Agenda 10/09/2018 Item #16E 110/09/2018
EXECUTIVE SUMMARY
Recommendation to renew the annual Certificate of Public Convenience and Necessity (COPCN)
for Ambitrans Medical Transport, Inc. to provide Class 2 Advanced Life Support (ALS) inter-
facility transport ambulance service for a period of one year.
OBJECTIVE: To provide Advanced Life Support inter-facility transport services in Collier County by a
private provider.
CONSIDERATIONS: A COPCN may be renewed routinely by the Board as provided by Section 50-60
of the Collier County Code of Laws and Ordinances governing medical transportation services.
Ambitrans inter-facility transport was originally granted a Certificate of Public Convenience and
Necessity on October 25, 2011. The certificate requires annual renewal and the current COPCN exp ires
on October 24, 2018.
Staff reviewed and deems Ambitrans’ renewal application as complete and recommends that the COPCN
be renewed for one year. A Class 2 operator provides post-hospital inter-facility medical transfer services,
both within and outside the County.
Section 50-60 of the Code of Laws and Ordinances provides:
Each certificate holder shall file within 90 days of expiration, an application for renewal of his
certificate. Renewals shall be based upon the same standards, as the granting of the original
certificate along with such other factors as may be relevant. The renewal application shall be
accompanied by a $250.00 renewal fee. The renewal certificate may be approved routinely by the
board, upon advice of the administrator, or the board ma y hold a hearing on same.
These requirements have been met and the administrator recommends renewal. The Emergency Medical
Authority reviewed the application on August 8, 2018 and unanimously recommended that the Certificate
be renewed.
FISCAL IMPACT: There is no fiscal impact to the Board for the granting of this certificate. The Board
is requested to accept and recognize as revenue in Fund (490) the $250.00 application fee with the
corresponding application.
GROWTH MANAGEMENT IMPACT: There are no Growth Management Impacts associated with
this action.
LEGAL CONSIDERATIONS: A hearing is not required for renewal. If a hearing is held, the Board
must find that the standards set forth in Section 50-57 of the Code of Laws and Ordinances have been
satisfied based on competent evidence as follows:
(1) That there is a public necessity for the service. In making such determination, the Board of
County Commissioners shall consider, as a minimum, the following factors:
a. The extent to which the proposed service is needed to improve the overall emergency
medical services (EMS) capabilities of the County.
b. The effect of the proposed service on existing services with respect to quality of service
and cost of service.
c. The effect of the proposed service on the overall cost of EMS service in the county.
d. The effect of the proposed service on existing hospitals and other health care facilities.
e. The effect of the proposed service on personnel of existing services and the availability of
sufficient qualified personnel in the local area to adequately staff all existing services.
16.E.1
Packet Pg. 785
10/09/2018
(2) That the applicant has sufficient knowledge and experience to properly operate the proposed
service.
(3) That, if applicable, there is an adequate revenue base for the proposed service.
(4) That the proposed service will have sufficient personnel and equipment to adequately cover the
proposed service area.
This item is approved as to form and legality and requires a majority vote for approval. -JAB
RECOMMENDATION: To renew and issue a Class 2 Certificate of Public Convenience and Necessity
to Ambitrans Medical Transport, Inc., for a period of one year expiring on October 24, 2019.
Prepared by: Dan E. Summers, Director, Bureau of Emergency Services
ATTACHMENT(S)
1. 2018-19 Ambitrans CoPCN Application (PDF)
2. Certificate signed (PDF)
3. Ambitrans Permit 2018 CAO Stamped (PDF)
4. VIN List Final CoPCN Ambitrans-4 (PDF)
16.E.1
Packet Pg. 786
10/09/2018
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.1
Doc ID: 6516
Item Summary: Recommendation to renew the annual Certificate of Public Convenience and
Necessity (COPCN) for Ambitrans Medical Transport, Inc. to provide Class 2 Advanced Life Support
(ALS) inter-facility transport ambulance service for a period of one year.
Meeting Date: 10/09/2018
Prepared by:
Title: Executive Secretary – Emergency Management
Name: Kathy Heinrichsberg
08/23/2018 3:39 PM
Submitted by:
Title: Division Director - Bureau of Emer Svc – Emergency Management
Name: Daniel Summers
08/23/2018 3:39 PM
Approved By:
Review:
Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 08/23/2018 3:55 PM
Emergency Management Daniel Summers Additional Reviewer Completed 08/23/2018 5:06 PM
Emergency Medical Services Tabatha Butcher Additional Reviewer Completed 08/27/2018 12:06 PM
County Attorney's Office Jennifer Belpedio Level 2 Attorney of Record Review Completed 08/27/2018 2:44 PM
Administrative Services Department Len Price Level 2 Division Administrator Review Completed 09/24/2018 10:10 AM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 09/24/2018 2:57 PM
Office of Management and Budget Laura Wells Additional Reviewer Completed 09/25/2018 11:34 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 09/26/2018 10:47 AM
County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 09/30/2018 11:50 AM
Board of County Commissioners MaryJo Brock Meeting Pending 10/09/2018 9:00 AM
16.E.1
Packet Pg. 787
AMBITRANS MEDICAL TRANSPORT, INC.
RECBIVED
iul 0 2 2018
EMERGENCY MANAGEMENT
201 B COPCN Renewal
Application
Collier County, Florida
Ambitrans Medical Transport, Inc., submits its 2018 Application for Renewal of its Certificate of
Public Convenience and Necessity in and for Collier County, Florida.
16.E.1.a
Packet Pg. 788 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Ambitrans Medical Transport, Inc. - Collier County C0PCN Renewal
Application
Sec. 50-55 Procedure for obtaining certificate.
An applicant for a certiftcate shall obtain forms from the department to be completed and
returned to the division administrator. Each application shall contain:
(1) The nome, age and address of the owner of the ambulance or ALS provider, or if the owner
is a corporation, then of the directors of the corporation and of all of the stockholders
holding more than 25 percent of the outstanding shares. For governmental units, this
information shall be supplied for members of the governing body.
Coruorate Offi cers /Directors
Michael J. Grant, 68,4351, Pinnacle Street, Charlotte Harbor, FL 33980
Lorraine B. Grant, 63,4351, Pinnacle Street, Charlotte Harbor, FL 33980
50o/o
50o/o
Alan J. Skavroneck,53,4351 Pinnacle Street, Charlotte Harbor, FL 33980 0o/o
Vanessa Grant Oliver,37, +357 Pinnacle Street, Charlotte Harbor, FL 33980 0o/o
(2) The boundaries ofthe territory desired to be served.
Collier County, Florida
(3) The number and brief description of the ambulances or other vehicles the applicantwill
have available.
Ambitrans currently has thirty-five [35) licensed ambulances available to its fleet, These
units are permitted with the Florida Department of Health - Bureau of EMS as Advanced
Life Support and Basic Life Support vehicles.
Through the use of the company's computer aided dispatch software, Zoll Data RescueNet
Dispatch-Billing'", management is able to staff according to anticipated demand. Staffing
levels and patterns are determined using historical data and other internal statistics.
Vehicles are posted in accordance with direction from our communications center
personnel to specified areas to aid in proper deployment and call response.
In the event of any unforeseen daily call volume, Ambitrans has the ability to schedule
additional labor and resources to meet continued on-going market demand.
A spreadsheet listing each ambulance in our fleet is attached hereto as Exhibit "A."
16.E.1.a
Packet Pg. 789 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal
Application
@) The address of the intended headquarters and ony substations.
Ambitrans corporate office is located at:
4351 Pinnacle Street, Port Charlotte, FL 33980
Our Collier County substation is located at:
2157 Pine Ridge Road, Naples, FL 34109
(former NCH ambulance station)
Our auxiliary substation to backup the Collier County operation is located at:
935 N.E. 7th Terrace, Cape Coral, FL 33909
,_qI -r-I ;_
16.E.1.a
Packet Pg. 790 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal
Application
(5) The training and experience of the applicant.
Ambitrans Medical Transport, Inc. was incorporated in 1983 to provide Paratransit
services to the residents of Charlotte County. In 1988, ownership of the company
transferred to its current principals. In 1995, Ambitrans commenced its ambulance
operations. Today, Ambitrans operates in Charlotte, Collier, Lee, Sarasota and Manatee
counties.
Ambitrans is committed to maintaining compliance with all federal, state and local laws
and regulations. We are compliant with Florida Statute 401 and Florida Administrative
Code 64f in accordance with standards set forth by the Bureau of EMS and Department of
Health. Our state license is valid through June 19, 20L9. A copy of our state license is
attached hereto as Exhibit "B."
Ambitrans is a licensed Medicare and Medicaid provider and we have contracts in place
with many national third-party payors, which enable us to serve all citizens of Collier
County. Further, we employ a national law firm specializing in Medicare issues related to
the ambulance industry to ensure we remain compliant with all federal laws, rules and
regulations relating to Medicare, as well as in an-house General Counsel to ensure our
facility contracts and daily operations conform with all federal, state and local
regulations.
The management team at Ambitrans collectively has over 250 years of experience in the
EMS industry. Our Training and Quality Assurance Department reviews patient care
reports for quality assurance and adherence to our medical protocols and standards of
care. Our education team is also responsible for our in-house training, which includes
CPR, Advanced Cardiac Life Support, Pediatric Advanced Life Support, Emergency
Vehicles Operators Course and on-going continuing education units needed for bi-annual
certification renewal.
Our in-house billing department is knowledgeable and responsive and available Monday
through Friday to answer any questions our customers may have.
16.E.1.a
Packet Pg. 791 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal
Application
Our personnel and managers have diverse experiences that take them well outside of
Southwest Florida. Michael Grant, our President and CEO, recently won re-election to the
Florida House of Representatives, District 75.
Our Chief Operating Officer, Alan Skavroneck, serves as the immediate Past-President for
the Florida Ambulance Association and recently completed his term as State Surgeon
General appointee to the Emergency Medical Services Advisory Council.
Governor Rick Scott appointed and the Florida Senate confirmed Vanessa Oliver, our
General Counsel, as a consumer member of the State Board of Funeral, Cemetery and
Consumer Services.
Dr. Daniel V. O'Leary serves as our medical director of record as mandated under Florida
Statute 401.265. This is in addition to his normal day-to-day duties as an emergency
room physician at Bayfront Hospital in Port Charlotte as well as serving as the Medical
Director for Charlotte County Fire and EMS and Medical Director for EMT and Paramedic
programs at Charlotte Technical College.
(6) The name and addresses of three Collier County residents who will act as references for
the applicanl
Patricia Davis
212 Napa Ridge Road East
Naples, FL 34L19
Former State Representntive Matt Hudson
3301 East Tamiami Trail
Naples, FL 34tLz
Former State Senator Garrett Richter
2320 Harrier Run
Naples, FL 34105
16.E.1.a
Packet Pg. 792 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal
Application
(7) A schedule of rates which the service intends to charge.
A0428 Basic Life Support Base Rate
A0429 Basic Life Support Base Rate
A0426 Advanced Life Support Base Rate
AO427 Advanced Life Support Base Rate
A0433 Advanced Life Support Base Rate - Level 2 $725.00
AO434 Specialty Care Transport Base Rate $900.00
AO425 Per Loaded Mile $10.00
A0999 Oxygen $4s.00
40999 Drugs $10.00 - $2s.00
IV Supplies $20.00 - $2s,00
Code Service Description Rate
$395.00
$42s.00
$395.00
$500.00
16.E.1.a
Packet Pg. 793 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal
Application
(B) Such other pertinent information as the administrator may require.
No additional information was requested by the administrator at the time of submission.
However, for your convenience, Ambitrans has attached hereto a copy of its Certificate of
Insurance as Exhibit "C" and its Certificate of Worker's Compensation Insurance as
Exhibit "D."
(9) An application or renewal fee of $250.00. (Exception Collier County EMS).
Ambitrans' check in the amount of $250.00 is enclosed with this Renewal Application.
(10) Financial data including assets and liabilities of the operator. A schedule
of all debts encumbering any equipment shall be included.
Ambitrans' financial data is attached hereto as Exhibit "8."
16.E.1.a
Packet Pg. 794 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal
Application
Schedule of Exhibits
Exhibit "A"List of Ambulances in Fleet
Exhibit "B"State License
Exhibit "C"Certificate of Insurance
Exhibit "D"Certificate of Worker's Compensation Insurance
Exhibit "E"Financial Data
16.E.1.a
Packet Pg. 795 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Name
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Profession
vEHrcLE PERMTT (ALS)
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16.E.1.a
Packet Pg. 796 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
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16.E.1.a
Packet Pg. 797 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
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Packet Pg. 798 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Client#: 16583 GRANTMED2
ACORD,,CERTIFIGATE OF LIABILITY INSURANCE 9ATE (Mm/9o/YYrr)
6t29t2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. TH|S CERTTFTCATE OF TNSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE |SSUtNG TNSURER(S), AUTHORTZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
Bouchard lnsurance (SAR)
5310 Clark Road, Suite 1
Sarasota, FL 34233
941 922-0245
fiXfiil'' Bouchard lnsuranceM_@
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INSURED
Grant Medical Transportation, lnc.
4351 Pinnacle Street
Charlotte Harbor, FL 33980
INSURER B
!!!!EEB c
INSURER D
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVEBEENISSUED TOTHE INSURED NAMEDABOVE FORTHE POLICYPERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUEO 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 REOUCEO BY PAID CLAIMS.
NsR ITRI TYPE OF INSURAI{CE LIMITS
A x I COMMERCIAL GENERAL LIABILITY_t_I l"*,r.-roo. I xlo".r*
-I Professional Liabt-r_
{'L AGGREGATE LIMIT APPLIES PER:
I l----l PRo-lpolrcvl JEcr I lloct-
I OTHER:
MAPK08386902
MAPK08386902
17101t20't8
17t01t2018
07 lO1 12019 EAcH occuRRENcE s 1,000,000
OAMAGE TO RENTEO
, PREMISES (Ea @rene)
MEO EXP (Any ss peEm)
07tO1t2}1d".".*o**"
GENERAL AGGREGATE
PRODUCTS . COMP/OP AGG
$ 100,000
I s 5,00Q
s 1.000.000
GEI s3.000.000
x s3.000.000
$
A AU'
x
TOMOBILE LIABILITY
I
I ANYAUTOIOWNED IV ISCHEDULEOIAUToSoNLY l,\ lluroslsrneo I-J NoH-owneo
I AUToS oNLY L]^l ruros otu-v
MAPK08386902 t7t0'U2018 o z/o r /2 o 1 g[E!u"$'.?,i "o "j' "L
, BODILY INJURY (Per p€rson)
, BODILY INJURY (Per a@ident)
i PROPERTY DAMAGE(Per a@ident)
c1.000.000
$
S
A x UMBRELLALTAB i X occuR
ExcEss LraB l...- "*,ra-roo,o., -{*rr=*r.*o
MAUM08509602 t7t01t2018 07 lO1l201g EAcH occuRRENCE
AGGREGATE
s2.000.000
$2,000,000
$
WORKERS COMPENSATION
ANO EMPLOYERS' LtABtLtTY Y / N
ANY PROPRIETORyPARTNER/EXECUTIVE T----
oFF|CER/MEMBER EXCLUOED? L ](Mandatory ln NH)
lf yes, describe under
DESCRIPTION OF OPERATIONS below
-'^ll
PER I IOTH.STATUTE I IER
E,L, EACH ACCIDENT
E.L. DISEASE. EA EMPLOYEE
E.L. DISEASE. POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD '101, Addltlonal Remarks Schedule, may be attachod it morc space is required)** Supplemental Name **
First Supplemental Name applies to all policies - Grant Medical Transportation, lnc.
Policy# MAPK08386902 - : Ambulance Management Services, LLC
Policy# MAPK08386902 - : Ambitrans Medical Transport, lnc.
Policy# MAPK08386902 - : Venice Ambulance Service, lnc.
(See Attached Descriptions)
TE HOLDER
@ 1988-2015 ACORD CORPORATION. Ail
The ACORD name and logo are registered marks of ACORD
KELHO
FOR INFORMATION PURPOSES ONLY SHOULD ANY OF THE ABOVE OESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION OATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ACORD 25 (2016/03) ,l of 2
#s884941tM88472'l
rights reserved.
16.E.1.a
Packet Pg. 799 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
DESCRIPTIONS (Gontinued from Page 1)
Policy# MAUM08509602 - : Ambulance Management Services, LLC
Policy# MAUM08509602 - : Ambitrans Medical Transport, lnc.
Policy# MAUM08509602 - : Venice Ambulance Service, lnc.
SAGITTA 2s.3 (2016/03) 2 of 2
#s884941tM884721
16.E.1.a
Packet Pg. 800 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
@ias"net Employers
fnsurance Company"
A Member of Great American lnsurance Group
A Stock lnsurer. P.O. Box 988. Lakeland, FL 33802-0988
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATTON PAGE
Carrier code 31267
Item 1. lnsured
Name Ambitrans Medical Transport, lnc.
and
Maitins 4351 Pinnacle St
Address Punta Gorda, FL 33980-2902
Other workplaces not shown above:
SEE EXTENSION OF INFORMATION PAGE ITEM 1
Policynumber 830-38697
RrsK rD 097488436
-
lndividual X Corporation
_ Partnership _ Subchapter,,S,,
_ Other
FEIN 65-0571 130
Item 2. Policy period
From 12127117 to ',12127118 p:01 a.m. standard time atthe address of the insured as stated herein.
Item 3. Coverage
A. Workers Compensation lnsurance: Part One of the policy applies to the Workers Compensation Law of the states listed here:
Florida
B. Employers Liability lnsurance: Part Two of the policy applies to work in each state listed in ltem 3 A The limits of our liability
under Part Two are: Bodily lnjury by Accident $ 1,OOO,OOO each accident
Bodily lnjury by Disease $ 1,000,000 each employee
Bodily lnjury by Disease $ 1,OOO,O0O poticy timit
C Other States lnsurance: Part Three of the policy applies to the states, if any, listed here:
Alabama Arkansas Georgia lndiana Kentucky Louisiana Mississippi North Carolina South Carolina
Tennessee Texas
D. This policy includes these endorsements and schedules:
SEE EXTENSION OF INFORMATION PAGE ITEM 3.D
Item 4. Premium
The premiumforthis policywill bedetermined byour Manualsof Rules, Classifications, Rates and Rating Plans.All information
required below is subject to verification and change by audit.
Total Estimated Annual premium $
-
MinimumPremirrs I Expenseconstant $ I
Classifications Code No.
Premium Basis:
Total Estimated
Annual Remuneralion
Rate Per $100 of
Remuneration
Estimated
Annual Premium
SEE EXTENSION OF INFORMATION PAGE ITEM 4
countersionedbv <--Date 1Ologl17
25 Roger Bouchard lnsurance, lnc.
crs Date Prepared:1OlO9l'17
WC 00 o0 01 A (05/88) lncluds copyright material ol the Natonalcouncrt on compensation lnsurance. used pi1h ils perm.sron.
O 1987 Nationat Council on ComDensation lnsurance
16.E.1.a
Packet Pg. 801 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
BnmN W. CRoSLAND, CPA, PL
CgRrlrIeo Punuc AccouxrINc & CoNSULTING
201 W. M.rnroN AvENrrE, SrrrE 1204 Ptrrir.r Conoa, FL 33950 Puoxr: 9t1.629.1197 FACSIMI,E: 941.205.5279
KRrsrr L. Scorr
SHAWN M. CooLEY, CPA
AMERICAN INSTITTjTE OF CERTIFIED PUBLIc A(CoUNTANTS
FLoRIDA lNsTlTtrTE Or CERTTFTED PrJBI-rc AccouNrANTs
MEDICAL G RoUP MANAGEMENI AssocIATIoN
CoMMUNtTy AssocrATroNs lNsTtTLrrE
INDEPENDENT ACCOUNTANTS' COMPILATION REPORT
To the Board of Directors
Ambitrans Medical Transport, Inc.
Charlotte Harbor. Florida
We have compiled the accompanying statement of assets and liabilities of the ambulance transportation
operations of Ambitrans Medical Transport, Inc. and subsidiaries as of April 30.2018. This financial
statement has been prepared on the income basis of accounting utilized by the Company for federal
income tax reporting purposes. We have not audited or reviewed the accompanying financial statement
and, accordingly, do not express an opinion or provide any assurance about whether the financial
statement is in accordance with the income tax basis of accounting.
Management is responsible for the preparation and fair presentation of the financial statement in
accordance with the income tax basis of accounting and for designing, implementing, and maintaining
intemal control relevant to the preparation and fair presentation of the financial statement.
Our responsibility is to conduct the compilation in accordance with Statements on Standards for
Accounting and Review Services issued by the American Institute of Certified Public Accountants. The
objective of a compilation is to assist management in presenting financial information in the form of a
financial statement without undertaking to obtain or provide any assurance that there are no material
modifications that should be made to the financial statement.
The accompanying statement was prepared for the purpose of presenting the assets and liabilities of the
ambulance transportation operations of Ambitrans Medical Transport, lnc. and subsidiaries, and is not
intended to be a complete presentation of Ambitrans Medical Transport, Inc. and subsidiaries
consolidated assets and liabilities. Accordingly, this report and related financial statement is restricted for
use only by known third parties with knowledge of these restrictions and should not be used for any other
purpose.
E4hr?d Ooo/*rz, U.<, PL
June 22,2018
Punta Gorda, Florida
EXCELLENCE SI\CE I98{
16.E.1.a
Packet Pg. 802 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
Ambitrans Medical Transport, lnc. and Subsidiaries
Statement of Assets and Liabilities of the Ambulance Transportation Operations
lncome Tax Basis of Accounting
April 30, 2018
(Unaudited)
Assets
Current Assets:
Cash available for
ambulance transportation operations
Propertv and Equipment:
Office equipment and computers
Machinery and equipment
Med ical transportation vehicles
Less accu mulated depreciation
Property and Equipment, net
Total Assets
988,000
185,338
389,'148
1,806,328
2,380,814
(2,374,405\
6,409
$ 994,409
Liabilities
Current Liabilities:
Accrued profit sharing
Other liabilities
Notes payable to banks
Lonq Term Liabilities:
Notes payable to banks
Less current portion above
$ 211,556
37,500
352,341
601,397
352,341
(352,341)
601,397Total liabilities
Net Assets Over Liabilities, income tax basis
Read lndependent Accountants' Compilation Report
393,012
16.E.1.a
Packet Pg. 803 Attachment: 2018-19 Ambitrans CoPCN Application (6516 : Ambitrans Annual Renewal)
16.E.1.b
Packet Pg. 804 Attachment: Certificate signed (6516 : Ambitrans Annual Renewal)
16.E.1.c
Packet Pg. 805 Attachment: Ambitrans Permit 2018 CAO Stamped (6516 : Ambitrans Annual Renewal)
16.E.1.d
Packet Pg. 806 Attachment: VIN List Final CoPCN Ambitrans-4 (6516 : Ambitrans Annual Renewal)
16.E.1.d
Packet Pg. 807 Attachment: VIN List Final CoPCN Ambitrans-4 (6516 : Ambitrans Annual Renewal)