HomeMy WebLinkAbout2020-001ESDRESOLUTION NO: .E_St) 2020-001
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 2020/2021 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 Peter D. O'BrvaWho moved its adoption. The
motion was seconded by Commissioner Joseph Earman and, upon being put to a vote, the vote was as follows:
Chairman Joseph E. Flescher
Vice -Chairman Peter D. O'Bryan
Commissioner Joseph Earman
Commissioner Laura Moss
Commissioner Susan Adams
AYE
AYE
AYE
AYE
AYE
The Chairman thereupon declared the resolution duly passed and adopted this first day of December,2(i�p j�j,1i�•
_ � � •:cin
EMERGENCY SEVICES DISTRICT
BOARD OF COMMI IONERS� z
INDRIVER C
BY
ATTEST:
effrey R. Smith, Clerk of
Court and Comptroller
Approved as to form and legal
sufficiency:
By
CW'illiam K. DeBraal
Deputy County Attorney
APPROVED
�l
Coun y A ministrator
Flescher,
CQUNTV
A TRUE COPY
CERTIFICATION ON LAST PAGE
Instructions: County Government Application Form 2020-2021 J.R. SMITH, CLERK
The amount of your new grant is in the "Total" column of the county amount table accessible at the state EMS
website link.
The first application form page has five numbered items. The first three are self-explanatory.
However, note that item 2 on the first application page is where the county's authorized person must provide his/her
signature and date.
Item 4 describes the content of the "resolution." Please provide this in your county's customary format and approval
process. The resolution must be current; or if a previous resolution has continuing authority, include a message
from a lead county official stating that the resolution is still in -effect, with a copy of it.
Item 5 of the first page of the application form asks for the name of the organization(s) to which you decide to
allocate funds from your new county grant. The second page of the application form is the budget page. One of
these budget pages is needed for each organization listed in item 5.
The budget page for each organization must have on it specific and quantifiable items or services, with the cost for
each unit or type of item or service. However, all costs in your budget combined must total to the exact amount of
total new funds for your grant. You can request budget changes and add unexpended previous funds after the new
grant begins.
Your budget totals in the application should be added for you if you place your cursor over a subtotal or total field,
right click your mouse, then left click "Update Field" on the resulting menu.
You should copy this form on your computer to use it. If you place the application in restricted editing mode, you can
use your keyboard Tab key to go from field to field.
Request for Grant Fund Distribution Form
Request for Grant Fund Distribution Form: this is the last page herein and you must complete the top part of the
form. State EMS will complete the bottom part, as indicated on the form. Your address on this form must be an
address in the state MyFlorida Marketplace (MFMP) system. A mailing address you place on this form is not usable
by state finance if it is not in the MFMP system.
Ask a staff member of your organization who does cash transactions with the state for the organization name to use
on the top half of the Distribution Form, the corresponding address and its 9 -digit federal tax ID plus its 3 -digit
sequence code. Otherwise, no funds can be sent to you until this situation is resolved.
If needed, you can contact MFMP customer service at 1-866-352-3776, Monday to Friday, 8 a.m. to 6 p.m., or at the
website: MyFloridaMarketPlace(a)dms.myflorida com
A TRUE COPY
CERTIFICATION ON LAST PAGE
J.R. SMITH, CLERK
FLORIDA DEPARTMENT OF HEALTH
Emergency Medical Services Section
MOM EMS County Grant Application
HEALTH
ID Code The State EMS Program will assign the ID Code — leave this blank
1. Count Name: Indian River Count
Business Address: 1800 2711 St
Vero Beach, FL 32960
Telephone: 772 226-3900
Federal Tax ID Number Nine Digit Number): VF 59-60006764
2. Certification: (The applicant signatory who has au , ojifi/contracts, grants, and other legal
documents for the county) I certify that all informatitji.an 4ata in' MS county grant application and its
attachments are true and correct. My signature aeknowl s an as Vires that the county shall comply
fully with the conditions outline the Florida ERAS. oun pption.
Signature: Date: December 1, 2020
Printed N Jos h E. Flesc er ;�% ._ 7
Position itleA hairman, Board of Countv Comm`rs4ioners•
3. Contact Person: (The individual with direct knowledge of the project on a day-to-day basis and has
responsibility for the implementation of the grant activities. This person is authorized to sign project reports
and may request project changes. The signer and the contact person may be the same.)
Name: Stephen R. Greer
Position Title: Captain
Address: 4225 43rd Ave.
Vero Beach, FL 32967
Telephone: 772 226-3951 Fax Number: 772 978-1820
Email 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, DeCemb &(&yi,4lly2Xi1$
lGOLD
r " i- a TORNEY
Rule 64J-1.015, Florida Administrative Code
Attest: Jeffrey R. Smith, Clerk of
Circuit Court and Comptroller
Wal,
`1
`� Deputy Clerk
BUDGET PAGE
A. Salaries and Benefits:
A TRUE COPY
CERTIFICATION ON LAST PAGE
J.R. SMITH, CLERK
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 travel costs 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 I Amount
I_ Total Expenses = I $ 0.001
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
Three (3) Elegard Heads Up CPR Devices $18,951.00
Total Vehicles & Equipment = I $ 18,951.00
Grand Total =
DH 1684, December 2008
$ 18,951.00
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:
The county name, address, and corresponding federal ID number r; USIL be in the state MyFloridaMarketPlace
(MFMP) system. A finance person in your organization who does business with the state must provide these.
Name of County: Indian River County Board of County Commissioners
Mailing Address: 1800 27th Street
Vero Beach, FL 32960
Federal 9 -digit Identification number: VF 59-60006764
Authorized County Official:
3 -digit seq. code 070
Signature Date
Joseph E. Flescher, Chairman
Type or Print Name and Title
December 1, 2020
Sign and return this page with your application to: APPROVED AS TO FORM
Florida Department of Health AiND LEGAL SUFFICIENC`
Emergency Medical Services Unit, Grants
4052 Bald Cypress Way, Bin A-22 BY
Tallahassee, Florida 32399-1722 DYLAN 2EIiNGOLD
COUNTY A T l 0R1-iEY
Do not write below this line. For use by State
Grant Amount for State to Pay: $
Approved By:
Approved By:
Signature of State EMS Unit Supervisor
Signature of Contract Manager
State Fiscal Year: 2020-2021
Organization Code E. 0. OCA
64-61-70-30-000 05 SF005
Federal Tax ID: VF
Grant Beginning Date:
envy Medical Services Section
Grant ID: Code:
Date , ` FLORIDA
I INDIAN RIVER COUNTY
CERTIFY THAT THIS IS
Date...: ;%ND CORRECT COPY OF
;E ORIGINAL ON FjLE IN THIS
FF I e 6'
I BY /.Z
Object Code CategoryrE
751000 059998 '_
Sequence Code: _
Grant Ending Date:
R.
DH 1767P, December 2008 (rev. June 8, 2018), incorporated by reference in Rule 64J-1.015, Florida Administrative Code
3