HomeMy WebLinkAbout2018-01ESD • RESOLUTION NO.2018- 01 ESD
A RESOLUTION OF THE EMERGENCY SERVICES DISTRICT BOARD OF
COMMISSIONERS, INDIAN RIVER COUTY, FLORIDA, AUTHORIZING THE
APPLICATION FOR FUNDING COUNTY EMERGENCY MEDICAL SERVICES
(EMS) GRANT AWARDS TO BE SUBMITTED TO THE STATE OF FLORIDA
• DEPARTMENT OF HEALTH, BUREAU OF EMERGENCY MEDICAL
SERVICES.
WHEREAS, The Florida Department of Health, Bureau of Emergency Medical Services announced that
applications for funding County Emergency Medical Services (EMS) Grant awards are now being accepted and a
grant application has been prepared for Indian River County;and
WHEREAS,an application for grant funds for fiscal year 2018/2019 has been prepared by the County;and
NOW, THEREFORE, BE IT RESOLVED BY THE EMERGENCY SERVICES DISTRICT BOARD OF
COMMISSIONERS OF INDIAN RIVER COUNTY, FLORIDA, that the Chairman is authorized to sign and
execute the application for EMS grant funds certifying that monies from the EMS Grant Program For Counties will
improve and expand the County's pre hospital EMS system and that the funds will not be used to supplant existing
County EMS budget allocations.
The foregoing Resolution was offered by Commissioner Solari
Who moved its adoption.The motion was seconded by Commissioner •Adams and,upon being put to a
vote,the vote was as follows:
Commissioner Joseph E.Flescher AYE
Chairman,Peter D. O'Bryan AYE
Commissioner Tim Zorc AYE
Vice-Chairman Bob Solari AYE
Commissioner Susan Adams AYE
The Chairperson thereupon declared the resolution duly passed and adopted this second day of October,2018.
. ..
.1-siONER:§*••••
.......
EMERGENCY SEVICES DISTRICT
BOARD 0 CO ISSIONER
,„ :N.•
INDIAN ", rA. A
BY: / alp 411111r* • :c);
• !Mkt„
Peter D. O'Bryan,Chaan tc" 111
•
• •
ATTEST: Jef ey R. Srn7:04.; lerk of Court •.. .
dComp ........•
BY: APPROVED
p y Cle ,
Approved as to form and legal
sufficienc : •
Pf‘P *kik
Count, inistrator
BA/V
William K.DeBraal
Assistant County Attorney
• ,: EMS COUNTY GRANT APPLICATION
1.
:- FLORIDA DEPARTMENT OF HEALTH
ori • a Emergency Medical Services Program o
o
HEALTH Complete all items w
0
ID.Code(The State EMS Program will assign the ID Code—leave this blank) C70 _ x
.°)
1. County Name: .:Indian River County 1
Business Address:. 1801 27th Street ..•N
Vero Beach, Fl 32960 ti \
Telephone: 772-226-3900 �`
Federal Tax ID Number(Nine Digit Number): VF 59-60006764 a x
h
2. Certification: (The applicant signatory whohas authority to sign contracts, grants, and other legal (4-1`:i 51
documents for the county) I certify that all information and data in this EMS county grant application and '
its attachments are true correct. My sig ature acknowledges and assures that the county shall 1-3 L
comply fully with the con. if .a•utli d i arida EMS County Grant Application. 1` •
Signature: H lb
ene..n„n�
gDate: 10/02/2018
issio,; w
Printed Name: Peter D. O'Bryan. 174/4 ,+••••j�M,,.......6'c.. .
Position Title: : Chairman, Board of County Commissit le s : , P
rQ
3 Contact Person (The individual with direct knowledge of the 5r. k.u nt'-i day-td•�ay basis and has.
responsibility for the.implementation of the grant activities. This; .fson ice' "'6.,:ze¢ sign project
reports and may request project changes. The signer and the contact per-'yi',4,- y.f ..the same.)
%Name: Steve Greer �ti,•,.(4 •.-:••��*.
Position Title: Training Captain �`'NrtivEa""
Address: 4225 43rd Avenue_
Vero Beach,FL 32967
Telephone: 772-226-3864 . . Fax Number: 772-226-3868
E-mail Address: sgreer@ircgov.com
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)
DH 1684, December 2008(Rev.July,2018) 64J-1.015, F.A.C.
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 travelcosts 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
Documed Interface with TrackEMS 5,000.00
Ballistic Vest 14731.00
Total Expenses = $19,731.00
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
Total Vehicles"&Equipment= $ : 0.00
Grand Total= ..$19,731.00
DH 1684, December 2008
2
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: :
Theagency name, address, and federal ID number must be inthe state MyFloridaMarketPlace (MFMP)
system..Ask a finance person in your organization who does business with the state to provide these
Name of Agency: Indian.River County Finance
Mailing Address: 1801 27t''Street, Building A
Vero Beach, FL.32960
Federal 9-digit Identification nu er VF 59-60006764' „v.ssior��R,s'°°,:. 3-digit seq. code 070
Authorized County Official: .e.64___ /,�0,44 �� q
✓" / •�' �10/02/2 ,18
ATTEST: Jeffr- R. Sm' lerjgnature. =z� 4,,, , : Date:o=
, ourt .�.. . stroller °v i
/� Peter D. O'Bryan, Chairman ►..,�•. �>:slaw_;' .:
BY: i / __ Type or Print Name and Title 't:
II-. y Cler. �. ••..•�'�N • 'P�o
•.• DIA RN .••'±
Sign and return this page with your applicafion�r . ''
Florida Department of Health
Emergency Medical Services Unit, Grants
4052 Bald Cypress Way, Bin.A-22 .
Tallahassee, Florida 32399-1722
Do not write below this line. For use by State Emergency Medical Services Section
Grant Amount for State to Pay: $ Grant ID:. Code: C70
_Approved By:
Signature of State EMS Unit Supervisor . . Date
Approved By: Signature of Contract Manager Date
State Fiscal Year: 2018 - 2019
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 FAC.64J-1.015
3