Resolution 2001-391
RESOLUTION NO. 2001--1.9..1
16Fl
A RESOLUTION CERTIFYING THAT THE APPLICATION FOR
AND USE OF EMS COUNTY GRANT FUNDS WILL IMPROVE AND
EXPAND PRE-HOSPITAL EMS DEPARTMENT ACTIVITIES AND
SERVICES 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 $82,643.92 in the EMS Grant will be used to purchase medicallrescue equipment and
training classes and these funds will not be used to supplant existing EMS Department
budget allocations.
This Resolution adopted lhis~day of ({)~ ,2001 after mOlion, second
and majority vote favoring same.
DA'fIU>" OCT - 9 2001
..<ArrES1'! c.
,',' DWIGI-rJ E.<;BROCK, Clerk
,;" >-_./ . J, :',
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA
-~~- 4:. ~~ /J.cz
r. ( .'
Att.ltu-'to Chairman's
Sfgftlture on 1 J.
, CARTER, Ph,D., Chairman
Approved as to form and
legal sufficiency:
:33~~
Assistant County Attorney
\
Emergency Medical Services (EMS) County Grant A8Plication
State of Florida 1 6 F 1
Department of Health
Bureau of Emergency Medical Services
Grant No. C.
1. Board of County Commissioners (grantee) Identification:
Name of County:
Collier
Business Address:_Building liB" - 3rd floor - 3301 East Tamiami Trail
Naples, FL 34112
Phone # ( 941) 774 - 8459
SunCom # ( )
2. Certification: I, the undersigned official of the previously named county, certify that to the best of
my knowledge and belief all information and data contained in this EMS County Award Application and
its attachments are true and correct.
My ~ignature acknowledges and ensures that I have read, understood, an~s'i'!~~I~~~UIly',with the
Flonda EMS County Grant Manual. DWIGHT.: !,~. BROCK; ~~C",ERl
'::-... \~.\:;-; :.\ '..,~.
t .' .~
Printed Name: ::tames D. Cart Title: Ch' ,,-, . ' -
, . - ,'C) ; 'rmail' s
Date Signed: /.,~~1gfld~O,Ot1J~:,~ ",,:0:'/'
v V-',,~ ',. ~ , :.....
Signature:
I
3. Authorized Contact Person: Person designated authority and responsibility to provide the
department with reports and documentation on all activities, services, and expenditures which involve this
grant.
Name: Diane B. Flaqq Title: Director of EMS Administration
Collier County EMS
Business Address: Building "B" - 3rd Hoor - 3301 East Tamiami Trail
Naples, FL 34112
(City)
Phone # ( 941 ) 774
8459
(State)
SunCom # (
(Zip)
)
4. . County's Federal Tax Identification Number: VF 59 6000558
DH Form 1684, Jan. 98
~
1
5. Resolution: Attach a resolution from the Board of County Commissioners certifying the monies
from the EMS County Grant will improve and expand the county's prehospital EMS system and that the
grant monies will not be used to supplant existing county EMS budget allocations.
6. Work Plan:
Work Activities:
lime Frames:
Bid, pur.chase, ann disr.ribute equipment
Six months (6) after
contract begins.
Provide specialized medical/rescue educational courses.
Six months (6) after
contract begins.
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JAN-08-2002 11:27
EMERGENCY MEDICAL SERVICE
850 488 940~ ~.~~/~~
8. APPLICATION (Requires SIgnature)
REQUEST FOR COUNTY GRANT DISTRIBUTION (ADVANCE PAYMENT)
EMERGENCY MEDiCAL SERViCeS (EMS)
COUNTY GRANT PROGRAM
In accordanc. with the provia/ens of section 401.113(2)(a), F.S., the undersigned hereby
requests an EMS county grant distribution (advance payment) for the Improvement and
expansion of prehospftaJ EMS.
Payment To:
COLLIER COUNTY BOARD OF COMMISSIONERS
3 01 Name of B..oard of c.ounty Commissioners (Payee)
3 East Tam.am~ Tra~l
Addrus
Naples, FL 34112
(Clty) (State) (Zlp)
SIGNA TURE:
9 60 00 55 '8 ....",,"',
- - - - - - - - - ~ffi.~.":"""". ~"'I
, DWIGHT' E' 8ROCt<"'CLE
rizing County Official ' . . ., . ....,~~ .
. '. ~
F.deral Tax ID Number or County: S
Printed Name:
If} ;,h I
James D. Carter, Ph.D.
SIGN AND RETURN WITH YOUR GRANT APPLJC;4 T/ON. TO
Department of Health
Bureau of Emergency Medical Services
EMS County Grants
4052 Bald Cypress Way, Bin C-18
Tallahassee, Florida 32399-1738
For Use Only by Department of Health
Bureau of Emergency Medical Services
Amount: $ ~,~:. 9~n ~rantNumb~~: ~\~)\\
Approved By: .z&IJl~ ~ Date: l (fi4//7'-7'
Signature, State ~m Officer 7 '7 ~
Fiscal Year: d-.OO I , ~oo:;t.
Amount: $ ~ ~, lnl\?,. q ~
Oraanizatfon Code
64-25-8(J.{}CI-OOO
E.O.
NU
O.C.A.
N2000
Obiect Code
730060
Federal Tax I.D. VF 5 9 6 a a a 5' 5 B
-------
Beginning Date: ~
Ending Date: .91~t9~
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TOTRL P.02