Resolution 2019-174 RESOLUTION NO. 2019 - 1 7 4
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-HOSPITAL 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 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 $63,560.00 in the EMS County Grant will be used to provide training and
purchase medical/rescue equipment 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 <( day of - rf62, 2019.
ATTEST: BOARD OF COUNTY COMMISSIONERS,
CRYSTAL K KINZEL, CLERK COLLI ' COUNTY,FLORIDA
(....
f
,,tust as t0 II(AiI S Clerk illiam L. McDaniel, Jr., Chairman
sianature.Only.
Approved as to form and
legality:
1110
Je mer A. Belpedio �1-' ,0-
Assistant County Attor 4,�
[19-EMS-00947/1494617/1]
FLORIDA DEPARTMENT OF HEALTH
EMERGENCY MEDICAL SERVICES(EMS) GRANT UNIT
REQUEST FOR GRANT FUND DISTRIBUTION
In accordance with the provisions of section 401.113(2) (a), Florida Statutes, the undersigned hereby requests
an EMS grant fund distribution for the improvement and expansion of pre-hospital EMS.
DOH Remit Payment To:
The agency name, address, and federal ID number must be in the state MyFloridaMarketPlace (MFMP)
system. Ask a finance person in your organization who does business with the state to provide these.
i
Name of Agency: Collier County Board of County Commissioners
Mailing Address: 3299 Tamiami Trail East,Suite 700
Naples, FL 34112-5747
Federal 9-digit Identification -u ib-r 'A 1558 " ` 3-digit seq. code
Authorized County Official: �_=
Si.' ature Date
William L. McDaniel,Jr., Chairman
Type or Print Name and Title
Sign and return this page with your application to:
Florida Department of Health
Emergency Medical Services Unit, Grants
4052 Bald Cypress Way, Bin A-22
Tallahassee, Florida 32399-1722 1
Do not write below this line. For use by State Emergency Medical Services Section
Grant Amount for State to Pay: $ Grant ID: Code: C80 _
Approved By:
Signature of State EMS Unit Supervisor Date
Approved By: _
Signature of Contract Manager Date
State Fiscal Year: 2019 - 2020
Organization Code E.O. OCA Object Code Category
64-61-70-30-000 05 SF005 751000 059998
Federal Tax ID:VF Seq. Code:
Grant Beginning Date: Grant Ending Date:
DH 1767P, December 2008 (rev. June 8,2018), incorporated by reference in F.A.C.64J-1.015
ATTEST:EST: 3 Approved as to form and legality
CRY 1. K. KI ' -L, CLERK `�,S 0
Deputy Clerk AsIrAant County Attprti \
Attest as to Chairman's i
sinnatitrp nnlv
EMS COUNTY GRANT APPLICATION
tm. FLORIDA DEPARTMENT OF HEALTH
HUH Cia Emergency Medical Services Program
HEALTH Complete all items
ID.Code(The State EMS Program will assign the ID Code—leave this blank) C80
1. County Name: Collier
Business Address: 3299 Tamiami Trail East, Suite 700
Naples, FL 34112-5747
Telephone: 239-252-3740
Federal Tax ID Number(Nine Digit Number): VF 59-6000558
2. Certification: (The applicant ',. : • who has authority to sign contracts, grants, and other legal
documents for the county) I _eft 't all infol-Mation and data in this EMS county grant application and
its attachments are tr - ..-d . - . 1 ..signature'acknowledges,d assures that the county shall
comply fully with the •- s ou i'l• th Florida EMS rtty grant Application.
r � 1.
Signature: Date: a\"Ly \ °
� �'.
Printed Name: • tlliam L.Mc aniel,Jr.
Position Title: hairman
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: Erin Page
Position Title: Accounting Supervisor
Address: 8075 Lely Cultural Pkwy,Naples, FL 34113
_
Telephone: 239-252-3756 Fax Number: 239-252-3298
E-mail Address: Erin.page@colliercountyfl.gov
4. Resolution: Attach a resolution from the Board of County Commissioners certifying the grant funds
will improve and expand the county pre-hospital EMS system and will not be used to supplant current
levels of county expenditures. We cannot process for funds without this resolution.
5. Organization List: Complete a budget page(s)for each organization,which at your option you will .
provide funds. List the organization(s) below. (Use additional pages if necessary)
Collier County Emergency Medical Services
DH 1684, December 2008(Rev.July 2018) 64J-1.015, F.A.C.
1
ATTEST:
AL K. KI LI., CLER
Approved as to form and legality
T.jst,as to.Cliai nits Clerk ' ',. .__C-\ _i PoPN
0
nc Att
Assistant County k
• ;;nature only. ��
BUDGET PAGE
A. Salaries and Benefits:
For each position title, provide the amount of salary per hour, FICA per
hour, other fringe benefits, and the total number of hours. Amount
TOTAL Salaries = $ 0.00
TOTAL FICA& Other Benefits=
Total Salaries& Benefits= $ 0.00
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 excluding expenditures classified as
operating capital outlay (see next category).
List the item and, if applicable,the quantity Amount
Training 5,000
Tuition for Paramedic School 50,000
Total Expenses= $ 55,000.00
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.
List the item and, if applicable,the quantity Amount
Medical/Rescue Equipment 8,560.00
t
Total Vehicles & Equipment= $ 8,560.00
Grand Total= $ 63,560.00
DH 1684, December 2008
2