HomeMy WebLinkAboutR-1994-108e zil-.--
RESOLUTTON NO. 108_94
A 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 DEPARTMENTOF HEALTH AND REHABILITATIVE SERVICES, OFFICE OF
EMERGENCY MEDICAL SERVICES, FOR EMERGENCY EQUIPMENT -
DEFIBRILLATION EQUIPMENT FOR ALS PARAMEDIC ENGINE
COMPANY; AND PROVIDING FOR AN EFFECTIVE DATE.
C
AYOR - C M SSIONER
ATTEST
APPROVED FOR FORM AND CORRECTNESS
2
''- ,11ttJBy
Frank C. Adler, City Attorney
BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF DANIA, 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 Equipment - Defibrillation
Equipment For ALS Paramedic Engine Company; 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.
PASSEDandADoPTEDthis 26 dayof Julv ,1994.
42,-Z//h&//'"-
CITY CLERK - AUDITOR
The City of Dania Fire Rescue Department
Emergency Equipment - Defibrillation Equipment
ALS Paramedic Engine ComPanies
Matching Grant Application
Florida Department of Health and Rehabilitative Services
Office of Emergency Medical Services (EMS)
James E. Mulford, Division Chiel
I
Grant Liaison:
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THE
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July 20, 1994
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W. DANIA EEAGH BLVD.
P.O. BOX 1708
DANIA, FL 33OO'I
Phone: (3051 92{ -8700
Fex: (305) lt21-2804
Re Emergency Equipment-Defi brillation Equipment
ALS Paramedic Engine Companies
Florida Department of HRS
Office of Emergency Medical Services @MS)
Matching Grant Application
The City ofDania is dedicated to the advancement of the quality of pre-hospital EMS aaivities
and services.
\Ye hope you will support our grant application and look upon them favorably. Ifyou have any
questions, or need additional information please contact me.
truly yours,
CLLUZ'o
ames E. Mulford
Division Chief
CITY OF DANTA
July 20, 1994
Department of Health and Rehabilitative Services
Office ofEMS
EMS Matching Grant Application
l3 t7 Winewood Boulevard
Tallahassee, Florida 32399-0700
Dear Sir:
Please find enclosed one original and eight (8) copies ofthe above subject matching grant
application.
ID Codc to be Assigned by Stetc EIvIS Office: M-
- - -Flori& Departmeut of Eeglth end Rehabilitativc Senices
Oftice of Energency Medical Serices (EIvlS)
MATCHING GRANT APPLICATION
4. Agency/Organi--tion's Federal
Tax Identification Number ning figlts YF5 9 6 0 0 0 3 0 2
I I-egal Name of
Agency/Organization:City of Dania Fire-Rescue
Name and Title of
Grant Signer:
Robert Flatley
C j.ty Manager
Mailirg
Address:
100 l{est Dania Beach BIvd.Dania, EIa. 33004 Counry: Broward
Tclephone Number:(305) 921-8700 SunCom Number:
2.Nnme and Title of
Contect Persou:
Jarnes Mu]- fordDivision Ch.ief -EMS
Mailing
Address
100 west Dania Beach B1vd.Dania, Fla. 33004
Tdephone Number:(305) 921-8700 x3o8 SunCom Numbcc
3. Legal Status of
Agency/Organi.-tion: (orcet onty oc)
PtiyrL No. fr hoit (,ro{ arrr prwido eopy of c.nifiqE)
Eir'.E for Protu X hllc
Your fiscel ycar:
t0/t 9/30
BECNS EIDS
(ld.dify lh. ol: olr plra oSjtctive thir projcrt griarerily rddrcm: Objcaire f : $-[".-!3 . 3
1
6. Type of hoject: (Gc.r only oE):
Co,n rnrnic.tion
-
Co it iDt Frolcliolrel Educrtion (rwd'tcrl dilt tot ftud lit! lls
Enerycxy Tnnrpoa Vc}iclar _ hbli. Educ{iod
Syram Ev.lu.tiodQurlity ArorrrE. _ Rcr.tdr
M.r'icruR..cuc E4uipnE (titmnr.c. .r4uird for IEnu l6b rnd l6c)
Do.t yoqr prtirat irlud. 6. purrhr.. of .6, coln rrrnic.tioo, cquigitrrrr?
-
ygs i- XO
16.)
HlS Form 1767, Mrnh 19
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For both the ueed gnd outcome statpnents: includc dt gvqitalls trr'neric &te, the -:,'.c fiz.ocfor-the &!e, the datr sourte, the arrmls1 of people wbo lrill dircctly rcceive projrt serric6,and other informatioo which clearly ideutifies yiuiuecd and aped,ed iutcome f6r tirie projca-
10. Research hojects Only:If ,oo rr! !g coriuctilt . r.L..r, p-;oi .Ep thir it:rrr rnd 3o to lterrl I l.
lf yor elltonduainj r le{t! projEq l!l.t .r U. .!d of 6. rpplicrrion .orsir rrt rEdr of rhc hyporlreriq d..i3/mcdro.l! ilrnt!lr[|, riod.lo prooar Lult.a r&jcu, l', liaitrlioar iwolvilt 6. crdr, t*.rci irrnr'Et{r, forlr. rrd !'rirEa ;'l arb.r rrtrvrq. andig.
n
11. M.qjor Work Activities aad Time Frarnes (Usc only the sprce bclow):
-order equipment. ....90 days after receipt of grant funds
-Delivery and installationof ALS equipment. ..1g0 days after receipt of grant funds
-Implementation of ALS EngineCompanies ....190 days after receipt of grant funds
-Total system evaluation: March 1995i June 1995; September 1995.
7. Need Statemeat (use only the space below): city of Dania Fire_Rescue servesa Fire-Rescuea similar 17tproximatley 233nal alarms,artment responseencies within 4 m
o 1u t ofn o f 1 7 3 53 o re 1 n.l_P p n 6 7 uars DAe.1m Isq
Sha Shol,rn an cn er1a e nl-EMS I rms o f n1tnl-a d
nI r e 1 99 4 t d t l-m 1u an ot 1 rms o ur ptehtt-me e u t1 n1 t n a ed naIl-r s ns t o I l-t oddsvporust1nl_.1,n r n 1t em .l-n l-f anct1Sg I bo t h dDOsv prt.l_foraJ.L.u s n de t r ndo ot 11 eemr
t. Outcome Stetenetrt (use only tbe space below)15"
companies will provide Dania Fire-Rescueand staffed first response non transportit.imes to second and third simultaneous aIsupport treatments within the 4 mi-nute re
initiation of ALS Enginewith two addit.ional AIS equipp
ng units, decreasing resDonse
arms delivering advanced life
sponse time criteria.
1993,anof
9. .Improveoeut and Exprnsi6g of Prehospital &IS. Dcscribc how your projca ioprovcs rad crpra&prehospid EMS. Also, sbow ho, ir buil& coordiartioa esd coopcnrioo with o6cr EMS systcos.Provides rapid intervention of medical emergencies by advanced 1ife :rsuPport units staffed in accordance with F.S.S. 10D-66. This projectwill provide overall system enhancement by providing mutual aia t6additional Broward County municipalities intl unicorporated areas lrith apopulation range of approximatley 150000 residents. This project willenhance overall delivery of emergency medical services for firstresponse and simultaneous alarms utilizingr AIS Engine Companies.
St8tGrrnt
Funds
APPI-ICAN'T
C$hMrtch
12. Salaries rrd B€nelits:
N/A 0 0 0
TOTAL SALARIES end BEI{E}ITS 0 0 0
CATEGORIES
13. Expenses
TOTAL EXPENSES III
CATEGORIES
APPLICANT
CrshMlt Jt
Stst
Grent
Funds TOTAL
14. Equipmeut:
(21 12 lead moni tor,/de f i br i I1a torlPacer
(3) Portable suction units
(4) Trauma 747 boxes
(2) Pulse oximeter
(6) Backboards
7500
i371
90
450
2t0
225A0
1114
270
1350
630
30000
1485
350
1800
840
TOTAL EQUIPMEI.{T COSTS 8621 25864 34485
,l
TOTAL
I
Notc: You mrv ttech r page or prgcs to exphia rad justify .s Dcccssrt7 thc uccd for ray rad dl positioas, crpcoscs, rad
cquipEcot i! aros of thc itcms, thcir queatities, thcir cosr, ead tlcir roles ia thc projca.
CATEGORIES
APPLICANT
C$bMrrlN
StruGrznt
Frurds TOTAL
15. Finel $rrrnmarT - Total of salarics
snd benefits, expeoses atrd equipmeot,
sll conbitred
1-gg-r-r--
14. .bovr 6tu!r
ltllr .{ud 25 parr.ri
of lb. ldd
s 25864
th. .bor. fiturr
nua cquel 7l
P.r!.d cf lla
Llrl
I-3tt95--
Ttr. &ovc f6ut
ttrrr a{ual tL
alln of tL
tt c.dit[ tr.o
collrttllr
I
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16. MGdicaI dirr s sigurtuns: Completc this itea only if your prc
Equipmeut, or Professronal Educatiou kojed.
b r MedicellRcscue
a. hofessional Education
Atl contiauing educstion dccribed ia this applicatioa is developcd aud conducted
with my input and approval.
Medical Dirtctor' s Siguature Date
Medicd Director's hinted Name
b. Medical Equipmeut Projects:
I hereby cccept authority and responsibility for tbe.use of Medical Anti-Shock
Trouser: CUeSff , fsopUigot OUt rfoto".liriays (EOes), seui-automatic snd euto6atic
defibrillators, nLS equipm-ent identified in Chalter 10H6, F.4.C., ald equipment not
ideDttf*d itr Chapt.iiOil-ee, i.A.C. tf ttUr.spoosibility is delegated, both the ddegated
physician and the medical ilircctor must sigu this sectiou.
/'-...2,-+-4 7t 20 tq4
Uedii5fOilort Signature
anil Delegated Physinien, lf auy
Date
Medicel Directorrs ted Name
and Delegated Physician, if any
c. I hereby acknowledge that the applicatrt_responds routinely to rcscue or medical
inciilents uuder rritteu agreement with my liceused EIVTS system.
Date
Prhted Name
Medical Director's or Authorized Person's Signature
5
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APPLICATION ITEIVI 17 (signature rcquired)
REQUESTtr'ORIVIATCHINGGRT{,NTDISTRIBUTION(ADVANCEPAIt{END
EIVTERGEI{CY MEDICAL SERVICES (&tS)
Goveramental Agency and Non-profit Entity ONLY
Io rcrordeace wi& thc provisioas of prnSnph 401.113(2)(b), F.S., 6c uadcrsigncd hcrcby requcsa ra EMS orahiag
8rrsrdistribudo!(rdvraccpryocat)fortheirProvcocotrodcxpeasiouofprehospitelEMs.
Payment To:City of Dania Eire-ReE cue
loo wesr Dkft'"NffiilA'E?.r3:-i-u"'
AddtBs
Dania,Fla.3004
(City)(Strtc)
Official -//SIGNATURE:DATE:
Printed Nane:bert F1atl ev
SIGNA}TDRETURNWITIIYOITRMATCIIINGGRANTAPPLICATIONTO:
DcPenocot of Hcrtt rnd Rchebilitrtivc Scr''rices
Officc of Eocrgeocy Mcdicrt Scrviccs (IISTM)
EMS Mrtchi.ug GnDls
13 17 Wincwood Boulcvrrd
Tdlrhrsscc, Flori& 3399{700
Approvcd By:
Sigm6p, st.8rc EMS Gnat olficcr
state Flsc.I Year: funount 3 S
M-
DeG:
Oroajiz.a!-,:tg!__e.9.dg
50-20-60-30-100
crant Begj,nning Date 3
obiect code
Ending Date:
-
E=-q-
BS
Eederrl tax ID V F:
6
(z;p)
Title Citv Manager
ec
Fo. U!. Ooly by D.?.rrsEa of Hc.lli lod Rthbiliudvc SGtYier'
Matching G'at A.oo*r,,
*tt ott ac] Mcdicrl scoriccroraat
ID code:
It. ASSI,IRANCES AND APPLICATION SIGNATURE
Certifi ca(ion of Stsndards Staternent
I, the uodcrsigacd, ccnify thtr if greatcd fuads un&r Cbeptcr 4Ot, Psrr II, F-S.l rs eocodcd, dl rpplieble rcauletions rad
surderdr u,ilt bc rdbcrcd ro iacluding: Cbapar 401, F.S.; G.prer l0D{6, F.A.C.; Miaioura Wrgc Ac!; Tide VI of thc
Civil RigbB Act of f964 (42 ISC 2OOOD c!. scg.); DHEW RcgulrrioD (45 CFR Prn 80); Rctebilitetios AcI (Scc 5O4);
Dcvclopocotelly Disrblcd Assisteacc rad Bill of fugbs of 1975 (P.L. 95{02) rs eocodcd by Titlc V of thc
Cooprcbcasivc Rchebilitetivc Scrviccs Aareadocols of l9?t: Coofidcorielity; Huoaa fughts; Hebiliutioo Plans;
Employmcut of tbc Hradicrppcd; Scrviccs for Persoas Uoeblc o Pry.
Staternent of Crsh Commionent
I. thc uodcrsigocd, c€rrify thrt c&eh Eerch tvill bc rvailablc during tbc arrat pcriod rad uscd ia dirtct support of this 3nal
prcjcct. StrE rDd fcderel fuo& will oor bc us.d for aetchirg rcquircE€ols. uoJcss spccificd by lew. No costs or third'
prrty coDrributioDs couot towerds satisfyiag r metchiag rpquircmcut of r dcpanoclt 8r-&! if tbcy ere used !o srtrsfy I
roatchilg requircocat of rDoaber slsrc or fcdenl graat. Cash. salerics, fringc beachr, erPcnses, cquipmeat, ead otbcr
erpcoscs as lisred ou this applicatioD shdl bc corDmittcd and uscd for the dcpartmcD!'s hnal approvcd project duri.ug the
3reot pcriod.
Acceotance of Terms and Conditions
I, the uodcrsigocd, rc€cpt the gnst tcrns rnd conditions in Appcndix B of tbc bookla, '1992 Florid: EMS Matching
Graat Progreo', by tbc Dcpenocot of Hcaltb rad Rcbebiliotivc Scrvic.cs rnd ecklowlcdgc this whco firnds ere drawu or
otbcrwisc obaincd froo the 3raat peyEcat systeE-
Disclaimer
I, the undersigned, bereby ccnify thet the fects and iaforo.etion contiin.d io this epplicetioo and eny follow-up docuurclas
rrc true and @rrcct !o thc bcst of oy knowlcdge, inforratiou, rnd bclicf. I furrier uadcrsuad t}at if il is subscqucutly
ddrrEi-ucd tb.a this is Dor corrcsr, tbc gra.ot firadcd undcr Qrapter 4Ol, Pan II, F.S. end Cbaplcr l0D{6, F.A.C., oey be
revoked, ud etry Eonics crroncously pdd ud i-otcrcst c.mcd will bc refundcd !o thc dcPanmeut with eoy pareldcs which
n:y bc iroposcd by lew or rpplicablc regulatioas.
Notification of Awards
I. tbc uodersigncd, understend the eveilebility of thc ooticc of rwerd will bc advcniscd io the Floride Admidstntivc
Wcckly, rad tbrt 30 calcoder days eftcr this Flori& Admirisr.tive Wcckly edvcniscmcnt I waive any righl to chsllcagc or
proarst i! rayway tbc dccisions to award grants.
of grut fuads irvolvcd,pl intcrcst if en to the dcpanmctlt.
/-(-/7
Signa of Authorized Grant Sig Date
(ladividual Idcntificd in ItcD l)
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 signature.
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Maintcnanca of Improrement rnd Expansion
I, thc uodcrsiglcd, agrec tber asy iEprovcmcot or expansion broughl ebout h wholc or pan by grent funds, will bc
oai-ouiacd for five years after abc projcd cads, unless specificd othcrwisc ia tbc approvcd appliation or unlcss tbe
dcpanmcot egrccs il wriring to rllow e cbaagc. Aay unauthorizcd cheoge withia tbc fivc years will oeccssitatc tbc rctum
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