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HomeMy WebLinkAbout23657AGREEMENT INFORMATION AGREEMENT NUMBER 23657 NAME/TYPE OF AGREEMENT FLORIDA DEPARTMENT OF HEALTH DESCRIPTION EMS MATCHING GRANT APPLICATION/IMPROVING & EXPANDING EMS BY PURCHASES CARDIAC MONITORS/FILE ID: 7702/R-20-0245/MATTER ID: 20-1551K/#79 EFFECTIVE DATE ATTESTED BY TODD B. HANNON ATTESTED DATE 9/29/2020 DATE RECEIVED FROM ISSUING DEPT. 11/1/2021 NOTE CITY OF MIAMI DOCUMENT ROUTING FORM a U! t)- ORIGINATING DEPARTMENT: Fire -Rescue _ DEPT. CONTACT PERSON: Maria T. Martinez NAME OF OTHER CONTRACTUAL PARTY/ENTITY: 4111\ EXT. 1672 "Emergency Medical Services ("EMS") - Matching Grant - M8052" IS THIS AGREEMENT A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? TOTAL CONTRACT AMOUNT: S FUNDING INVOLVED? TYPE OF AGREEMENT: ❑ MANAGEMENT AGREEMENT PROFESSIONAL SERVICES AGREEMENT X GRANT AGREEMENT ❑ EXPERT CONSULTANT AGREEMENT ❑ LICENSE AGREEMENT OTHER: (PLEASE SPECIFY) ❑ YES X NO ❑ YES X NO ❑ PUBLIC WORKS AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ INTER -LOCAL AGREEMENT ❑ LEASE AGREEMENT ❑ PURCHASE OR SALE AGREEMENT PURPOSE OF ITEM (BRIEF SUMMARY): The purpose of this grant is to assist the Department of Fire -Rescue in improving and expanding EMS by purchasing seven (7) cardiac monitors. COMMISSION APPROVAL DATE: 9/10/20 FILE ID: 7702 ENACTMENT NO.: R-20-0245 IF THIS DOES NOT REQUIRE COMMISSION APPROVAL, PLEASE EXPLAIN: ROUTING, INFORMATION Date PLEASE PRINT AND SIGN PRINT: Ty McGann, AFC APPROVAL BY DEPARTMENTAL DIRECTOR 9/11/2020 SIGNATURE: ✓�_ 9/11 /20 PRINT: ANN - MA RI ARPE SUBMITTED TO RISK MANAGEMENT tG SIGNATURE: ! / PRINT: VICTORIA MENDEZ SUBMITTED TO CITY ATTORNEY 9/25/20 (20-1551 K- GKW) SIGNATURE: Is George K. TVysong, III PRINT: APPROVAL BY ASSISTANT CITY MANAGER SIGNATURE: PRINT: ART NORIEGA RECEIVED BY CITY MANAGER SIGNATURE: PRINT: 1) ONE ORIGINAL'TO CITY CLERK,= SIGNATURE: 2) ONECOPY,TO CITY ATTORNEY'S OFFICE SIGNATURE: 3) REMAINING ORIGINALS) TO ORIGINATING MEN_Tj��� ����� �� _.____ DEPART PRINT: SIGNATURE: PLEASE ATTACH THIS ROUTING FORM TO ALL DOCUMENTS THAT REQUIRE EXECUTION BY THE CITY MANAGER H EMS MATCHING GRANT APPLICATION FLORIDA DEPARTMENT OF HEALTH Emergency Medical Services Program Complete all items unless instructed differently within the application. Type of Grant Requested: U Rural Ll Matching ID Code (The State EMS Section will assisn the ID Code — (leave this blank) 1. Organization Name: City of Miami Dept of Fire -Rescue 2. Grant Signer: (The applicant signatory who has authority to sign contracts, grants, and other legal documents. This individual must also sign this application.) Name: Lillian Blondet Position Title: Director Office of Grants Administration Address: 444 SW 2nd Avenue, 5th Floor City: Miami County: Miami -Dade State: Florida Zip Code: 33130 Telephone: 305-416-1536 Fax Number: Email Address: LBlondet@nuanugov.com 3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and responsibility for the implementation of the grant activities. This person may sign project reports and may request project changes. The signer and the contact person may be the same.) Name: Nior e Aragon Position Title: Assistant Fire Chief Address: 1151 N.W. 7`h Street City: Miami County: Miami -Dade State: Florida Zip Code: 33136 Tele hone: 305-416-5450 Fax Number: 305-400-5354 Email Address: naragon@miamigov.com DH FORM 1767 [2013] 64J-1.015, F.A.C. 4. Legal Status of Applicant Organization (Check only one response): (1) ❑ Private Not for Profit [Attach documentation-501 (3) ©] (2) ❑ Private for Profit (3) ® City/Municipality/Town/Village (4) ❑ County (5) ❑ State (6) ❑ Other (specify): 5. Federal Tax ID Number (Nine Digit Number): VF 596000375 _ _ _ _ _ 6. EMS License Number: 2276 Type: ®Transport ❑Non -transport ❑Both 7. Number of Permitted Vehicles by Type: 0 BLS 28 ALS Transport 18 ALS non -transport 8. Type of Service (check one): ® Rescue ❑ Fire ❑ Third Service (County or City Government, non -fire) ❑ Air Ambulance ❑ Fixed Wing ❑ Rotor Wing ❑ Both ❑ Other (specify) .2 9. Medical Director of Licensed EMS Provider: If this project is approved. I agree by signing below that I will affirm my authority and responsibility for the use of all' medical equipment and/or the provision of all continuing EMS education in this project. [No signature is needed if medical equipment and professional EMS education are -not!' us roject.] . RO., M.A., FACOEP �� � 0Signature: Date: Print/Type: Name of Director Dr. Paul Joseph Adams Florida License Number OS 7893 Note: All organizations that are not licensed. EMS providers must obtain the signature of the medical director of the licensed EMS provider responsible for EMS services in their area of operation for projects that involve medical eauinment and/or continuinz EMS education. If your activity is a research or evaluation project, omit Items 10, 11,12, 13, and skip to Item Number 14. Otherwise, proceed to Item 10 and the following items. 10. Justification Summary: Provide on no more than three one-sided, double-spaced pages, a summary addressing this project covering each topic listed below. A) Problem description (Provide a narrative of the problem or need); B) Present situation (Describe how the situation is being handled now); C) The proposed solution (Present your proposed solution); D) Consequences if not funded (Explain what will happen if this project is not funded); E) The geographic area to be addressed (Provide a narrative description of the geographic area); F) The proposed time frames (Provide a list of the time frame(s) for completing this project); G) Data sources (Provide a complete description of data source(s) you cite); H) Statement attesting that the proposal is not a duplication of a previous effort (State that this project doesn't duplicate what you've done on other grant projects under this grant program). UH I-UHM 1767 t20131 ITEM 10. Justification Summary 3 Pages A) Problem Description: Miami Fire Rescue (MFR) is currently utilizing 18 cardiac monitors that do not meet the needs of the community. They are deteriorated, outdated, and often need repair and so prohibit MFR from providing the highest level of care and life saving measures. They lack enhanced lifesaving capabilities such as carbon monoxide (CO) monitoring to protect residents and firefighters. Parts are not available; we are still waiting for the repair of six (6) sent out six (6) months ago. In 11 months the vendor will discontinue servicing these units. We need equipment which will be reliable, can be easily maintained, and with the necessary advanced capabilities to effectively provide EMS. Due to budget constraints, we do not have the funds to purchase this equipment without state assistance. According to the Center for Disease Control, someone has a heart attack every 40 seconds in the U.S. In surviving a cardiac emergency, experts agree time is the single most important critical factor. In 2019, there were 540 heart attacks and 384 myocardial infarctions suspected cardiac events in the City of Miami. MFR has responded to numerous calls during which its monitors could not evaluate CO levels to prevent death from CO poisoning; annually, more than 400 Americans die from unintentional CO poisoning'. Today's cardiac monitors have sensors which will allow MFR to continuously monitor CO levels to save the lives of residents and firefighters (as recommended by NFPA 15845). EMS responders are frequently the first line of defense in treating the aforementioned incidents. The use of cardiac monitors increases the chances of survival by allowing for more effective treatment of a patient before arrival at a treatment facility and reducing the time it takes to treat patients on arrival at the facility 3 MFR's cardiac monitors were used in 35,908 calls in 2019, MFR is dedicated to continuous quality improvement of its services for residents, inclusive of rapid on -scene arrival. MFR is charged with responding to all emergency calls within its jurisdiction and to provide mutual aid in four other municipalities and automatic aid in another. Miami has a 51 disturbingly high mortality rate, many cardiac events and is in need of new cardiac monitors to respond to the over 95,000 calls it receives annually and to increase the probability of patient survival. B) Present Situation: MFR uses obsolete cardiac monitors which limit and decrease the efficiency in MFR's care of residents. They are difficult to maintain and require costly repairs which divert funding away from other critical EMS supplies and equipment. When they are undergoing repairs, loaners from the manufacturer are utilized but these are also starting to fail. When these are in use and other monitors malfunction, EMS units lose their EKG capabilities and are at risk of being placed out of service until a working EKG is available. This impedes MFR's ability to quickly assess patients and respond to emergencies, it extends the door to cath time, augments the risk of cardiac damage and chances of death. Miami's high call volume causes monitors to deteriorate rapidly. With increases in MFR service, new cardiac monitors are sorely needed. For large scale events, MFR borrows monitors from another county. They are not programmed for Miami -Dade County and thus, we can only use them for life saving intervention. These monitors cannot transmit information (EKG data etc.) to the receiving hospital. If transport is needed, the patient must be transferred to a transporting rescue to transfer information to the hospital. This delays the hospital's receipt of life saving information, the confirmation of certain types of heart attacks, and the interpretation and diagnosis of the specific type of heart attack. It can also delay the discernment of appropriate treatment. MFR provides both fire and EMS services, consisting of 28 fully staffed ALS rescue units and 18 fire response ALS non -transport units. Its cardiac monitors are outdated, deteriorated, malfunction frequently and require extensive servicing. In 2019, they were placed out of service due to repairs 25 times and repair will be unavailable in 11 months, when the vendor discontinues servicing. They misinterpret heart attacks and in over 15,285 calls involving smoke, fire or other respiratory distress, MFR was not able to check the CO levels for many patients. The same was true for its personnel involved in over 3000 smoke and/or fire related incidents. C) Proposed Solution: It is imperative that MFR provide effective treatment and improve its ability to care for the more than 1 million people transiting through Miami daily. We are requesting financial assistance to purchase 18 cardiac monitors to ensure EMS units do not lose their EKG abilities and are not at risk of being placed out of service until a working EKG is available. Without all 18 monitors, many of the emergency victims treated during MFR's 95,000 plus calls will not have the lifesaving assistance they require. These cardiac monitors will include CO monitoring capabilities, as well as improved EKG algorithms and functionality to assure effective service to our residents, visitors, and members. In addition, the cardiac monitors will have biphasic defibrillation capabilities, improved display visibility, end tidal carbon dioxide technology for intubated and non-intubated patients, oxygen saturation monitoring, non-invasive blood pressure monitoring, continuous 12-lead monitoring, 12- lead transmission capabilities, the ability to store and upload data into patient care reporting systems, and the ability to extract data for training and quality improvement. These monitors will allow for increased chances of survival for victims by 5 providing enhanced lifesaving capabilities and adequate equipment to perform EMS duties. In addition, maintenance and repair services will be available for this equipment. D) Consequences If Not Funded: Without this grant, MFR will not be able to fund this project. As previously stated, its current cardiac monitors are continuously taken out of service for repairs. The current vendor will be unable to support these monitors in 11 months, hindering ALS capabilities significantly and endangering lives. Furthermore, current cardiac monitors lack the technology and functionality that can facilitate the effective treatment and survival of residents, visitors and members. These monitors are the difference between life and death and in our financial condition; MFR does not have the funds to purchase them without state assistance. E) The geographic area to be addressed: The City of Miami is comprised of 34 sq. miles with about 470,914 residents. Daily, the population swells to nearly 1 million during working hours. Current vulnerabilities are: _1) High rate of ill -health due to poverty: 24% of people are living in poverty2 ; 2) High rate of elders: The City ranks third in the nation in seniors6 (over age 65) comprising 16% of the total population; 3) High rate of ethnic diversity and rates of cardiac individuals; 4) Mutual Aid Obligations: MFR provides automatic aid to the Village of Key Biscayne, and mutual aid to Miami -Dade County, the cities of Miami Beach, Coral Gables and Hialeah. F) The proposed time frames: Months 1 to 5: present award to the city commissioners for approval, research supply and purchase equipment. MFR anticipates units will arrive two to four weeks from the date ordered; Months 6 to 8: training of 700 plus firefighters/ paramedics and; Month 9: implementation of units into service and record and evaluate the positive effects of the newly acquired monitors. G) Data Sources: https://www.cdc.gov/l: www.census.Qov2; A Guide to Our Emergency Medical Equipment, http://westchesterems.orq/eguipment.html3. Miami Department of Fire Rescue4•; NFPA 15845; and www.forbes.com Aging America: The U.S. Cities Going Gray the Fastest6. H) Statement of Non -Duplication: This funding will enable MFR to obtain reliable cardiac monitors with advanced capabilities to improve patient services. In 2013 the City of Miami received funding for 10 cardiac monitors from the Florida EMS matching grant program for 10 of our response vehicles. This grant request is for 18 additional advanced capability monitors for 18 other vehicles which were not previously equipped, and does not duplicate any other grant funded initiative. n. Next, only complete one of the following: Items 11, 12, 13 or 14. Read all four and then select and complete the one that pertains the most to the preceding Justification Summary. Note that on all, that credible before -after differences for emergency victim data are the highest scoring items on the Matching Grants Evaluation Worksheet used by reviewers to evaluate your application form. 11. Outcome for Projects that Provide or Effect Direct Services to Emergency Victims: This may include vehicles, medical and rescue equipment, communications, navigation, dispatch, and all other things that impact upon on -site treatment, rescue, and benefit of emergency victims at the emergency scene. Use no more than two additional one- sided, double-spaced pages for your response. Include the following. A) Quantify what the situation has been in the most recent 12 months for which you have data (include the dates). The strongest data will include numbers of deaths and injuries during this time. B) In the 12 months after this project's resources are on-line, estimate what the numbers you provided under the preceding "(A)" should become. C) Justify and explain how you derived the numbers in (A) and (B), above. D) What other outcome of this project do you expect? Be quantitative and explain the derivation of your figures. E) How does this integrate into your agency's five-year plan? ITEM 11. Outcome For Proiects That Provide or Effect Direct Services To Emer-gency Victims: (2 PAGES) A) Quantify Situation in Last 12 Months: From January 1, 2019 through December 31, 2019, MFR responded to over 97,000 incidents. Of those, 82,711 calls were EMS responses, during which cardiac monitors were employed in the assessment and treatment of 35,908 patients. In addition, over 15,285 of those calls involved either smoke, fire and/or some type of respiratory distress, during which MFR was unable to check many of the patients for elevated CO levels. Miami also has a high level of obesity as well as a high percentage of poverty and elderly. This exponentially increases our population's risk of death from heart attacks and other cardiac events. MFR has had several issues with its current cardiac monitors, including their unreliability and constant removal from service to undergo repairs. In many documented instances, our current cardiac monitors have actually exhibited asystole on viable patients, therefore further increasing our need for functional and reliable cardiac monitors that have been beyond MFR's reach due to its current fiscal state. The City of Miami has a large, over 1,000,000 daily population, significant number of high risk patients, plethora of EMS responses, array of calls necessitating CO monitors, and impending obsoleteness of the monitors. These critical issues make it imperative that MFR acquires functional and reliable cardiac monitors to effectively serve and decrease the risk of mortality of our residents, visitors and firefighters. B) Data of Change with Project Implementation: Implementation of the cardiac monitors in 18 City of Miami Fire - Rescue Department ALS transport and nontransport vehicles will ensure that MFR can effectively and efficiently perform lifesaving measures, quickly identify heart attacks and other lethal arrhythmias and monitor CO levels. The 15,285 calls on which we could not effectively check for elevated CO levels in the previous 12 months will be eliminated in the 12 months after implementation of and staff training on using the monitors. Also, MFR will no longer lack reliability, real time CPR tracking and the ability to determine the origin of heart attacks which it lacked in 35,908 7 calls in 2019. Therefore, MFR expects to see improvement in: a) save rates; b) identification of STEMI's; c) door to catherization times in heart attacks; d) identification of patients with elevated CO levels; e) overall efficiency in EKG interpretation; and f) improvement in cardiac and other treatments. MFR has exhibited a significant increase in responses and population served each year. This project is critical to MFR's efforts and will decrease morbidity and mortality in Miami for years to come. Residents, visitors, and members of the City of Miami will be better protected and receive an extensive increase in quality of care and better service. The health of firefighters will also be better protected and monitored at fire incidents. C) Justification and Explanation of Above Data: Information given in question (A) and (B) was obtained using data from the Miami Fire -Rescue Department data collection system and other outside resources. D) Additional Outcomes: The funding of this project will result in the improved well-being of firefighters through early monitoring and recognition of the early symptoms of CO poisoning, as well as cardiac monitoring at fire and other events. MFR will also be able to provide citizens and visitors with consistent state of the art treatment. The new monitors are extremely durable, have longer battery lives, enhanced screen visibility, improved functionality, will have a longer lifespan and require fewer repairs. E) Integration into Agency's Five Year Plan: Miami Fire -Rescue's five year plan includes a complete review of our current treatment protocols and equipment needs, and the impact of AHA guidelines. This project integrates seamlessly into the achievement of MFR's goals. In addition, our plan includes improving the wellness and health of our members. These monitors will effectuate this by effectively monitoring CO levels in our personnel's blood, as well as performing cardiac assessments on our members. These assessments clearly save lives as was the case when one of our member's experienced a heart attack at a drill and a cardiac monitor was used to quickly identify the heart attack and save his life, as well as an array of other instances where cardiac monitors have identified dangerous arrhythmias on our members. ALL APPLICANTS MUST COMPLETE ITEM 15. 15. Statutory Considerations and Criteria: The following are based on s. 401.113(2) (b) and 401.117, F.S. Use no more than one additional double-spaced page to complete this item. Write N/A for those things in this section that do not pertain to this project. Respond to all others. Justify that this project will: A) Serve the requirements of the population upon which it will impact. B) Enable emergency vehicles and their staff to conform to state standards established by law or rule of the department. C) Enable the vehicles of your organization to contain at least the minimum equipment and supplies as required by law, rule or regulation of the department. D) Enable the vehicles of your organization to have, at a minimum, a direct communications linkup with the operating base and hospital designated as the primary receiving facility. E) Enable your organization to improve or expand the provision of: 1) EMS services on a county, multi county, or area wide basis. 2) Single EMS provider or coordinated methods of delivering services. 3) Coordination of all EMS communication links with police, fire, emergency vehicles, and other related services. 15. Statutory Considerations and Criteria (1 PAGE): A) Serving the Requirements of the Population of Miami: The purchase of cardiac monitors would serve the needs of the over 1,000,000 people in Miami daily by providing effective treatment for cardiac related events and CO level monitoring. Miami has a critical need for the monitors due to its large number of low-income residents and middle aged to elderly citizens, and others at risk of cardiac emergencies. Also, potential CO poisoning stemming from the increased use of generators during hurricane and thunderstorm power outages, increases the need for these cardiac monitors. B) Enabling of Emergency Vehicles to Conform to Standards: This funding will enable MFR to meet state standards. It will also meet NFPA 1584 standards which recommend the presence of both pulse oximetry and CO monitoring on the fire ground and in certain training situations. In addition, MFR will be equipped to continue to conform to AHA guidelines and standard of care by offering biphasic defibrillation, infant/pediatric defibrillation, and 3-lead and 12- lead ECG capability in all our advanced life support vehicles. C) Enable vehicles to contain minimum equipment and supplies: MFR requires that its vehicles contain cardiac monitors as a part of its minimum equipment requirement. The requested funding would allow MFR to purchase 18 cardiac monitors to meet this obligation. D) Enable vehicles communications: This equipment will allow for increased communication and data transfer of 12 leads during and after events and allow for a Continuous Quality Improvement (CQI) process to be implemented by MFR. The improved communications will also allow MFR to provide the highest standard of care. E) Enable your organization to improve or expand the provision of services: The acquisition of the cardiac monitors will exponentially improve MFR's ability to serve populations in the City of Miami and throughout the county. Increased technology will allow MFR to acquire and analyze data to improve service. The addition of CO monitoring capabilities will allow MFR to better protect its residents and firefighters. The ability to upgrade as newer technology is developed will allow MFR to ensure a long and reliable useful life for the cardiac monitors. 9 16. Work Activities and Time Frames: Indicate the major activities for completing the project (use only the space provided). Be reasonable, most projects cannot be completed in less than six months and if it is a communications project, it will take about a year. Also, if you are purchasing certain makes of ambulances, it takes at least nine months for them to be delivered after the bid is let. Work Activity Number of Months After Grant Starts Begin End Grant Acceptance (commission approval) 1 3 Bid Issuance and vendor selection 3 5 Purchase unit 5 5 Training 6 8 Unit Deployment 9 9 17. County Governments: If this application is being submitted by a county agency, describe in the space below why this request cannot be paid for out of funds awarded under the state EMS county grant program. Include in the explanation why any unspent county grant funds, which are now in your county accounts, cannot be allocated in whole or part for the costs herein. N/A DH FORM 1767 [20131 10 18. Budget: Salaries and Benefits: For each position title, provide the amount of salary per hour, FICA per hour, fringe benefits, and the total number of hours. Costs Justification: Provide a brief justification why each of the positions and the numbers of hours are necessary for this project. 0 TOTAL: 0.00 Right click on 0.00 then left click on "Update Field" to calculate Total Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an agency, such as, commodities and supplies of a consumable nature, excluding expenditures classified as operating capital outlay (see next category). Costs: List the price and source(s) of the price identified. Justification: Justify why each of the expense items and quantities are necessary to this project. 0 TOTAL: 0.00 Right click on 0.00 then left click on "Update Field" to calculate Total DH FORM 1767 [20131 11 Vehicles, Equipment, and Other: Costs: List the price of Justification: State why each of the items and Operating capital outlay means the item and the quantities listed is a necessary component of equipment, fixtures, and other tangible source(s) used to this project. personal property of a non- identify the price. consumable and non -expendable nature, and the normal expected life of which is 1 year or more. 18 — Cardiac monitors $590,688.00 The units are sold at $32,816 each and are necessary to facilitate the goals of this grant and This price was reduce mortality in the City of Miami. They determined based on 2 will include: quotes provided by • Trimode display monitor vendors of this product. • Advisory algorithm • USB data transfer capability • SA02 Capability • CO Capability • 3 & 12 lead capability and dynamic 12 lead view • ETCO2 capability • Bp capability • Cables, Batteries, Wi-Fi / Bluetooth capabilities • Clinical training included • Data Management package • Bi hasic defibrillation capabilities TOTAL: $590,688.00 Right click on 0.00 then left click on "Update Field" to calculate Total State Amount (Check applicable program) Right click on 0.00 then left click on "Update ® Matching: 75 Percent $ 443,016.00 Field" to calculate Total Right click on 0.00 then left click on "Update ❑ Rural: 90 Percent 0.00 Field" to calculate Total Local Match Amount (Check applicable program) Right click on 0.00 then left click on "Update ® Matching: 25 Percent $ 147,672.00 Field" to calculate Total Right click on 0.00 then left click on "Update ❑ Rural: 10 Percent Field" to calculate Total 0.00 Grand Total $ 590.688.00 Right click on 0.00 then left click on "Update DH FORM 1767 [20131 12 19. Certification: My signature below certifies the following. I am aware that any omissions, falsifications, misstatements, or misrepresentations in this application may disqualify me for this grant and, if funded, may be grounds for termination at a later date. I understand that any information I give may be investigated as allowed by law. I certify that to the best of my knowledge and belief all of the statements contained herein and, on any attachments, are true, correct, complete, and made in good faith. I agree that any and all information submitted in this application will become a public document pursuant o Section 119.07, F.S. when received by the Florida Bureau of EMS. This includes material which the applicant might consider to be confidential or a trade secret. Any claim of confidentiality is waived by the applicant upon submission of this application pursuant to Section 119.07, F.S., effective after opening by he Florida Bureau of EMS. I accept that in the best interests of the State, the Florida Bureau of EMS reserves the right to reject or revise any and all grant proposals or waive any minor irregularity or technicality in proposals received and can exercise that right. I, the undersigned, understand and accept that the Notice of Matching Grant Awards will be advertised in he Flof•ida Administrative Weekly, and that 21 days after this advertisement is published I waive any right o challenge or protest the awards pursuant to Chapter 120, F.S. certify that the cash match will be expended between the beginning and ending dates of the grant and will be used in strict accordance with the content of the application and approved budget for the activities identified. In addition, the budget shall not exceed the department approved finds for those activities identified in the notification letter. No fiends count towards satisfying this grant if the funds were also used to satisfy a matching requirement of another state grant. All cash, salaries, fringe benefits, expenses, equipment, and other expenses as listed in this application shall be committed and used for the activities approved as a part of this grant. Acceptance of Terms and Conditions: If awarded a grant, I. certify that I will comply with all of the above and also a pt any attached grant terms and conditions and acknowledge this by signing below. r ignature o Authorized Grant Signer MM / DD / YY (Individual Identified in Item 2) DH FORM 1767 [2013] THE TOP PART OF THE FOLLOWING PAGE ii1i11UST ALSO BE COMPLETED AND SIGNED. FLORIDA DEPARTMENT OF HEALTH EMERGENCYNIE DICA L SERVICES (EMS) GRANT UNIT REQUEST FOR GRANT FUND DISTRIBUTION In accordance with the provisions of section 401.113(2) (a), Florida Statutes, the undersigned hereby requests an EMS grant fund distribution for the improvement and expansion of pre -hospital EMS. DOH Remit Pavment To: Ask a finance person in your organization who does business with the state to provide the information to complete the top part of this form, but it should be signed by the person identified in Item,2, 11' application page. Name of Agency: City of Miami Department of Fire — Rescue Mailing Address: 1151 NW 7 St. 3rd Floor Miami, FL 33136 Federal 9-digit Identification Num r: VF 596000375 3-digit Seq. Code Authorized County Official: oq U Signature Date Lillian Blondet, Director of Grants Administration Type or Print Name and Title Sign and return this page with your application to: Florida Department of Health Emergency lYledical Services Unit, Grants 4052 Bald Cypress Way, Bin A-22 Tallahassee, Florida 32399-1722 Do not write below this line. For use by State Emergency Medical Services Section Grant Amount for State to Pay: $ Grant ID: Code: _Approved By: Signature of State EMS Unit Supervisor Date Approved By: Signature of Contract Manager Date State Fiscal Year: 2019 - 2020 Organization Code EO OCA Object Code Category 64-61-70-30-000 03 SF003 751000 059999 Federal Tax ID: V F _ _ _ _ _ _ _ Seq. Code: Grant Beginning Date: Grant Ending Date: DH 1767P, December 2008 (rev. June 8, 2018), incorporated by reference in F.A.C. 64J-1.015 0 FUND TITLE: EMS Matching Grant Award - M8052 RESOURCES: State of Florida Department of Health Florida of EMS Grant Program City Matching Grant from Account No. 11000.184010.896000.0000.00000 $172,280.00 $57,427.00 APPROPRIATIONS: $229,707.00 ATTEST: Todd B. Hanno City Clerk APPROVED AS TO FORM AND CORRECTNESS: Victoria K46ndez City Attorney (20-1551K - GKW) CITY OF MIAMI FLORIDA, a municipal corporation, >Li Arthur Ndi-iega V. City Manager APPROVED AS TO INSURANCE REQUIREMENTS: ;1k Ann -Marie Sharpe, Director Department of Risk Management Counterparts and Electronic Signatures. This Agreement may be executed in any number of counterparts, each of which so executed shall be deemed to be an original, and such counterparts shall together constitute but one and the same Agreement. The parties shall be entitled to sign and transmit an electronic signature of this Agreement (whether by facsimile, PDF or other email transmission), which signature shall be binding on the party whose name is contained therein. An) party providing an electronic signature agrees to promptly execute and deliver to the other parties an original signed Agreement upon request. EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic OfficeR Treasury Information Reporting Currency: USD Bank:121000248 Account: 2696204833948(FL) Payment Amount: 156,856.74 Originator Receiver WELLS FARGO BANK, N.A. CITY OF MIAMI Entry Class: - CCD Transaction Type: Credit Originator Company Name: US HHS Stimulus Entry Description: HHSPAYMENT Originator Company ID: 1911911912 Receiver Name: City Of Miami Receiver ID: 596000375 Payment Detail Addenda Items: 0 Trace: 124384872311039 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 156,856.74 Credit/Debit: C Method: ACH Format: CCP Originator ID Type: ABA T/R Originator ID: 124384877 Originator Company ID: 1911911912 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Note/Special Instruction (NTE) Description: PAYMENT ADDENDA FORMAT ERROR Description: TOO MANY ELMENTS IN SEGMENT. Note Reference Type: PAYMENT Description: TRN 1 7502265641911911912 CARES ACT RELIEF PAYMENT HHS.GOV Note Reference Type: PAYMENT Description: PH 866-569-3522 Reference ID (REF) Reference ID Type: TRACE NUMBER Reference ID: 124384872311039 Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20200417 Name (N1) Entity ID Type: PAYEE Name: City Of Miami ID Type: ID CODE ID: 596000375 Entity ID Type: PAYER Name: US HHS Stimulus Page: 1 Note: Intraday information subject to change EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic Officeo Treasury Information Reporting Payment Amount: 73,670.38 Originator Receiver Entry Class: CCD Transaction Type: Credit Originator Company Name: ELAVON MER SVCS Entry Description: MERCH DEP Originator Company ID: 9990100039 Receiver Name: CITY OF MIAM0000000000 Discretionary Data: MERCHANT ACTIVITY Receiver ID: 8030254604 Payment Detail Addenda Items: 0 Trace: 091000014794408 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 73,670.38 Credit/Debit: C Method: ACH Format: CCD Originator ID Type: ABA T/R Originator ID: 091000019 Originator Company ID: 9990100039 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Trace Number (TRN) Type: CURRENT TRAN TRACE # Trace: 091000014794408 Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20260417 Date Description: EFFECTIVE Date: 20200417 Name (N1) Entity ID Type: PAYEE Name: CITY OF MIAM0000000000 ID Type: ID CODE ID: 8030254604 Entity ID Type: PAYER Name: ELAVON MER SVCS Payment Amount: Originator Entry Class: Originator Company Name: Originator Company ID: Discretionary Data: Payment Detail 18,484.97 CCD ELAVON MER SVCS 9990100039 MERCHANT ACTIVITY Addenda Items: 0 Trace: 091000014794365 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Receiver Transaction Type: Entry Description: Receiver Name: Receiver ID: Credit MERCH DEP MIA CHANGEHE0000000000 8033275911 Page: 2 Note: Intraday information subject to change EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic Office(B) Treasury Information Reporting Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 18,484.97 Credit/Debit: C Method: ACH Format: CCD Originator ID Type: ABA T/R Originator ID: 091000019 Originator Company ID: 9990100039 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Trace Number (TRN) Type: CURRENT TRAN TRACE # Trace: 091000014794365 Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20200417 Date Description: EFFECTIVE Date: 20200417 Name (N1) Entity ID Type: PAYEE Name: MIA CHANGE HE0000000000 ID Type: ID CODE ID: 8033275911 Entity ID Type: PAYER Name: ELAVON MER SVCS Payment Amount: 9,187.00 Originator Receiver Entry Class: CTX , Transaction Type: Credit Originator Company Name: MIAMI-DADE COUNT Entry Description: VENDOR PAY Originator Company ID: 1269620669 Receiver Name: OF MIAMI Discretionary Data: ACH TRANSFER Receiver ID: 596000375 03 Payment Detail Addenda Items: 6 Trace: 091000016723551 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Payment Amount: Originator Entry Class: Originator Company Name: Originator Company ID: Discretionary Data: Payment Detail 3,443.55 CCD ELAVON MER SVCS 9990100039 MERCHANT ACTIVITY Addenda Items: 0 Trace: 091000014794186 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Receiver Transaction Type: Entry Description: Receiver Name: Receiver ID: Credit MERCH DEP MIA MARINA A0000001005 385100300000725 Page: 3 Note: Intraday information subject to change EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic Office Treasury Information Reporting Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 3,443.55 Credit/Debit: C Method: ACH Format: CCD Originator ID Type: ABA T/R Originator ID: 091000019 Originator Company ID: 9990100039 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Trace Number (TRN) Type: CURRENT TRAN TRACE # Trace: 091000014794186 Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20200417 Date Description: EFFECTIVE Date: 20200417 Name (N1) Entity ID Type: PAYEE Name: MIA MARINA A0000001005 ID Type: ID CODE ID: 385100300000725 Entity ID Type: PAYER Name: ELAVON MER SVCS Payment Amount: 2,917.17 Originator Receiver Entry Class: PPD Transaction Type: Credit Originator Company Name: FCSO, INC. Entry Description: HCCLAIMPMT Originator Company ID: 6593514335 Receiver Name: CITY OF MIAMI Discretionary Data: FIRST COAST SVC OPT Receiver ID: 1821109612 Payment Detail Addenda Items: 0 Trace: 031100203046660 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 2,917.17 Credit/Debit: C Method: ACH Format: PPP Originator ID Type: ABA T/R Originator ID: 031100209 Originator Company ID: 6593514335 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Page: 4 Note: Intraday information subject to change EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic Office a Treasury Information Reporting Trace Number (TRN) Type: Trace: Company ID: Reference ID (RI Reference ID Type: Reference ID: Date/Time Reference Date Description: Date: Name (N1) CURRENT TRAN TRACE # 806235186 1593514335 TRACE NUMBER 031100203046660 SETTLE DATE/ORIGINAT 20200417 Entity ID Type: PAYEE Name: CITY OF MIAMI ID Type:- ID CODE ID: 1821109612 Entity ID Type: PAYER Name: FCSO, INC. Payment Amount: 665.00 Originator Receiver Entry Class: CTX Transaction Type: Credit Originator Company Name: STATE OF FLORIDA Entry Description: PAYMENTS Originator Company ID: 9001395052 Receiver Name: CITY OF MIAMI Receiver ID: 152898180581458 Payment Detail Addenda Items: 7 Trace: 091000014003889 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Addenda Detail Remittance (BPR) Transaction Type: PAYMENT ACCOMP REMIT Payment Amount: 665.00 Credit/Debit: C Method: ACH Format: CTX -Originator ID Type: ABA T/R Originator ID: 091000019 Originator Account Type: DEMAND DEPOSIT Originator Account Number: 2079900545225 Originator Company ID: 9001395052 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Trace Number (TRN) Type: CURRENT TRAN TRACE # Trace: 152898180581458 Reference ID (REF) Reference ID Type: TRACE NUMBER Reference ID: 091000014003889 Reference Description: ACH ASSIGNED TRACE NUMBER Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20200417 Page: 5 Note: Intraday information subject to change EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic Office Treasury Information Reporting Name (N1) Entity ID Type Name: Entity ID Type Name: Communications Contact (PER) Contact Function Type: Name: Contact Number Type: Contact Number: PAYEE CITY OF MIAMI PAYER STATE OF FLORIDA ACCOUNTING DEPARTMEN DEPT. OF HIGHWAY SAFETY & MOTOR VEH TEL. (850) 617-3301 Accounts Receivable Open Item Reference (RMR) Reference ID Type: SELLER'S INVC NBR Reference ID: EC041320 Payment Action Type: PAYMENT ON ACCOUNT Amount Paid: 665.00 Payment Amount: 615.91 Originator Receiver Entry Class: CCD Transaction Type: Credit Originator Company Name: CIGNA Entry Description: HCCLAIMPMT Originator Company ID: 9751677627 Receiver Name: /CITY OF MIAMI EMERG S Receiver ID: 1821109612 Payment Detail Addenda Items: 0 Trace: 091000012203010 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 615.91 Credit/Debit: C Method: ACH Format: CCP Originator ID Type: ABA T/R Originator ID: 091000019 Originator Company ID: 9751677627 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Trace Number (TRN) Type: CURRENT TRAN TRACE # Trace: 200414090026852 Company ID: 1591031071 Reference ID (REF) Reference ID Type: TRACE NUMBER Reference ID: 091000012203010 Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20200417 Page: 6 Note: Intraday information subject to change EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic Office Treasury Information Reporting Name (N1) Entity ID Type: PAYEE Name: /CITY OF MIAMI EMERG S ID Type: ID CODE ID: 1821109612 Entity ID Type: PAYER Name: CIGNA Payment Amount: 404.46 Originator Receiver Entry Class: CCD Transaction Type: Credit Originator Company Name: AMERICAN EXPRESS Entry Description: SETTLEMENT Originator Company ID: 1134992250 Receiver Name: MARINE STADI1090175548 Discretionary Data: PAYMENT DATE 20108 Receiver ID: 1090175548 Payment Detail Addenda Items: 0 Trace: 091000016032705 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 404.46 Credit/Debit: C Method: ACH Format: CCD Originator ID Type: ABA T/R Originator ID: 091000019 Originator Company ID: 1134992250 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Trace Number (TRN) Type: CURRENT TRAN TRACE # Trace: 091000016032705 Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20200417 Date Description: EFFECTIVE Date: 20200417 Name (N1) Entity ID Type: PAYEE Name: MARINE STAD11090175548 ID Type: ID CODE ID: 1090175548 Entity ID Type: PAYER Name: AMERICAN EXPRESS Page: 7 Note: Intraday information subject to change EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic Officeo Treasury Information Reporting Payment Amount: 402.32 Originator Receiver Entry Class: CCD Transaction Type: Credit Originator Company Name: MERCHANT SERVICE Entry Description: MERCH DEP Originator Company ID: 1841010148 Receiver Name: CM DINNER KEY MARINA 0 Discretionary Data: MERCHANT ACTIVITY Receiver ID: 8016259916 Payment Detail - Addenda Items: 0 Trace: 042000019225154 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 402.32 Credit/Debit: C Method: ACH Format: CCD Originator ID Type: ABA T/R Originator ID: 042000013 Originator Company ID: 1841010148 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Trace Number (TRN) Type: CURRENT TRAN TRACE # Trace: 042000019225154 Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20200417 Date Description: EFFECTIVE Date: 20200417 Name (N1) Entity ID Type: PAYEE Name: CM DINNER KEY MARINA 0 ID Type: ID CODE ID: 8016259916 Entity ID Type: PAYER Name: MERCHANT SERVICE Payment Amount: 289.71 Originator Receiver Entry Class: CCD Transaction Type: Credit Originator Company Name: WEX BANK Entry Description: AP PAYMENT Originator Company ID: 1010526993 Receiver Name: CITY OF MIAMI Discretionary Data: 06192169 MERCH Receiver ID: MERC-AHT635514 Payment Detail Addenda Items: 0 Trace: 041001038455870 Settlement Date: 04/17/2020 Effective Date: 04/17/2020 Page: 8 Note: Intraday information subject to change EDI Payment Detail Report Custom As of 04/17/2020 Company: CITY OF MIAMI User: Elmita Bolivar 04/20/2020 11:11 AM ET Commercial Electronic Office Treasury Information Reporting Addenda Detail Remittance (BPR) Transaction Type: PAYMT ACCOMP. REMIT Payment Amount: 289.71 Credit/Debit: C Method: ACH Format: CCD Originator ID Type: ABA T/R Originator ID: 041001039 Originator Company ID: 1010526993 Receiver ID Type: ABA T/R Receiver ID: 121000248 Receiver Account Type: DEMAND DEPOSIT Receiver Account Number: 2696204833948 Effective Date: 20200417 Trace Number (TRN) Type: CURRENT TRAN TRACE # Trace: 041001038455870 Date/Time Reference (DTM) Date Description: SETTLE DATE/ORIGINAT Date: 20200417 Date Description: EFFECTIVE Date: 20200417 Name (N1) Entity ID Type: PAYEE Name: CITY OF MIAMI ID Type: ID CODE ID: MERC-AHT635514 Entity ID Type: PAYER Name: WEX BANK Credit Total For Account 2696204833948(USD) 266,937.21 Account Net Total(USD) 266,937.21 Credit Total For Bank 121000248(USD) 266,937.21 Bank Net Total(USD) 266,937.21 Currency Credit Total(USD) 266,937.21 Currency Net Total(USD) 266,937.21 -- END OF REPORT -- A 3 wf)l Page: 9 Note: Intraday information subject to change