Ambulance Service Contract Signed

AMBULANCE SERVICES CONTRACT
CITY OF CHANDLER CONTRACT NO. FD1-990-4220

THIS AMBULANCE SERVICES CONTRACT (the “Agreement”) is entered into by and between
Maricopa Ambulance, LLC, a Delaware LLC (“Contractor”), and City of Chandler, Arizona (“City”). This
Agreement is not in effect until approved by the Director of the Arizona Department of Health Services
(“ADHS”), and any amendments, addendums or extensions to the agreement will not be in effect until
reviewed and approved by the Director. Together, Contractor and City are the “Parties” or “parties”.

Assuming the Agreement has been approved by the Director of ADHS, services under this
Agreement will commence January 1,2022, or upon such other date subsequent to Director approval,
mutually agreed to by Contractor and City.

RECITALS

WHEREAS, Contractor has a Certificate of Necessity CON #147 issued by the Arizona
Department of Health Services (“ADHS”) necessary to provide emergency 911 ground ambulance
services within the City’s city limits and represents that it has the expertise and capacity to provide
emergency 911 ground ambulance services within the City’s city limits; and under requirements Arizona
Revised Statutes, the Arizona Administrative Code, or the Arizona Department of Health Services rules
or regulations, all as modified, updated or amended from time to time; and

WHEREAS, the City and Contractor wish to enter into this Agreement for the provision of
emergency 911 ground ambulance services within the City’s city limits; and

WHEREAS, Contractor and the City deem it beneficial for the City to provide City firefighter
paramedic staffing to assist Contractor in providing the 911 ambulance service contemplated under this
Contract, and be reimbursed for providing such staffing, pursuant to the terms and conditions set forth

in this Contract.

NOW, THEREFORE, in consideration of the mutual covenants and promises contained in this
Contract and other good and valuable consideration, the adequacy of which is hereby acknowledged, the
parties agree as follows:

Section|. Definitions

1.1. The term “Advanced Life Support” or “ALS” means those medical treatments,
procedures (including assessment), and techniques, which may be administered or
performed by ALS personnel established pursuant to A.R.S. sec. 36-2205.

1.2 The term “Ambuiance® means vehicies used in the transport of those receiving EMS
(emergency medical services).

1.3. The term “Code 3 Call,” means:

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1.5

1.6

1.7

1.8

1.9

1.10

(a) an emergency response call in which the use of red lights and sirens are
requested at the time of the initial request and red lights and sirens are used
until arrival on the scene of an incident, or a call in which the initial request by
the Emergency Dispatch Center was fora Code 2 Call, but was upgraded by
the 9-1-1 Emergency Dispatch Center or responding fire unit to a Code 3 Call
prior to arrival on the scene of an incident.

The term “Code 2 Call,” as used in this Agreement, means:

(a) An emergency response call in which the use of red lights and sirens are not
requested by the 9-1-1 Emergency Dispatch Center for Ambulance response to
the scene of an incident, or

(b) Acallin which the initial request by the 9-1-1 Emergency Dispatch Center as for
a Code 3 Call, but was downgraded by the 9-1-1 Emergency Dispatch Center or
responding fire unit to a Code 2 Call prior to arrival on the scene of an incident.

The term “Cumulative Response Time” means the sum-total elapsed time of 9-1-1
emergency dispatch and response time for an emergency call.

The term “Designated Ambulance” or “Dedicated Ambulance” means Ambulances
used to perform the services required under this Agreement. The terms “Designated
Ambulance” and “Dedicated Ambulance” may be used interchangeably.

The term “DHS,” means the State of Arizona Department of Health Services.

The term “Emergency Paramedic” or “Paramedic” means a person who has been
trained in an emergency paramedic training program and who is certified to act as
a paramedic under the laws, rules or regulations of the State of Arizona.

The term “EMS Service Area,” means all areas within the boundaries of the City of
Chandler. Any use of the phrase “EMS Service Area,” or similar terms will in all
respects be limited to the geographical boundaries of the City of Chandler, and any
automatic/mutual aid partners, special districts, state lands, and county islands
contained therein. Both Parties acknowledge that these boundaries may change by
annexation or otherwise bylaw.

The term “Exception” means ambulance responses not meeting the minimum
response requirements established herein.

1.11 The term “9-1-1 Emergency Dispatch Center’, means the Phoenix Fire Regional

Dispatch (PFRD) or any future facility used to dispatch fire and emergency medical
incidents. The term “Response Time”, means the elapsed time from dispatch to “on-
scene” arrival (wheels stopped) at the dispatched location.

Section Il.

1.12 The term “Response Zone” means the defined geographical areas within the City of
Chandler.

1.13 The term “Peak Time”, means any period less than twenty-four hours for which
higher ambulance call volumes are anticipated.

Services To Be Provided

2.1

2.2

Type of Service. Except as otherwise expressly set forth herein, Contractor must
provide emergency 911 ground ambulance services within Chandler’s city limits, and
outside Chandler's city limits when provided under the terms of an approved automatic
aid agreement between the City and another political subdivision, provided this service
area is within Contractor's CON certificated area, on an “as needed” basis.

Dispatch and Access to 911System.

2.2.1

2.2.2

2.2.3

Phoenix Fire Regional Dispatch (PFRD). The City contracts with PFRD for
access to the City of Phoenix 911 system and for dispatch services. The
Contractor hereby agrees to dispatch Contractor ambulances — through
PFRD’s dispatch system under the terms and conditions set forth herein.

Dispatch Costs. The City has entered an agreement with the PFRD to
dispatch ambulances directly. Contractor agrees to reimburse the City for
all costs incurred relating to the dispatch of ambulances within city limits
pursuant to Exhibit B of this Contract. The parties agree that any
reimbursement shall not exceed the actual amounts paid or due by the City
for these services on behalf of Contractor and will reflect only those charges
for dispatch of ambulances and reiated equipment costs and fees.

Dispatch and Acceptance. Unless requested otherwise, Contractor must
respond to all requests for services under this Contract using emergency red
lights and sirens (Code 3). The City may, however, request that Contractor
respond without red lights and sirens (Code 2) and will confirm the response
mode at the time of dispatch. Contractor must accept all requests for
transportation services dispatched by or on behalf of the City.

Contractor must accept and respond within response time requirements of
Section 2.3 to all requests for ambulance transportation dispatched by the
City for incidents arising within the EMS Service Area. When the City requests
multiple ambulances on a single incident, the Contractor will be responsible
for meeting the response time reauirements of Section 2.3 for the first two
arriving Ambulances.

The City and Contractor acknowledge that certain requests for ambulance
service within the EMS Service Area may require transportation of the patient

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2.3

beyond the boundaries of the EMS Service Area and Contractor agrees to
provide such service as may be required.

In the event Contractor notifies the City of a possible prolonged response
time, the City reserves the right, in its sole discretion, to dispatch requests for
transportation and medical services to other ambulance companies, to
provide such service itself as prescribed in ARS sec. 36-2208(B), or to
otherwise obtain the necessary ambulance services as provided by law.

Response Time. Response Time: Minimum compliance is achieved when 95% or
more of responses for Code 3 and Code 2 calls for any month combined meet the
specified Cumulative Response Time requirement. If 95% is not achieved in Code 3
responses in any month, Contractor will conduct a three-month review/assessment of

Code 3 calls.

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2.3.2

2.3.3

2.3.4

Code 3 Responses. Contractor must arrive on the scene where emergency
care is required within eight (8) minutes fifty-nine (59) seconds for ninety-five
percent (95%) of all Code 3 cumulative calls received by Contractor for
transportation requests within the City’s city limits for each calendar month.
The Parties agree arrival at 9 minutes 00 seconds is deemed late.

Code 2 Responses. Contractor must arrive at the scene where emergency
care is required within fourteen (14) minutes and fifty-nine (59) seconds for
ninety-five percent (95%) of all Code 2 cumulative calls received by Contractor
for transportation requests within the City’s city limits for each calendar month.
The Parties agree arrival at 15 minutes 00 seconds is deemed late.

Switch in Response Type After Dispatch. If Contractor was originally
requested to provide a Code 3 response but was later requested to provide
a Code 2 response on a particular call, Contractor must arrive on the scene
where emergency care is required within fourteen (14) minutes fifty-nine
(59) seconds from the time that Contractor was originally dispatched to
provide a Code 3 response. If Contractor was originally requested to
provide a Code 2 response but was later requested to provide a Code 3
response on a particular call, Contractor must arrive on the scene where
emergency care is required within the shorter of the following:

(i) eight (8) minutes fifty-nine (59) seconds from the time that
Contractor was requested to go to a Code 3 response; or

(ii) fourteen (14) minutes fifty-nine (59) seconds from the time that
Contractor was originally dispatched to provide a Code 2 response.

Measure of Response Time. Arrival “on-scene” means the moment an
ambulance crew member notifies the 9-1-1 Emergency Dispatch Center that
it is fully stopped at the location where the ambulance will be parked while

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2.3.5

the crew exits to approach the patient. In situations where the ambulance
has responded to a location other than the specified scene (e.g. staging
areas for hazardous scenes), arrival “on-scene” will be the time the
ambulance arrives at the designated staging location. The City may also
require the Contractor to log time “at patient” for medical research
purposes. However, during the term of this Agreement, at patient times will
not be considered part of the contractually stipulated response time.

In instances where the ambulance fails to report “on-scene” as required in
this section, the time of the next communication with the ambulance crew,
after arrival “on-scene”, will be used as the “on-scene” time. However,
Contractor may appeal such instances by providing appropriate
documentation of the actual “on-scene” arrival time. Such documentation
may include Automatic Vehicle Locator position equipment or verification by
City’s fire department personnel.

Review of Response Time Performance. Response time performance will
be reviewed by the City on a weekly, monthly, and annual basis. Such review
may include evaluation of performance on a unit location or City-wide basis.
Contractor will meet with the City on a monthly basis to discuss response
time and Contract implementation issues including any individual incident
where the requirements of Section 2.3 above were not met.

For purposes of response time calculations, cumulative response time will be
calculated from the point in time when the 9-1-1 Emergency Dispatch Center
initially notifies Contractor of a request for service (noted as “dispatch” in CAD)
to the time the Contractor's responding Ambulance notifies the 9-1-1
Emergency Dispatch Center and Contractor of its “on- scene” arrival time
(wheels stopped) at the specific location to which Contractor was dispatched.

The City may conduct a monthly evaluation of response times at the end of
each month for the prior month’s reporting. The evaluation will include all
responses that occurred within the City’s boundaries. The City will provide
incident numbers for all out of compliance incidents as requested by the
Contractor.

(i) Exception Reports. The City may generate monthly exception reports
reflecting possible non-compliant response times. These reports will be
provided to the Contractor whereby the Contractor willresearch each
incident and be prepared to provide a written response to the City at
the following evaluation meeting. Contractor must also identify cause
of possibie deiay and immediately impiemeni corrective actions, if
applicable, prior to monthly evaluation meetings.

The exceptions detailed below may be considered by the City. In all
cases Contractor must document that the exemption being
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2.3.7

requested was the direct cause for the late response. The Contractor
may have access to all the City’s information related to Contractor
activities and include audio and data information on EMS/911
responses. Exception requests that may be considered by the City
during the Contract period include, but are not limited to:

(a)

(c)

(d)
(e)
(f)

2.3.5.1

Call was reduced from Code-3 (emergency response) to Code-2
(non-emergency response) by on-scene responders or by the
dispatcher;

Multiple units responded to the same scene;

“Move up and cover’ or “mutual aid” consistent with EMS policy
and procedure;

“Weather”, e.g., Haboob;
“Technology Failure” e.g., MCT terminal failure;

Late responses due to circumstances not in Contractor control,
e.g., railroads, as determined by both the Contractor and the

City.

In some cases, late responses will be excused from financial
penalties and from response time compliance reports. The
burden of proof that there is good cause for an exemption
rests with the Contractor, and the Contractor must have acted
in good faith. The alleged good cause must have been the
causative factor in producing the excessive response time.
Exceptions may be considered on a case-by-case basis.

Evaluation Data. The evaluation of response time data will
include the total number of requests for services within the
EMS Service Area and the total number of exceptions.
Exceptions may be determined at evaluation meetings.
Contractor may request waiver of exceptions based upon
extenuating circumstances. The Fire Chief, or designee, will
issue final determination whether a call is excluded from the
exceptions.

Notice. Contractor must immediately notify PFRD if Contractor does not
have an ambuiance that is staffed and equipped as necessary to respond to
an incident close enough to the incident scene to meet any required
response time in Section2.3.

Notice of Extended or Prolonged Cumulative Response Time — Code 3.

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2.3.8

Contractor must use commercially reasonable best efforts to notify the City’s
9-1-1 Emergency Dispatch Center, at time of dispatch or at the earliest
indication, the possibility of an extended Code 3 Cumulative Response Time
greater than ten (10) minutes. Upon notification of a possible extended
response time, the City or 9-1-1 Emergency Dispatch Center may, in its
discretion and considering the severity of the situation, obtain other
transport means that are faster. Contractor must notify the City’s 9-1-1
Emergency Dispatch Center, at time of dispatch or at the earliest indication,
the possibility of a prolonged Code 3 Cumulative Response Time greater
than twenty (20) minutes. Upon notification of a possible prolonged
response time, the City or the 9-1-1 Emergency Dispatch Center may, in its
discretion, obtain a response time estimate from another ambulance
company and if the Cumulative Response Time estimate is less than twenty
(20) minutes or the response time stated by Contractor, the City or the 9-1-1
Emergency Dispatch Center may request the dispatch of another ambulance
company to transport. The 9-1-1 Emergency Dispatch Center will notify the
Contractor that such second dispatch has been made, and Contractor will be
advised to discontinue response to the scene. Such incidents will be
considered as not meeting response time requirements as stated in Section

2.3.1.

Notice of Extended or Prolonged Cumulative Response Time — Code 2.
Contractor must use commercially reasonable best efforts to notify the 9-1-1
Emergency Dispatch Center, at time of dispatch or at the earliest indication,
the possibility of an extended Code 2 Cumulative Response Time greater
than twenty (20) minutes. Upon notification of a possible extended
response time, the City or the 9-1-1 Emergency Dispatch Center may, in its
discretion and considering the severity of the situation, obtain other
transport means that are faster. Contractor shall notify the 9-1-1 Emergency
Dispatch Center, at time of dispatch or at the earliest indication, the
possibility of a prolonged Code 2 Cumulative Response Time greater than
thirty (30) minutes. Upon notification of a possible prolonged response
time, the City or the 9-1-1 Emergency Dispatch Center may, in its discretion,
obtain a Cumulative Response Time estimate from another ambulance
company and if the Cumulative Response Time estimate is less than thirty
(30) minutes or the response time stated by Contractor, the City or the 9-1-1
Emergency Dispatch Center may request the dispatch of another ambulance
company. The 9-1-1 Emergency Dispatch Center shall notify the Contractor
that such second dispatch has been made, and Contractor shall be advised
to discontinue response to the scene. Such incidents will be considered as
not meeting response time requirements as stated in Section 2.3.2.

Liquidated Damages for Failure to Meet Requirements. The City will notify

Contractor in writing of any liquidated damages being assessed not less than thirty
(30) days after they first become known to the City. Upon notification of any liquidated
damage assessments, Contractor will have fifteen (15) days to dispute any

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2.6

assessment, any dispute must be submitted in writing. An Assistant Fire Chief, or
designee, will meet with Contractor to review the assessment and Contractor's
response and to determine the validity or invalidity of the assessment. Should the City
and Contractor fail to reach an agreement on the validity or invalidity of the
assessment, the matter will be referred to the Fire Chief, or designee, who will review
the circumstances of the assessment with the Contractor and City personnel. The
determination of the Fire Chief will be final.

2.4.1 Failure to Meet 95% Response Time Requirement in EMS Service Area:

The following liquidated damages will be assessed when the Cumulative
Response Time compliance for Code 3 calls and Code 2 calls combined fall
below 95% for any given month in the EMS Service Area.

Compliance % Liquidated Damages
94.9%-90.0% $5,000

89.9%-88.0% $7,000

87.9%-87.0% $9,000

86.9%-86.0% $11,000
85.9%-85.0% $13,000

84.9% and below $15,000 plus $3,000 per percentage point thereafter

2.4.2 Notwithstanding liquidated damages in Section 2.4.1, each Code 3
Cumulative Response Time in excess of 19 minutes 59 seconds will be
assessed liquidated damages of $1,000. Notwithstanding liquidated
damages in Section 2.4.1, each Code 2 Cumulative Response Time in
excess of 29 minutes 59 seconds will be assessed liquidated damages of

$1,000.

24.3 Failure to meet requirement for MCT for “enroute” activation will result
liquidated damages of $1,000 per percentage point under 95%.

2.4.4 Failure tomeetrequirementfor MCT use for “on- scene” activation will result
liquidated damages of $1,000 per percentage point under 95%.

Emergency and Disaster Assistance. Contractor must set forth its plans for
responding to major emergency and disaster situations within Chandler’s city limits
and its city limits where Designated Ambulances may be involved. In addition,
Contractor must set forth its plans for declared disaster situations and required
assistance. All such plans must be in accordance with and comply with applicable
law, regulation, rules, policies, and protocols.

Interruption of Service. In the event Contractor is unable to perform services
under this Agreement, Contractor must notify City of such possibility at least
seventy-two (72) hours prior to the anticipated inability to perform as agreed upon
in this Agreement. If Contractor knows or suspects such inability to perform with

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2.8

less than seventy-two (72) hour notice, Contractor must notify the City of such
possibility immediately.

In the event the Contractor is unable to provide services as required by this
Agreement, the Contractor shall allow the City to staff and operate a sufficient
number of Ambulances, as permitted by Arizona law, in order to meet the response
time standards. Contractor agrees to reimburse the City for reasonable labor costs.
Any alteration in the method or nature service delivery as described in this section
shall be subject to the statutory authority and approval of DHS as provided in ARS

36-2242.

If required, Contractor must execute an Associate Agreement and maintain good
standing with the Regional Wireless Cooperative (“RWC”). Contractor must pay any
fees as set forth in the RWC Agreement.

Radio Communications. When Contractor utilizes the City’s radio frequencies,
Contractor will be required to adhere to Federal Communications Commission (FCC)
rules and regulations regarding radio communications. Specific guidelines regarding
direct communications on the City’s communication system will be by directive from
the City or by PFRD. The City will be the authority regarding the City’s
communication system utilization. Contractor acknowledges that the FCC licenseis
held by the City or PFRD and that any shared transmitter use under this Agreement
and pursuant to Section 90.179 of the FCC’s Rule shall be subject to the City’s or

PFRD’s control.

Section lil. Ambulance Resources

3.1

3.2

Number of Ambulances Provided. Contractor hereby commits to dedicate the
number and type of Advanced Life Support (ALS) equipped ambulances for twenty-
four hour and peak-time use as necessary to provide the services required under
this Agreement. Upon execution of this Agreement, Contractor will provide a list of
Designated Ambulances to the City. Designated Ambulances will be billeted in the
designated City fire station locations agreed between City and Contractor.
Contractor may provide such other, additional ambulance resources that it deems
necessary to consistently satisfy the response time requirements set forth in this

Agreement.

Conditions on Use of Designated City Fire Stations.

3.2.1. Contractor Attendants. Contractor must hire, train, and supervise all
medical attendants in accordance with the laws of the State of Arizona and
reguiations of DHS. Attendanis musi be properly certified Emergency
Medical Care Technician (EMCT) or Emergency Medical Care Technician -
Paramedic (EMCT-P).

Designated Ambulances responding to calls for service within the EMS
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3.2.2

3.2.3

Services Area may be staffed with personnel on a 24-hour shift schedule (3
platoon system; A, B, & C shifts) or such other schedule as the system
requires. Due to workload, the Contractor may staff these units with split shift
multiple crews as long as the same crews are used on each shift. The
personnel may be replaced with any other Contractor personnel for the
purpose of covering vacations, sick leave, or other temporary absences.

While at any designated City fire station, Contractors attendants must
participate in all applicable station activities in the same manner as City Fire
Department personnel and must otherwise conduct themselves in the
manner necessary to promote a harmonious work atmosphere.

Station activities include cleaning and maintenance of the station and
equipment, preparation and clean-up of meals, educating and interacting
with the public during station tours and participation in appropriate physical
training activities.

The City expects that at all times Contractor's personnel will present
themselves in a professional manner. Contractor's personnel must be
attired at all times in their assigned uniform that indicates the employee
works for the contracted Ambulance provider.

Contractor's attendants assigned to City fire stations must not be deemed to
be employees of the City. Contractor is legally responsible for all salaries,
wages, bonuses, retirement, withholdings, workmen’s compensation and
occupational diseases compensation insurance, unemployment
compensation, other benefits and all taxes and premiums appurtenant
thereto and all other appropriate insurance concerning Contractor's
attendants assigned to City fire stations, as Contractor does with all of its
other personnel utilized in fulfilling its obligations under this Agreement.

Contractor must indemnify and hold harmless the City for any damage or
liability caused solely by Contractor’s attendants while at a designated City fire
station.

No Repair. Except for periodically cleaning or checking the tire pressure of
the ambulances billeted at any designated City fire stations, no maintenance
or repair of such ambulances may be conducted at any designated City fire
station, unless specifically as approved by City.

Contractor Access. Personnel designated by Contractor will have

reasonable access to any designated City fire stations billeting Contractor's

ambulances to provide necessary supervisory oversight, retrieve ambulances

for servicing, restock supplies, review, and prepare response and billing

records and undertake similar activities related to the provision of 911

ambulance services under this Agreement. Contractor will provide a list to the
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3.4

3.2.4

3.2.5

3.2.6

City of all persons it has designated to have access to designated City fire
stations and must update this listmonthly.

Condition of Fire Stations. Contractor accepts use of each of the
designated City fire stations in their “as is” condition and has independently
verified that these stations are suitable for billeting its ambulances.
Contractor may not alter any City building or structure under this Agreement
without the City’s express, written approval.

Waiver. The City is not be responsible for any damage to any of
Contractor’s ambulances billeted in a designated City structure or building,
or for any injury to any Contractor personnel given access to a designated
City structure or building under this Agreement, and Contractor expressly
waives any right to damages related to such occurrences unless such
damage is due solely to the negligence of the City or its employees.

Reimbursement. The Parties agree that the rent reimbursement amounts set
forth in Exhibit B of this Agreement for use of the designated City fire
stations are fair and reasonable and will be paid as set forth in Exhibit B of
this Agreement.

Additional Ambulances. !n addition to the minimum obligations for ambulance

units required under this Agreement and Contractor’s right to designate additional
units from time to time to meet its obligations under this Agreement, Contractor
may increase the required number of twenty-four hour ALS equipped ambulances
by one (1) to address any of the following circumstances:

(i) increased ambulance call volume by ten percent (10%) over the call
volume experienced during the first year of this Agreement; or

(ii) population increases within the City’s city limits of twenty percent
(20%) or more over the population in effect during the first year of
this Agreement; or

(iii) increased traffic congestion within the City’s city limits resulting in on-
scene wait time increases experienced by City’s Chandler Fire
Department personnel of ten percent (10%) or more over the on- scene
wait times experienced during the first year of this Agreement; or

(iv) increased 95" percentile ambulance response times of ten percent
(10%) or more over the 95" percentile response times experienced
during the first year of this Agreement.

Designation of Ambulances. For purposes of this Agreement, each Designated

Ambulance provided by Contractor under this Agreement:

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3.6

(i) must remain within its ambulance billeting location unless being
used to respond to an emergency call or during training activities;
and

(ii) must be assigned by Contractor to an emergency call within the City
and must be available to respond to Code 3 calls into jurisdictions
who have automatic aid agreements with the City of Chandler only if
it is the closest appropriate apparatus to the emergency scene; and

(iii) must immediately return to its ambulance billeting location at the
conclusion of an emergency call unless assigned to another
emergency call for which it is the closest appropriate apparatus to
the emergency scene; and must have the words “Chandler Fire
Department” legibly printed on both sides of the ambulance with a
letter size at least equal to that used for Contractor’s markings and
be labeled in compliance with Arizona law.

Replacement Ambulances. Contractor must notify the City’s Fire Department Shift
Commander, as soon as practically possible, if any ambulance designated to service
under this Agreement is temporarily removed from service and provide a replacement
ambulance for each Designated Ambulance removed from service for any of the

following reasons:

(i) removal of a Designated Ambulance from service for scheduled
routine maintenance or repair; or

(ii) removal of a Designated Ambulance from service for unplanned
maintenance or repair, when the ambulance is expected to be out of
service for longer than four (4) hours, unless otherwise provided by the
City’s Fire Department Shift Commander; or

(iii) removal of Contractor personnel for administrative or disciplinary
purposes; or

(iv) unavailability for any reason of a Designated Ambulance normally
assigned to a station for a period of more than three (3) consecutive
hours.

Positioning of Reserve Ambulances. Contractor will start service with a peakload of
seven (7) ambulances but provide ten (10) virtually identical ambulances. This reserve
inventory is primarily to facilitate maintenance on the fleet of ambulances and equipment,
but also provides surge capacity if reserve ambulances are not in a maintenance status.
City Fire Department and Contractor agree that reserve ambulances that are not actively
deployed or in a state of maintenance, may be positioned in Chandler to facilitate a rapid
transfer of the ambulance crew into a reserve ambulance due to a need to exchange
ambulances. Similarly, when possible, positioning one or more reserve ambulances not
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3.9

otherwise engaged in service or maintenance in the City of Chandler, enhances the ability
to call back additional crew members to increase ambulance supply to address episodic
surge in demand.

3.6.1. Contractor hereby commits to designate two (2) ambulances for “back-up”
purposes to the front-line ambulances as set forth in Exhibit A in order to provide
the services required under this Agreement. These Designated Ambulances will
be housed at a City facility to facilitate weekly apparatus check-offs and after-
hours access for vehicle change outs. All additional ambulances used for back-up
purposes shall meet the same specifications of the Designated Ambulances. The
location of the reserve ambulances will be placed at the discretion of the City after
consultation with Contractor.

Move-Up Policy. For purposes of this Agreement, “move-ups” mean a systemof
ambulance resource allocation designed to place ambulances in geographically
strategic locations with the intent of minimizing response times during periods of
increased ambulance activity. Contractor shall notify the City of any such intent to
change, and confirm that service will not be diminished due to such change, prior to
any implementation.

Joint Training. The City and Contractor agree to cooperate in providing periodic
training to City and Contractor personnel in an ambulance setting and to acquaint
individuals with the field of emergency medical service operations. This joint
training may occur in an ambulance unit that is not designated to services under this
Agreement.

In no event will the City’s participation in joint training be construed or deemed to
constitute control over Contractor’s employees or any students.

Equipment and Maintenance.

3.9.1 Maintenance. Contractor will be solely responsible for properly
maintaining all ambulances utilized under this Agreement and for meeting
all requirements of the CON issued by ADHS to Contractor for emergency
911 ground ambulance service within the City’s city limits. As used herein,
maintenance also refers to repair and replacement of the ambulances to be
utilized pursuant to this Agreement.

Prior to removing a Designated Ambulance from service for maintenance
or repair, a back-up ambulance must be posted at the appropriate City fire
station.

Designated ambulances must be replaced within six (6) months upon reaching
150,000 miles.

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3.9.2

3.9.3

Basic Equipment. Contractor will be solely responsible for providing all of
the emergency medical equipment and supplies necessary for the
Contractor to perform the required services under this Agreement. The
equipment and supplies must be current in nature and maintained in
accordance with standard medical practices, the laws of the State of Arizona,
and regulations of DHS. Failure to meet this Section requirement will result
in per occurrence liquidated damages of $1,000.

Without limiting the foregoing, Contractor shall install and maintain in each
ambulance serving the EMS Service Area the following equipment:

(i) equipment necessary to adequately and safely transport children
under the age of eighteen (18) available in each Designated
Ambulance and available upon request for non-designated
ambulances; and

(ii) that equipment, by “brand-name”, agreed by the parties; and

(iii) a fixed mobile radio that is integrated into an ambulance headset
system and two (2) portable radios that are dual-band (800 MHz and
VHF) capable as well as compatible with the Regional Wireless
Cooperative system that will allow for the dispatch and coordination
of Contractor’s ambulances through the City’s dispatching authority;
and

(iv) a mobile computer terminal (MCT) unit meeting City specifications for
receiving and transmitting dispatch and status notices; and

(v) automatic vehicle locator (AVL) equipment meeting City
specifications; and

(vi) compartment space for storage of PPE, including turnout coat, pants,
boots, helmet, self-contained breathing apparatus, mask; and

(vii) an Opticom emitter system approved and programmed to regional
traffic control standards; and.

(viil) | Power-LOAD motorized gurney loading system.

Additional or Different Equipment. The City reserves the right to require
Contractor to carry additional or different equipment during the term of this
Contract if reasonably necessary and will give Contractor ninety (90) days’
notice of intent to require such additional or different equipment. Such

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request(s) shall not require expenditures of more than Three Thousand
Dollars ($3,000) per Designated Ambulance in total value in any calendar
year. Notwithstanding the foregoing, prior to providing notice of its intent to
require additional or different equipment, to the extent reasonably possible,
the parties shall meet to discuss the desired requirements and work in
good faith on a reasonable resolution in compliance with the intent of this

Contract.

3.9.4 Minimum Ambulance Fleet Specifications. The Designated Ambulances in

service under this Agreement shall meet the following minimum specifications:

(i) Must be Type Ill and certified by the manufacturer to meet federal
specification KKK-A-1822F as well as meet applicable National Fire
Protection Association standards in effect. An exception to this
requirement will be permitted only for those items and features that
must deviate from the above-referenced federal specifications in order
to satisfy ADHS requirements; and

(ii) Must be capable of transporting two (2) patients and two (2) attendants
in the patient compartment, one person in the passenger seat, one
driver and all required equipment without exceeding the
Manufacturer's Maximum Gross Vehicle Weight assuming the
standard per person weight of one hundred seventy-five (175) pounds;

and

(iii) Must provide a usable safety restraint system for personnel
attending to the patient; and

(iv) Must be equipped with adequate crew cab air conditioning and
separate standalone RV style A/C, heating, and ventilation as agreed
upon by the Parties; and

(v) Must contain appropriate space for SCBA equipment and firefighter
turnout gear.

3.9.5 Ambulances Not Designated to Service under this Contract.
Ambulances not designated to service under this Contract shall be similarly
equipped as Designated Ambulances and shall be required to include the
MCT and AVL equipment necessary to receive dispatches for emergency
transportation calls within the City’s city limits. Use of Substitute
Ambulances for periods greater than twelve (12) hours shall require
notification by the Contractor to the City.

Section|IV. Staffing

4.1 Basic Staffing Criteria. Contractor must assign two (2) attendants per ambulance
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4.2

43

and maintain such staffing at all times when such ambulances are designated to use
pursuant to this Agreement. On designated ALS equipped ambulances, one
attendant must be a state certified EMCT-P and the other must be a state certified
EMCT. Contractor must also meet all ADHS requirements with regard to staffing
and is solely responsible for all staffing conditions not inconsistent with the terms of

this Agreement.

More than two failures to staff a contracted ambulance position resulting in the
ambulance being out of service for greater than one hour within a 30-day period
may result in a per occurrence assessment of liquidated damages in the amount of

$1,000.

Training. In addition to the certification and training required by ADHS and other
sections of this Agreement, all of Contractor’s attendants to be assigned on a
regular basis to an ambulance that is dedicated to the City under this Agreement
must attend the following training programs provided by the City at the regularly
scheduled date and time that the City offers such training:

(i) 8-hour orientation training program which includes training on EMS,
Fire, Special Operations and Incident Scene procedures provided by
City’s fire department personnel; and periodic EMS training
provided by the City’s fire department personnel.

Ambulance operators must be properly certified EMCT or EMCT-P
and have completed a comprehensive emergency driver-training
program and possess an appropriate driver's license. Contractor must
provide on a regular basis driver's training continued education and
require all Contractor Ambulance personnel to attend.

In addition to the certification and training required by the ADHS and
this Agreement, all Ambulance crew members assigned to or
available for assignment to the Designated Ambulances will attend
the following training programs provided by the Fire Department at
the regularly scheduled dates and times that the Fire Department
offers such training: an orientation-training program provided by the
Fire Department's personnel. Orientation training and six (6) months
911 experience must be completed by each Ambulance crew
member before that crew member is assigned temporarily or
permanently to a Designated Ambulance. Contractor will be
responsible for compensating the crew members attending training
and for providing, or otherwise arranging for, transportation for its
crew members to attendtraining.

Records. Contractor must maintain complete and accurate staffing records in
accordance with applicable laws, rules, and DHS regulations.

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4.4

4.5

Personnel Issues. While Contractor will be responsive to City input regarding
issues the City may have with Contractor's personnel, Contractor is solely
responsible for the hiring, termination, and initiation of disciplinary action of all of
its personnel and Contractor’s personnel must remain subject to the rules, policies
and regulations adopted by Contractor. Contractor agrees, however, to immediately
reassign any personnel assigned to a designated City fire station at the reasonable
request of the City when a supervisor cites safety or other immediate concern or
the request is made by a Chandler Fire Department Chief Officer.

Contract Labor.

4.5.1

4.5.2

4.5.3

General Provisions. Contractor hereby contracts for the labor of City
Firefighter Paramedics (“City Attendant Staff’) for use in staffing Advanced
Life Support (ALS) equipped ambulances to assist in providing 911
ambulance transports within the City and for automatic aid under the terms
of an approved automatic aid agreement, provided such automatic aid is
within Contractor’s CON certificated area, in conjunction with the services
provided by Contractor pursuant to this Agreement.

Staffing Commitment. The City will provide City Attendant Staff for the
twenty-four hour and peak-time ambulances dedicated to service under
Exhibit A of this Agreement in accordance with the terms of this Agreement
and the schedule set forth in Exhibit A. The City is not obligated to provide
any City Attendant Staff beyond that set forth in this Agreement.

City Employees. City Attendant Staff are the employees of the City subject
to all laws, rules, policies, regulations, procedures, standards, and
contractual provisions applicable to City employees, including internal City
Fire Department policies, procedures, and guidelines. The City will be solely
responsible for all salaries, wages, retirement, withholdings, workers'
compensation, occupational disease insurance, unemployment
compensation, other benefits and all taxes and premiums appurtenant to
said wages and all other appropriate insurance related to the City
employees provided hereunder. Further, while the services of the City
Attendant Staff will be provided in a manner consistent with Contractor's
established standards for ambulance operations, as set forth in Subsection
4.5.4 below, the City will be solely responsible for the hiring, performance
management and appraisal, and initiation and conduct of disciplinary action,
including termination, of all City personnel provided pursuant to this

Agreement.

(i) The City’s ALS provider is, at all times, required to maintain
certification as required by the ADHS at the Paramedic level. If at any
time it is found that a City’s ALS provider is not certified, or loses
his/her certification, Contractor will be notified as soon as possible.
Any damages or reimbursements to any patients, state or federal

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4.5.4

4.5.5

4.5.6

payers that are caused by the actions of a non-certified City ALS
provider, will be the responsibility of the City.

Compliance with Ambulance Operation Standards.

(i) City Staff must render services under this Contract in a manner
consistent with Contractor's standards, policies and procedures for
the operation of Contractor's ambulances. An Electronic Patient
Care Record (e-PCR) must be completed in atimely manner for each
patient transported and be submitted to Contractor and the receiving
facility prior to the end of each 24-hour tour. City Staff will be
responsible for completing the patient care encounter on the
Department specific ePCR program per department documentation
standards. Any additional Contractor documentation requirements
will be the responsibility of Contractor Staff and should be performed
on Contractor designated ePCR.

(ii) Each ambulance staffed with City Attendant Staff under this
Agreement must operate within the defined deployment, move-up
and general operational systems for 911 services set forth in this
Agreement.

Periodic Training. City Attendant Staff staffing each of the twenty-four hour
ambulances identified in Exhibit A will periodically need to attend pre-
scheduled City training and receive annual medical exams. Ambulances may
be returned to service based on need and Battalion Chief request. The City
will provide Contractor with notice at least forty-eight (48) hours before any
such event for each twenty-four (24) hour ambulance identified in Exhibit A.
Attendance by City Attendant Staff for City training and medical exams will
not reduce the compensation amounts to be paid to City by Contractor as
set forth in ExhibitB.

Reimbursement. The parties agree that the staffing cost reimbursements set
forth in Exhibit B of this Agreement are based upon the City’s estimated costs
and fair market value for the labor and services provided and that the costs do
not exceed the City’s actual costs of providing City Attendant Staff. The cost
reimbursements will be paid as set forth in Exhibit B of this Agreement and
any increases in these costs shall not exceed the percentage allowed in A.R.S.
sec. 36-2234(E).

SectionV. Contract Administration

5.1

Contract Administrator. Contractor will provide the City with the name, contact

information, and responsibilities of the executive responsible for this Agreement
and the staff member with daily operational supervisory responsibilities of the
attendants Contractor has assigned to the ambulances dedicated to service under

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5.2

5.3

this Agreement, prior to commencement of services under this Agreement, and will
timely update this contact information as necessary during the term of this
Agreement.

At minimum, the Contract Administrator is responsible for the following:

(i) Assure compliance with the Agreement.

(ii) Develop and coordinate training for personnel.

(iii) Participate in meetings with the City.

(iv) Act as liaison with the City and medical facilities receiving patients.
Coordinate research and reporting on ambulance services and
transports.

(v) Perform field observations and report such observations to
Contractor and the City.

(vi) Monitor response times.

(vii) Coordinate ambulance coverage for special events and Fire
Department training.

(viii) | Coordinate or conduct customer (including patient) surveys and such
other similar duties as assigned.

(ix) Act as primary liaison between the City and the Contractor in the
problem resolution process.

Complaints. Contractor will notify the City of all written complaints and
compliments concerning ambulance services within the City or involving a City
designated unit. Issues involving Contractor or City personnel will be reported by the
close of the business day following receipt of the complaint. Complaints of a
financial or billing nature will be reported to the City within ten (10) working days of
the receipt of the complaint. Contractor will provide to the City anyinvestigational
findings and a disposition of all complaints described in this paragraph within
twenty (20) days of the receipt of complaint.

Records.

5.3.1. All books, accounts, reports, files, and other records related to or arising out
of this Agreement (collectively “Records”) are subject at all reasonable times
to inspection and audit by the City for five years after the expiration or
termination of this Agreement. Contractor must produce the Records at a
mutually agreed to location within Maricopa County, Arizona. Contractor
must maintain complete and accurate records in accordance with applicable
laws, rules, and regulations including record retention requirements of DHS.

5.3.2 Contractor must make its publicly available financials available to the City
upon reasonable request. Nothing herein shall limit or alter Contractor's
obligation to maintain books and records as required by law or ADHS. All
accounting records shall be maintained and reported in accordance with

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5.4

5.5

standard accounting procedures.

5.3.3. Contractor must maintain a complete and accurate record of all requests for
service and deployment of resources. These records must include the time
and date of the request, location of the incident, identification of the
ambulance and personnel dispatched, the arrival time of the ambulance at
the scene, and the total elapsed time between dispatch and arrival. The
record must also include the time of departure from the scene and arrival
time at the emergency care facility.

5.3.4 Upon request by the City, Contractor must provide a list of all Designated
Ambulances used to provide service under this Agreement. This list will
include vehicle identification number, make, model, year of manufacture,
current mileage, and summary of maintenance history.

5.3.5 Upon request by the City, Contractor must provide to designated City
personnel a list of all management, supervisory, vehicle maintenance, and
field and dispatch personnel.

5.3.6 Upon request by the City, Contractor must submit service and deployment
records to designated Citypersonnel.

5.3.7 Failure to meet the requirements of this Section may result in a per
occurrence assessment of liquidated damages in the amount of $1,000.

Evaluation. The City may survey users or professionals that interact with the
Contractor during transports (i.e. City staff or hospital staff) periodically to
determine the level of satisfaction with the service provided by Contractor.
Contractor will be given an opportunity to respond to any unfavorable responses.

No Cost to City. All patient charges by Contractor for services to the public under
the terms of this Agreement will be in accordance with such public rates and
charges set under federal or Arizona law. In the event a ground ambulance is
enroute to or has arrived on the scene, where Contractor did not transport the
patient Contractor must not charge the patient for such response.

In general, the City will not be responsible for the costs of a response. However,
if the City would be responsible for an ambulance service charge because it is the
employer or insurer for an individual receiving ambulance service (e.g., self-
insured worker's compensation for ambulance service to a City employee), the
City will be responsible for said costs as would any similar employer or responsible
party. As such, in the event a ground ambuiance is enrouie to or has arrived on
the scene and medical control then deems air transport necessary, Contractor
must not charge the City for such response. Charges for services provided under
this Agreement will be paid directly to Contractor by the individual(s) receiving the
service. The City will not be responsible for non-payment of bills tendered to the
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