Backup Documents 10/27/2020 Item #16E5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16 E 5
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. Jennifer Belpedio County Attorney Office 10/27/2020
3. BCC Office Board of County /35 Commissioners 16-
a b
4. Minutes and Records Clerk of Court's Office to I rl :3),
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 Tabatha Butcher Phone Number 239-252-3780
Contact/ Department
Agenda Date Item was 10/27/2020 Agenda Item Number 16E5
Approved by the BCC
Type of Document CPOCN Number of Original 2
Attached 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. O� (Initial) Applicable)
1. Does the document require the chairman's original signature? NA
2. Does the document need to be sent to another agency for additional signatures? if yes, NA
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAB
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 NA
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 JAB
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 JAB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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 10/27/2020 and all changes made during the is not
meeting have been incorporated in the attached document. The County Attorney's option for
Office has reviewed the changes,if applicable. s line.
9. Initials of attorney verifying that the attached document is the version approved by the � is not
BCC,all changes directed by the BCC have been made,and the document is ready for the option for
Chairman's signature. — : line.
ON" 6
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 1—\<,`
16E5
MEMORANDUM
Date: November 2, 2020
To: Tabatha Butcher, EMS Chief
Emergency Services
From: Teresa Cannon, Sr. Deputy Clerk
Minutes & Records Department
Re: Emergency Medical Services — COPCN Renewal
Attached is one (1) original of the document as referenced above, (Agenda Item #16E5)
as approved by the Board of County Commissioners on Tuesday, October 27, 2020.
The Board's Minutes & Records Department has kept the original as part of the
Board's Official Records.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
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16E5
COLLIER COUNTY FLORIDA
Renewal of Class 1 COPCN
This Permit Expires December 31, 2021
Name of Service: Collier County Emergency Medical Services
Name of Owner or Manager: Collier County Board of County Commissioners
Principal Address of Service: 8075 Lely Cultural Parkway,Naples, Florida 34113
Business Telephone: (239) 252-3740
Emergency Telephone: 9-1-1
Description of Services Area: The 2,032 square miles encompassing Collier County
Number of Ambulances on 24- hour duty: 26 ground units(ambulances)
Number of Ambulances on 12- hour duty: 2 ground units(as needed during season taken from reserve fleet).
Number of reserve Ambulances: 18
Number of non-transport ALS vehicles 13
Number of Medivac helicopter: 1
See attachment"A" for description of vehicles.
This permit, as provided in Ordinance 04-12, as amended, shall allow the above named Ambulance Service to
operate Emergency Medical Services for a fee or charge for the following area(s): Collier County until the
expiration date hereon, except that this permit may be revoked by the Board of County Commissioners of Collier
County at any time the service named herein shall fail to comply with any local, state or federal laws or regulation
applicable to the provision of Emergency Medical Services.
h 1
Issued and approved this 1 day of �,i v 1�e—� , 2020.
ATTEST: BOARD OF COUNTY COMMISSSIONERS
Crystal K. Kinzel, LERK COL R COUNTY, RIDA
1INest__
a to atriUa 1beputy Clerk Burt L. Saunders, Chairman
"�.:l it only.
Approved as to form & legality:
C
Jennifer A. Belpedio
Assistant County Attorney
16E5
Permit# ALS Year Make Model VIN Assigned
1453 T 1999 EUROCOPTER EC135 N911CK MHQ
22340 T 2019 FORD F550 1FDUF5GT9KDA04460 Truck 41
23189 T 2020 FORD F550 1 FDUF5GT9LDA03369 Truck 7
23192 T 2020 FORD F550 1 FDUF5GT9LDA03372 Truck 22
23190 T 2020 FORD F550 1 FDUF5GT5LDA03370 Truck 8
17255 T 2012 FORD F550 1 FDUF5GT8CEB23691 Truck 1
17256 T 2012 FORD F550 1 FDUFSGTXCEB23692 Truck 25
17257 T 2012 FORD F550 1 FDUF5GT1 CEB23693 Truck 27
17258 T 2012 FORD F550 1FDUF5GT3CEB23694 Truck 37
18087 T 2013 FORD F550 1FDUF5GTODEA35168 Truck 38
18088 T 2013 FORD F550 1FDUF5GT7DEA35166 Truck 24
18089 T 2013 FORD F550 1FDUF5GT2DEA35169 Truck 15
18090 T 2013 FORD F550 1FDUF5GT9DEA35167 Truck 6
18866 T 2015 FORD F550 1 FDUF5GT7FEA64024 Truck 14
18867 T 2015 FORD F550 1 FDUF5GT9FEA64025 Truck 31
18868 T 2015 FORD F550 1FDUF5GTOFEA64026 Truck 39
18869 T 2015 FORD F550 1 FDUF5GT2FEA64027 Truck 40
23191 T 2020 FORD F550 1 FDUF5GT7LDA03371 Truck 18
19044 T 2015 FORD F550 1FDUF5GT8FEC82389 Truck 4
19046 T 2015 FORD F550 1FDUF5GT6FEC82391 Truck 43
19047 T 2015 FORD F550 1FDUF5GT8FEC82392 Truck 30
19048 T 2015 FORD F550 1 FDUFSGTXFEC82393 Truck 42
20437 T 2015 FORD F650 3FRWF6GZ1 FV675309 Truck 33
20443 T 2016 FORD F550 1FDUF5GT8GED28644 Truck 3
20444 T 2016 FORD F550 1FDUF5GT6GED28645 Truck 11
20445 T 2016 FORD F550 1FDUF5GTXGED28643 Truck 19
20548 T 2015 FORD F550 1FDUF5GT4FEC82390 Truck20
20549 T 2019 FREIGHTLINER M2EC 2FZACFDJ18AZ51747 Truck 35
20550 T 2007 STERLING ACETERA 2FZACFCS17AY33965 Truck 34
22299 T 2019 FORD F550 1 FDUF5GT1 KEE37245 Truck 44
22298 T 2019 FORD F550 1FDUF5GTXKEE37244 Truck 9
21169 T 2017 FORD F550 1FDUF5GT5HDA02856 Truck21
21170 T 2017 FORD F550 1 FDUF5GT9HDA02858 Truck 16
21171 T 2017 FORD F550 1 FDUF5GT7HDA02857 Truck 36
22300 T 2019 FORD F550 1 FDUF5GT3KEE37246 Truck 17
22301 T 2019 FORD F550 1FDUF5GT5KEE37247 Truck 10
21405 T 2017 FORD F550 1 FDUF5GT1 HEF21218 Truck 5
21403 T 2017 FORD F550 1 FDUF5GT1 HEF21221 Truck 32
21404 T 2017 FORD F550 1 FDUF5GT3HEF21219 Truck 29
21709 T 2017 FORD F550 1 FDUF5GTXHEF21220 Truck 12
21861 T 2019 FORD F550 1 FDUF5GT4KDA01138 Truck 02
21862 T 2019 FORD F550 1 FDUF5GT6KDA01139 Truck 23
21863 T 2019 FORD F550 1 FDUF5GT2KDA01140 Truck 26
21864 T 2019 FORD F550 1FDUF5GT4KDA01141 Truck28
20438 N 2017 FORD EXPLORER 1FM5K8AROHGB64925 CC2-1628
20439 N 2017 FORD EXPLORER 1FM5K8AR2HGB64926 CC2-1630
16E5
20440 N 2017 FORD EXPLORER 1FM5K8AR4HGB64927 CC2-1629
20441 N 2017 FORD EXPLORER 1FM5K8AR6HGB64928 CC2-1632
19797 N 2016 FORD EXPLORER 1 FM5K8ARXGGAO8079 CC 1130
19303 N 2015 FORD EXPLORER 1 FM5K8AR0FGC26952 CC2-1076
19304 N 2015 FORD EXPLORER 1 FM5K8AR2FGC26953 CC2-1085 _
21084 N 2013 FORD EXPLORER 1FM5K8R8DGA18380 CC2-668
21085 N 2016 FORD EXPLORER 1FM5K8AR2GGA46941 CC2-1135
21086 N 2017 FORD EXPLORER 1 FM5K8AR7HGC57022 CC2-1631
21087 N 2017 FORD EXPLORER 1FM5K8AR3HGA36372 CC2-1401
21088 N 2016 FORD EXPLORER 1 FM5K8AR5GGC07850 CC2-1314
awaiting permit N 2020 FORD EXPLORER 1FM5K8AWOLGC13670 CC2-2547