HomeMy WebLinkAboutC-2972(B) - Emergency Ambulance Transportation ServicesC- 2972(B)
AMENDMENT TO AGREEMENT FOR PROVISION OF EMERGENCY AMBULANCE
TRANSPORTATION SERVICES
SECONDARY RESPONDER
This amendment will amend the existing AGREEMENT dated January 17,1994, (the
"Agreement") between the City of Newport Beach ( "City") and Schaefer Ambulance Service
Inc., ( "Contractor").
On May 28, 1996, the City Council adopted Ordinance No. 96 -20, Revisions to Chapter 5.14 of
the Newport Beach Municipal Code, that allowed the Fire and Marine Department to deliver
Emergency Ambulance Transportation Services as a part of a comprehensive emergency
medical services system.
On June 24, 1996, the City Council adopted Resolution 96-42, Approving Paramedic Service
Fees pursuant to Chapter 5.60 of the Newport Beach Municipal Code, and revising member
benefits to include emergency ambulance transportation services.
In consideration of the promises and agreements in this Amendment, both parties wish to
amend the Agreement as follows:
City agrees that Section 6, Rate Schedule, shall be amended to include that Contractor may bill
the City for payment of any uninsured portion of paramedic subscription members bills
incurred from August 12,1996 through expiration of the AGREEMENT. City agrees to pay
Contractor within thirty (30) days upon receipt of said bills. City will make available a roster of
paramedic subscription members.
Except as expressly amended in this Agreement, all other terms and conditions shall remain
unchanged in full force and effect.
This amendment to the AGREEMENT shall be effective as of August 12,1996.
Approved as to form by:
CITY OF NEWPORT BEACH, A
MUNICIPAL CORPORATION
City Attorney Mayor
SCHAEFER AMBULANCE SERVICE INC
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• �� i " August 12,1996
Council Agenda
APPROVED Item 9
TO: Mayor and Members of the City Council C _ acl
FROM: Timothy Riley, Fire and Marine Chief
SUBJECT: Amend Agreement with Schaefers Ambulance Service Inc. as
Secondary Provider of Emergency Ambulance Transportation
Services
RECOMMENDATION:
Approve an amendment to the existing agreement with Schaefers Ambulance as
Secondary Provider of emergency ambulance transportation services to
accommodate our paramedic subscription members' emergency ambulance
transportation benefit.
Deny Schaefers Ambulance's request to increase their ground ambulance rates to
the maximum rate schedule adopted by the County Board of Supervisors on
• June 4, 1996.
DISCUSSION:
A written request for consideration of a rate increase was received on June 9,
1996. At the July 8, 1996, Council meeting, rates for Medicare patients, residents
and non - residents were approved. The rate schedule requested by Schaefers
Ambulance exceeds the approved rates for Medicare and residents. (Schaefers'
proposed rate schedule is attached.) Schaefers Ambulance has been advised that
they may remain with their existing rate schedule approved in 1994 or they can
change their rates in accordance with the approved structure.
Jim Karras, Regional Manager of Schaefers, has expressed continuing concerns
regarding the potential for violating federal Medicare regulations. The City
Attorney's Office has advised us that there does not appear to be any such
violations. Additional information has been requested from Mr. Karras to clarify
his concerns.
Schaefers Ambulance is the designated secondary provider for our City. In this
role they provide emergency ambulance transportation within our city, including
our paramedic subscription members. Since emergency ambulance
transportation is now a benefit of our program an amendment is required to
• ensure our subscription members do not receive a bill from Schaefers for the
uninsured charges.
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AMENDMENT TO AGREEMENT FOR PROVISION OF EMERGENCY AMBULANCE
TRANSPORTATION SERVICES •
SECONDARY RESPONDER
This amendment will amend the existing AGREEMENT dated January 17,1994, ( the
"Agreement") between the City of Newport Beach ( "City") and Schaefer Ambulance Service
Inc., ( "Contractor").
On May 28, 1996, the City Council adopted Ordinance No. 96 -20, Revisions to Chapter 5.14 of
the Newport Beach Municipal Code, that allowed the Fire and Marine Department to deliver
Emergency Ambulance Transportation Services as a part of a comprehensive emergency
medical services system.
On June 24, 1996, the City Council adopted Resolution 96 -42, Approving Paramedic Service
Fees pursuant to Chapter 5.60 of the Newport Beach Municipal Code, and revising member
benefits to include emergency ambulance transportation services.
In consideration of the promises and agreements in this Amendment, both parties wish to
amend the Agreement as follows:
City agrees that Section 6, Rate Schedule, shall be amended to include that Contractor may bill
the City for payment of any uninsured portion of paramedic subscription members bills •
incurred from _ through expiration of the AGREEMENT. City agrees to pay Contractor
within thirty (30) days upon receipt of said bills. City will make available a roster of paramedic
subscription members.
Except as expressly amended in this Agreement, all other terms and conditions shall remain
unchanged in full force and effect.
This amendment to the AGREEMENT shall be effective as of August .1996.
Approved as to form by:
City Attorney
CITY OF NEWPORT BEACH, A
MUNICIPAL CORPORATION
City Manager
SCHAEFER AMBULANCE SERVICE INC
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SCHAEFER AMBULANCE SERU:CE
Chief Timothy Riley
NEWPORT BEACH FIRE AND
MARINE DEPARTMENT
P.O. Box 1768
Newport Beach, California 92658 -8915
0
July 9, 1996
IES P02
SENT VIA FAX
Re. :BEQUEST FOR REVISION IN MAXIMUM EMERGENCY GROUND AMBULANCE
RATES.
Dear Chief Riley:
Pursuant to the City Council action on 07108196, which revised the maximum emergency
ground ambulance rates within the City of Newport Beach to be consistent with those rates set
by the Orange County Board of Supervisors on 06/04/96, and pursuant to our agreement with
the City, we do hereby respectfully request that an amendment to our agreement be made to
reflect a new 'Exhibit A' containing the rates set forth below.
MAXIMUM EMERGENCY GROUND BLS AMBULANCE RATES
BLS Emergency Base Rate
Applicable for urgent or
$296.20
Code III response at the
request of a public
safety employee
Mileage
Per patient mile or
$ 10.05
fraction thereof
Oxygen (includes mask
Applicable when
$ 40.90
or cannula)
administered
Standby
Per 15 minutes after the
$ 29.20
first 15 minutes and any
fraction thereof
Expendable Medical
Maximum per response or
$ 13.30
supplies
fair market value,
whichever is least
2216 S. BRISTOL, SANTA ANA, CALIFORNIA 92704 . PHONE (714)
545 -3048
FAX (714) 545-1294
Chief Riley - Letter
07/01IMS
Pago 2 of 2.
It is our intent to have the above mentioned rates placed into effect as of 07/09/98 at
12.01 hours, which is consistent with the action of the council for the Fire Ambulance program.
As we previously pointed out in our 1994 proposal and subsequent agreement with the City, the
above mentioned rates will be charged for both city residents and non - residents. As you know,
we have been advised by our legal council that charging the Medicare program more than other
payers is a violation of the federal Medicare anti - kickback statute.
Thank you for your consideration of our request. We look forward to working with you
and your staff under the new ambulance transport system the City has recently implemented.
Sincerely,
SCHAEFER AMBULANCE SERVICE, INC.
Jim Karras
Regional Manager
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December 13,1993
Council Agenda
c - 2 ?72M) Item No. 11
TO: Mayor and Members of the City Council 2-972- (8)
FROM: Tim Riley, Fire Chief 11L F
SUBJECT: Request to Award Contract for Emergency Ambulance
Transportation Services DEC 1 3 1993
RECOMMENDATION:
Authorize the Mayor to:
1. Sign an agreement with 6eaison, Inc. to serve as the City's primary emergency
ambulance transportation services provider effective January 1, 1994.
2. Sign an agreement with $chaefer's Ambulance Service to serve as the City's
secondary emergency ambulance transportation services provider effective
January 1, 1994.
DISCUSSION:
On October 11, 1993, the Council authorized the City Clerk to advertise for bids to
contract for emergency ambulance transportation services. Five companies responded
(see list below).
On December 1, 1993, an oral interview with each company was conducted by a review
panel. The panel consisted of Ken Delino, City of Newport Beach; Carol Porth, Oasis
Senior Center; CeCe Waite, Hoag Hospital; Bill Hamilton, local business owner; and
Vickie Cleary, Newport Beach Fire Department.
The panel awarded a maximum of 300 points to each company based on the oral
interview and the proposals which included:
1. Commitment to Clinical Performance
2. Quality of Equipment & Equipment Maintenance Practices
3. Plan for Takeover of Service and Responsibilities
4. Commitment to Response Time
5. Experience and Background
6. Billing and Collection Services
7. Responsiveness to the Request for Proposal
The point totals were as follows:
Sealson, Inc. 1,319
Schaefer's Ambulance Service 1,214
Doctors Ambulance Service 1,200
Superior Ambulance 1,176
Medix Ambulance Service, Inc. 1,137
The complete proposals of all five companies are on file and available for Council
review.
C - Z %72 (OV
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AGREEMENT FOR PROVISION OF
EMERGENCY AMBULANCE TRANSPORTATION SERVICES
SECONDARY RESPONDER
THIS AGREEMENT, entered into this day / < ofG/ 19 K
which date is enumerated for purposes of reference only, by and
between the City of Newport Beach, hereinafter referred to as
"CITY" and Schaefer Ambulance Service, hereinafter referred to as
"CONTRACTOR." This Agreement shall be administered by the Fire
Chief for the City of Newport Beach, hereinafter referred to as
"FIRE CHIEF."
WITNESSETH:
WHEREAS, CITY desires to assure the availability of prompt
emergency medical transportation services within the City of
Newport Beach; and
WHEREAS, CONTRACTOR desires to provide such services upon the
terms and conditions set forth in this Agreement:
NOW, THEREFORE, IT IS MUTUALLY AGREED AS FOLLOWS:
1. DEFINITIONS:
Agreement:
The following terms and definitions shall be used in this
A. "Emergency Ambulance Transportation Services,"
hereinafter referred to as "EATS, 11 means the provision of ambulance
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services in response to an unforeseen event giving rise to the need
for transport of one or more patients requiring basic or advanced
life support services. This service may require Code 3 response.
B. "Emergency Dispatch Center" means the designated
Fire Department Communications Center, responsible for authorizing
EATS provided pursuant to this Agreement.
C. "Advanced Life Support" as defined in the California
Health and Safety Code, Section 1797.52, as now in existence or
hereafter amended or changed, means special services designed to
provide definitive prehospital emergency medical care, including,
but not limited to, cardiopulmonary resuscitation, cardiac
monitoring, cardiac defibrillation, advanced airway management,
intravenous therapy, administration of specified drugs and other
medical preparations, and other specified techniques and procedures
administered by authorized personnel under the direct supervision
of a base hospital as part of a local EMS system at the scene of an
emergency, during transport to an acute care hospital, during
interfacility transfer, and while in the emergency department of an
acute care hospital until responsibility is assumed by the
emergency or other medical staff of that hospital.
D. "Basic life support" as defined in the California
Health and Safety Code, Section 1797.60, as now in existence or
hereafter amended or changed, means emergency first aid and
cardiopulmonary resuscitation procedures which, as a minimum,
include recognizing respiratory and cardiac arrest and starting the
proper application of cardiopulmonary resuscitation to maintain
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life without invasive techniques until the victim may be
transported or until advanced life support is available.
E. "Dry Run" means a response by CONTRACTOR to a
request for EATS by the Emergency Dispatch Center, after which such
EATS are determined to be unnecessary.
F. "Primary Responder" means the ambulance company
which shall be requested first by the Emergency Dispatch Center to
provide EATS within the City limits.
G. "Secondary Responder" means the ambulance company
which shall be requested by the Emergency Dispatch Center to
provide EATS in the event that the Primary Responder is unable to,
or does not, provide such services.
H. "Response Time" means the interval of time from
initiation of an emergency medical response vehicle run to arrival
at the scene of the emergency incident.
I. "Code 3" means the use of red warning lamps and
siren as permitted by vehicle Code Section 21055 if the vehicle is
being driven in response to an emergency call.
J. "FIRE CHIEF" means the Director of Fire Services for
the City of Newport Beach.
2. AUTHORITY:
The Request for Proposals and CONTRACTOR'S response are
included as part of this Agreement by reference as though set forth
in full. Where the RFP and CONTRACTOR'S response conflict with
this Agreement, this Agreement shall prevail.
3.
3. DESIGNATION:
A. In consideration of the services CONTRACTOR agrees
to provide pursuant to this Agreement, CITY designates CONTRACTOR,
as Secondary Responder within the City limits of Newport Beach.
CITY may suspend or terminate such designation for failure to
maintain compliance with, or for violation of, any provisions of
this Agreement, and any applicable laws, rules, or regulations of
any governmental entity.
B. CITY assumes no financial liability for the cost of
services to be provided to patients pursuant to this Agreement,
including financial liability for the costs of Dry Runs.
4. SERVICES:
A. CONTRACTOR shall possess, maintain, and provide such
equipment, facilities, and supplies, and shall hire, train and
provide such personnel, as are necessary to respond on a
twenty -four (24) hour basis to requests by the Emergency Dispatch
Center for EATS. At a minimum, CONTRACTOR shall provide ambulances
and equipment described in Exhibit "B. 11 when so requested,
CONTRACTOR shall respond as directed unless CONTRACTOR is incapable
of thus responding, in which case CONTRACTOR shall immediately
notify the Emergency Dispatch Center.
B. CONTRACTOR shall adhere to the following operational
standards:
1. Emergency Response Time (Code 3 -red lights and
siren) shall not exceed ten (10) minutes for eighty -five
percent (85%-) of responses over a ninety (90) day period.
Es
2. Urgent, or Code 2 Response Time (expeditious
response without red lights and siren) shall not exceed
fifteen (15) minutes for eighty -five percent (85 %) of the
responses over a ninety (90) day period.
3. A field supervisor shall be immediately
available on a twenty -four (24) hour basis.
C. Personnel performing duties under this Agreement
shall meet all requirements of Chapter 5.14 of the Newport Beach
Municipal Code and other applicable laws, rules and regulations of
governmental entities as now in existence or as hereafter amended.
1. Attendants shall be at least eighteen (18)
years of age and be trained and competent in the proper
use of all equipment, and shall hold a current permit or
certificate issued by the County of Orange indicating
compliance with all applicable state and local laws,
rules and regulations.
2. Proof of license or permits required by this
Agreement shall be maintained by each attendant and
driver and available to the FIRE CHIEF or designee upon
request.
D. CONTRACTOR shall have at least one dispatcher on a
twenty -four (24) hour basis who is adequately trained in radio
operations and protocol standards established by all applicable
laws, rules and regulations.
E. CONTRACTOR shall install and maintain state of the
art communications equipment such as radios and KDTS acceptable to
5.
the
FIRE
CHIEF in each
first
line
and
reserve units
in compliance
with
any
governmental
rules,
laws,
or
regulations.
F. CONTRACTOR shall fully comply with all medical
standards, protocols and ambulance rules and regulations
established by the EMSA, and shall cooperate with the Program and
Medical Directors in the monitoring, regulations, and oversight of
the EMS system, throughout the term of this Agreement.
G. CONTRACTOR agrees to perform all services hereunder
in a manner commensurate with the community professional standards
and agrees that all services shall be performed by qualified and
experienced personnel who are not employed by CITY nor have any
contractual relationship with CITY.
5. DISASTER ASSISTANCE:
During a declared disaster, locally or in a neighboring
jurisdiction, the normal course of business under this Agreement
shall be interrupted from the moment the disaster situation is made
known to the CONTRACTOR by the Fire Department. Immediately upon
such notification, CONTRACTOR shall commit such resources as are
necessary and appropriate, given the nature of the disaster, and
shall assist in accordance with disaster plans and protocols
applicable in the locality where the disaster has occurred. The
disaster - related provisions of this Agreement are:
A. During such periods, the CONTRACTOR shall be
released from response time performance requirements until notified
by the Fire Department's authorized representative that disaster
assistance may be terminated. At the scene of such disasters, the
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s
CONTRACTOR'S personnel shall perform in accordance with local
disaster protocols established by the Newport Beach Fire
Department.
B. when disaster assistance has been terminated, the
CONTRACTOR shall resume normal operations as rapidly as is
practical considering exhaustion of personnel, need for restocking,
and other relevant considerations.
C. During the course of the disaster, CONTRACTOR shall
use best efforts to provide local emergency coverage and shall
suspend non - emergency transport work as necessary, informing
persons requesting such non - emergency service of the reason for the
temporary suspension.
6. RATE SCHEDULE:
A. CONTRACTOR may charge the maximum allowable rates
for services to be provided under this Agreement as set forth in
Exhibit "A" which is incorporated herein by this reference. No
other rates may be charged without prior compliance with Chapter
5.14 of the Newport Beach Municipal Code.
B. CONTRACTOR shall be a "Medicare Provider" for
Medicare and Medi -Cal, and shall accept payments from the Orange
County Indigent Medical Services program as payment for services
rendered. No patient covered under any of these three programs
shall be billed directly by the provider for any amount in excess
of the State or County approved co- payment or deductible.
C. CONTRACTOR shall accept insurance payments for
services rendered. Patients shall not be billed directly by the
7.
provider for any amount in excess of the policy's approved
co- payment or deductible.
D. CONTRACTOR may bill for services rendered which are
not covered by government programs or insurance. CONTRACTOR agrees
to bill for non - covered services as follows: If the first bill is
not paid, a second bill will be sent with a business letter
informing the client that payment is due immediately to avoid
collection. At the third billing CONTRACTOR shall notify client by
business letter that it will commence appropriate procedures for
collection of the bill. All billing procedures shall otherwise
conform to State Consumer Protection laws.
7. ALTERATION OF TERMS:
This Agreement and Chapter 5.14 of the Newport Beach
Municipal Code, together with any Exhibit (s) attached hereto, which
are incorporated herein by reference, fully express all
understandings of CITY and CONTRACTOR with respect to the subject
matter of this Agreement and shall constitute the total Agreement
between the parties for these purposes. No addition to, or
alteration of, the terms of this Agreement or any
Exhibit(s) thereto, whether written or verbal, shall be valid
unless made in writing and formally approved and executed by both
parties.
8. INDEPENDENT PARTIES:
CITY and CONTRACTOR intend that the relation between them
created by this AGREEMENT is that of employer- independent
contractor. The manner and means of conducting the work are under
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the control of CONTRACTOR, except to the extent they are limited by
statute, rule or regulation and the express terms of this
Agreement. No civil service status or other right of employment
will be acquired by virtue of CONTRACTOR'S services. None of the
benefits provided by CITY to its employees, including, but not
limited to unemployment insurance, worker's compensation plans,
vacation and sick leave are available from CITY to CONTRACTOR its
employees or agents. Deductions shall not be made for any state or
federal taxes, FICA payments, PERS payments, or other purposes
normally associated with an employer- employee relationship from any
fees due CONTRACTOR. Payments of the above items, if required, are
the responsibility of CONTRACTOR.
9. HOLD HARMLESS:
CONTRACTOR shall indemnify and hold harmless CITY, its
City Council, boards and commissions, officers and employees from
and against any and all negligence, loss, damages, liability,
claims, suits, costs and expenses whatsoever, including defense
costs and reasonable attorneys' fees, which arise out of or result
from or occur in connection with CONTRACTOR'S performance of
services or work conducted or performed pursuant to this Agreement.
CONTRACTOR shall indemnify and hold harmless CITY, its
City Council, boards and commissions, officers and employees from
and against any and all loss, damages, liability, claims, suits,
costs and expenses whatsoever, including reasonable attorneys'
fees, accruing or resulting to any and all persons, firms, or
corporations furnishing or supplying work, services, materials,
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equipment or supplies arising from or in any manner connected to
the CONTRACTOR'S performance of services or work conducted or
performed pursuant to this Agreement.
CITY shall indemnify and hold harmless CONTRACTOR from
and against any and all negligence, loss, damages, liability,
claims, suits, costs and expenses whatsoever, including defense
costs and reasonable attorneys' fees, which arise out of or result
from or occur in connection with CITY'S performance of services or
work conducted or performed pursuant to this Agreement.
10. MINIMUM INSURANCE REQUIREMENTS:
A. Prior to the time CONTRACTOR is entitled to commence
any part of the project, work, services under this Agreement,
CONTRACTOR shall procure, pay for and maintain at least the
insurance coverages and limits specified below. The insurance
shall be evidenced by delivery to the Fire Chief of a certificate
of insurance executed by the insurers authorized to do business in
the State of California listing coverages and limits; expiration
dates and terms of policies and all endorsements whether or not
required by the City, and listing all carriers issuing said
policies and a certified copy of each policy, including all
endorsements. Throughout the duration of this agreement, the
Contractor shall provide current certificates of insurance to the
Fire Chief. At the option of the City, Contractor shall provide to
the City certified copies of all policies providing coverage as
required by this contract. Such certified copies of insurance
policies shall contain all policy endorsements.11
10.
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B. The following insurance requirements shall remain in
effect throughout the term of this Agreement:
1. Workers' Compensation and Employers Liability
insuring statutory Workers' Compensation limits as
required by the Labor Code of the State of California and
$1,000,000.00 per accident Employers Liability.
2. Business Automobile Liability insurance,
insuring all owned, non -owned and hired automobiles -
coverage code 1 "any auto" with a limit of liability of
$2,000,000.00 combined single limit per accident for
bodily injury and property damage.
3. Commercial General Liability insurance with a
limit of liability of $1,000,000.00 combined single limit
per occurrence for bodily injury, personal injury and
property damage. If the policy contains a general
aggregate limit, then such aggregate limit shall not be
less than $2,000,000.00.
4. Professional liability insurance in the sum of
not less than one million dollars ($1,000,000.00) per
person and two million dollars ($2,000,000.00) annual
aggregate.
C. All insurance policies except Worker's Compensation
and Employer's Liability and Professional Liability shall contain
the following clauses:
1. City of Newport Beach, its officers and
employees are added as additional insureds as respects
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operations of the named insured performed under contract
with the City of Newport Beach."
2. "It is agreed that any insurance maintained by
the City of Newport Beach shall apply in excess of and
not contribute with, insurance provided by this policy.,,
3. Should any of the above described policies be
non - renewed, cancelled or coverage reduced before the
expiration date, the insurance carrier shall provide
thirty (30) days minimum advance written notice to the
Fire Chief.
11. PROHIBITION AGAINST TRANSFER:
CONTRACTOR shall not assign, sublease, hypothecate, or
transfer this Agreement or any interest therein directly or
indirectly, by operation of law or otherwise without prior written
consent of CITY. Any attempt to do so without said consent shall
be null and void, and any assignee, sublessee, hypothecate or
transferee shall acquire no right or interest by reason of such
attempted assignment, hypothecation or transfer.
The sale, assignment, transfer or other disposition of
any of the issued and outstanding capital stock of CONTRACTOR, or
of the interest of any general partner or joint venturer or
syndicate member if CONTRACTOR is a partnership or joint venture or
syndicate or cotenancy, which shall result in changing the control
of CONTRACTOR, shall be construed as an assignment of this
Agreement. Control means fifty percent (50%-) or more of the voting
power of the corporation, or a sale or transfer of over twenty -five
12.
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percent (25 %) of the assets of the CONTRACTOR.
12. LICENSES AND LAW:
A. CONTRACTOR shall, throughout the term of this
Agreement, maintain all necessary licenses, permits, approvals,
waivers and exemptions necessary for the provision of the services
hereunder and required by the laws and regulations of the United
States, the State of California, the County of Orange and the City
of Newport Beach. CONTRACTOR shall notify the FIRE CHIEF
immediately and in writing of its inability to obtain or maintain
such permits, licenses, approvals, waiver and exemptions. The
refusal of any such application, irrespective of appeal, shall
require written notification of the FIRE CHIEF.
B. All services furnished by the CONTRACTOR under this
Agreement shall be rendered in full compliance with all applicable
federal, state and local laws, rules, and regulations. It shall be
the CONTRACTOR'S sole responsibility to determine which laws,
rules, and regulations apply to the Services rendered under this
Agreement, and to maintain
standards at all times.
13. NONDISCRIMINATION:
compliance with these applicable
CONTRACTOR shall not discriminate in the provision of
services, employment practices, or in the allocation of benefits on
the basis of color, race, religion, national origin, sex, age,
physical or mental handicap in accordance with Titles VI and VII of
the Civil Rights Act of 1964, Title 42 of the United States Code,
Section 2000(d), rules and regulations promulgated pursuant
13.
thereto, and under the laws of the State of California as each law,
rule or regulation may not exist or hereafter be amended.
14. CONFLICT OF INTEREST:
CONTRACTOR must certify that he is not nor will not be
violating, either directly or indirectly, any conflict of interest
statute or any other applicable statute or principle by his
performance of this service.
15. NOTICES:
All notices, demands, requests or approvals to be given
under this Agreement shall be given in writing and conclusively
shall be deemed served when delivered personally or on the second
business day after the deposit thereof in the United States mail,
postage prepaid, registered or certified, addressed as hereinafter
provided.
All notices, demands, requests, or approvals from
CONTRACTOR to CITY shall be addressed as follows at:
City of Newport Beach
Attention: Fire Chief
3300 Newport Boulevard
P.O. Box 1768
Newport Beach, CA 92658 -8915
All notices, demands, requests, or approvals from CITY to
CONTRACTOR shall be addressed to CONTRACTOR at:
Schaefer Ambulance Service
Attn: James N. Karras
2215 S. Bristol
Santa Ana, CA 92704
16. REPORTS:
FIRE CHIEF may request reasonable written reports of
CONTRACTOR, at no cost to CITY, in order to determine the quality
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of services provided hereunder. The report shall include, but not
be limited to, the following:
A. Dispatch; enroute, on -scene and available times;
B. Mileage;
C. Services performed;
D. Name and permit number of attendants and driver on
duty;
E. Supplies and equipment expended;
F. Patient information to include name, insurance
information, residence, medical status, vital
signs, chief complaint and disposition;
G. Fees charged.
H. Computer data according to file specifications of
patient billing information and itemized listing of
activity.
FIRE CHIEF will be specific as to the information
requested, and to allow CONTRACTOR five (5) business days to
respond in writing. Each and every report, draft, work product,
map, record and other document reproduced, prepared or caused to be
prepared by CONTRACTOR pursuant to or in connection with this
Agreement shall be the exclusive property of CITY. No report,
information or other data given to or prepared or assembled by
CONTRACTOR pursuant to this Agreement shall be made available to
any individual or organization by CONTRACTOR without prior notice
and approval by CITY, except as otherwise required by law.
15.
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17. RECORDS:
0
CONTRACTOR shall maintain adequate records of services
provided in sufficient detail to permit an evaluation of services.
All such records shall be maintained in accordance with generally
accepted accounting principles and shall be clearly identified and
readily accessible. At any time during normal business hours, and
as often as may reasonably be deemed necessary, the Fire
Department's representatives may observe CONTRACTOR'S operations
and CONTRACTOR shall make available to the Fire Department for its
examination, its records with respect to all matters covered by the
Agreement, and the Fire Department may audit, examine, copy, and
make excerpts or transcripts from such record, records of
personnel, daily logs, conditions of employment, and other data
related to all matters covered by this Agreement. The Fire
Department representative may, at any time and without
notification, directly observe CONTRACTOR'S operation of the
ambulance dispatch center, maintenance facility, any ambulance post
locations, and a Fire Department representative may ride as
"Observer" on any of the CONTRACTOR'S ambulance units at any time.
Provided, however, that in exercising this right to inspection and
observation, the Fire Department representatives shall conduct
themselves in a professional and courteous manner, shall not
interfere in any way with CONTRACTOR'S employees in the performance
of their duties, and shall at all times be respectful of
CONTRACTOR'S employer /employee relationships.
The Fire Department's right to observe and inspect
16.
operations or records in CONTRACTOR'S business office shall be
restricted to normal business hours and reasonable notification
shall be given the CONTRACTOR in advance of any such visit.
18. TERMS OF AGREEMENT AND RENEWAL PROVISIONS:
A. Agreement Start Date. The Agreement start date
shall be 12:01 a.m., January 1, 1994, at which time the CONTRACTOR
shall assume full responsibility for the provision of all emergency
ambulance services throughout the designated service area.
B. Initial Term of Contract. The initial term of this
Agreement shall be three (3) years. Unless extended by the
provision for renewal set forth below in Paragraph D, or terminated
as provided in Paragraph C, this Agreement shall automatically
terminate at midnight, December 31, 1996.
C. Termination.
1. Either party may terminate this Agreement without
cause upon providing the other party with sixty (60) days
prior written notice.
2. Authorization to provide Emergency Transportation
Services under this Agreement may be suspended or this
Agreement may be terminated pursuant to Newport Beach
Municipal Code Section 5.14.100. Any notice of suspension or
termination of this Agreement shall be given in the manner set
out in the paragraph called Notices of this Agreement.
D. Renewal Provisions. The CONTRACTOR shall be
eligible to apply for one contract extension of two (2) years,
provided all of the following conditions are satisfied:
17.
0 0
1. The City Council must determine, by formal vote,
that CONTRACTOR'S services rendered then -to -date are
reasonably and accurately characterized as "excellent,
courteous, professional, and significantly above the
performance requirements of the Agreement."
2. To allow ample time to initiate and complete
competitive procurement processes in the event renewal is, for
any reason, denied, CONTRACTOR'S written request for renewal,
and the City Council determination of eligibility for renewal
must all be completed at least six months prior to the
expiration of this Agreement.
3. The CONTRACTOR'S written request for renewal will
include documentation of excellent, courteous and professional
Services rendered. In addition, Services that are
significantly above the Agreement's performance requirements
which result in a higher level of patient care will be
outlined and defined by the CONTRACTOR.
19. WAIVER OF DEFAULT:
waiver of any default shall not be deemed to be a waiver
of any subsequent default. waiver or breach of any provision of
this Agreement shall not be deemed to be a waiver of any other or
subsequent breach, and shall not be construed to be a modification
of the terms of this Agreement unless stated to be such, in
writing, by CITY and attached to the original Agreement.
20. MAJOR BREACH AND EMERGENCY TAKEOVER PROVISIONS:
Conditions and circumstances which shall constitute a
fl
major breach of Agreement by the CONTRACTOR shall include, but not
be limited to, the following:
A. Failure of the CONTRACTOR to operate the ambulance
service system in a manner which enables the Fire Department and
the CONTRACTOR to remain in substantial compliance with the
requirements of applicable federal and state laws, EMSA rules and
regulations, and with the requirements of Newport Beach Municipal
Code and related rules and regulations;
B. Supplying to the CITY false or misleading
information during this bid process or supplying information so
incomplete as to effectively mislead;
C. Withholding or willful falsification of data
supplied to the CITY, the Fire Department or to the EMSA Medical
Director during the course of operation, including by way of
example but not by way of exclusion, dispatch data, patient report
data, response time data, financial data, or falsification or
deliberate omission of any other data required under this
Agreement;
D. Failure to comply with or exceed the proposed and
accepted plan for ambulance coverage during the first three months
of operation under this Agreement;
E. Deliberate and unauthorized scaling down of
operations to the detriment of performance;
F. Failure to maintain equipment in accordance with
good maintenance practices, or to replace equipment in accordance
with CONTRACTOR'S submitted and accepted equipment replacement
•
E
policy, except as extended use of such equipment is approved by the
Fire Department as provided for herein;
G. Persistent failure of CONTRACTOR'S employees to
conduct themselves in a professional and courteous manner, and to
present a professional appearance, to such an extent that the fire
service's reputation suffers;
H. Failure by the CONTRACTOR to furnish key personnel
of quality and experience as bid;
I. Failure by CONTRACTOR to cooperate with and assist
the Fire Department in its takeover of CONTRACTOR'S operations
after a major breach has been declared and confirmed by the Fire
Department, as provided for herein;
J. Failure to substantially and consistently meet or
exceed the various clinical and response standards required
hereunder.
21. COST OF LITIGATION:
If any legal or equitable action is necessary to enforce
any provision hereof or for damages by reason of any alleged breach
of any provisions of this Agreement, the prevailing party shall be
entitled to receive from the losing party all costs and expenses in
such amount as the court may adjudge to be reasonable attorneys'
fees.
20.
IN WITNESS WHEREOF, the parties have executed this
Agreement in the City of Newport Beach, County of Orange, State of
California on the day, month and year above written.
CITY OF NEWPORT BEACH
A Municipal Corporation
BY:
Mayor
ATTEST:
�U
City Clerk
CONTRACTOR:
21.
0 0
Exhibit "A"
MAXIMUM EMERGENCY GROUND AMBULANCE RATES
Type of Charge
Basis for Charge
Rates
Emergency Base Rate
Applicable for urgent or
$185.25
Code III response at the
request of a public
safety employee
Mileage
Per patient mile or
$9.75
fraction thereof
Night Call
Applicable when time of
$39.75
service request is
between 7:00 p.m. and
7:00 a.m.
oxygen (includes mask
Applicable when
$39.75
or cannula)
administered
Standby
Per 15 minutes after the
$28.50
first 15 minutes and any
fraction thereof
Expendable Medical
Maximum per response or
$13.00
Supplies
fair market value,
whichever is least
Exhibit "B"
GROUND AMBULANCE REQUIREMENTS
Section 1. GROUND AMBULANCE DESIGN /DOCUMENTATION /EQUIPMENT
A. Ambulance Design:
1. The patient compartment of an ambulance shall, at a
minimum, be of sufficient size and design to comply with
those standards in KKK- A -1822A "Ambulance Federal
Specifications," including:
a. Adequate space for required personnel to perform
their functions safely and efficiently.
b. Adequate space for any required and necessary
medical equipment and safety supplies needed to
treat patients.
C. Adequate space to accommodate two (2) litter
patients so situated that at least one patient can
be given intensive life- support during transit.
2. Each ambulance shall have:
a. A rear loading doorway vertical clearance of not
less than 46 inches.
b. Gaskets affixed to the perimeters of all doors and
windows to prevent carbon monoxide gas leaks into
the vehicle.
C. The word "Ambulance" affixed to the front or both
sides of the vehicle. The lettering shall be 4 to
6 inches in height.
d. A Black unit number (two to four digits), 3 to 4
inches in height affixed to the right rear and both
sides of the vehicle.
B. Required documentation in each ambulance shall include:
1. A current and valid County of Orange ambulance license
(or facsimile) in the driver compartment.
2. A current and valid County of Orange ambulance license
decal affixed to the lower portion of the right rear of
the ambulance.
3. Proof of passage of annual vehicle inspection performed
by the California Highway Patrol within the preceding
twelve (12) months.
0
Exhibit "B"
Ground Ambulance Requirements
Page 2
4. Proof of passage of annual odometer inspection performed
by the Division of Weights and Measures of the
Agriculture Department of the County of Orange within the
preceding twelve (12) months.
C. Ambulance Equipment
1. All ambulance equipment shall be maintained in a clean
condition and in good working order at all times.
2. Required Non - Medical Equipment:
a. Seat belts for all passengers in the patient
compartment.
b. Operational heating and air conditioning units in
the patient compartment.
3. Required Medical Equipment and Supplies:
Medical equipment and supplies used to treat patients
shall be stored in the patient compartment and shall be
readily accessible; such equipment shall include:
a. Oxygen Delivery Supplies:
1) One (1) "H," "M," or equivalent cylinder for
operation with a wall mount oxygen outlet.
2) Two (2) portable "E" cylinders:
a) One (1) at full pressure at all times.
b) One (1) at not less than 1000 psi.
OR
Four (4) portable "D" cylinders:
a) Two (2) at full pressure at all times.
b) Two (2) at not less than 1000 psi.
3) One (1) oxygen - powered resuscitator with LISP
40 1pm control valve which allows complete
exhalation.
4) Clear plastic oxygen administration masks:
a) Six (6) adult size.
b) Six (6) child size.
c) Six (6) infant size.
0 9
Exhibit ,B,,
Ground Ambulance Requirements
Page 3
6) Clear plastic nasal cannulas:
a) Four (4) adult size.
b) Two (2) child size.
7) One (1) oxygen tank wrench.
b. Suction Equipment:
1) One (1) portable suction device capable of
providing, at a minimum, an airflow of over 30
liters per minute at the end of a delivery
tube and a vacuum of over 300 mmHg (milli-
meters of Mercury) when the tube is clamped.
2) One (1) installed suction device capable of
providing, at a minimum, an airflow of over 30
liters per minute at the end of a delivery
tube and a vacuum of over 300 mmHg when the
tube is clamped.
3) Suction Catheters:
a)
Two
(2)
10 French with Venturi valve.
b)
Two
(2)
14 French with Venturi valve.
a)
Two
(2)
18 French with Venturi valve.
d)
Two
(2)
rigid pharyngeal suction tips.
C. Cervical
collars,
rigid type (Stiffneck,
Philadelphia,
or
equivalent):
1) One (1) large, one (1) medium, one (1) small,
and one (1) pediatric size collar; or
2)
Four (4) multi -size rigid cervical collars.
d.
One
(1)
disposable, single -use, humidifier.
e.
Four
(4)
cold packs.
f.
Two
(2)
heat packs.
g.
Four
(4)
pair disposable gloves.
h.
Four
(4)
surgical masks.
i.
Backboards with a minimum of three (3) sets of
straps.
Exhibit "B"
Ground Ambulance Requirements
Page 4
Section 2. GROUND AMBULANCE COMMUNICATION EQUIPMENT /DISPATCH
STANDARDS
A. Communication Equipment:
1. All ambulance communication equipment shall be
operational at all times.
2. Each ambulance shall have:
a. One (1) UHF /EMS MED -10 Radio with roof -top five (5)
db highgain antenna for communication with the
Orange County Paramedic Coordinated Communication
System.
b. One (1) additional five (5) db highgain antenna for
use with the paramedic Coronary Observation Radio
(COR) Antenna to be mounted on the roof of the
ambulance with 8 feet of excess cable in the
patient compartment with BNC connector.
3. MED -10 Radio shall be in the "on" position at all times
and the microphone attached while the ambulance is in
operation.
4. The ambulance service provider shall be responsible for
all maintenance and repair costs to the communications
equipment installed in the ground ambulance.
B. Ambulance Communication Equipment Inspection:
1. Each ambulance shall have its MED -10 Radio, five (5) db
highgain antenna, antenna cable and BNC connector
inspected and certified each calendar year to verify
proper installation and Federal Communications Commission
(FCC) compliance of equipment by one of the following
agents:
a. Orange County Communications (OCC).
b. An authorized service representative designated by
the radio manufacturer.
2. Elements of Inspection and Certification:
a. All ambulance communication equipment inspections
shall be documented by OCC.
Exhibit "B"
Ground Ambulance Requirements
Page 5
1) Radio equipment will be checked for:
a) Model number.
b) Serial number.
c) Vehicle identification number.
2) FCC compliance on:
a)
Frequency.
b)
Modulation.
c)
Power.
d)
Receive sensitivity.
3) COR accessories
a) Highgain antenna.
b) Antenna cable length.
c) Connector.
b. The inspection form shall be designed by OCC and
supplied to ambulance service providers by Orange
County Emergency Medical Services Authority
(OCEMSA).
ACORD CERTIFICA7: OF
DAM (MM OONY)
ABI 1 111 U E
11/13/1997
PRODUCER (310)309-2200 FAX (310)309-2623
It:KUr INrUKMAIIUM
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
iander A. Kessler & Associates, Inc.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2850 Ocean Park Boulevard
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 200
COMPANIES AFFORDING COVERAGE
Santa Monica, CA 90405
COMPANY Admiral Insurance Company
Attn: Michelle Dominguez EM:
299 A
INSURED
COMPANY Clarendon National Insurance
Schaefer A m b u 1 a n c e Service I nc.
IS
4627 W. Beverly Blvd.
.......
Los Angeles, CA 90004
COMPANY
C
COMPANY
D
. . . . .. . . . . il"_1 ... "I .. .... . . .. ... .... . . . I ..
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION
OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
.......... ........ . .............. . . ............
ro TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE POLICY EXPIRATION
LIMITS
DATE (MMMDfM DATE (MWDDNY)
GENERAL LIABILITY
GENERAL AGGREGATE s 5,000,000
................................ ....................
X COMMERCIAL GENERAL LIABILITY
PRODUCTS - COMP /OP AGG $ 5,000,000
CLAIMS MADE X OCCUR
PERSONAL & ADV INJURY s Included
A A97CM06500
11/18/1997 11/18/1998 ........... ...................... ...... ............................
OWNER'S 8 CONTRACTOR'S PROT
EACH OCCURRENCE 1 51000,000
. ... ...... I . ................
,X: Professional Liab
FIRE DAMAGE (Any we fire) $
.................
.....................................................
................. I— ......... I ....................
MED EXP (Any one Person) 3
AUTOMOBILE LIABILITY
.......
COMBINED SINGLE LIMIT s
ANY AUTO
1,000,000
ALL OWNED AUTOS
BODILY INJURY
�X SCHEDULED AUTOS
(Per Person)
B :BAOB-704185
11/18/1997 11/18/1998
X HIRED AUTOS
BODILY INJURY
;X NON -OWNED AUTOS
(Per accident)
................ ................ ...........
:PROPERTY DAMAGE 3
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT S
ANY AUTO
................. ......... I ........
OTHER THAN AUTO OHM
EACH ACCIDENT 6
........ ..................... ...............................
........ ..........
AGGREGATE 3
EXCESS LIABILITY
EACH OCCURRENCE
............. 111 ................... ...............
UMBRELLA FORM
AGGREGATE s
OTHER THAN UMBRELLA FORM
. .. . ........ ...
WORKERS COMPENSATION AND
JTR""
EMPLOYERS' LIABILITY
EL EACH ACCIDENT 3
THE PROPRIETORJ :INCL
EL DISEASE - POLICY LIMIT $
IV
PARTNERSPEXECUTE
OFFICERS ARE: EXCL:
EL DISEASE -EA EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESMPECIAL ITEMS
:VIDENCE ONLY
;chedule of vehicles available with carrier.
-Except 10 days notice for non-payment of premium.
N,
A,
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
'It) DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of Newport Beach
License Superintendent
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
P.O. Box 1769
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
ZI //
Newport Beach, CA 92658
ACORD CERTIFICATbPF
LIABILITY
INSUR SCE CSR SL DATE(MM /DD /YY)
ne
MEDI% -2 11/13/97
PRODUCER
San Joaquin Valley Insurance
7405 N. First St.
THIS CERTIFICATE IS ISMED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P. 0. Box 28906
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fresno CA 93729-8906
COMPANIES AFFORDING COVERAGE
I COMPANY
Lyn FauntLeRoy
Phone NO. 209- 447 -4600 Fex No
A Hartford Insurance Company
INSURED
COMPANY
B
Medix Ambulance
COMPANY
Estelle Fedan
C
26021 Pala Street
Mission Viejo CA 92691
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE IMM /DD/YYI DATE(MMJDDNY)
GENERAL LIABILITY
GENERAL AGGREGATE
11 2000000
A
I X I COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ® OCCUR
P
39UENSM6445W
11/20/97
11/20/98
PRODUCTS - COMPIOP AGG
_
$ 2000000
PERSONAL &ADV INJURY
$ 1000000
IOWNER'S& CONTRACTOR'S MOT
j
$1000000_
EACH OCCURRENCE
FIRE DAMAGE (Any one fire)
_
$300000
MED EXP (Any one Person)
$ 10000
AUTOMOBILE
LIABILITY
A
ANY AUTO
39UENSM6445W
11/20/97
11/20/98
COMBINED SINGLE UMIT
$1000000
BODILY INJURY
(Per Person)
ALL OWNED AUTOS
SCHEDULED AUTOS
$
$
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per eccdent)
$
X
PROPERTY DAMAGE
$
AGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
n
OTHER THAN AUTO ONLY
EACH ACCIDENT
4
AGGREGATE
$
EXCESS LIABILITY
EACH OCCURRENCE
*1000000
A
X UMBRELLA FORM
39LOSSM6446W
11/20/97
11/20/98
AGGREGATE
$1000000
OTHER THAN UMBRELLA FORM
_
WCC STAT IT - ()ER
TORY LIMBS ER
$
WORKERS COMPENSATION AND
EMPLOYERS'
EMPLOYERS' LIABILITY
EACH ACCIDENT
$
THE NERSI XECU INCL
PARTNEflS /E %ECNIVE
EL DISEASE - POLICY LIMIT
$
$
OFFICERS ARE EXCL
EL DISEASE - EA EMPLOYEE
OTHER
A
PROFESSIONAL LIAB
39UENSM6445W
11/20/97
11/20/98
OCCURRENC $1000000
AGGREGATE $2000000
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /SPECIAL ITEMS
* A 10 DAY NOTICE OF CANCELLATION WILL
BE GIVEN FOR NON - PAYMENT OF PREMIUM
CERTIFICATE HOLDER
CANCELLATION
CITYNBl
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
CITY OF NEWPORT BEACH
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
LICENSE SUPERINTENDENT
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
330 NEWPORT BEACH
OF ANY KIND UPON fHII COMP AGEN ORR EB ATIVES.
NEWPORT BEACH CA 92660
AUTHORIZED REPRES VE_ t
Lyn FauntLeRQ E
ACORD 25- 511/951
RATION 1988
AIHORD. CERTIFICAIS OF
INSURANCE CSR TS DATE(MM /DDNV)
SCHAB -- 11/17/95
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ABI Business Insurance Service
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
32107 W. Lindero Canyon #126
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Westlake Village CA 91361-
COMPANIES AFFORDING COVERAGE
COMPANY
818- 889 -0006
A Clarendon National Ins. Co.
INSURED
COMPANY
B Evanston Insurance Company
COMPANY
Schaefer Ambulance Serv., Inc
C
4627 Beverly Blvd
Los Angeles CA 90004
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR
CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM /DDNV)
POLICY EXPIRATION
DATE (MM/DDNY)
LIMITS
GENERAL
LIABILITY
GENERAL AGGREGATE
52,000,000,
B
X
COMMERCIAL GENERAL LIABILITY
SM- 704093
11/18/95
11/18/96
PRODUCTS - COMP /OP AGG
51,000,000,
CLAIMSMADE X OCCUR
PERSONAL &AOV INJURY
51,000,000,
EACH OCCURRENCE
51,000,000,
OWNER'S& CONTRACTOR'S PROT
FIRE DAMAGE (Any one fire)
5
MED EXP (Any one person)
5
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
51,000,000,
ANY AUTO
BODILY INJURY
IPer Person)
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
HA08702265
11/18/95
11/18/96
X
BODILY INJURY
(Per acciEenU
_
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
ANY AUTO
EACH ACCIDENT
$
AGGREGATE
$
EXCESS LIABILITY
EACH OCCURRENCE
$
AGGREGATE
UMBRELLA FORM
$
$
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
STATUTORY LIMITS
EMPLOYERS' LIABILITY
EACH ACCIDENT
$
THE PROPRIETOR/ INCL
PARTNERSIEXECUTIVE
DISEASE - POLICY LIMIT
s
DISEASE - EACH EMPLOYEE
$
OFFICERS ARE: EXCL
OTHER
B
Professional Liab
SM- 704093
11/18/95
11/18/96
occu $1,000,000
aggr $2,000,000
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /SPECIAL ITEMS
Scheduled vehicles on file with the insurance
company.
CERTIFICATE HOLDER
CANCELLATION
NEWPORT
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
City of Newport Beach
License Superintendent
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
330 Newport Beach
OF ANY KIND UP N THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REP ENTATIVE
Newport Beach CA 922660
ACORD 2" 431931
A CORD CORPORATION 1993
I
issuE DHSS tuJaloDivv)
11/30/93
PRODUCER.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
ABI Business Insurance Services, Inc.
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
32107 West Lindero Canyon road #126
Westlake Village, Ca. 91361
COMPANIES AFFORDING COVERAGE
LETTERNY A Clarendon National Insurance Company
COMPANY
LETTER B Classic Syndicate / Illinois Ins Exchange
INSURED
COMPANY `.
LETTER
Schaefer Ambulance Service
Incorporated, etal
4627 W. Beverly Blvd.
COMPANY D
LE
Los Angeles, Ca. 90004
COMPANY E
LETTER
0
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW
HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION
OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDD/YY)
POLICY EXPIRATION
DATE (MM /DD/YY)
LIMITS
GENERAL
LIABILITY
BODILY INJURY DOC.
$
B
COMPREHENSIVE FORM
X
BODILY INJURY AGG.
$
PREMISES /OPERATIONS
DOL187641
11/18/93
11/18/94
X
PROPERTY DAMAGE OCC.
$
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PROPERTY DAMAGE AGG.
$
BI & PO COMBINED OCC.
$ 1 I 000, •
PRODUCTS /COMPLETED OPER.
CONTRACTUAL
BI & PO COMBINED AGG.
$ I I
INDEPENDENT CONTRACTORS
PERSONAL INJURY AGG.
$
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
Fire Auage
50,WO.
AUTOMOBILE
LIABILITY
ANY AUTO
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS ( Priv. Pass. )
ALL OWNED AUTOS ( Other Than I
Priv. Pass,
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
$
HIRED AUTOS
NON -OWNED AUTOS
A
GARAGE LIABILITY
l
Schedued Autos
009000101
11 /18/93
11 /18/94
BODILY INJURY &
PROPRTY
COMBINED DAMAGE
$
1,000,000.
x
E %LESS LIABILITY
EACH OCCURRENCE
$
UMBRELLA FORM
AGGREGATE
$
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
STATUTORY LIMITS
EACH ACCIDENT
$
AND
DISEASE — POLICY LIMIT
$
EMPLOYERS' LIABILITY
DISEASE EACH EMPLOYEE
$
B
OT4Tofessional Liab
DOL187641
11/18/93
11/18/94
$1,000,000. Agg & Occur.
DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /SPECIAL ITEMS
City Of Newport Beach
License Superintendent
330 Newport Beach
Newport Beach, CA 92660
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY F ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZ
REPRESF IVE
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