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EMA Agenda 01/10/202416.A.3 COLLIER COUNTY EMERGENCY MEDICAL AUTHORITY (EMA) AGENDA January 10th, 2024— Wednesday 9:30am 3299 Tamiami Trail, Bldg F 51h Floor IT Training Room 1. CALL TO ORDER AND PLEDGE OF ALLEGIANCE 2. AGENDA AND MINUTES a. Approval of Today's Agenda b. Approval of the November 8th 2023, Meeting Minutes 3. OLD BUSINESS a. Performance Measures Update 4. NEW BUSINESS a. Brewster COPCN Renewal b. Seminole Tribe COPCN Renewal c. North Collier Fire COPCN Renewal 5. FIRE SERVICE DISCUSSION 6. STAFF REPORTS 7. PUBLIC COMMENT 8. BOARD MEMBER DISCUSSION 9. NEXT MEETING DATE a. February 14th, 2024 10. 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Pipe Ridgy Rd -cOftly�cllki Itnmu -t f -s :tuna, L:oac! (ir Vineyards Pint ftldum Rd n9tWO" wool Packet Pg. 214 16.A.3 Gouniy Rafts! 546 9fl lm okaise:Rd Ave Mafia Pagi w GO Ctub 0 Packet Pg. 5 16.A.3 L r' � CAD LEmer EC 0 12023 T12REWSTER ollier County esPncyMana ement AMBULANCE SERVICE Collier County 2023-2024 Renewal Application for our CLASS "2" TRANSPORT COPCN Just Like Family Concierge Medical Transport Services LLC. DBA: Brewster Ambulance Service Contact: Yohandy Machin 11820 Lacy Lane Fort Myers, FL 33966 239-682-8907 November 14th, 2023 The enclosed information is the complete 2023-2024 renewal application for a Certificate of Public Convenience and Necessity for Collier County, Florida. Packet Pg. 216 16.A.3 Brewster Ambulance Service — Collier County 23-24 COPCN Renewal Application An applicant for a certificate shall obtain form 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 or ALS provider, or if the owner is a corporation, then of the directors of the corporation and 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. Service Owners/ Directors Paul Hobaica MD, 57 — 1061 Collier Center Way Suite #1 42.0% Brewster Ambulance - 25 Main Street, Weymouth MA 35.0% Jeffery Panozzo MD, 63 — 1061 Collier Center Way Suite #1 13.0% Chris Dibona, 49 — 1061 Collier Center Way Suite #1 5.0% Yohandy Machin, 33 — 1061 Collier Center Way Suite #1 5.0% Mark Brewster, 47 — 1061 Collier Center Way Suite #1 0.0% 2. The Boundaries of the area to be served. All area contained within Collier County, Florida boarders. 3. The number and a brief description of the ambulances or other vehicles the applicant will have available. Brewster Ambulance Service currently has (16) licensed ambulances in its Florida division. Brewster Ambulance Service uses the most current technology for staffing units. We staff ambulances to meet the anticipated needs of our service area by using FirstWatch Solutions. FirstWatch turns raw data into meaningful information, helping us improve situational awareness, operational performance and clinical patient outcomes. Our system does this by securely capturing, translating and transmitting information about our callers, patients and systems via FirstWatch triggers all in real-time. A FirstWatch "trigger" is a representation of data based on a set of user -defined data filter criteria using one or more FirstWatch analytical methods. Triggers draw data from one or more data sources, like CAD, ProQA, RMS and ePCR. Typically, data is consumed as events; each event is uniquely identified and has a date time stamp. Each event can also be supplemented with additional information, such as location and comments. This information is then used to calculate need and location of available ambulances like never done before. Packet Pg. 7 16.A.3 Brewster Ambulance Service — Collier County 23-24 COPCN Renewal Application Continued... Tracking of vehicles is accomplished with FleetLocate by Spireon, we are able to track (in real time) our vehicles exact location and provide more accurate arrival times to our customers, thus improving the patient flow at the local hospitals. 4. The address of the intended headquarters and any substations. Brewster Ambulance Service Naples location is: 150 Aviation Drive S, Naples FL 34104 Our Lee County Location is: 11820 Lacy Lane, Fort Myers FL 33966 P't"�w M �r(mat Packet Pg. 218 16.A.3 Brewster Ambulance Service — Collier County 23-24 COPCN Renewal Application 5. The training and experience of the applicant. This will be the 8t' consecutive year serving Collier County. We have safely transported over 50,000 patients within Collier County. The management team at Brewster Ambulance Service collectively has over 300 years of experience in the EMS industry with varied experience in Field training, education, management, air medical and critical care transport. With over a century in the ambulance industry, we can provide the expert leadership needed to run a respectable, high quality service. Our Quality Assurance Department is staffed by 10 full-time Paramedics. All QA staff have a minimum of 10 years with a Paramedic certification. Our QA staff reviews patient care reports for quality assurance and adherence to our medical protocols and standards of care. Brewster Ambulance Service 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 May 15, 2024. Brewster Ambulance Service accepts all insurance providers. All billing and collections are done in house with our team of close to 60, to ensure patient confidentiality and a payment plan for all patients with financial difficulty. All BAS field employees maintain their credentials in a proactive manner as well as pursue continuing education tracks so they achieve individual career and certification objectives. During orientation and throughout the year, all employees are required to take a course or refresher course in infection control, airborne pathogens, blood -borne pathogens, HIPAA, injury prevention, and emergency vehicle operations. EMTs and Paramedics are responsible for maintaining their own credentials and certifications. Brewster Ambulance Service sponsors continuing education support in order for employees to maintain their certifications thru CMTI which is an accredited EMS education provider. The required 16-hour Emergency Vehicles Operators Course is handled by our in house EVOC Instructor. We uses a combination of classroom and practical driving to train staff on the proper driving techniques to safely drive an emergency vehicle in the state of Florida. All staff is required to renew this certification every two years by completing an online update course. Packet Pg. 219 16.A.3 Brewster Ambulance Service — Collier County 23-24 COPCN Renewal Application 6. The name and addresses of three Collier County residents who will act as references for the applicant. Michael V. Reagen — Former president and CEO of the Greater Naples Chamber of Commerce 10391 Regent Circle Naples, Florida 34109 Nicole Bishop-Tregea BSN, RN — NCH Nursing Director 13523 Pond Apple Drive E Naples, FL 34119 Jim S. Bloom — CCSO Undersheriff 3319 Tamiami Trail East Naples, FL 34112 Packet Pg. 220 16.A.3 Brewster Ambulance Service — Collier County 23-24 COPCN Renewal Application 7. Schedule of rates, which the service intends to charge. Code Service Description Rate A0428 BLS Non- Emergency $450.00 A0429 BLS Emergency $500.00 A0426 ALS Non- Emergency $525.00 A0427 ALS Emergency Level 1 $575.00 A0433 , ALS Level 2 $725.00 A0434 SCT $950.00 A0425 Mileage (PLM) $15.00 LO N O ti a� aM M .19 M a. c c a� E t U Q Packet Pg. 221 16.A.3 Brewster Ambulance Service — Collier County 23-24 COPCN Renewal Application 8. Such other pertinent information as the administrator may require. At this time, we are unaware of any other mandatory information required by the administrator for this application. We have included copies of all pertinent information. 9. An application or renewal fee of $250.00 (Exception Collier County EMS). Enclosed check 10. Financial data including assets and liabilities of the operator. A schedule of all debts encumbering any equipment shall be included. Attached Packet Pg. 222 (bZOZ `4306 Ajenuer -Al!joy}my jeaipaw A3uGBa8w3 : 5Z8LZ) a6eVed fuenuer :;uawyaeuv �I a 0 � N � O o b oo u L N• V � C C/J p LL W 0 �j U •CL4 w U N coo F cd U O eyC ^D :e Lu o N WZ w F Gn ��w� �j s _ 3 � VI J w Q � Q w W in OG20 w uj LL Vi } W p 2 O C.0)LL 67 o 4 °- n E- LL U z 0 C. a o F ''vo x¢ `' rt a W H .; G Z W mc W a N �-� Q F ;.�� pv 1 uj LL z v FQ-�W wz 'z v) a g �. i� 76a E� s W W w a o U. 0 z N °� > z coo o� w J L.T. r U r•� o �zco V X ¢ CO �M a Y� a O C U U } O v. c�0 F- (bZOZ `4306 Ajenuer -A;iaoy}my jeaipaw A3ua6a8ua3 : 5Z8LZ) a6eVed fuenuer :w9wLi3euv m a_ N a_ N W J 0 W J W J O W J 0 W -� W J O m W J CL N W J W J W J O W yj J W J O Ln Ln r 00 00 m m a) 00 00 Ln to N N ri e-1 ri r1 r-I r-I e-I r-I e-i r-i ri r-I r-I r-I N N N N O O O O O O O O O O O O O O O O N N N N N N N N N N N N N N N N 00 u- 0 m Z W 0) Z Z W L.0 W cr ]G Ln W CI ]G � � = Z 0) N Y J � = Z rN-I � a Lt- Oa0 Q) > U m M > U co LO m m_ ca O) I- m_ cc O 00 U II m U LLn m Lr) N L Ln N L O Ln ri O Ln r-i O Ln r-i O Ln r-I O IJ) N O Ln ri O Ln r-I O Lr) r-1 O Ln O Ln 01 0J ++ 4 + ++ ++ 4+ ++ ++ 41 C • 0- C 0-m Ln V) C H N C m F- !n C m 1-- N C m H h C m F- N C m F- to C m F- N C m {— Ln M W Ln M W O m W O m W N C H c f— mLn aj N C) v U i CC G ccv G L LL L L L LL L LL L LL L U- L L. L LL L LL L LL L L L L L L L L O LL 0) m 00 00 r-I r-I LLLL 00 u I\ W N ri r-I r I N r-i LLY 00 o r- W N It Ln Ln r-I ¢ rl U N O 00 00 I,- 00 ¢ Y X U N Q0 C) O e-i 00 ¢ Y N U N 0l ct O m LD ¢ N X N tN0 O M t0 Q Y ^ X N N O) H r"I N ¢ X N RT H tt N N m Y O X N r-I r -t N N m Y N X fV Il m ri LO H Q LL. N LL M W Ln ct O 0) N Q LA-z N LL M W rrl 0) r.i N U Z LL M W 00 O r-I N U Z Z LL (Y) W O 00 o0 M ¢ Y <7 X " L0 M m ¢ ]G U' X r-i a m a- m a LY o LL rl = >- 0 LL e-i m >- 0 W ri LY 0 W rl m 0 LL ri OG >- LL ri 3: m 0 LL e-i 3 m 0 LL ri S� LL rl o W rl LL ri LL ri m o LL ri m 0 LL ri N M � N M Ln LA I-- 00 m r I ci e-I r�-I a -I H rr 4 16.A.3 Brewster Ambulance Service Balance Sheet As of November 1, 2023 ASSETS Current Assets Bank Accounts Other Current Assets Total Current -Assets TOTAL $2,292,074_96 $1464872.48 $2,438,94Z44 Fixed Assets $5"67-23 Other Assets $195,15L34 TOTAL ASSETS $2,684,266.01 LIABILITIES AND EQUITY Liabilities Current Liabilities Accounts Payable $186,780.16 Credit Cards $0.00 Other Current Liabilities $214,247_86 Total Currentl abMies $401,028-02 Long -Term Liabilities $123,910-13 Total 1labMiss $524,938-15 Equity $2,159,327-86 TOTAL LIA8lL1T(ES AND 1=QUn Y $2,684,266-01 Packet Pg. 225 16.A.3 A� O® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11 / 13l2023 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER rONNAME" T Anna Seymour C 8 S Insurance Agency, Inc. (508) 339-2951 FAX (508) 339-4811 PHCONEo AI AINExt : C. No 190 Chauncy St E-MAIL anna@candsinS.Com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC p Mansfield MA 02048 INSURERA: Landmark American Insurance Company INSURED INSURER B : Old Republic Insurance Company 24147 INSURER C : Coverys Specialty Insurance Company 15686 Just Like Family Concierge Medical Transport LLC INSURER D : 11820 Lacy Lane INSURER E : INSURER F : Fort Myers FL 34105 COVERAGES CERTIFICATE NUMBER: 23-24 JLF 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. I SR LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER POLICY EFF MMIDDJYYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERC14ALGENERALLIABILITY X CLAIMS -MADE OCCUR LHC799186 11/09/2023 11/09/2024 EACH OCCURRENCE $ 1,000,000 A A ' t�A7T PREMISES Ea occurrence $ 100,000--- MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY ❑ X PRO- LOC OTHER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS $ 1,000,000 $ BOWNED AUTOMOBILE I LIABILITY ANY AUTO SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY MWTB31356923 06/01/2023 06/01/2024 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) _ $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Par accident $ $ C X UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE 005MA000026155 06/01/2023 06/01/2024 EACH OCCURRENCE $ 4,000,000 _ AGGREGATE $ 4,000,000 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) II yes, describe under DESCRIPTION OF OPERATIONS below NIA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Collier County Board of Commissioners ACCORDANCE WITH THE POLICY PROVISIONS, 3299 Tamiami Trail East AUTHORIZED REPRESENTATIVE Suite 303 Naples FL 34112 © 1988-2015 ACORD CORFURArIUN. An rlgnts reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Packet Pg. 226 16.A.3 CERTIFICATE OF LIABILITY INSURANCE 11/1(6/2023) 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 rights to the certificate holder in lieu of such endorsement s . PRODUCER MICHAEL GEE INC 786 S Orange Ave, North Unit Sarasota, FL 34236 CONTACTMICHAEL C GEE AME: PHONE 941 907-0914 FAX 0:(941)907-0916 E-DAILE tron verizon.net INSURERS AFFORDING COVERAGE NAICX INSURER A-RETAILFIRST INSURANCE CO 10700 INSURED JUST LIKE FAMILY CONCIERGE MEDICAL TRANSPORT SERVICES, LLC 11820 LACY LANE FORT MYERS, FL 33966-1345 239 682-8907 INSURER a: INSURERD: 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. LTR TYPE OF INSURANCE INSD P Y E POLICY EFF M YY POLICY EXP Y LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE=OCCUR EACH OCCURRENCE S S MED EXP (Anyoneperson)S PERSONAL & ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: POLICPRO- JECT =LOC JECT OTHER GENERAL AGGREGATE S PRODUCTS - COMP/OP AGG S S AUTOMOBILE LIABILITY ANYAUTO OWNED SCHEDULED -AUTOS ONLY AUTOS HIRED NON -OWNED -AUTOS ONLY AUTOS ONLY COMB NEDSINGLE LIMIT S BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE r c e S $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ RETENTIONS A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ON EXCLUDED? N (Mandatory H) In NH) If yes, describe under DESCRP P 1 N/A 520-57989 7/09/237/09/29 PEAT T O H E.L. EACH ACCIDENT 1 000 000 S / r E.L. DISEASE - EA EMPLOYEE $ 11000,000 DISEASEEL-P ICY LIMIT 1 0 0 0, 0 0 0 DESCRIPTION OF OPERATIONS i LOCATIONS t VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) INSUREDS COPY I 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 U 198b-ZU10 AL:VKU t.UKl'U"I Ivry. HR Ilynts le�crvuu. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Packet Pg. 227 16.A.3 SEMINOLE TRIBE FIRE RESCUE DEPARTMENT FIRE/EMS ADMINISTRATION c/o OFFICE OF FIRE CHIEF 3101 North State Road 7 Hollywood, Florida 33021 (954)967-5100 BRGHTON RESERVATION WILDLAND STATION H27 380 Billie Road Okeechobee, Florida 34974 (863)763-2957 December 5, 2023 BIG CYPRESS RESERVATION FIRE STATION #2 30290 Josie Billie Highway, PMB #280 Clewiston, Florida 33440 (863)983-2150 IMMOKALEE RESERVATION FIRE STATION #38 1110 South First Street Immokalee, Florida 34142 (239) 657.3659 Dan E. Summers, CEM, FPEM, Director Collier County Bureau of Emergency Services Emergency Services Center, Suite 445 8075 Lely Cultural Parkway Naples, Florida 34113 BIG CYPRESS RESERVATION WILDLAND STATION #22 34275 Josie Billie Highway Clewiston, Florida 33440 (863)763-2957 HOLLYWOOD RESERVATION FIRE STATION N108 3105 North State Road 7 Hollywood, Florida 33021 (954)986-2080 BRIGHTON RESERVATION FIRE STATION N7 600 E. Harney Pond Road Okeechobee, Florida 34974 (863)763-1581 TAMPA RESERVATION c/o POLICE STATION 5217 Orient Road Tampa, Florida 33610 (813)623-5748 �CC�C�OMGD DEC 0 7 2023 Collier County Emergency Mananpi Re: Certificate of Public Convenience and Necessity (COPCN) Renewal Application - Seminole Tribe of Florida Class I - ALS Transport & Class 2 - ALS Transfer Dear Mr. Summers, In accordance with Collier County Ordinance No. 04-12, Chapter 50, Article III, Sections 1-25, please find attached the Certificate of Public Convenience and Necessity (COPCN) Application Renewal. The Seminole Tribe of Florida Fire Rescue Department wishes to continue to provide Basic/Advanced Life Support Emergency Medical Services, Class -I Transport and Class-2 Transfer services for the Seminole Indian Immokalee Reservation located in Collier County, Florida. Please note that, by submission of this application, notwithstanding anything contained herein (including any standard forms or certifications required), the Seminole Tribe of Florida agrees only to comply with those laws which are applicable to federally recognized Indian Tribes, assuming that all conditions for applicability are met. The Tribe does not intend to diminish its sovereignty or to be bound by any law which is otherwise inapplicable. Your assistance with this matter is greatly appreciated. Should you have questions or require additional information please do not hesitate to contact me at (954) 966-6300 x 11611. Respectfully, Michael Mackey, Fire Chief Attachment Cc: file Confidentiality Notice. The information contained in this message/document may be privileged and confidential and protected from disclosure. If the reader of this message is not the intended recipient, or an employee or agent responsible for delivering this message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Packet Pg. 228 16.A.3 Seminole Tribe of Florida COPCN Application Fire Rescue Collier County Ord. No. 04-12, § 4; Ord. No. 05-16, § 4; Ord. No. 201 1-36. § 2 Sec. 50-55. — Procedure for obtaining certificate ( l ) The name, age, and address of the owner of the ambulance or ALS Operator, or if the owlier is a corporation, then e f the directors of the corporation and of all the stockholders holding more than 25% of the orrtstancling shards. For governmental units, this information shall be supplied for members of the governing hotly. • SEE ATTACHMENT #1 MarcellUS W. Osceola, Jr., Chairman Holly Tiger, President Mariann Billie, Councilwoman Larry Howard, Jr. Councilman Christopher Osceola, Councilman c/o Seminole Tribe of Florida 6300 Stirling Road Hollywood, FL 33024 Telephone: (954) 966-6300 Age/DOB: 51 y/o, 06/ 18/ 1972 Ave/DOB: 49 y/o, 08/05/ 1974 Age/DOB: 41 y/o, 05/ 13/ 1982 Age/DOB: 52 y/o, 09/ 19/ 1971 Age/DOB: 53 y/o, 01 /20/ 1970 (2) The boundaries of the territory desire(/ to he served. • SEE ATTACHMENT #2 The geographical boundaries of the territory served will encompass the entire Seminole Tribe of Florida Immokalee Reservation as noted in Attachment #2. Occasionally mutual aid requests by Collier County and/or other Public Safety Agencies have necessitated responses outside the geographical boundaries of the reservation. In such cases, STFR will attempt to promptly notify the appropriate licensed EMS provider via the Seminole Police/Fire Rescue Communications Dispatch Center, or authorized interagency mutual aid radio communications channels of all such incidents. (.3) The number and brief description of the runbrdcmc•e,v or other vehicles the applicant gill have available. • Two (2) Medical Rescue Units (Ambulances) — Rescue 38: Class 1&2 ALS Transport and intra-Facility — Rescue 238: Class 1&2 ALS Transport and Intra-Facility • One (1) Fire Engine 1250 GPM Pumper — Engine 38: Class 3 ALS Non -Transport • One (1) Fire Brush Truck/Utility Vehicle — Utility 38: Non-ALS, Non -Transport, Suppression Unit, Exempt Q Page 1 of 4 Packet Pg. 229771 16.A.3 Seminole Tribe of Florida COPCN Application Fire Rescue Collier County (3) Cnnthmed • One (1) Squad Truck Vehicle — Squad 38: Non-ALS, Non -Transport, Air Truck, Exempt • One (1) Fire/EMS Supervisory Vehicle — Battalion 38: Support Vehicle, Exempt Note: Only permanently assigned vehicles listed above. STFR has additional spare Fire/EMS vehicles used For temporary maintenance, hack -fill or special events permitted in accordance with Florida Statutes 401 and FDOH Regulations 64-E. (4) The address of the intended headquarters and anY substations. • Fire Rescue Headquarters: — Seminole Tribe of Florida .L Fire Rescue Department 0 m 3101 North State Road 7 a Hollywood, FL 33021 • Fire Rescue Substations: — Fire Station #38 — Fire Station #7 I 1 10 South I st Street 660 East Harney Pond Road aD [mmokalee. FL 34142 Okeechobee, FL 34974 E — Fire Station #2 — Fire Station #108 w 30280 Josie Billie Highway 3105 State Road 7 N Clewiston, FL 33440 Hollywood, FL 33021 N (Executive Admin. Offices) m (S) The training and experience of the applicant. Y ti Experience — The Seminole Tribe of Florida Fire Rescue (STFR) Department was established in 3 2003 and has provided single -tier, Advanced Life Support Emergency Medical Services (ALS/EMS) _ since 2005 at all eight Tribal reservations and non -trust lands state-wide directly or indirectly via contractual relationships. STFR employs approximately 130 dual certified fire and rescue personnel E licensed through the State of Florida. The department serves 4,000 full time residents and over 22 million visitors annually at its public venues and attractions. Annually STFR and its contractual ea Q partners respond to approximately 10,000 requests for 911 emergency and non -emergency fire rescue services. The Seminole Tribes Fire Rescue Department manages or provides Fire/EMS services in multiple statewide locations including Broward, Dade, Hendry, Saint Lucie, Polk and Hillsborough Counties. The department is highly recognized by the State of Florida DOH/EMS Bureau and receives outstanding ratings on annual EMS in-service inspections. It is compliant on annual data reports to EMSTARS. NFIRS and FFIRS incident data collection systems sent directly to federal, state and local agencies. Page 2 of 4 Packet Pg. 230 16.A.3 Seminole Tribe of Florida Fire Rescue (5) Continued COPCN Application Collier County STFR's Executive/Management team averages 35+ years' experience in fire and emergency medical services; and field operations personnel average 11.5 years of experience. Several staff members have been recognized by the state or other EMS organizations and awarded such distinctions as; "Firefighter/Paramedic of the Year", and "Paramedic Instructor of the Year". Training— All Seminole Tribe of Florida Fire Rescue (STFR) employees are dual -certified fire and rescue personnel licensed by the State of Florida. The department provides vigorous six (6) week multi -disciplinary Fire/EMS orientation training program for all new employees. An additional ( 12) month probationary "in-service" skills sign -off program is mandated for successful completion by all new employees. Every two years all personnel must successfully complete a continuing education medical training matrix including but not limited to the State of Florida EMS mandatory contact hours to include ACLS, Protocols and "hands on" lab skills testing, etc. The department's Medical Director has adopted clinical guidelines that are in compliance with the State of Florida's standards for medical oversight. The Tribes Medical Director Wayne Lee, MD is a certified Emergency Medical physician with more than 40 years' experience as a local and statewide leader in the field of prehospital and emergency medicine. Additionally, the department delivers life safety classes (CPR/AED/Fire Extinguisher training) and Crowd Manager Classes. They also provide Youth Safety, Senior Safety, CPR/AED classes and Fire Drill presentations. On average, this pro -active life safety training has reached approximately 10,000 people annually. (6) The names and addresses of three Collier County residents irho will act cis references for the applicant. • Tina Marie Osceola, 5920 Westport Lane, Naples, FL 34116.. Ph. (239) 298-3279 • O.B. Osceola, Sr., 5870 Westport Lane, Naples. FL 34116, Ph. (239) 455-2171 • Michael D. Murphy, 1280 San Marco Rd., Marco Island, FL 34145, Ph. (239) 393-0099 (7) A schedule of' rates which the service intends to change. • Class 1 - ALS/BLS Emergency Transports Only * The Seminole Tribe of Florida contracts with a third party billing firm for all EMS patient transportation billing/collections services. All non -emergency Class 2 - EMS Intra-facility Transports are typically for the private use of Seminole Tribal members and billed directly to Medicare eligible patients only. Q Page 3 of 4 Packet Pg. 231 1 ti.A.3 Seminole Tribe of Florida Fire Rescue (8) Such other pertinent nitorinatlon as the administrator maY require. • ATTACHMENT #3 Florida Department of Health Bureau of Emergency Medical Oversight Advanced Life Support License #2603 • ATTACHMENT #4 Harry W. Lee, M.D. - Medical Director License (9) An appliccition or renewal fee n1'$250.00. (E.rception Collier County EMS). • ATTACHMENT #7 Payment to Collier County enclosed with application — Check # COPCN Application Collier County (/0) Financial data including, assets and liabilities of' the operator. A schedule of all debts encumbering an}' egntpnient shall be included. • The Seminole Tribe Fire Rescue is funded by the Seminole Tribe of Florida, an organized Indian Tribe as defined in Section 16 of the Indian Reorganization Act of June 18, 1934. All financial information is strictly for the private use of the Seminole Tribe of Florida. Mission Statement: "To protect and enhance the quality of life of the Seminole Tribe of Florida communities, through it comprehensive program of services committed toward education, prevention and control of fire, rescue, medical emergencies, life safety, forestry and all hazard responses." Values: We (-wl)ect to ►nal e a di1J'erence in the quality nf'life to the Seminole Tribe and guests. To this end, u•e fiwits our resources,lor the most enduring benefit. • improve the quality of life safety through education and code enforcement to prevent fires, reduce injuries and other harmful events. • Deliver responsive and caring emergency services. • Protect life and property from fire, hazards, injuries and illness. • Mitigate emergencies and disasters, both man-made and natural. • Enhance customer and community relations. Q Page 4 of 4 Packet Pg. 232 16.A.3 Hollywood Councilman ATTACHMENT # 1 Tribal Council Chairman President Brighton Councilman E W Big Cypress Councilwoman Packet Pg. 2 3 (bZOZ `4306 Ajenuer -Aj!joy}my jeaipaw A3uGBa8ua3 : 5Z8LZ) 06eVed fuenuer :w9wLi3euv !rY r X P 9.9 tir 4 1� 7� ` r 1 4l f � � ttGAA f 1 Xp }� I - . •.I I (I too L11 � — m I/I a' u 1S sauaP i It ';0 ;z f w o u Q Q J O 1S PIC S c u Q 2 o S o " ' G V O co4If p Q i 3 c a o 0 0 - u ut NE S 1� 419 S�� I(I aldi w a a R a c i o a IS 413 S a m a I S 41b S M N a d r+ d Y a u C (Q d m d b� �W a® 0 h o $ Na �g @� N h4 0 0 ou` ui S g W C 111 (bZOZ `4306 Ajenuer -Al!joy}my jeaipaw A3uGBa8ua3 : 5Z8LZ) a6eVed fuenuer :w9wLi3euv M ZC: o v o c .L E U °> o =v 00 -°U �uQ) >z H r N• V �, ¢ aj C Cn O N U N �k c O cn u E C N O E p 5 03 2 O x C �vC dA a N 0 W � w = o N v ` N oo UU v uJa E W` Z w > > �� o N s = / U L °� "z Q -0 �. L 2O F—J D o �.�>, Z c v n w cam c3 o c QQV -e (L)U Z o Q W w w w ¢ = v 0 A c7 O O U. 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W M M JQ J F CV) � w O W Z W w w J J ow ..t O O m p N� o m� 0 3 W W Wg wCL �ocz�- IX tZ-- w 2 iv OL N W Amy Patterson, County Manager Collier County 3299 Tamiami Trail East Naples, Florida 34112 Re: Certificate of Public Convenience and Necessity Renewal Application Dear Ms. Paterson: This letter serves as the District's application to renew its Class 3 Advanced Life Support (ALS) non -transport Certificate of Public Convenience and Necessity (COPCN), in accordance with Collier County Ordinance 81-75. With this application, I have enclosed a check for the renewal fee in the amount of $250.00, the names of the District's Board of Fire Commissioners (Attachment "A"), a list of the District's Apparatuses (Attachment "B"), and our references (Attachment "C"). The District has continued to provide high -quality ALS non -transport services through one of the most trying times in Collier County's history. Furthermore, the District engages in the Collier County Non -Transport Quality Assurance Committee, the Collier County Fire/EMS Chiefs Protocol Sub -Committee, and communication with Dr. Tober and Dr. Lee. I respectfully request the approval of the District's application to renew its COPCN. In the meantime, if you have any questions regarding this matter, please feel free to contact my office at your convenience. Sincerely, Eloy Ricardo Fire Chief Enclosures cc: Michael Choate, Executive Director of Public Safety NORTH COLLIER FIRE CONTROL AND RESCUE DISTRICT 1885 Veterans Park Drive Naples, FL 34109 . (239) 597-3222 . northcollierfire.com FIRE CHIEF ELOY RICARDO BOARD OF FIRE COMMISSIONERS M. James Burke . Christopher Crossan .James A. Calamari . Norman E. Feder .1. Christopher Lombardo Packet Pg. 237 BOARD OF FIRE COMMISSIONERS 1. M. lames Burke 1885 Veterans Park Drive Naples, Florida 34109 2. James Calamari 1885 Veterans Park Drive Naples, Florida 34109 3. Christopher Crossan 1885 Veterans Park Drive Naples, Florida 34120 4. Norman E. Feder 1885 Veterans Park Drive Naples, Florida 34109 5. J. Christopher Lombardo 1885 Veterans Park Drive Naples, Florida 34109 Attachment "A" Packet Pg. 238771 16.A.3 Insurance Company 7VFIS Type of Insurance Insurance Expiration Date Vehicle Liability Ot/OI12024 Date Certificate of Public Convenience and County of Service Necessity Expires Collier 03/30/2024 Permit Tvae Sub Type Make Model Year License Status Issue Dale Vehicle Identifier Permit Fee 16471 ALS N PIERCE QUANTUM 2010 Clear 02/28/2011 4P1CUO1E3AA010553 25.00 16472 ALS N PIERCE QUANTUM 2002 Clear 02/28/2011 4PICT02S02A002256 25.00 16473 ALS N PIERCE QUANTUM 2004 Clear 02/28/2011 4P1CT02SWA003679 25.00 16654 ALS N FORD F450 2005 Clear 06/07/2011 1FDAF56P95ED24543 25.00 17400 ALS N FORD F350 2012 Clear 08/29/2012 1 FT8W38T6CEC56211 25.00 18591 ALS N PIERCE IMPEL 2013 Clear 09103M14 4P1CJ01A8FA014108 25.00 18592 ALS N PIERCE IMPEL 2013 Clear 09/03/2014 4P1CJO1A8EA014125 25.00 19031 ALS N PIERCE QUANTUM 2006 Clear 04/23/2015 4PICUOIS36A006032 6.00 19424 ALS N PIERCE CONTENDER 2005 Clear 09/15/2015 4PICCOt M65A004732 25.00 19741 ALS N PIERCE PUMPER 2016 Clear 02/04/2016 4PIBAAFF7GA015968 25.00 19822 ALS N FORD F650 2013 Clear 0313WO16 1FDOX5HTXDFA80905 25.00 19823 ALS N FORD F550 2015 Clear 03/30/2016 1 FDOX5HT2FE871542 2500 19824 ALS N SUTPHEN S2 2006 Clear 03/30/2016 1SOAlBLD261003097 25.00 20435 ALS N PIERCE QUANTUM 2016 Clear 02/20/2017 4P1BAAFF5HA017350 2500 20436 ALS N PIERCE QUANTUM 2016 Clear 02/20/2017 4PIBAAFFOHA017349 25.00 21892 ALS N PIERCE IMPEL 2017 Clear 111261201It 4P16AAFF7HA017379 25.00 21893 ALS N PIERCE VELOCITY 2017 Gear ll2612018 4PIBCAGFXHA017417 25.00 21894 ALS N PIERCE VELOCITY 2017 Clear 11/26/2018 4PISCAGFlJA019028 25.00 23087 ALS T INTERNATIONAL MFDTEC 2007 Clear 07/13/2020 11-ITMNAAM671-1460580 25.00 23088 ALS T FORD F450 2017 Clear 07/13/2020 1 FDUF4GTXHDA02636 2500 23089 ALS T FORD F450 2017 Clear 07/13/2020 1FDUF4GT4HECO4205 25.00 23090 ALS T FORD F450 2017 Clear 07/13/2020 iFDUF4GT1HDA02637 25.00 23117 ALS N PIERCE QUANTUM 1998 Clear 08/07/7020 4PICT02SSWA000816 6.00 23427 ALS N PIERCE QUANTUM 1998 Clear 01/13/2021 4PICT02SIWAo00604 25.00 23428 ALS N PIERCE QUANTUM 1998 Clear 01/13/2021 4PICT02S4WA000600 25.O0 24021 ALS N FORD F250 2013 Clear 101222021 1FT7W2B69DEA80904 25.00 24705 ALS T BRAUN AMBULANCE 2021 Clear 10/24/2022 1FDUF4GT5KEG78994 25.00 25099 ALS T INTERNATIONAL BRAUN CHEVY 2014 Clear 0513O/2023 114TMNAAMOFH762735 2500 25276 ALS N FORD F-25O 2022 Clear 08/17/2023 1FT7MR68NEF91308 25.00 Count of vehicles with status of "issued' I Total f C 28 L� .00 0 ALS(Transoortl 6 ALS INon-Transportl 23 AIR 0 Report Date & Time: 8/17/2023 10.13:49AM Page 2 of 3 Aftachment"0" W In N 00 ti N d Im Y V a 7 C i C N s V a Packet Pg. 239 REFERENCES 1. Michael Reagen 10391 Regent Circle Naples, Florida 34109 2. Ramon Chao 164 Flame Vine Drive Naples, Florida 34110 3. Reg Buxton 1885 Veterans Park Drive Naples, Florida 34109 Attachment "C" Packet Pg. 240