Backup Documents 06/09/2015 Item #16E5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 6 E 4.)
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office VI? (0 V°115
4. BCC Office Board of County TW ".\
Commissioners NIVS 4/ (sAk\VS
5. Minutes and Records Clerk of Court's Office —Tht\, b/ (c ( [(5p
3-2�
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff 1, , ,.. / Phone Number
Contact/ Department `•:.:1 i C L C�11�C• / I V ( `j r .�--� _ . ) S
Agenda Date Item was Agenda Item Number
Approved by the BCC '�` Ir (a 1 q tt5 ✓ 1 . C • 5
Type of Document Number of Original
Attached 1- C- t`l i V' '<A, ' Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? if SQA A4{) 0116111
2. Does the document need to be sent to another agency for additional signatures? If yes, 1
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. ' l p
3. Original document has been signed/initialed for legal sufficiency. (All documents to be �(,�j
signed by the Chairman,with the exception of most letters,must be reviewed and signed C�""'
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's 1.J A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on S" G tenter date)and all changes made
�W(�
during the meeting have been incorporated in attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the c:
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
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MEMORANDUM
Date: June 12, 2015
To: Maria Franco, Administrative Assistant
EMS Operations
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Agreement for Field Internship Experience between Collier County
and the City of Coral Springs
Attached is a certified copy of the original of the agreement referenced above, (Item
#16E5) approved by the Board of County Commissioners on Tuesday, June 9, 2015.
The original agreement will be held in the Minutes and Records Department for the
Board's Official Record.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
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MEMORANDUM
Date: June 12, 2015
To: Fire Chief Frank Babinec
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Agreement for Field Internship Experience between Collier County
and the City of Coral Springs
Attached is a certified copy of the original of the agreement referenced above, (Item
#16E5) approved by the Board of County Commissioners on Tuesday, June 9, 2015.
The original agreement will be held in the Minutes and Records Department for the
Board's Official Record.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
16E5 -
RECEIVED
MAY 13 2015
AGREEMENT FOR FIELD INTERNSHIP EXPERIENCE EMS
By and Between Dept.
THE CITY OF CORAL SPRINGS AND
THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AGREEMENT entered into this )7c;;' of April 2015, by and between the City of Coral
Springs, Florida located at 9551 West Sample Road, Coral Springs, Fl 33065 (hereinafter
referred to as the "Fire Academy") and the Collier County Board of County Commissioners, on
behalf of the Collier County Emergency Medical Services Department (CCEMS).
WITNESSETH:
WHEREAS, Fire Academy provides Emergency Medical Services Technology Programs
as a part of it curriculum for its enrolled students; and
WHEREAS, Fire Academy desires to augment said programs by providing skill
training/field experiences for its students through the activities and practices of the Collier
County Emergency Medical Services Department; and
WHEREAS, Collier County Emergency Medical Services Department has the ability to
assist Coral Springs Fire Academy in said Program endeavors, including providing opportunities
for students to observe and perform appropriate Emergency Medical Technician and/ or
Paramedic skills under supervision during field experiences; and
WHEREAS, the objective of the herein described relationship of the parties is to benefit
the community by and through the enhanced education of its students.
NOW, THEREFORE, based on the premises and the mutual covenants, conditions and
considerations hereafter expressed, the parties agree as follows:
SECTION ONE: Term.
This Agreement shall become effective upon approval by the Board of County
Commissioners and shall remain in effect for one year. The Agreement shall be reviewed and/or
re-negotiated and may be renewed for three (3) additional one year terms. This Agreement
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16E5
may be amended only by written agreement of the parties executed with the same formalities as
herein expressed.
SECTION TWO: Obligation of Fire Academy.
Fire Academy shall:
1. Provide current copies of the Program's objectives, curricula, and course objectives,
and field experiences objectives to the Collier County Emergency Medical Services
Department.
2. Provide a schedule of students' related courses/activities to the appropriate
personnel of the Collier County Emergency Medical Services Department. Schedules
will include names and identification numbers of students, dates and times of student
association/experience(s) with Collier County Emergency Medical Services
Department and its personnel.
3. It is understood between the parties that those students participating in this program
shall not be deemed to be employees or volunteers of the Collier County Emergency
Medical Services Department or the Collier County Board of Commissioners and that
the Collier County Emergency Medical Services Department and the Collier County
Board of Commissioners shall not be liable for injury to a participant under Ch. 440,
Florida Statutes, Florida's Workers' Compensation law. Collier County is required to
maintain workers' compensation insurance in compliance with Ch. 440, Fla. Stat.
4. Neither the Collier County Emergency Medical Services Department, the Collier
County Board of Commissioners, nor their employees, or agents shall be responsible
for the compliance of participants with State or Federally mandated occupational
safety laws. The Fire Academy shall ensure and document if appropriate that
students and interns maintain compliance.
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16E5
5. All students must complete background screening through Collier County Facilities
Management Department at students' expense in compliance with Ordinance No.
04-52, as amended.
SECTION THREE: Obligations of Collier County Emergency Medical Services Department
The Collier County Emergency Medical Services Department shall:
1. Provide opportunities for those qualified students of the Fire Academy to observe
and perform appropriate Emergency Medical Technician and / or Paramedic skills
during field experiences with department personnel.
2. Provide for direct supervision of the student interns while in association with the
Department and during field experiences, observation and training.
3. CCEMS shall provide proof of its accreditation/licensure status to the Fire Academy
upon request at any time during the term of this Agreement.
SECTION FOUR: Mutual Responsibilities and Goals.
The parties shall:
1. Communicate and act cooperatively through meetings and operational plans to plan
and evaluate the field experience segment of the Emergency Medical Services
Technology Programs and assist each other within the limits of their respective
professional abilities to ensure a successful field experience program for qualified
students. Students will be evaluated by Collier County supervisors on evaluation
forms furnished by the Fire Academy.
2. Utilize established lines of authority and communication in effectuating this
Agreement and/or addressing/solving problems which may arise in the
implementation of this Agreement.
SECTION FIVE: Termination.
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5
1. At any time, Collier County Emergency Medical Services staff may refuse any Fire
Academy student(s) from participating in the Program including but not limited to:
performing observation, ambulance ride time or practice.
2. Either party may terminate this Agreement without cause upon ten (10) days written
notice.
SECTION SIX: Government Regulations.
To the extent applicable, the parties agree that they will comply with:
1. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d et seq., which
prohibits discrimination on the basis of race, color, or national origin in programs and
activities receiving or benefiting from federal financial assistance.
2. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, which
prohibits discrimination on the basis of handicap in programs and activities receiving
or benefiting from federal financial assistance.
3. Title IX of the Education Amendments of the 1972, as amended, 20 U.S.C. 1681 et
seq. , which prohibits discrimination on the basis of sex in education programs and
activities receiving or benefiting from federal financial assistance.
4. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq., which
prohibits discrimination on the basis of age in programs or activities receiving or
benefiting from federal financial assistance.
5. The Omnibus Budget Reconciliation Act of 1981 , P.L. 97-35, which prohibits
discrimination on the basis of sex and religion in programs and activities receiving or
benefiting from federal financial assistance.
6. Executive Order 11246 of September 24, 1965 as amended, and of the rules,
regulations, and relevant orders of the Secretary of Labor, which prohibit
discrimination in government employment on the basis of race, creed, color, or
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national origin.
7. The Vietnam Era Veteran's Readjustment Assistance Act of 1974, as amended, 38
U.S.C. 219 et seq., covering rehabilitation measures for Vietnam Veterans.
8. The Americans with Disabilities Act of 1990, which prohibits discrimination on the
basis of disability and/or perceived disability.
9. Chapter 760, Florida Statutes, which prohibits discrimination on the basis race,
color, religion, sex, national origin, age handicap, or marital status.
10. Title 45, C. F. R. 160.103, Health Insurance Portability and Accountability Act which
governs privacy regulations associated with medical information.
11. All regulations, guidelines, and standards which are now or may be lawfully adopted
under the above statutes, as well as any other federal, state, or local rules,
regulations and ordinances.
SECTION SEVEN: Equal Opportunity.
The Fire Academy is committed to providing an educational and working environment free from
discrimination and harassment.
All programs, activities, employment and facilities of the Fire Academy are available to all on a
non-discriminatory basis, without regard to race, sex, age, color, religion, national origin,
ethnicity, disability, sexual orientation, marital status, genetic information or veteran's status.
The Fire Academy is an equal access/equal opportunity institution. Questions pertaining to
educational equity, equal access, or equal opportunity should be addressed to the Coral Springs
Human Resources Department, 9551 West Sample Road, Coral Springs, Fl 33065.
SECTION EIGHT: Indemnification.
Each party agrees to assume the cost of fines, suits, claims, demands, penalties, liabilities,
costs or expenses, losses, settlements, judgments and awards including attorney's fees and
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costs arising from their negligent acts or breach of this Agreement by such party, its officers,
board members, agents or employees. This paragraph shall not be construed in any way to alter
the State's waiver of sovereign immunity or extend the parties liability beyond the limits
established in Section 768.28, Florida Statutes.
SECTION NINE: Entire Agreement.
This document incorporates and includes all prior negotiations, correspondence, conversations,
agreements and understandings applicable to the matters contained herein and the parties
agree that there are no commitments, agreements or understandings concerning the subject
matter of this Agreement that are not contained in this document. Accordingly, the parties agree
that no deviation from the terms hereof shall be predicated upon any prior representations or
agreements, whether oral or written.
SECTION TEN: Waiver.
The parties agree that each requirement, duty and obligation set forth herein is substantial and
important to the formation of this Agreement and, therefore, is a material term hereof. Any
party's failure to enforce any provision of this Agreement shall not be deemed a waiver of such
provision or modification of this Agreement. A waiver of any breach of a provision of this
Agreement shall not be deemed a waiver of any subsequent breach and shall not be construed
to be a modification of the terms of this Agreement.
SECTION ELEVEN: Governing Law.
This Agreement shall be interpreted and construed in accordance with and governed by the
laws of the State of Florida. Any controversies or legal problems arising out of this Agreement
and any action involving the enforcement or interpretation of any rights hereunder shall be
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16E5
submitted to the jurisdiction of the State courts of the Seventeenth Judicial Circuit of Broward
County, Florida.
SECTION TWELVE: Notice.
When any of the parties desire to give notice to the other, such notice must be in writing, sent by
U.S. mail, postage prepaid, addressed to the party for whom it is intended at the place last
specified; the place for giving notice shall remain such until it is changed by written notice in
compliance with the provisions of this paragraph. For the present, the Parties designate the
following as the respective places for giving notice:
To Fire Academy: Fire Chief Frank Babinec
2801 Coral Springs Drive
Coral Springs, FL 33065
To CCEMS: Collier County Emergency Medical Services Department
8075 Lely Cultural Parkway, Suite: #267
Naples, FL 34113
SECTION THIRTEEN: Authority.
Each person signing this Agreement on behalf of either party individually warrants that he or she
has full legal power to execute this Agreement on behalf of the party for whom he or she is
signing, and to bind and obligate such party with respect to all provisions contained in this
Agreement.
th
IN WITNESS WHEREOF, the parties hereto have executed this Agreement, this —1
day of --- , 2015.
ATTEST: BOARD OF COUNTY COMMISSIONERS
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A
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA
BY:
< 1C-E.--
'1'1''St as to Chairman's , Deputy Clerk Tim Nance, Chairman
signature only v ' '
Approved as to form and legality
4111 ..-'/ lc l 5
Jennifer A. Belpe. •, Assistant County Attorney
ATTEST: City of Coral Springs
417117C. f -
BY:
//a/ 17 ZO Fire Chief Frank Babinec
.' '4 ROBIN B.MACDONALD Coral Springs Fire Department
••Y Y PV'�4
INA' Notary Public-State of Florida
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4 a; Commission N FF 127788
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