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Agenda 09/24/2024 Item #16F 6 (Permit renewal - Annual Certificate of Public Convenience and Necessity (COPCN) for Ambitrans Medical Transport, Inc.)9/24/2024 Item # 16.F.6. ID#: 2024-902 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 recommend the renewal of Ambitrans Class 2 ALS inter-facility transport services in Collier County by a private provider. CONSIDERATIONS: A COPCN may be approved routinely by the Board as provided by Ordinance 24-25, Section 6: Review of Application, and Section 7: Requirement for Board Approval in Granting Certificate, governing medical transportation services. Ambitrans inter-facility transport was granted a Certificate of Public Convenience and Necessity on October 25, 2011, by the Board. Staff has deemed 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 10 of the Ordinance provides: Each non-governmental entity certificate holder shall file within 90 days of expiration, an application for renewal of the 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. If the initial certificate was issued under this Ordinance, the renewal certificate may be approved routinely by the Board, upon advice of the Administrator, or the Board may hold a hearing on same. These requirements have been met and the administrator recommends renewal. The Emergency Medical Authority was unable to convene a quorum on August 14, 2024. to review the routine renewal application. To prevent a lapse in the Certificate and postpone essential interfacility transports, Staff is requesting the Board to grant the annual renewal. The Department of Public Safety is not aware of any objections to the renewal. 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 (0001) 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 based on competent evidence that each of the following standards set forth in Section 7 of Ordinance No. 24-25 have been satisfied: A. 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: 1. The extent to which the proposed service is needed to improve the overall emergency medical services (EMS) capabilities of the County. 2. The effect of the proposed service on existing services with respect to quality of service and cost of service. 3. The effect of the proposed service on the overall cost of EMS service in the County. 4. The effect of the proposed service on existing hospitals and other health care facilities. 5. 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. B. That the applicant has sufficient knowledge and experience to properly operate the proposed service. C. That, if applicable, there is an adequate revenue base for the proposed service. D. That the proposed service will have sufficient personnel and equipment to adequately cover the proposed service area. Page 3656 of 4908 This item is approved as to form and legality and requires a majority vote for approval. -JAK RECOMMENDATIONS: To renew the annual Certificate of Public Convenience and Necessity (COPCN) with Ambitrans Medical Transport, Inc., to provide Class 2 Advanced Life Support (ALS) inter-facility transport ambulance service for a period of one year. PREPARED BY: Bruce Gastineau, Chief, Collier County EMS ATTACHMENTS: 1. Certificate - Ambitrans CoPCN renewal 2024-25 2. Permit - Ambitrans CoPCN renewal 2024-25 with Exhibit A attached 3. Application Response 2024 Renewal Page 3657 of 4908 Page 3658 of 4908 Page 3659 of 4908 Page 3660 of 4908 AMBITRANS MEDICAL TRANSPORT, INC. 2024 COPCN Renewal Application Collier County, Florida Ambitrans Medical Transport, Inc., submits its 2024 Application for Renewal of its Certificate of Public Convenience and Necessity in and for Collier County, Florida. Page 3661 of 4908 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 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. Corporate Officers/Directors 50% 50% Michael J. Grant, 75, 4351 Pinnacle Street, Charlotte Harbor, FL 33980 Lorraine B. Grant, 69, 4351 Pinnacle Street, Charlotte Harbor, FL 33980 Vanessa Grant Oliver, 43, 4351 Pinnacle Street, Charlotte Harbor, FL 33983 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-eight 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. Using the company’s computer aided dispatch software, Zoll Data RescueNet Dispatch-Billing™, management can 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.” Page 3662 of 4908 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: 8848 Walter Way, Apartment #2204, Naples, FL 34120 Our auxiliary substation to back up the Collier County operation is located at: 935 N.E. 7th Terrace, Cape Coral, FL 33909 Page 3663 of 4908 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, 2025. 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 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. Ambitrans’ management team has extensive 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 local, in-house billing department is knowledgeable and responsive and available Monday through Friday to answer any questions our customers may have. Page 3664 of 4908 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. Vanessa Oliver, our Chief Executive Officer, is also an attorney and is Florida Bar Board Certified in Health Law. Ms. Oliver was elected county-wide 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 daily duties as an emergency room physician at Shorepoint Health Port Charlotte and serving as the Medical Director for Charlotte County Fire and EMS. He is a member of the United States Army National Guard and has deployed numerous times. (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, CCIM Managing Broker Crandall Commercial Group LLC 27499 Riverview Center Blvd. Suite 127 Naples, FL 34134 Page 3665 of 4908 Ambitrans Medical Transport, Inc. - Collier County COPCN Renewal Application (7) A schedule of rates which the service intends to charge.Ambitrans Ambulance’s current usual and customary rates, as of July 1, 2024, are as follows: Code Service Description Rate A0428 Basic Life Support - Non-Emergency Base Rate $600.00 A0429 Basic Life Support - Emergency Base Rate $750.00 A0426 Advanced Life Support - Non-Emergency Base Rate $800.00 A0427 Advanced Life Support - Emergency Base Rate $1,000.00 A0433 Advanced Life Support Base Rate – Level 2 $1,600.00 A0434 Specialty Care Transport Base Rate $2,000.00 A0425 Per Loaded Mile $20.00 Mileage, long distance (60 miles and over) 1.5 x loaded miles Wait Time (BLS or ALS) $400 per hour Wait Time (Critical Care) $500 per hour Extra Ambulance for Lift Assistance $250 per hour Canceled on scene $200 Canceled en route $150 Flight team canceled on scene $250 Flight team canceled en route $200 Long distance transport canceled with less than 24 hours’ notice $600 Long distance transport rescheduled for same day with less than 24 hours’ notice $400 Page 3666 of 4908 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 “D.” Dr. O’Leary’s DEA license and Department of Health license information is attached hereto as composite Exhibit “E.” (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 “F.” Page 3667 of 4908 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 Page 3668 of 4908 Unit Number Unit Type VIN License Plate FL ALS Permit FL BLS Permit 266 BLS 1FDSS3ES7BDB27804 MIP 802 17026 5213 327 BLS 3C6LRVDG0ME507993 MIU 00U 23949 6456 328 BLS 3C6MRVJG4ME545168 MIU 01U 23949 6456 329 BLS 3C6LRVDG3PE535792 MIX 49T 25912 7348 330 BLS 3C6LRVDG0PE583413 MIX 50T 25913 7349 359 BLS 1FDSS3ES6ADA31208 MIN 36Q 20880 4678 364 BLS 1FDSS3ES7BDB27799 MIU 97T 20883 4777 365 BLS 1FDSS3ES1BDB27801 MIU 95T 17027 5212 372 BLS 1FDSS3ES5CDA18372 MIU 66Y 20886 4954 374 BLS 1FDSS3ES0DDA41561 MIU 71Y 20886 4954 379 BLS 1FDSS3ES8DDB02266 MIU 72Y 20889 4776 381 BLS 1FDSS3ES9EDA22265 MIL 19V 20890 4823 606 ALS 1FDXE4FS6CDA90604 MIP 59X 25631 7214 609 BLS 1FDWE3FS4ADA62447 MIP 61X 20891 5119 615 BLS 1FDWE3FS8BDA01958 MIP 66X 21048 5368 617 ALS 1FDXE4FS2EDA55898 MIP 71Z 22002 5693 618 ALS 1FDXE4FS0GDC00665 MIP 74Z 22759 6007 619 ALS 1FDXE4FS2GDC00666 MIP 75Z 22760 6008 620 BLS 1FDXE4FS8GDC04320 MIS 37N 25632 7215 621 ALS 1FDXE4FSXGDC04321 MIS 38N 23010 6113 622 ALS 1FDXE4FS5EDA77930 MIU 96T 23534 6312 623 ALS 1FDWE3FSXDDA26427 MIP 79Z 23547 6317 625 ALS 1FDXE4FS2EDA12033 MIU 98T 23547 6317 626 ALS 1FDXE4FN3NDC07228 MIU 99T 23948 6455 629 ALS 1FDWE3FS1JDC23238 MIU 04U 24293 6672 630 ALS 1FDXE4FSXDDA11436 MIU 69Y 24722 6856 632 BLS 1FDWE3FS5CDB31455 MIU 70Y 24896 6909 636 ALS 1FDXE4FS8HDC51865 MIP 58F 25232 7015 637 NICU 1FDXE4FS5HDC56358 MIP 59F 25233 7016 638 CCT 1FDWE3FNXPDD07139 MIU 76U 25448 7136 639 ALS 1FDWE3FN9PDD07133 MIU 77U 25447 7135 640 ALS 1FDXE4FS9JDC07783 MIU 74Y 25523 7166 641 ALS 1FDXE4FS6HDC51864 MIN26Q 0025780 007291 642 ALS 1FDXE4FS2JDC21654 MIN27Q 0025779 007290 643 BLS 1FDXE4FS9EDA55896 MIX 47T 25914 7350 644 ALS 1FDXE4FS9KDC09597 MIX 48T 25915 7351 712 BLS 1FDWE3FS5ADA20885 MIP 63X 24646 6828 731 BLS 1FDXE4FS2DDA11415 MIU 68Y 24721 6857 Page 3669 of 4908 STATE OF FLORIDA DEPARTMENT OF HEALTH BUREAU OF EMERGENCY MEDICAL OVERSIGHT ADVANCED LIFE SUPPORT SERVICE LICENSE This is to certify that: AMBITRANS MEDICAL TRANSPORT, INC. Provider Number # 804 Name of Provider 4351 PINNACLE STREET, PORT CHARLOTTE, FLORIDA 33980 Address has complied with Chapter 401, Florida Statutes, and Chapter 64J-1, Florida Administrative Code, and is authorized to operate as an Advanced Life Support Service subject to any and all limitations specified in the applicable Certificate(s) of Public Convenience and Necessity and/or Mutual Aid Agreements for the County(s) listed below: CHARLOTTE, COLLIER, LEE, SARASOTA & MANATEE County (s) Michael Hall, Section Administrator Emergency Medical Services Florida Department of Health THIS CERTIFICATE EXPIRES ON: 06/19/2025 This certificate shall be posted in the above mentioned establishment Page 3670 of 4908 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 7/2/2024 Marsh &McLennan (CLW) 101 N Starcrest Dr Clearwater FL 33765 MMA -Bouchard Region CertsTeam@MarshMMA.com Arch Insurance Company 11150 GRANTMEDIC1 Arch Specialty Insurance Company 21199GrantMedicalTransportation,Inc. 4351 Pinnacle Street Charlotte Harbor FL 33980 1780912846 A X 1,000,000 X 100,000 10,000 1,000,000 3,000,000 X MAPK08386909 7/1/2024 7/1/2025 3,000,000 A 1,000,000 X X X MAPK08386909 7/1/2024 7/1/2025 A X X 2,000,000MAUM085096097/1/2024 7/1/2025 2,000,000 X 0 B Professional Liability MAPL20015504 7/1/2024 7/1/2025 $1M Occ /$3M Agg **Supplemental Names below apply to all Policies** First Supplemental Name-Grant Medical Transportation,Inc. Ambulance Management Services,LLC Ambitrans Medical Transport,Inc. Venice Ambulance Service,Inc. Ambitrans Ambulance 4351 Pinnacle St Charlotte Harbor FL 33980 Page 3671 of 4908 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 7/29/2024 Marsh &McLennan (CLW) 101 N Starcrest Dr Clearwater FL 33765 Certificates Department 727-447-6481 727-449-1267 CertsTeam@MarshMMA.com Benchmark Insurance Company 41394 AMBITMEDIC Ambitrans Medical Transport,Inc. 4351 Pinnacle Street Punta Gorda FL 33980 683167119 A X N FPD23193403 12/27/2023 12/27/2024 1,000,000 1,000,000 1,000,000 For Informational Purposes Only For Informational Purposes Only Page 3672 of 4908 Page 3673 of 4908 Page 3674 of 4908 E X C E L L E N C E S I N C E 1 9 8 4 _____________________________________________________________________________________ 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, 2024. 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. June 20, 2024 Port Charlotte, Florida BRIAN W. CROSLAND, CPA, PL CERTIFIED PUBLIC ACCOUNTING & CONSULTING 2200 KINGS HIGHWAY #3L242 PORT CHARLOTTE, FL 33980 PHONE: 941.676.8900 AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS FLORIDA INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS MEDICAL GROUP MANAGEMENT ASSOCIATION COMMUNITY ASSOCIATIONS INSTITUTE BRIAN W. CROSLAND, CPA SHAWN M. COOLEY, CPA ALICIA K. PRESTON CAITLIN R. TESCH Page 3675 of 4908 Assets Current Assets: Cash available for ambulance transportation operations 695,000$ Property and Equipment: Office equipment and computers 248,538 Machinery and equipment 1,465,164 Medical transportation vehicles 3,144,185 4,857,887 Less accumulated depreciation (4,386,556) Property and Equipment, net 471,331 Total Assets 1,166,331$ Liabilities Current Liabilities: Accrued profit sharing 177,205$ Other liabilities 37,500 Notes payable to banks 150,930 365,635 Long Term Liabilities: Notes payable to banks 325,532 Less current portion above (150,930) 174,602 Total liabilities 540,237 Net Assets Over Liabilities, income tax basis 626,094$ Statement of Assets and Liabilities of the Ambulance Transportation Operations Income Tax Basis of Accounting April 30, 2024 (Unaudited) Ambitrans Medical Transport, Inc. and Subsidiaries Read Independent Accountants' Compilation Report Page 3676 of 4908