitments, writings, advertisements, publications, and understandings of
any nature whatsoever unless expressly included in this Agreement. This Agreement may be
executed in several counterparts by the parties hereto, in which case, all of such executed duplicate
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counterpart originals thereof, taken together, shall be deemed to be one and the same legal
instrument.
20.NO THIRD PARTY BENEFICIARIES
4 Notwithstanding anything stated to the contrary in this Agreement, there shall not be
5 any intended third party beneficiaries to this Agreement.
6 21.DISCLOSURE OF SELF-DEALING TRANSACTIONS:
7 This provision is only applicable if Contractor is operating as a corporation (a for-profit or non-
8 profit corporation) or if during the term of this Agreement, Contractor changes its status to operate as a
9 corporation.
1 o Members of Contractor's Board of Directors shall disclose any self-dealing transactions that
11 they are a party to while Contractor is providing goods or performing services under this Agreement.
12 A self-dealing transaction shall mean a transaction to which Contractor is a party and in which one or
13 more of its directors has a material financial interest. Members of the Board of Directors shall disclose
14 any self-dealing transactions that they are a party to by completing and signing a Self-Dealing
15 Transaction Disclosure Form, attached hereto as Exhibit B and by this reference incorporated herein,
16 and submitting it to County prior to commencing with the self-dealing transaction or immediately
1 7 thereafter.
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Month
EXHIBIT A
Payment Due
EXHIBIT B
SEl.F-DEAUNG 1RANSAC110N 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).
Mail the completed form to: County of Fresno
Attn: Lease Services (L-305)
Internal Services Department
2220 Tulare Street, Suite 2100
Fresno, CA 93721-2106
COUN1Y OF FRESNO
Fresno, CA
(1)Company Board Member Information:
Name: Todd R. Valeri Date: 06/20/2019
Job President / CEO Title:
(2)Company/Agency Name and Address:
TRV Properties, LP and American Ambulance Billing, LP 2911 East Tulare St Fresno, CA 93721
(3)Disclosure (Please describe the nature of the self-dealing transaction you are a party to):
Todd Valeri owns and controls both entities. TRV Properties, LP leases real property to K.W.P.H. Enterprises and American Ambulance Billing, LP provides billing and accounting services to K.W.P.H Enterprises.
(4)Explain why this self-dealing transaction is consistent with the requirements of
Corporations Code 5233 (a):
Corporations Code 5233 is inapplicable because neither TRV Properties, LP nor American Ambulance Billing, LP are a California Public Benefit Corporation.
(5)Authorized Signatu�'
Signature: j . ,(lI'\� � \Jo 1'--L= Date: I ceo !Uo IZD lq
COU 1Y OF FRESNO
Fresno, Cr\