Resolution 2011-146
RESOLUTION NO. 2011 - 1 46
RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA,
CERTIFYING THAT THE APPLICATION FOR AND USE
OF EMS COUNTY GRANT FUNDS WILL IMPROVE AND
EXPAND PRE-HOSPIT AL EMS DEPARTMENT
ACTIVITIES AND WILL NOT SUPPLANT EXISTING
COUNTY EMS BUDGET ALLOCATIONS.
WHEREAS, EMS Department Paramedics and Paramedic/Firefighters provide
basic and advanced life support care and highly technical service to the citizens and
visitors of Collier County; and
WHEREAS, the purchase of equipment and provision of training classes shall
greatly enhance the effectiveness of pre-hospital emergency medical care.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
The $38,919 in the EMS County Grant will be used to purchase medical/rescue
supplies/equipment and training classes and these funds will not be used to supplant
existing EMS Department budget allocations.
PASSED AND DULY ADOPTED by the Board of County Commissioners of Collier
County, Florida, this J.?j"h day Of~ 2011.
ATTEST:
DWIGHT E. BROCK, Clerk
BOARD OF COUNTY COMMISSIONERS,
COLLIER COUNTY, FLORIDA
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BY: Nw. ~
FRED W. COYLE, Chal
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Approved as to form and
legal sufficiency:
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Assis t County Attorney
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FLORIDA DEPARTMENT OF HEAL TH
EMS GRANT PROGRAM
B5QUEST FOR GRANT FUND DISTRIBUTION
In accordance with the provisions of Section 401.113(2)(a), F. S., the undersigned hereby
requests an EMS grant fund distribution for the improvement and expansion of pre-hospital
EMS.
DOH Remit Payment To:
Name of Agency: Collier County Board of County Commissioners
Mailing Address: 3299 Tamiami Trail East. Suite 303
Naples, FL 34112
Federal Identification number ~OO05~8
Authorized Official: ~ W.
Signature
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Date
Fred W. Coyle, Chairman
Type Name and Title
Sign and return this page with your application to:
Florida Department of Health
BEMS Grant Program
4052 Bald Cypress Way, Bin C18
Tallahassee, Florida 32399-1738
Do not write below this line. For use by Bureau of Emergency Medical Services personnel only
Grant Amount For State To Pay: $
Approved By
Grant 10: Code:
Signature of EMS Grant Officer
Date
State Fiscal Year:
Oraanlzation Code
64-42-10-00-000
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Object Code
75??oo
Federal Tax 10: VF
Grant Beginning Date:
Grant Ending Date:
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Asalltant County Attornev
BUDGET PAGE
per
Amount
Grand total Salaries and FICA
B. Expenses: These are travel costs and the usual, ordinary, and incidental expenditures by an
agency, such as, commodities and supplies of a consumable nature excludina expenditures classified as
operating capital outlay (see next category).
List the item and, if applicable, the quantity Amount
TOTAL $28,919
c. Vehicles, equipment, and other operating capital outlay means equipment, fixtures, and other
tangible personal property of a non consumable and non expendable nature with a normal expected life
of one (1) year or more.
ist the item an ,if applicab e, t e quantity Amount
Medical/Rescue EquIpment
,
t$10,OOO
TOTAL $10,000
Grand Total ,$38.919
DH Form 1684, December 2008
4
EMS COUNTY GRANT ApPLICATION
FLORIDA DEPARTMENT OF HEALTH
Bureau of Emergency Medical Services
Complete all items
10. Code (The State Bureau of EMS will assIgn the 10 Code - leave this blank) C
uite 303
Tele hone: 239-352-3740
Federal Tax 10 Number (Nine O. it Number. VF 59-6000558
2. Certification: (The applicant signatory who has authority to sign contracts. grants, and other legal
documents for the county) I certify that all Information and data in this EMS county grant application and its
attachments are true and correct. My signatur acknowledges and assures that the County shall comply
fully with ~e cooditions outlined in the Flor MS uafra Appl" ion. J
S nature: . Date:
Printed Name: Fred W. Co Ie
Position Title: aIrman
3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and has
responsibility for the implementation of the grant activities. This person is authorized to sign project
reports and may request project changes. The signer and the contact person may be the same.)
Name: Artie Ba
osition TiUe: Administrative upervisor, EMS
Address: 8075 LeIy Cultural Parkw . Suite 267
ap I 411
Fax Number: 239-252-3298
4. Resolution: Attach a current resolution from the Board of County Commissioners certifying the grant
funds wllllmprove and expand the county pre-hospital EMS system and will not be used to supplant
current levels of county expenditures.
5. Budget: Complete a budget page(s) for each organization to which you shall provide funds. List
the organization(s) below. (Use additional pages if necessary)
CoRier County Emergency Medical Services
DH Fonn 1684. ~~2~t.
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DWI~T E:'i8AO~ Cltrk
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A..,ltan ounty Attorney
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