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EMA Agenda 08/11/2021
COLLIER COUNTY EMERGENCY MEDICAL AUTHORITY (EMA) AGENDA August 11, 2021— Wednesday 9:30am 3299 Tamiami Tr E, Bldg. F 51h Floor Training Room 1. CALL TO ORDER AND PLEDGE OF ALLEGIANCE 2. AGENDA AND MINUTES a. Approval of Today's Agenda b. Approval of the July 14, 2021 Meeting Minutes 3. OLD BUSINESS a. Performance Measures Update 4. NEW BUSINESS a. Ambitrans COPCN Renewal 5. FIRE SERVICE DISCUSSION 6. STAFF REPORTS 7. PUBLICCOMMENT 8. BOARD MEMBER DISCUSSION 9. NEXT MEETING DATE a. September 8, 2021 10. ADJOURNMENT Q Packet Pg. 279 15.A.b COLLIER COUNTY FIRE & EMS CHIEFS' ASSOCIATION, INC. MONTHLY MEETING Naples, Florida 34119 Name Agency AJ A 2 err Cf w �;�:t'T(t l�oc��C4 /tmiJc�/'yhs' �mO�I�Gintt� C�c ) Eve1n Cox e Me.8 A�,b�z�Grvice. 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A MBIT WS AMBULANCE 2021 COPCN Renewal Application Collier County, Florida Ambitrans Medical Transport, Inc., submits its 2021 Application for Renewal of its Certificate of Public Convenience and Necessity in and for Collier County, Florida. M a E a Packet Pg. 312 15.A.b Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal Application Sec. 50-55 Procedure for obtaining certificate. An applicant for a certificate shall obtain forms from the department to be completed and returned to the division administrator. Each application shall contain. (1) The name, age and address of the owner of the ambulance orALS 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. Corporate Officers/Directors Michael J. Grant, 71, 4351 Pinnacle Street, Charlotte Harbor, FL 33980 50% Lorraine B. Grant, 66, 4351 Pinnacle Street, Charlotte Harbor, FL 33980 50% Alan J. Skavroneck, 56, 4351 Pinnacle Street, Charlotte Harbor, FL 33980 0% Vanessa Grant Oliver, 40, 4351 Pinnacle Street, Charlotte Harbor, FL 33980 0% (2) The boundaries of the territory desired to be served. Collier County, Florida (3) The number and brief description of the ambulances or other vehicles the applicant will have available. Ambitrans currently has thirty-five licensed ambulances available to its fleet. These units are dually 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-BillinW", 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 increased call volume, Ambitrans has the ability to schedule additional labor and resources to meet any unforeseen increase in market demand. A spreadsheet listing each ambulance in our fleet is attached hereto as Exhibit "A. Packet Pg. 313 Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal Application (4) The address of the intended headquarters and any substations. Ambitrans corporate office is located at: 4351 Pinnacle Street, Port Charlotte, FL 33980 Our Collier County substation is located at: 1120 Turtle Creek Drive, Unit 625, Naples, FL 34110 Our auxiliary substation to back up the Collier County operation is located at: 935 N.E. 7th Terrace, Cape Coral, FL 33909 Packet Pg. 314 15.A. b 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 64J in accordance with standards set forth by the Bureau of EMS and Department of Health. Our state license is valid through June 19, 2023. 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 E a� with many national third -party payors, which enable us to serve all citizens of Collier (D County. Further, we employ a national law firm specializing in Medicare issues related to w the ambulance industry to ensure we remain compliant with all federal laws, rules and 00 00 regulations relating to Medicare, as well as our CEO, who is also a Florida Bar Board ~ Certified Health Law attorney, to ensure our facility contracts and daily operations conform with all federal, state and local regulations. U a The management team at Ambitrans collectively has over 200 years of experience in the EMS industry. Our Training and Quality Assurance Department reviews patient care Q reports for quality assurance and adherence to our medical protocols and standards of a� care. Our education team is also responsible for our in-house training, which includes CPR, Advanced Cardiac Life Support, Pediatric Advanced Life Support, Emergency Q Vehicles Operators Course and on -going continuing education units needed for bi-annual certification renewal. Our local, in-house billing department is knowledgeable and responsive and available Monday through Friday to answer any questions our customers may have. Packet Pg. 315 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 co-owner, is the Representative for District 75 in the Florida House, where he serves as Majority Leader. Our Chief Operating Officer, Alan Skavroneck, served as President for the Florida Ambulance Association and recently completed his term as State Surgeon General appointee to the Emergency Medical Services Advisory Council. Vanessa Oliver, our Chief Executive Officer, was elected to the Charlotte County Airport Authority, where she oversees the Punta Gorda Airport, one of the fastest growing airports in the nation. She is also a past gubernatorial appointee to 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 Health Port Charlotte as well as serving as the Medical Director for Charlotte County Fire and EMS. (6) The name and addresses of three Collier County residents who will act as references for the applicant. Patricia Davis 212 Napa Ridge Road East Naples, FL 34119 State Senator Garrett Richter 2320 Harrier Run Naples, FL 34105 Jay Crandall, CUM Managing Broker Crandall Commercial Group LLC 27499 Riverview Center Blvd. Suite 127 Naples, FL 34134 Q Packet Pg. 316 15.A.b Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal Application (7) A schedule of rates which the service intends to charge. Code Rate A0428 Basic Life Support Base Rate $425.00 A0429 Basic Life Support Base Rate $455.00 A0426 Advanced Life Support Base Rate $470.00 A0427 Advanced Life Support Base Rate $575.00 A0433 Advanced Life Support Base Rate - Level 2 $725.00 A0434 Specialty Care Transport Base Rate $950.00 A0425 Per Loaded Mile $11.00 Wait Time (BLS or ALS) $200 per hour Wait Time (Critical Care) $350 per hour Extra Ambulance for Lift Assistance $200 per hour Packet Pg. 317 Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal Application (8) 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 T." Dr. O'Leary's DEA license and Department of Health license information is attached hereto as composite Exhibit T." (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 T." Packet Pg. 318 15.A.b 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" Medical Director Certifications Exhibit "F" Financial Data Q Packet Pg. 319 15.A.b Ambitrans Medical Transport, Inc. 2021 Licensed Ambulance List Vehicle Identification Number License Type License Number Effective Date 1FDSS3ESODDA41561 VEHICLE PERMIT (ALS) 20888 8/24/2017 1FDSS3ESODDA41561 VEHICLE PERMITS (BLS) 4956 2/18/2016 1FDSS3ES1BDB27801 VEHICLE PERMIT (ALS) 17027 12/8/2011 1FDSS3ES1BDB27801 VEHICLE PERMITS (BLS) 5212 8/24/2017 1FDSS3ES3CDA18371 VEHICLE PERMIT (ALS) 20885 8/24/2017 1FDSS3ES3CDA18371 VEHICLE PERMITS (BLS) 4832 4/8/2015 1FDSS3ES4BDA26137 VEHICLE PERMIT (ALS) 20882 8/24/2017 1FDSS3ES4BDA26137 VEHICLE PERMITS (BLS) 4775 7/31/2014 N 1FDSS3ES5CDA18372 VEHICLE PERMIT (ALS) 20886 8/24/2017 04 1FDSS3ES5CDA18372 VEHICLE PERMITS (BLS) 4954 2/18/2016 1FDSS3ES6ADA31208 VEHICLE PERMIT (ALS) 20880 8/24/2017 1FDSS3ES6ADA31208 VEHICLE PERMITS (BLS) 4678 8/1/2013 1FDSS3ES6BDB36820 VEHICLE PERMIT (ALS) 22521 10/1/2019 Q 1FDSS3ES6BDB36820 VEHICLE PERMITS (BLS) 5940 10/1/2019 1FDSS3ES7BDB27799 VEHICLE PERMIT (ALS) 20883 8/24/2017 L t 1FDSS3ES7BDB27799 VEHICLE PERMITS (BLS) 4777 7/31/2014 Q 1FDSS3ES7BDB27804 VEHICLE PERMIT (ALS) 17026 12/8/2011 1FDSS3ES7BDB27804 VEHICLE PERMITS (BLS) 5213 8/24/2017 1FDSS3ES8DDBO2266 VEHICLE PERMIT (ALS) 20889 8/24/2017 (D 1FDSS3ES8DDBO2266 VEHICLE PERMITS (BLS) 4776 7/31/2014 1FDSS3ES9EDA22265 VEHICLE PERMIT (ALS) 20890 8/24/2017 1FDSS3ES9EDA22265 VEHICLE PERMITS (BLS) 4823 3/10/2015 1FDWE3FD7ADA20886 VEHICLE PERMITS (BLS) 5121 3/8/2017 w 1FDWE3FS4ADA62447 VEHICLE PERMIT (ALS) 20891 8/24/2017 1FDWE3FS4ADA62447 VEHICLE PERMITS (BLS) 5119 3/8/2017 00 w 1FDWE3FS5ADA20885 VEHICLE PERMIT (ALS) 20892 8/24/2017 1FDWE3FS5ADA20885 VEHICLE PERMITS (BLS) 5120 3/8/2017 aD 1FDWE3FS6BDA87027 VEHICLE PERMIT (ALS) 20896 8/24/2017 Y 1FDWE3FS6BDA87027 VEHICLE PERMITS (BLS) 4821 3/10/2015 a 1FDWE3FS7ADA20886 VEHICLE PERMIT (ALS) 20893 8/24/2017 +. 1FDWE3FS7ADA69148 VEHICLE PERMIT (ALS) 18535 7/31/2014 1FDWE3FS7ADA69148 VEHICLE PERMITS (BLS) 5216 8/24/2017 Q 1FDWE3FS88DA01958 VEHICLE PERMIT (ALS) 21048 10/25/2017 1FDWE3FS88DA01958 VEHICLE PERMITS (BLS) 5368 10/25/2017 1FDWE3FS8BDA09607 VEHICLE PERMIT (ALS) 18896 3/10/2015 1FDWE3FS8BDA09607 VEHICLE PERMITS (BLS) 5218 8/24/2017 Q 1FDWE3FS9ADA34661 VEHICLE PERMIT (ALS) 19943 6/6/2016 1FDWE3FS9ADA34661 VEHICLE PERMITS (BLS) 5224 8/24/2017 1FDWE3FSXDDA26427 VEHICLE PERMIT (ALS) 23547 3/2/2021 1FDWE3FSXDDA26427 VEHICLE PERMITS (BLS) 6317 3/2/2021 1FDXE4FSOEDA55897 VEHICLE PERMIT (ALS) 22001 1/18/2019 1FDXE4FSOEDA55897 VEHICLE PERMITS (BLS) 5692 1/18/2019 1FDXE4FSOGDC00665 VEHICLE PERMIT (ALS) 22759 2/3/2020 1FDXE4FSOGDC00665 VEHICLE PERMITS (BLS) 6007 2/3/2020 1FDXE4FS2BDB29932 VEHICLE PERMIT (ALS) 19699 1/19/2016 1FDXE4FS2BDB29932 VEHICLE PERMITS (BLS) 5220 8/24/2017 Exhibit "A" Packet Pg. 3 0771 15.A. b Ambitrans Medical Transport, Inc. 2021 Licensed Ambulance List 1FDXE4FS2EDA12033 VEHICLE PERMIT (ALS) 23784 7/8/2021 1FDXE4FS2EDA12033 VEHICLE PERMITS (BLS) 6385 7/8/2021 1FDXE4FS2EDA55898 VEHICLE PERMIT (ALS) 22002 1/18/2019 1FDXE4FS2EDA55898 VEHICLE PERMITS (BLS) 5693 1/18/2019 1FDXE4FS2GDC00666 VEHICLE PERMIT (ALS) 22760 2/3/2020 1FDXE4FS2GDC00666 VEHICLE PERMITS (BLS) 6008 2/3/2020 1FDXE4FS3BDB29941 VEHICLE PERMIT (ALS) 19758 2/18/2016 1FDXE4FS3BDB29941 VEHICLE PERMITS (BLS) 5222 8/24/2017 1FDXE4FS3BDB35786 VEHICLE PERMIT (ALS) 19759 2/18/2016 1FDXE4FS3BDB35786 VEHICLE PERMITS (BLS) 5223 8/24/2017 1FDXE4FS4BDB35781 VEHICLE PERMIT (ALS) 19757 2/18/2016 1FDXE4FS4BDB35781 VEHICLE PERMITS (BLS) 5221 8/24/2017 1FDXE4FS5EDA77930 VEHICLE PERMIT (ALS) 23534 2/23/2021 1FDXE4FS5EDA77930 VEHICLE PERMITS (BLS) 6312 2/23/2021 1FDXE4FS6CDA90604 VEHICLE PERMIT (ALS) 19956 6/20/2016 1FDXE4FS6CDA90604 VEHICLE PERMITS (BLS) 5225 8/24/2017 1FDXE4FS8BDB35783 VEHICLE PERMIT (ALS) 19957 6/20/2016 1FDXE4FS8BDB35783 VEHICLE PERMITS (BLS) 5226 8/24/2017 1FDXE4FS8GDC04320 VEHICLE PERMIT (ALS) 23009 6/5/2020 1FDXE4FS8GDC04320 VEHICLE PERMITS (BLS) 6112 6/5/2020 1FDXE4FSDDA34901 VEHICLE PERMIT (ALS) 23548 3/2/2021 1FDXE4FSDDA34901 VEHICLE PERMITS (BLS) 6318 3/2/2021 1FDXE4FSXGDC04321 VEHICLE PERMIT (ALS) 23010 6/5/2020 1FDXE4FSXGDC04321 VEHICLE PERMITS (BLS) 6113 6/5/2020 Q Packet Pg. 321 (4ZOZ `L4IsnBnV-Al!joy;my leoipaw A3uGBJGw3 : 9LgL0 a6eIloed }sn6nd :;u9wLj3ejjV U � � N � o � �a z ca o Cd v PLO 00 U L Ca co co W Z d U G1 W .4 .� 2 J •� �, d p I— J J Q W U U w " r CU o v' W ow_ � w a ¢� � �' d z O U LL. } z� a x� ULL w� r / a O W Z a° o¢ o wW W mM W ucd a °�¢ w �C cq z CJ cd o HAW � w U• ¢ cd o W J F' � U �..� a LLI W o z w � w U a U � o F O U O Q z cd ~ > > z cncd d w H w w c (1)z W W � �' • � (/) TVA n N t o U FL o o U CCi C N N M a d r+ d Y V cc d Client#: 707514 GRANTMEDICI 15.A.b ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/29/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS 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 Marsh & McLennan Agency Bouchard Region 5310 Clark Rd Sarasota, FL 34233 CONTACT NAME: AI°NN , Ext : 727 447 6481 n/C, No): ADDRESS: cicerts@bouchardinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Arch Insurance Company 11150 INSURED INSURERB: Arch Specialty Insurance Company 21199 Grant Medical Transportation, Inc. 4351 Pinnacle Street INSURER C Charlotte Harbor, FL 33980 INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY MAPK08386906 07/01 /2021 07101/2022 EACH OCCURRENCE $1 000 000 CLAIMS -MADE 51OCCUR PREMISES Ea occurs nce $1001 000 MED EXP (Any one person) $10,000 X 3rd Party PD Incl. PERSONAL & ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $3,000,000 X POLICY ECT LOC PRODUCTS-COMP/OPAGG $3,000,000 $ OTHER: A AUTOMOBILE LIABILITY MAPK08386906 07/01/2021 07/01/202 SINGLE LIMIT COEa accident $MBINED 1 000 000 BODILY INJURY (Per person) $ ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY A X UMBRELLA LIAB X OCCUR MAUM08509606 07/01/2021 0710112022 EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 EXCESS LIAR CLAIMS -MADE DED I X RETENTION $O $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Professional Liab MAPL20015500 07/01/2021 07/01/202 $1M Occ/$3M Agg DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ** Supplemental Name ** First Supplemental Name applies to all policies - Grant Medical Transportation, Inc. Policy# MAPK08386906 - : Ambulance Management Services, LLC Policy# MAPK08386906 - : Ambitrans Medical Transport, Inc. Policy# MAPK08386906 - : Venice Ambulance Service, Inc. (See Attached Descriptions) FL Dept. of Health, Bureau of Emergency Medical Services 4052 Bald Cypress Way MB C-18 Tallahassee, FL 32399-1738 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Q ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD Packet P 323 #S8438855/M8437288 Exhibit "C" RCMXC g 15.A.b DESCRIPTIONS (Continued from Page 1) Policy# MAUM08509606 - : Ambulance Management Services, LLC Policy# MAUM08609606 - : Ambitrans Medical Transport, Inc. Policy# MAUM08509606 - : Venice Ambulance Service, Inc. Policy# MAPL20015500 - : Ambulance Management Services, LLC Policy# MAPL20015500 - : Ambitrans Medical Transport, Inc. Policy# MAPL20015500 - : Venice Ambulance Service, Inc. SAGIlTA 25.3 (2016/03) 2 Of 2 #S8438855/M8437288 Packet Pg. 324 Client#: 711402 AMBITMEDIC 15.A.b ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 15/14/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS 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 Marsh & McLennan (SAR) 5310 Clark Road, Suite 1 CONTACT Bouchard Insurance NAME: PHONE g41 922-0245 FAX 941 923-4126 AIC, No, E# ; AIC, No ADDRIESS, cicerts@bouchardinsurance.com Sarasota, FL 34233 941 922-0245 INSURERS) AFFORDING COVERAGE NAIC # Benchmark Insurance Company INSURER A: P Y 41394 INSURED Ambitrans Medical Transport, Inc. 4351 Pinnacle Street INSURER B : INSURER C Punta Gorda, FL 33980 INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUB WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ PREMISESOERENTED occu ence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER; PRO POLICY JECT LOC OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ HOCCUR AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYSTAT ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A FPD20129000 12/27/2020 12127/2021 X PER E OTH- IER E.L. EACH ACCIDENT[$1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT 1 $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) For Informational Purposes Only For Informational Purposes Only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Q ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD Packet P 325 #S8295719/M7056730 Exhibit "D" RCMXC g' 15.A. b DEA REGISTRATION THIS REGISTRATION FEE NUMBER EXPIRES PAID F00441218 12-31-2021 $731 SCHEDULES BUSINESS ACTIVITY ISSUE DATE 2,2N, PRACTITIONER 11-07-2018 33N45 O'LEARY, DANIEL V MD MBITRANS MEDICAL TRANSPORT 351 PINNACLE ST PORT CHARLOTTE, FL 33980-2902 REPORT N CHANGES ih N PROMPTLY LL CONTROLLED SUBSTANCE/REGULATED CHEMICAL REGISTRATION CERTIFICATE UNITED STATES DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION WASHINGTON D.C. 20537 Sections 304 and 1008 (21 USC 824 and 958) of the Controlled Substances Act of 1970, as amended, provide that the Attorney General may revoke or suspend a registration to manufacture, distribute, dispense, import or export a controlled substance, THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF OWNERSHIP, CONTROL, LOCATION, OR BUSINESS ACTIVITY, AND IT IS NOT VALID AFTER THE EXPIRATION DATE. REQUESTING MODIFICATIONS TO YOUR REGISTRATION CERTIFICATE To request a change to your registered name, address, the drug schedule or the drug codes you handle, please 1. visit our web site at dead] version.usdo).gov - or 2. call our customer Service Center at 1-(800) 882.9539 - or 3. submit your change(s) In writing to: Drug Enforcement Administration P.O. Box 2639 Springfield, VA 22152.2639 See Title 21 Code of Federal Regulations, Section 1301.51 for complete instructions. _______ You have been registered to handle the following chemical/drug codes_______ Exhibit "E" Packet Pg. 326 15.A.b BRIAN W. CROSLAND, CPA, PL CERTIFIED PUBLIC ACCOUNTING & CONSULTING 2200 KINGS HIGHWAY #3L242 PORT CHARLOTTE, FL 33980 PHONE: 941.676.8900 FACSIMILE: 941.347.4275 KRISTI L. SCOTT AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS FLORIDA INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS SHAWN M. COOLEY, CPA MEDICAL GROUP MANAGEMENT ASSOCIATION COMMUNITY ASSOCIATIONS INSTITUTE 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, 2021. 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 internal 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, Inc. 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. July 21, 2021 Port Charlotte, Florida EXCELLENCE SINCE 1984 Exhibit "F" Packet Pg. 3 7 V71 Ambitrans Medical Transport, Inc. and Subsidiaries Statement of Assets and Liabilities of the Ambulance Transportation Operations Income Tax Basis of Accounting April 30, 2021 (Unaudited) Assets Current Assets: Cash available for ambulance transportation operations $ 695,000 Property and Equipment: Office equipment and computers 172,336 Machinery and equipment 824,028 Medical transportation vehicles 1,831,986 2,828,350 Less accumulated depreciation (2,761,506) Property and Equipment, net 66,844 Total Assets $ 761,844 Liabilities Current Liabilities: �a Accrued profit sharing $ 85,645 Other liabilities 37,500 a Notes payable to banks 226,615 349,760 Q c aD Long Term Liabilities: E U Notes payable to banks 344,648 Q Less current portion above (226,615) 118,033 Total liabilities 467,793 Net Assets Over Liabilities, income tax basis $ 294,051 Packet Pg. 328 Read Independent Accountants' Compilation Report