HomeMy WebLinkAboutR-1994-109A RESOLUTION OF THE CITY OF DANIA, FLORIDA, AUTHORIZING
THE CITY MANAGER OR HIS DESIGNEE TO APPLY FOR A GRANT
BEING OFFERED THROUGH THE STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES,
OFFICE OF EMERGENCY MEDICAL SERVICES, FOR EMERGENCY
PATIENT EXTRICATION EQUIPMENT; AND PROVIDING FOR AN
EFFECTIVE DATE.
BEITRESOLVEDBYTHECITYCOMMISSIONOFTHECITYOFDANIA,FLORIDA:
Section 1. That the city commission of the city of Dania, Florida, hereby
authorizes the city manager or his designee to pursue the application for a grant being
offered through the State of Florida Department of Health and Rehabilitative Services,
Office of Emergency Medical Services, for Emergency Patient Extrication Equipment;
a copy of which is attached hereto as "Exhibit A".
section 2. That this resolution shall be in force and take effect immediately upon
its passage and adoption.
PASSED and ADOPTED this 2 6 day of July ,1994
AYOR -o ISSIONER
ATTEST
"//)UDITOR
APPROVED FOR FORM AND CORRECTNESS:
4^l'/ 6/L--By:
Frank C. Adler, City Attorney
RESOLUTTON NO. 10e-e4
CITY CLERK.
The City of Dania Fire Rescue Department
Emergency Patient Extrication Equipment
Matching Grant Application
Florida Department of Health and Rehabilitative Services
Office of Emergency Medical Services (EMS)
Grant Liaison:
James E. Mulford, Division Chief
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THE
luly 20, 1994
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CITY OF DANIA
IOO W. DANIA BEACH ALVD.
P.O. BOX {708
DANIA, FL 33OO'
Phono: (305) 021-0700Frx: (3061 921-2601
July 20, 1994
Re Emergency Patient Extrication Equipment
Florida Department of HRS
Office of Emergency Medical Services @MS)
Matching Grant Application
Dear Sir:
Please find enclosed one original and eight (8) copies ofthe above subject matching grant
application.
The City of Dania is dedicated to the advancement of the quality of pre-hospital EMS activiries
and services.
we hope you will support our grant application and look upon them favorably. Ifyou have any
questions, or need additional information please contact me.
Very truly yours,
Urra\ e
ames E. Mulford
Division Chief
Department of Health and Rehabilitative Services
Office ofEMS
EMS Matching Grant Application
13 l7 Winewood Boulevard
Tallahassee, Florida 32399-0700
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ID Code to be Assiged by Statc EIvIS OfIice M-
- - -Floride Departoetrt of Eealtb end Rehabilitative Serrices
Oflice of Energency Medical Services (EIVIS)
MATCEING GRA}TT APPLICATION
A gency/Organi"-tion's Federal
Tax Identilicatiou Nurnber uine digits 1rF 5 9 G _-0_ _0_ _0_ l_ o 2-
I I-egal Nrme of
Agency/Orgauization:City of Dania Fire-Rescue
Namc and Title of
Grant Signer:
Robert FlatleyCity Manager
Mailing
Address:
l-00 West Dania Beach Blvd.Dania, Fla. 33 004 County: Broward
Telephone Number:(30s) 921-8700 SunCom Number:
,Neme and Title of
Contact Person:
Mailing
Address:
100 West Dania Beach Blvd.
Dania, FIa. 33004
Telcphonc Number:(30s) 921-8700 x308 SunCom Number:
3. kgal Status of
Agencyi Organization: (crcct onty oe)
Eivrl. Noa fq hEdt (rou tu. Ptlvid. cogy of cdiicre)
hirtt. for Ploir X hr[c
Your frscal ycer:
Ll/L 9/30
BEGNS E{trS
5. Idrltiry OrG orE r.tr plea objccriyc 6ir fojecr prir!.rily .dd(t!..t1 objodhe f 33 .3, 35.1
6. Type of hoject: (occl oily oo.)l
Corununicrtjonr _ CoDrinrri'3 Plofcrioarl Educrtioa (rrcdicrl dirtctor anrn ri,a lrts 16r)
Enrcrycncy Tnarpon Vcliclcr _ Public Educ],ion
Syttlm Ev.lulior/Qu.:ity Alrlrur. _ n'GE .ch
Mcdicr!&.ocur E4uipn d (titruorlr ftqui*a for llrra.l l6b rnd l6G)
Doct yoot proj..i iIrlu& 6. ,uEhu o( rny comnruaiorionr rquipnrrr?
-
|eS X |{9
HnS Fo'ln 1767, M.'Eh t9
James MuLfordDivision Chief -El'lS
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For bot! the need end outcomc stateher8: Iacludc rll rveileblc srrrn3f is &te, the rl"rc fruocfor-the daa, thc datl sourcc,- thq 't:1-'bs of pcoplc vbo wiU dLc"ttt.o.i".i-j*t sor.i.ts,rnd other inforaration which cteerly identilies yiur'necd eud apcacd 6,.rtcomc nn iLis projca- '
7 Need stateme[t (use onIy thc spec.belo w)Da F1 R ded 3 I 6 1nl-a T S cue re pon t oEMSII993t_a rm I n t h z 5 0 mot or ehI 1 o t t he e )5 0 MVA12trequIdtreexrl-C at l_o n and I 5 9 5 h h d d ded h harel_g 5pee l-1 l-gav1otdthl-c a wl-n Dan I a S t I t V h 1 d h hCIr-m l_s e l-e ac c t"ent l-o urotheh1shwavoftIvo1Ithtl_t J-D Fagvaoanl_a .t-r e cneedstoetrtit1hh.t"d nd1on1meSn.l-s n rg v aC ent s aehl-c l-e ro1 Io r s
9. .Improv-em"ut ead Expansiou of hehospital EtlIS. Dcssribc Low your projca iqrovcs rod c*pradsprehospid EMS. Al$, sbor horrl ir brulds coordiutioa rad coopcntio wi6 o6cr EMS sy.-..This. project will improve prehospital EMS by reducing patientextrication times in vehicle accidents and iolloversl -patient mortalitand norbidity is-reduced when ext rication rstabil ization, and transportis carried out efficiently and effectivelv. The extrication tool not ,only adds versatiliry but-decreases oatiJfri d;;$;;i;aiorr-ti*"s totrauma centers. This project will ada additional capabilities to thedepartments provision or ar,s mutual aid to the 4 providers in a 20square mile area surrounding the City of Dania. ihis has significanteffect on the overall EMS system enhincement and patient "o16 bytransport of trauma injuriei within the "golden h6ur".
10. Research hojecrs OnIy:u ,q, r,l gE corilcuD, . '.s.ci pr!,ct .tip llli! it 6 ud to !o ll,n! ll.
If Y* {rroalaia. r tB.Gt tojd. .s..1 .r tlr cod o(t!r rpplicsiro ccir rdd. cf li. fyFh..is, d..itddrodr irtrrrt rt rlod,!o Pdd LB!r.! .Ajc{ rry Eoilio ilrolvi{ tb. Gdr, rdtf iarrrut, fqo .!a frirlt; ch.. ,.f.r.i -raa-
11. I44jor Wort Activities and Time Fraoc 6Ue oaly 6c ryrcc bctow):
-order extrication too1.. ..60 days after receipt of grant
-Train personnel in use of tool..90 days after receipt of grant
-fmplementation of extricationtooI.. ......160 days after receipt of grant
funds
funds
fund s
accidnets.r-95
decreas e
6. . -- -Ou*rcome SEteqent (use only the space betov): This project will equip a Dania!'r-re-Rescue Engine compahy wilh a hydiaulic Lxtiication toor,- signif-rcantly decreasing extricition times in high energy accidents anarolLovers. This extrication tool will be iv.iraril to mutual aidresponses to surrounding conununities.
APPLICANT
CATEGORIES
C&rtMrlth
StrtrGrurl
Funds TOTAL
12. Sglsries rud Belefits:
N/A 0 0
TOTAL SALARIES sEd BEI{EITIS 0 0 0
13. Expeuses
N,/a 0 0
TOTAL EXPET{SES 0 0 0
CATEGORIES
APPLICANT
Ststc
Grant
Funds TOTAL
14. Equipment:
Hydrau l ic
inc l udingand power
extrication toolcutter, spreader,unit
set
Iam
4250 127 50 17000
TOTAL EQUIPMEI.IT COSTS 42s0 t2'7 50 17000
'l
0
0
CsshM!tch
t
.lrfojd eql uI srrl(u rlagl pq! 'nsoc Jl.$ 's3nDurnb Jtaql 'suat aql Jo sEra ur lsrodrnbe
pB 's6cedre '5ssrlrsod 1p pm lur roJ p€u aqt &tss?€s sr Irftsnl p"r wrldxa o sattd ro atrd r q:atr iru no1 :aoN
n'rrqot
od ,urprnrd
nD Jo qr
rqt Ft Be,
.nUU . oqr qL
-'cccEt'
I
Fpr
rqt Jo lrrarad
t! Fbr Fr!
.triru .^oqt rqt
nTtTt-t
Fro! .ql ro
r,' rrd t! pnt',lllr
.rn 9 .,roqr .ql
"'6qzF'I
PaulqEoJ Il8
'Sratudlnbe pEB sasuadr, 'slgaoaq puu
saHEIEs Jo lBlol - ,Cr"IIIIIInS put{ 'gI
TVIOI trJl;hIqsrJ
INYf,llddV
s:truo9grY)spunl
luBJ9,lEts
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f 6. Medical d. ,r's siguetums: Completc this iteo only if your p
Equipment, or hor6sioDel Education Project.
is e Medic.eYRescu e
l. hofessiooal Education
All continuing educgtion decrib€d in this application is developed and conducted
with my i.Eput rnd approval.
Medicsl Dir€ctor's Signature Date
Medical Director's kinted Name
b. Medical Equipment Projects:
I herrby eccept authority and responsibili_ty for tbe.rse of Medical Anti-Shock
Trousers MAST), isophigesl Obtufotor Airways (EOAs), semi-automatic and sutomstic
defibrillat'ors, .lLS eqdipmiut ideutified in Cbalter 10H61 {.4.C., and €quipmetrt Dot
identilied in Chapter 10i!55, F.A.C. If this res-pousibility is delegated, both the delegated
physician and thd medical director must sign this section.
.'lr'l w 20 1AQ{
DatriMedical Director's Si gnaturc
and Delegated Physician, lf auy
L. Scott Ulin M_t)
Mdical Directorrs kiDted NaEe
and Delegated Physician, if any
Medical Director's or Authorized Persou's Signature Date
Pri.oted Name
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c. I hereby acklowledge that the applicant responds routinely to rtscue or medical
incidents under wrinen agre€Eent witb my liceosed EJvf.S system.
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APPLICATION ITEIVI 17 (signarurc rcquircd)
REQUEST FOR MATCIIING GRANT DISTRIBUTION (N)VANCE PAY}TENT)
EIVIERGENCY MEDICAL SERVICES (EI'{S)
Governrnetltrl Agency and Non-profit Entity ONLY
Ia rcrordeacc wi& thc pmvisions of pengnph lol.l l3(2Xb), F.S., thc uadcrsigacd hcrcby rtqucsts u EMS oechi.ug
grrat distributioa (tdvi!c! PryEc[t) for thc imProvcocar rod cxpeuioa of prEhosPi'd EMS'
Payment To:City of Dania Fire- Rescue
Lcgd N..Ec of Agcocy/Orgraizrtiol
100 West Dania B each Blvd.
AddressDaniaFIa.33004
(City)(Srrtc)(zip)
Official V17-79SIGNATIJRE:DATE:
kinted Name:Title@
SIGN AT{D RETI]RN WTIII YOIJR MATCIIING CRANT APPLICATION TO:
Dcpsnocot of Hcelth ud Rchrbilitetive Scrrriccs
Officc of Eocrgeacy Mcdicrl Scrviccs (HSTM)
EMS Matchirg Grraa
l3 17 Y/iaa*,ood Boulcvrrd
Tdlebrsscc, Flori& 32399{700
Fot Ur. Only by D.p.rrcrcar of Hcrlrl rnd Rdrbiliu.iv. S.dic..'
Ollhc of Ert4encY Mcdicrl Scrviccr
Matchirg Grrl! A-6ouot:S Gnot ID Codc: E
Apprord By:
Sigaenre, St8E EMS Gnut Officcr
stato Ej.scal YGar:- lnount ! S
Drlr:-
Orqanlzation Code
60-2 0-60-30-:.00
Cuss!-codC
H5
Federal Tax lD V f
Grant Beginning Data:Ending Date:
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IE. ASSI'RANCES AND APPLICATION SIGNATIIRE
Cefl ifi cation of Standards Stat€'rre'rt
I, tbe uo&rsipcd, ccrtify rbrr if gnorcd fuods undcr Cbaprcr 4Ol, Pert II, F.S.; rs rocodcd, dl rpplicrblc rcauletioos ud
str.oderds urill bc dbcrcd o includi.og: Cbaptcr 401, F.S.; Cheptcr l0D{6, F-A.C.i MiaiEuE Wr8c Act: Titlc VI of tbc
civil Ri3hs Ad of 196'4 (42 Isc zoooD a. scg.)l DHEW Rc8ul'rior (45 cFR Plrt t0); Rcbrbiliurioa Act (s'c 5oa)i
Developocotelly Disrblcd Assisuacc rod Bill ofRigbs of 1975 (P.L 95-602) rs roeodcd by Titlc V of tbc
Comprehcosivc Rchebilirrtivc Scwiccs Ancadocots of l9?8: Coofidcotielity; HuII,rs fu8bts; Hrbilitetios Pleos;
Eoployocot of thc Hrodicrppcd; Scrviccs for Pcrsoos Uoeblc to Pey.
Staterent of CEsh Commitnent
I, rbc uudcrsigocd, ccnify thet cash anrch win bc evaihble during tbc grrnt pcriod utd uscd i! dircct suPPorr of this 3r:ol
projccr Sh;rDd fcderrl fuo& will Bot bc uscd for oetcbiog rcquircEcots, uolcss sPccificd by hw. No costs or third'
perty coorributioos coult rowrrds s.tisfyi-og r trstchi!8 rrquircmcnt of e depanocor tr.r! if thcy erc uscd o setrs! r
uatching rcquiremcot of roothcr surc or fcdaral 8rant. C.sh, salerics, fringc bcocfis, expcnscs, cquiPmcot, rod otlcr
cxpcgscs as lisrcd oa this applic:'riotr sball bc comsriucd and uscd for tbe dcPannett's frnal approvcd projcct duri-og tbe
greot pcriod.
Acceotance of Terms and Conditions
I, thc uldersigled, rcccpt the great t rELs and conditions in Appcadir B of tbc bookla, '1992 Flori& EMS Matching
Grrlt ProgrrE', by tbc Dcpanocat of Hceltb rod Rcbrbilireuve Serviccs ead ecknowlcdge this when fira& rrc drawu or
otlcrwisc obtaiaed from the grant peyEcDt systeE
Disclaimer
I, thc undersigncd. bcrcby ccnify rhst thc facts end iaforo:tior conrained in this epplietioa aod any follow-up docuocots
rre truc :nd conrc! to thc bcst of my knowlcdge, inforroatiou, and bclief. I funher undersuad that if ia is subscqucudy
dcrcrmilcd th this L Eoa correct, tbe gnnt fuodcd under Chepter 4Ol, Prn II, F.S, rnd Cbapter t0D56, F.A.C., oey bc
ravokcd, aDd r[y oonics crroncously paid and inErcst eamcd will be refundcd to thc dcP.nmes! with aoy perrltics whicf
Eay bc iEposcd by lew or rpplieblc rcguladons.
Notification of Awards
l, tbc undersigncd, undcrund tbc eveilebility of thc lotic. of awerd will bc advcniscd io thc Floride Admi.uistrstivc
Wc.kly, rad rbrr 30 calcadar deys aftcr this Floride Admioisrntive Wcckly rdvcniscmcnt I waivc aay right o cballcage or
protlst iu rayway tic dccisions to awerd Srants.
Itlaintenance of Imorovernent and ExoaRsion
I, the usdcrsigtcd, agrec tber aDy improvcmeot or expansion brought about in wholc or Part by grertt funds, will bc
Eai.Brai.ncd for fivc ycers after thc projccr cuds, unlcss specificd othcrwisc i.u the approved applieliou or unlcss thc
depanoeot rgrccs il writiag to rllow r cbange. Any unautborizrd chaage withir tbc five yars will Dccrssiut! tbc renrru
of8r..ot fiLD& i.uvolv plus irterast if lny to meot.7-/
Signat of Authorized Grant Signer
(lndividud ldcutificd h ltrn l)
Date
NOTE: Please check to insure thar all required signatures have been made for ltems 16, 17, and 18.
The application will not be considered for funding without any required signaturc.
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