My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
2023-215A
CBCC
>
Official Documents
>
2020's
>
2023
>
2023-215A
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/2/2023 1:26:27 PM
Creation date
11/2/2023 1:16:11 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/26/2023
Control Number
2023-215A
Agenda Item Number
15.A.2.
Entity Name
State of Florida Agency for health Care Administration
Subject
Letter of Agreement for Public Emergency Medical Transportation
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
7
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
iHCARP., <br />a z° <br />OF FIOR��P <br />A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />Intergovernmental Transfers Questionnaire <br />IGT Provider Name: Indian River Count <br />Health Care Provider Name: <br />IGT Amount: $363,337.25 <br />State Fiscal Year Ending: 6/30/2024 <br />1. What type of governmental entity is your organization considered? (county, city, hospital taxing <br />district, or other) <br />County <br />If other, please explain <br />The Emergency Services District is a Dependent Special District of Indian River County <br />2. Does your organization have a relationship with the provider for which you contribute IGTs as named <br />in the preamble of the enclosed Letter of Agreement (LOA)? <br />Yes <br />If yes, please describe your relationship, including services provided to/by the provider to/by the <br />organization and any other financial transactions between the provider and the organization. <br />The District is both the provider of and the agency that will be making the required IGT. <br />3. Please describe the source of the IGT funding for your organization, including whether the source is <br />from a tax, a provider donation, or other funds. Provide the amount of funding from each source. <br />Source Amount <br />Ad Valorem Tax Revenue FY 23/24 Budget $ 363,337 <br />If other, please explain <br />a. Verify whether the funds are public funds as defined by 42 CFR § 433.51, and exclude any <br />federal funds. <br />Yes <br />If no, please explain <br />4. Does your organization have taxing authority? <br />Yes <br />
The URL can be used to link to this page
Your browser does not support the video tag.