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HomeMy WebLinkAbout25F - AGMT - EMERGENCY TRANSPORTATION SRVSREQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: SEPTEMBER 17, 2012 TITLE: APPROVAL OF FIRE/EMS EMERGENCY AMBULANCE TRANSPORTATION AND RELATED SERVICES AGREEMENT CITY MANAGER RECOMMENDED ACTION Staff recommends that the Mayor and City Council: CLERK OF COUNCIL USE ONLY: APPROVED ? As Recommended ? As Amended ? Ordinance on 1s' Reading ? Ordinance on 2nd Reading ? Implementing Resolution ? Set Public Hearing For_ CONTINUED TO FILE NUMBER 1. Elect to retain final contract selection and contract award authority for Exclusive Operating Area 20 - City of Santa Ana 2. Approve the professional grading panel recommendation to select CARE Ambulance Services, as the 9-1-1 Emergency Ambulance Service provider for the City of Santa Ana effective September 20, 2012, and authorize the City Manager to execute the three-year Agreement including any non-substantive amendments as determined by the City Attorney in an amount not to exceed the three-year total contract amount of $2,881,675 for the first year, $2,968,125 for year two and $3,057,169 for year three; and 3. Authorize the City Manager to execute two optional one-year extensions for a possible total contract period of five years; and 4. Upon completion of a cost analysis review of outsourcing the ambulance billing function, if the results reflect an overall positive benefit to the City of Santa Ana, authorize the City Manager to enter into an agreement with CARE Ambulance Services to perform the 9-1-1 ambulance billing for the City of Santa Ana at the agreed upon rates as stated within the bid submittal. DISCUSSION Competitive Process for Exclusive Operatinq Area #20 for Ambulance Service Pursuant to the Emergency Medical Services (EMS) act, only the County may create Exclusive Operating Areas (EOA) for the provision of ambulance services. The City of Santa Ana was established as EOA No. 20 and, until the transition to the Orange County Fire Authority (OCFA), was not required to conduct the competitive process as the 9-1-1 transportation service was provided by city firefighter personnel prior to 1980 and therefore exempt from the EMS statue that requires the process competitive. 25F-1 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 2 The act only requires that the competitive bid process occurs for agencies that change their method of 9-1-1 transportation service delivery after 1980. Effective April 20, 2012, Santa Ana transitioned to the OCFA and, as part of the transition, now contracts out 9-1-1 emergency transportation services. Consistent with the EMS Act, the city is required to conduct a competitive bid process. Under the State EMS guidelines, the County must conduct the competitive process for the selection and award of exclusive operating areas in order for jurisdictions to avoid anti-trust liability. The County has delegated its responsibility for conducting the competitive process to the OCFA for all OCFA jurisdictional areas except the cities of Buena Park, San Clemente, and Westminster. While the competitive process was delegated to the OCFA, the State and County EMS agencies are still responsible for ensuring the process is fair and competitive and have ultimate oversight responsibility, including the review and approval of all RFP documents. Contracting Authority Under the current County EMS system, OCFA member cities may decide whether they want to retain final selection and contracting authority for themselves or whether they want to delegate such authority to the OCFA Board of Directors. Currently, approximately half of OCFA cities have elected to retain final selection and contracting authority, while half have delegated such responsibility to OCFA. Recommended action number one of this staff report will formalize the City of Santa Ana election to retain the selection and award authority. Summary of the RFP process The Orange County Fire Authority (OCFA), on behalf of the City of Santa Ana, developed and issued Phase I (the Prequalification Phase) of the Request for Proposals for Fire/EMS Emergency Ambulance Transportation and Related Services. The Phase I RFP announcement was sent to the Ambulance Association of Orange County and all licensed Orange County ambulance providers on February 22, 2012. The purpose of Phase I was to ensure that qualified and experienced 9-1-1 providers were offered the opportunity to participate in Phase II (Proposal, Grading, Recommendation, and Selection) of the RFP process. The Phase I RFP was issued on February 23, 2012. Key components and submittal requirements of the Phase I included: • A resume of recent (9-1-1 emergency ambulance transportation experience) • Submission of audited financial statements • Acknowledgement of willingness to commit to the insurance requirements • Litigation and Performance History 25F-2 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 3 • Agreement to the terms and conditions specified in the RFP As part of the Phase I RFP process, OCFA and Santa Ana staff conducted a Mandatory Bidder's Conference was held on February 29, 2012. There were 24 individuals who attended the meeting representing 13 potential bidders (AmeriCARE, CARE, Doctors, GCTI, Gerber, Lynch, Medix, Pacific, Premier, Priority, Rural Metro, Schaefer, and Shoreline). During the conference, staff outlined the following key components of the RFP: 1. Scope: Provide sufficient number of ambulances to respond to 100% of the 9-1-1 call volume within response time requirements. 2. Experience Requirements: Must have recent and comparable 9-1-1 transport experience equivalent to 80% of 2011 call volume not transports 1. Response Requirements: Bidder must strictly adhere to the following minimum required response times at a quarterly compliance rate of ninety percent (90%) in each Code 2 and Code 3 categories, which shall be reported separately: 2. Code 3-Response time must not exceed ten (10) minutes, zero (0) seconds. 3. Code 2-Response time must not exceed fifteen (15) minutes, zero (0) seconds. 3. Vehicles: Selected provider will be required to provide and incur all costs (including gas/repair maintenance costs) for Type III ambulances for Tier I and II service 4. Billing: City will retain billing authority/responsibility for all calls and transports within the City of Santa Ana 5. Phase 2 may include an option that the selected provider bills on behalf of the City of Santa Ana and remits all revenue back 6. Bid Submittal Cost: Proposal must be all inclusive for all First, Second, and Mutual Aid Emergency Transportation Services within the City of Santa Ana 7. Housing: Bid submittal should assume units will not be housed in Santa Ana Fire Stations or facilities. Staff also presented a summary of the 2011 historical call and transportation data for the City of Santa Ana. Phase 1 (Prequalification) Results On March 5, 2012, OCFA received proposals from eight (8) ambulance providers. Of the eight submissions four were disqualified for insufficient 9-1-1 experience, and one for not providing recent audited financial statements. The selection panel established the following companies as meeting or exceeding the RFP requirements and were allowed to compete in Phase II of the RFP process: • CARE Ambulance Services Inc. (CARE) • Doctors Ambulance Services Inc. (Doctors) • Schaefer Ambulance Services Inc. (Schaefer) 25F-3 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 4 Request for an Interim 9-1-1 Ambulance Transportation Provider Due to the time required to review, grade, and award the Phase II Emergency Ambulance Transportation contract, OCFA and Santa Ana staff received authority from the Orange County Emergency Medical Services Agency (OCEMSA) to issue an interim Request for Proposal for 9- 1-1 Ambulance Transportation Services until the evaluation and award of the Phase II process could be completed. The requirements to submit a proposal for the interim period were: • Current OC licensed 9-1-1 ambulance provider • 9-1-1 experience with a system similar to the size of Santa Ana • Adhere to the response time criteria • Agree to insurance requirements The RFP for the interim period was issued on March 20, 2012. The two submittals received were from CARE and Doctors. Subsequent to their submittal, Doctors withdrew their bid. CARE Ambulance was the sole bidder that met the requirements of the RFP. On April 2, 2012, the City Council authorized award of the interim contract to CARE effective April 20, 2012 for an initial 120 days and has been extended 30 days and is currently set to expire September 20, 2012. Phase 11 - Proposal Submission, Grading, Recommendation and Selection On June 14, 2012, OCFA issued the Phase II RFP to the three providers (CARE, Doctors, and Schaefer) who met the minimum requirements of Phase I. The Phase II RFP requested bidders to submit responses to 16 areas. Included in the RFP, was the requirement to attend a Mandatory Bidder's Conference that was held on June 27, 2012. Bidders were given the opportunity to submit written questions to staff regarding the RFP prior to the conference. During the conference (attended by all three prequalified bidders), staff answered all pre-submitted questions from the providers. Staff also summarized the key factors that would be used by the grading panel: A. Experience of the Proposer; B. Financial strength/stability of the Proposer; C. Cost to City; D. Quality of service to be provided; E. Level of service to be provided; F. Experience and qualifications of the Transportation Personnel who will provide services to the City of Santa Ana under the proposed contract; G. Training of replacement Transportation Personnel when one or more leaves; and H. Whether a Proposer is responsible. The term "responsible" refers not only to the attribute of trustworthiness, but also to the quality, fitness, and capacity of the Proposer to perform the proposed services satisfactorily and in accordance with the specifications and delivery criteria set forth herein. 25F-4 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 5 Staff also provided bidders with updated 9-1-1 Santa Ana EMS call and transport statistics based on actual volume from the first 60 days of the transition to OCFA. Public Bid Opening On July 9, 2012, proposals were received from all three prequalified providers. Consistent with the State EMS requirements, a public bid opening was conducted. During the bid opening, the following information was released and made public with all three bidders in attendance: A. RFP number B. Submission date C. General description of service being procured D. Names of responders E. Amounts proposed: a. Transports for Initial Year Service Period b. Optional: Transports + Ambulance Billing Evaluation Process Oversight Orange County Emergency Medical Services (OCEMS) staff have been involved in the RFP Process (both Phase I and II) since inception. Consistent with the State guidelines, the role of OCEMS oversight is to ensure that the RFP process (from issuance of the RFP to ultimate contract award) was conducted in a fair and competitive manner. The competitive RFP process utilized by City of Santa Ana, including Phase I and II RFP's, was submitted to Orange County EMSA (OCEMSA) and the State Emergency Medical Services Authority and was approved by both agencies. Overview of Proposal Evaluation Process in Phase 11 The focus of the comprehensive evaluation process was to select the bidder that provided the most thorough, and competitive bid proposal and program design that would meet or exceed the performance standards set forth in the RFP. All three proposals proceeded to the evaluation process, which was designed to accomplish the following goals: • Provide a method of evaluating each proposal not just on its own merits, but as it compares to the other proposals under evaluation. • Provide a method of evaluation that is fair and unbiased. • Provide a method that evaluates the: ¦ Bidder's business as a whole, and ¦ 2) Proposal specific to the operational needs of the City of Santa Ana in the delivery of 9-1-1 emergency transportation services. 25F-5 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 6 PrnrPCC As stated above, the rating process was designed to provide a method that evaluates the Bidder's business as a whole and evaluates the proposal specific to the operational requirements of the city in the delivery of 9-1-1 emergency transportation services as listed in the RFP. Each member of the Proposal Grading Panel reviewed eight (8) categories defined as Item Numbers 2,3,4,5,7,10,11,13 on the rating sheet. Each member of the Grading Panel ranked the proposal responses from best to least responsive (a ranking of "1" would reflect the best response). Responses were limited to a rating of 1, 2 or 3. The Grading Panel could, however, assign the same ranking for a given item to more than one Bidder if it was thought that the proposals for a given item were equivalent. The listed requirements within each Item Number were assigned a weighting based on the item's relative importance. A final "score" was derived by averaging the individual Grading Panel Members' rankings for each item, multiplying this number by the relative weight assigned to the item, and then calculating the cumulative score. Using this methodology, the lowest weighted average numerical score would reflect the best proposal. RFP Grading Panel The RFP Grading Panel consisted of three `primary evaluators' and two OCFA `staff evaluators'. The primary evaluators included an OCFA Fire Captain with over 22 years of front line experience with the City of Santa Ana Fire Department, OCFA's EMS Coordinator with extensive EMS experience including ten years with the Orange County EMS agency as Program Manager. As part of his Program Manager responsibilities, he was responsible for the oversight of all 9-1-1 Emergency Ambulance Transportation RFP in the County to ensure they were fair and competitive and consistent with State guidelines. The third primary evaluator was a Sergeant from the City of Santa Ana with 17 years of experience working in the city with first-hand experience dealing with the community and Fire/EMS responders. The primary evaluators reviewed and evaluated the eight (8) narrative responses. To avoid any bias or conflict of interest, the panel evaluators were not provided the relative weighting for each item. The staff evaluators were the OCFA EMS Battalion Chief and Finance Manager/Auditor, both with extensive experience with EMS Request for Proposals. The two staff evaluators evaluated the eight (8) mandatory requirements (Mutual Aid, HIPAA Compliance, Corporate Compliance, Phase I Approval, Conflict of Interest, Statement of Truth, Non-Collusions, and Agreement to provide insurance) of the proposal for compliance. The mandatory submission items were not graded or ranked, but rather checked for inclusion and completeness by the staff evaluators. Grading Criteria 25F-6 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 7 The proposal primary evaluators ranked each bid proposal according to established criteria. As stated in the RFP, the evaluators used the following criteria during their review for this RFP: 1. Quality of service; 2. Level of service; 3. Cost; 4. Experience; 5. Whether a Bidder is responsible. The term "responsible" referred to the quality, fitness, and capacity of the Bidder to perform the proposed services satisfactorily and in accordance with the specifications and delivery criteria. Gradinq Panel Final Evaluations The proposals from the three bidders were evaluated by the three primary evaluators for assessment and scoring. The panel completed its grading and also conducted a site visit at all three proposer's facilities. During the site visits each bidder was provided an opportunity to present key points of their proposal, and as appropriate, respond to bid clarification requests from the grading panel. The site visit also provided the panel the opportunity to validate elements of the bidder's proposal to ensure that each bid proposal was complete and accurate. Attachment 1 is a summary of the Proposal Grading Results. The Grading Panel recommends that the City's service agreement be awarded to the bidder with the lowest numerical score. Evaluation Panel Ratings and Recommendation The Grading Panel final rankings of the bidders for the City of Santa Ana 9-1-1 Contract were as follows: (with the lower score being better) Provider Final Score, Rank of Proposal CARE 113.3 1 (Panel Recommended) Doctors 211.7 2 Schaefer 230 3 Additional Services Option- Ambulance Billing Services In addition to providing proposals for Ambulance transportation and related services, bidders were offered the opportunity to bid on performing the billing service on behalf of the city. Both CARE and Schaefer submitted proposals, Doctors did not. The proposed costs were $17.50 (CARE) and $17.40 (Schaefer) respectively per transport. Staff is recommending that a cost analysis and study be performed to decide if the optional billing service is beneficial for the City of Santa Ana. Upon further analysis and successful completion of the study, should the City decide to implement this option, the city would enter into a contract with the selected provider to 25F-7 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 8 perform the billing service. The specific terms and conditions of the contract would be agreed upon by the City Manager, Contractor, and City Attorney. SUMMARY: The proposals were similar in overall content; although, there were notable differences between the three companies in terms of, responses to the RFP requirements, 9-1-1 operating experience, and depth of resources. While Schaefer did submit the most competitive priced bid the panel felt that the bid submittal lacked sufficient detail and was ambiguous in many areas. Specific areas of concern with Schaefer's response to the overall operational system that lack detail, poor discussion at the personnel and training, did not have the current communication equipment but was committed to acquire it. Schaefer does not currently have any 9-1-1 contracts with other Orange County jurisdictions. Some of the answers to the points were incomplete. The evaluation panel also felt that Schaeffer did not appear to have sufficient depth of management required to manage the contract. Doctors submitted the highest cost for providing the service. While ranked as number 2, Doctors also did not provide comprehensive answers to a number of the RFP requirements as CARE. They also bid up to 8 units based on the call load, but the proposal reflects a cost almost $2.9 million greater than Schaefer and $2.0 million greater than CARE's proposal. All three providers were given the Santa Ana call and transport volume analysis, so the proposed price is unreasonable in the panels opinion. CARE was unanimously rated as number 1 overall. Other than price, CARE provided the most comprehensive and robust response to the overall RFP requirements. Additionally, CARE has the required communication equipment, and has agreed to a response time commitment to meet code 2 and code 3 response times 93% (rather than the RFP 90%) of the time. CARE also proposed a dedicated level of supervisory and management oversight in support of the Santa Ana contract. CARE is also CAAS accredited and has a depth of local/regional resources serving other Orange County 9-1-1 ambulance contracts. Listed below are some comparisons of the proposals submitted by CARE, Doctors, and Schaefer. The list is not intended to be all-inclusive. Key Areas CARE Doctors Schaefer Cor orate CARE Corporate Doctor's corporate Schaefer corporate 25F-8 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 9 Headquarters headquarters, facilities and dispatch center are located in Orange, California. headquarters and dispatch center are located in Laguna Hills, California. headquarters and dispatch center (Pomona) are located in Los Angeles, California. Schaefer has a satellite office on Bristol Street in Santa Ana. Company History and 9-1-1 Experience CHAS Certification (The intent of the CAAS Standards is to define a "gold standard" for the medical transportation industry of a higher caliber than is typically required for state or local licensing. There are approximately 120 CARE was incorporated in March 1988. CARE responds to approximately 98,000 9-1-1 calls annually in both Orange and Los Angeles County. In addition to 22 cities and communities in South-East Los Angeles area, CARE currently provides 9- 1-1 service to the following Orange County EOA's; Anaheim, Buena Park, Costa Mesa, Cypress, Fountain Valley, Fullerton, Garden Grove, La Palma, Los Alamitos, Seal Beach, and Stanton CARE has been accredited by the Commission on Accreditation of Ambulance Services (CAAS) since 1993. Doctor's Ambulance Service has been providing emergency ambulance services to the residents and visitors of Orange County for over 34 years. It responds to over 74,000 9-1-1 calls annually. Doctor's currently provides service to Irvine, Laguna Woods, Dana Point, Laguna Hills, Tustin, Aliso Viejo and Laguna Beach. Doctor's has been accredited by the Commission on Accreditation of Ambulance Services (CAAS) since 2002. Schaefer Ambulance Service, Inc. has been providing emergency ambulance services to the residents and visitors of Imperial County for over 37 years and LA County Fire District for over 6 years. It responds to approximately over 44,000 9-1-1 calls annually. Actively pursuing CAAS certification. 25F-9 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 10 ambulance services throughout the United States that are CAAS accredited.) Mutual Aid CARE is a party to the Doctor's is a party to Schaefer is a party to Agreements existing Master the existing Master the existing Master Mutual Aid Mutual Aid Mutual Aid Agreements between Agreements between Agreements between OCFA 9-1-1 contract OCFA 9-1-1 contract OCFA 9-1-1 contract providers. providers. providers. Communications CARE's entire fleet Doctor's entire fleet Schaefer is fully includes 800 HHz includes 800 HHz committed to acquire radios located within radios located within all radio and the units and the the units and the communications dispatch center. dispatch center. equipment required in During the site visit, the RFP, including the evaluation panel 800 HHz radios noted that CARE's located within the communication center units and the dispatch had redundant backup center. systems including the ability to dispatch the fleet from command vehicles and a remote back up site. Proposed Cost CARE submitted the Doctor's submitted the Schaefer submitted the following cost following cost following cost proposal for year one: proposal for year one: proposal for year one: $ 2,881,675 annually $ 4,955,004 $ 2,061,700 $240,140 not to $416,285 not to $171,808 not to exceed monthly exceed monthly exceed monthly Fleet Size and CARE maintains a Doctor's maintains a Schaefer maintains a Proposed Type fleet of 13 0, 9-1-1 fleet of 28, 9-1-1 fleet of 71, 9-1-1 III Ambulances ready ambulances in ready ambulances in ready ambulances in Orange County. Orange County. Los Angeles, Pomona, and Imperial County. Response Time CARE proposes to Doctor's proposes to Schaefer proposes to meet the Code 2 and meet the Code 2 and meet the Code 2 and (The minimum Code 3 response time Code 3 response time Code 3 response time requirement is 90 requirements 93% of requirements 90% of requirements 90% of 25F-10 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 11 %.) the time. the time. the time. Number of Units 7 dedicated units 8 units 6 dedicated units The panel unanimously recommends CARE Ambulance Service as the 9-1-1 emergency transportation provider for the City of Santa Ana. FISCAL IMPACT The new agreement will be effective for an initial term of three years, with an option to extend the agreement up to an additional two years. The city currently receives approximately $3,500,000 annual in 9-1-1 ambulance transportation and subscription revenue. Costs for the three-year agreement for Fire/EMS emergency ambulance transportation services with CARE Ambulance Service are as follows: Descriptibn Year 1 Year 2 Year 3 Total Annual Cost Annual Cost Annual Cost $9,906,969 Ambulance $ 2,881,675 $ 2,968,125 $ 3,057,169 CARE Transport S i Monthly Cost Monthly Cost Monthly Cost erv ces not to not to not to $742,248 exceed exceed exceed $240,140 $247,344 $254,764 Optional year renewal pricing (if exercised) are as follows: DescTiption Annual Contract 1-Year Ambulance Annual Cost Transport Services $ 3,148,884 1-Year Ambulance Annual Cost Transport Services $ 3,243,250 Optional Ambulance Billing CARE Ambulance billing per transport: 25F-11 Approval of Fire/EMS Emergency Ambulance Transportation and Related Services Agreement September 17, 2012 Page 12 Year 1- $17.50 per transport Year 2- $18.00 per transport Year 3- $18.50 per transport Year 4- $19.00 per transport Year 5- $19.50 per transport ATTACHMENTS: 1. Summary of Proposal Grading Results: a. Grading Results by Total Points b. Grading Results by Percentage of Total Points 2. Phase 11 RFP I Agreement for Fire/EMS Emergency Ambulance Transportation and Related Services 25F-12 Attachment 1: City of Santa Ana Phase II Ambulance RFP Score Summaries CARE AMBULANCE Weighted Weighted Evaluation Categories Score Staff Evaluator) Evaluator2 Evaluator3 Total Average Average 1. Cover Letter Pass 2. General Overall Plan to Provide Emergency Services 10 1 1 1 3 1 0 3. Overall Operational System 10 1 1 1 3 1 10 4. Driver Training 10 1 1 1 3 1 10 5. Internal Medical Quality Control 10 1 1 1 3 1 10 6. Mutual Aid Provider Pass 7. Personnel and Training 10 1 1 1 3 1 10 8. HIPAA Compliance Plan Pass 9. Corporate Compliance Plan Pass 10. Plan for Takeover of Service/Start-Up 15 2 1 1 4 1.3 20 11. EMS Resume 15 2 1 1 4 1.3 20 12. Phase I Approval Notification Pass 13. Price Worksheet-Transport Only 20 1 2 2 5 1.7 33.3 13B. Price Worksheet-Transport & Optional Billing 14. Conflict of Interest Certification Pass 15. Statement of Truth Pass 16. Non-collusion Certification Pass 17. Photographs (Optional) N/A TOTALS: 100 Pass 10 9 9 28 9.3 113.3• DOCTORS AMBULANCE Weighted Weighted Evaluation Categories Score Staff Evaluatorl Evaluator2 Evaluator3 Total Average Average 1. Cover Letter Pass 2. General Overall Plan to Provide Emergency Services 10 1 3 2 6 2 20 3. Overall Operational System 10 2 2 2 6 2 20 4. Driver Training 10 2 2 2 6 2 20 5. Internal Medical Quality Control 10 3 2 1 6 2 20 6. Mutual Aid Provider Pass 0 0 0 7. Personnel and Training 10 2 2 1 5 1.7 16.7 8. HIPAA Compliance Plan Pass 0 0 0 9. Corporate Compliance Plan Pass 0 0 0 10. Plan for Takeover of Service/Start-Up 15 2 2 2 6 2 30 11. EMS Resume 15 1 3 1 5 1.7 25 12. Phase I Approval Notification Pass 0 0 0 13. Price Worksheet-Transport Only 20 3 3 3 9 3 60 13B. Price Worksheet-Transport & Optional Billing 14. Conflict of Interest Certification Pass 15. Statement of Truth Pass 16. Non-collusion Certification Pass 17. Photographs (Optional) N/A TOTALS: 100 Pass 16 19 14 49 16.3 211.7 SCHAEFER AMBULANCE Weighted Weighted Evaluation Categories Score Staff Evaluator) Evaluator2 Evaluator3 Total Average Average 1. Cover Letter Pass 2. General Overall Plan to Provide Emergency Services 10 3 2 3 8 2.7 26.7 3. Overall Operational System 10 3 3 3 9 3 30 4. Driver Training 10 2 3 3 8 2.7 26.7 5. Internal Medical Quality Control 10 2 2 2 6 2 20 6. Mutual Aid Provider Pass 0 0 0 7. Personnel and Training 10 3 3 2 8 2.7 26.7 8. HIPAA Compliance Plan Pass 0 0 0 9. Corporate Compliance Plan Pass 0 0 0 10. Plan for Takeover of Service/Start-Up 15 3 3 3 9 3 45 11. EMS Resume 15 3 2 2 7 2.3 35 12. Phase I Approval Notification Pass 0 0 0 13. Price Worksheet-Transport Only 20 1 1 1 3 1 20 136. Price Worksheet-Transport & Optional Billing 14. Conflict of Interest Certification Pass 15. Statement of Truth Pass 16. Non-collusion Certification Pass 17. Photographs (Optional) N/A TOTALS: 100 Pass 20 19 19 58 19.3 "230 *The lowest weighted average represents the highest ranked proposal. CARE has the lowest weighted average of 113.3 Exhibit 1 25F-13 25F-14 CITY OF SANTA ANA REQUEST FOR PROPOSALS RFP No. JRSB002 PHASE 2 FIRE/EMS EMERGENCY AMBULANCE TRANSPORTATION AND RELATED SERVICES DATE OF ISSUANCE: Thursday, June 14, 2012 SUBMISSION DUE DATE: Monday, July 9, 2012 SERVICES EFFECTIVE (TBD) A. Only the following 3 proposers who have prequalified under the Phase I RFP are allowed to participate in the Phase II RFP: a. Care Ambulance Service, Inc. b. Doctor's Ambulance Service c. Schaefer Ambulance Service B. Please note the mandatory Pre-Submission Conference is scheduled for Wednesday, June 27t4 at 1:00 P.M. located in the Orange County Fire Authority Board Breakout Room. Exhibit 2 25F-15 City of Santa Ana City of Santa Ana Phase 2: Emergency Ambulance Transportation and Related Services RIP Table of Contents GENERAL INFORMATION 1.1 BACKGROUND .................................................................................................................................1 1.2 SCOPE OF SERVICES ........................................................................................................................2 1.2.1 FIRST TIER SERVICE ...............................................................................................................2 1.2.2 M MUTUAL AID SERVICES ......................................................................................................3 1.2.3 BLS AND ALS SERVICES ...........................................................................................................4 1.2.4 MINIMUM QUALIFICATIONS OF TRANSPORTATION PERSONNEL ...........................................4 1.2.5 COMPENSATION ......................................................................................................................4 1.2.6 BILLING ..................................................................................................................................5 1.2.7 TERM ......................................................................................................................................5 1.2.8 ANNUAL REVIEW ....................................................................................................................6 1.3 NOTICE INVITING PROPOSALS ..........................................................................................................6 1.4 REJECTION OF BIDS ..........................................................................................................................6 1.5 COST OF PREPARATION ....................................................................................................................6 1.6 UNDERSTANDING PROPOSAL ............................................................................................................7 1.7 CONTRACTOR SELECTION AND AWARD ...........................................................................................7 2. ADMINISTRATION ............................................................................................................................8 2.1 BID PROPOSAL SUBMISSION PROCESS ..............................................................................................8 2.2 MANDATORY BID PROPOSAL PRE-SUBMISSION CONFERENCE .........................................................8 2.3 BID PROPOSAL SUBMISSION REQUIREMENTS ...................................................................................8 2.3.1 BID PROPOSAL SUBMISSION DATE ...........................................................................................8 2.3.2 BID PROPOSAL SUBMISSION INSTRUCTIONS ............................................................................9 2.4 PUBLIC OPENING OF BID PROPOSALS ............................................................................................. 12 2.4.1 BID PROPOSAL OPENING ........................................................................................................ 12 2.4.2 LATE SUBMISSION .................................................................................................................. 13 2.5 BID PROPOSAL EVALUATIONS ........................................................................................................ 13 2.5.1 COMPETITIVE PROCESS ......................................................................................................... 13 2.5.2 PROPOSAL GRADING PANEL ................................................................................................... 13 2.6 ADMINISTRATIVE ........................................................................................................................... 14 2.6.1 BID PROPOSAL DEPOSIT ......................................................................................................... 14 2.6.2 ORAL PRESENTATIONS ........................................................................................................... 14 2.6.3 PROPRIETARY INFORMATION ................................................................................................ 14 2.6.4 VOLUNTARY WITHDRAWAL OF BID PROPOSAL ..................................................................... 15 2.6.5 CANCELLATION OF RFP PROCESS .......................................................................................... 15 2.7 BID PROPOSAL REJECTION ............................................................................................................. 15 2.8 AWARD PROTEST ............................................................................................................................ 16 2.9 PROPOSED SCHEDULE OF EVENTS .................................................................................................. 17 3. GENERAL TERMS AND CONDITIONS .......................................................................................18 3.1 PROPOSED CONTRACT ....................................................................................................................18 3.2 CONTRACT DOCUMENTS ................................................................................................................18 3.3 CONTRACT MODIFICATIONS AND AMENDMENTS ...........................................................................18 3.4 CONTRACT ADMINISTRATION ........................................................................................................19 3.5 CONTRACT EFFECTIVE DATE .........................................................................................................19 3.6 CONTRACT TERM ............................................................................................................................19 3.6.1 TERM ....................................................................................................................................19 3.6.2 CONTRACT EXTENSION ........................................................................................................19 3.6.3 TERMINATION ......................................................................................................................19 3.7 INSURANCE .............................................................................................................................. 20 25F-16 ^ City of Santa Ana TABLE OF CONTENTS (CONTINUED) 3.8 ASSIGNMENT ................................................................................................................................... 24 3.9 AUDITS AND INSPECTIONS .............................................................................................................. 25 3.9.1 BUSINESS OFFICE .................................................................................................................... 25 3.10 COOPERATION .............................................................................................................................. 25 3.11 NON-COLLUSION CERTIFICATE .................................................................................................... 25 3.12 INDEPENDENT CONTRACTOR ....................................................................................................... 25 3.13 INDEMNIFICATION ........................................................................................................................ 26 3.14 COMPLIANCE WITH LAWS ............................................................................................................ 27 3.15 RESPONSIBILITY ........................................................................................................................... 27 3.16 ACTS OR OMISSIONS OF REPRESENTATIVES ................................................................................ 27 3.17 INSOLVENCY ................................................................................................................................. 27 4. OPERATIONAL STANDARDS PROCEDURES & PERFORMANCE REQUIREMENTS ....29 4.1 EMERGENCY RESPONSE COMMUNICATION SYSTEM ...................................................................... 29 4.1.1 COMMUNICATIONS REQUIREMENTS .................................................................................... 29 4.1.2 VEHICLE COMMUNICATIONS ............................................................................................... 29 A. 800MHZ MOBILE RADIO ................................................................................................ 29 B. MOBILE DATA COMPUTER SYSTEM ............................................................................... 30 4.2 SERVICE HOURS .............................................................................................................................. 32 4.2.1 SERVICE ................................................................................................................................ 32 4.2.2 FIELD SUPERVISOR ............................................................................................................... 32 4.3 RESPONSE TIMES ............................................................................................................................ 33 4.3.1 GENERAL REQUIREMENTS ................................................................................................... 33 4.3.2 RESPONSE TIME MEASUREMENT .......................................................................................... 33 4.3.3 RESPONSE TIMES REQUIRED ................................................................................................ 33 4.3.4 RESPONSE TIME REPORTING ................................................................................................ 33 4.3.5 CALL CANCELLATION .......................................................................................................... 34 4.3.6 QUARTERLY RESPONSE TIME REPORT- FORMAT ............................................................... 34 4.3.7 EXEMPTIONS TO RESPONSE TIME REQUIREMENTS ............................................................. 34 A. HIGH CALL VOLUME ........................................................................................................ 34 B. DISASTERS ........................................................................................................................ 34 C. MULTIPLE AMBULANCE RESPONSE ..................................................................................35 D. RESPONSE UP/DOWNGRADE ............................................................................................. 35 E. RETURN OF OCFA PERSONNEL ......................................................................................... 35 4.3.8 PROCEDURES TO REQUEST RESPONSE TIME EXEMPTION .................................................... 35 4.3.9 USE OF ALTERNATIVE METHODS TO MEET RESPONSE TIME REQUIREMENTS .................... 36 4.3.10 DISCIPLINARY ACTIONS FOR FAILURE TO MEET RESPONSE TIME REQUIREMENTS AND PERFORMANCE, DEFICIENCY .............................................................................................. 37 A. MEET AND CONFER ........................................................................................................ 37 B. PENALTIES ..................................................................................................................... 37 C. CORRECTIVE ACTION PLAN ........................................................................................... 38 D. TIMELY PERFORMANCE REQUIRED .............................................................................. 39 E. WAIVER .......................................................................................................................... 40 4.3.11 EMERGENCY ON-SCENE PROCEDURES ............................................................................... 40 4.3.12 DISASTER ASSISTANCE ....................................................................................................... 41 4.3.13 STANDARD OF PERFORMANCE ........................................................................................... 42 4.3.14 GENERAL PROVISIONS ........................................................................................................ 42 A. RETURN OF OCFA PERSONNEL ....................................................................................... 42 B. 911 CALLS FOR SERVICE/REFERRAL .............................................................................. 43 C. PERFORMANCE ............................................................................................................... 43 D. CONFLICT OF INTEREST ................................................................................................. 43 25F-17 City of Santa Ana TABLE OF CONTENTS (CONTINUED) 4. OPERATIONAL STANDARDS PROCEDURES & PERFORMANCE REQUIREMENTS E. COMPLAINTS ...................................................................................................................43 F. HIPAA BUSINESS ASSOCIATE ASSURANCES .....................................................................44 G. MEDICARE/MEDI-CAL PARTICIPATION ..........................................................................45 4.3.15 EXTERNAL MEDICAL QUALITY CONTROL ..........................................................................46 4.3.16 INTERNAL MEDICAL QUALITY CONTROL ...........................................................................46 5. PERSONNEL ......................................................................................................................................47 5.1 PERSONNEL REQUIREMENTS ..........................................................................................................47 5.2 CONTROL ........................................................................................................................................50 6. SUPPLIES, EQUIPMENT AND VEHICLES .................................................................................51 6.1 STANDARDS ....................................................................................................................................51 6.1.1 STANDARD INVENTORY .........................................................................................................51 6.1.2 REQUIRED EQUIPMENT ..........................................................................................................51 6.1.3 PERSONAL SAFETY EQUIPMENT .............................................................................................52 7. A. SUBMISSION OUTLINE (PHASE 2) BID PROPOSAL SUBMISSION FORMS & CHECKLIST ........................................................................53 TITLE PAGE/COVER SHEET .............................................................................................................54 BID PROPOSAL DEPOSIT ..................................................................................................................55 TABLE OF CONTENTS ......................................................................................................................56 B. DESCRIPTION OF REQUIRED ITEMS I COVER LETTER .......................................................................................................................... 57 2 GENERAL OVERALL DESCRIPTION OF PLAN TO PROVIDE 9-1-1 EMERGENCY TRANSPORTATION SERVICE IN CITY ........................................................................................ 58 3 OVERALL OPERATIONAL SYSTEM ............................................................................................. 59 4 DRIVER TRAINING ...................................................................................................................... 60 5 INTERNAL MEDICAL QUALITY CONTROL .................................................................................. 61 6 MUTUAL AID PROVIDER ............................................................................................................. 62 7 PERSONNEL AND TRAINING ..................................................................................................63-64 A. ASSIGNED PERSONNEL PROFILE B. FIELD TRAINING OFFICERS C. PRIMARY PERSONNEL D. EMPLOYEE RECRUITMENT, SCREENING & ORIENTATION E. CONTINUING EDUCATION PROGRAMS F. HIPAA TRAINING PROGRAMS 8 HIPAA COMPLIANCE PLAN ......................................................................................................... 65 9 CORPORATE COMPLIANCE PLAN ............................................................................................... 66 10 PLAN FOR TAKEOVER OF SERVICE/START UP ............................................................................ 67 11 EMS RESUME .........................................................................................................................68-69 12 PHASE 1 APPROVAL. NOTIFICATION ........................................................................................... 70 13 PRICE WORKSHEET ................................................................................................................... 71 14 CONFLICT OF INTEREST CERTIFICATION .................................................................................. 72 15 STATEMENT OF TRUTH .............................................................................................................. 73 16 NON-COLLUSION CERTIFICATION ............................................................................................. 74 17 PHOTOGRAPHS (OPTIONAL) ...................................................................................................... 75 25F-18 CRt City of Santa Ana TABLE OF CONTENTS (CONTINUED) ATTACHMENTS ATTACHMENT 1 -SAMPLE CONTRACT WITH CITY ...................................................................76 25F-19 0 City of Santa Ana SECTION 1 GENERAL INFORMATION 1.1 BACKGROUND The City of Santa Ana is initiating a Request for Proposal (RFP) for emergency ambulance transportation and related services for up to a three-year (3) contract period with an option for two (2) one (1) year extensions commencing on or after the contract effective date. This document provides information and specific requirements for "Phase 1: Prequalification" that must be followed by ambulance providers interested in submitting a proposal. In the City, the OCFA operates out of ten city-owned fire stations located at 1029 West 17`h Street, (Station No. 1), 1668 East 4'" Street (Station No. 2), 419 South Franklin Street (Station No.3), 1427 South Broadway (Station No.4), 120 West Walnut (Station No.5), 950 West MacArthur (Station No.6), 2317 South Greenville (Station No.7), 501 North Newhope (Station No.8), 1320 East Warner (Station No.9), and 2301 Old Grande Street North (Station No. 10). Estimated Response Volume: Calendar Year 2011 Call Responses 16,196 The City of Santa Ana (City) has a long and proud history of providing emergency medical care for the citizens of Santa Ana and its visitors. For many years the City of Santa Ana has provided its own transportation services. Effective April 20, 2012 the City of Santa Ana contracted with the Orange County Fire Authority (OCFA) for fire and emergency medical services. The Orange County Fire Authority is a regional fire service agency that serves 22 cities in Orange County and all unincorporated areas. The OCFA currently protects over 1,300,000 residents from its 61 fire stations located throughout Orange County. 1.2 SCOPE OF SERVICES The City of Santa Ana is soliciting proposals from qualified ambulance service operators (hereinafter referred to as either "Proposer" or "Contractor") to contract with the City of Santa Ana to provide 9- 1-1 Emergency Transportation Service within the territorial jurisdiction of the City of Santa Ana related to operation of the City's ambulance service (the "Contract"). All personnel assigned to Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page I I June 14, 2012 25F-20 City of Santa Ana perform services under the Contract, whether under the First Tier Service or under the Mutual Aid Contract (each of which is defined below), shall be hereinafter referred to as the "Transportation Personnel." The provision of the First Tier Service and the Mutual Aid Service, together with all of the other services, duties and obligations Contractor may provide under the proposed Contract, shall be hereinafter jointly referred to as the "9-1-1 Emergency Transportation Service" or "9-1-1 Emergency Transportation Services." The details of the 9-1-1 Emergency Transportation Services which must be provided by Contractor under the proposed Contract are as follows: 1.2. 1 First Tier Service The proposed Contractor will be required to provide, with its own forces, a sufficient number of fully equipped ambulances and Transportation Personnel, so as to provide, in accordance with OCEMS standards and this RFP, all of the City's needs for 9-1-1 Emergency Transportation Service, being able to respond 24 hours a day 7 days a week to all 9-1-1 and other emergencies as required (referred to as the "First Tier Service" or "First Tier"). The First Tier Service will be designed so as to ensure that there are enough of Contractor's ambulances and Transportation Personnel available to meet 100% of all calls for 9-1-1 Emergency Transportation Service in the City of Santa Ana within the response time criteria. The First Tier Service shall meet the OCFA response times and all other requirements of this RFP for the 9-1-1 Emergency Transportation Service. A. The provision of the First Tier Service shall include an adequate number of fully equipped committed ambulances and associated staffing/Transportation Personnel, to provide 9-1-1 Emergency Transportation Services exclusively for the City of Santa Ana. The Ambulances must be able to respond 24 hours a day 7 days a week to all 9-1-1 and other emergencies as required within the City of Santa Ana. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 2 June 14, 2012 25F-21 ` City of Santa Ana k? B. In addition to the First Tier Service Contractor must also provide whatever additional number of fully equipped ambulances and Transportation Personnel which may be required to meet the response times in this RFP, and to otherwise meet 100% of all 9-1-1 calls for Emergency Transportation Service within the City of Santa Ana 9-1-1 Emergency Transportation Services. C. OCFA, in cooperation with the Transportation Personnel, will provide on-scene Advanced Life Support ("ALS") services. The Transportation Personnel will provide Basic Life Support ("BLS") services and transport patients to medical facilities when required and under the direction of OCFA on behalf of the City of Santa Ana. 1.2.2. Mutual Aid Service Contractor shall also be required to enter into a mutual aid agreement with a separate qualified 9-1-1 ambulance service provider doing business in Orange County, to provide backup services in the event the Contractor is unable to respond to a call for Emergency Services (hereinafter "Mutual Aid Contract" or "Mutual Aid Service"). The company providing the Mutual Aid Service will be hereinafter referred to as the "Mutual Aid Provider." In providing 9-1-1 Emergency Transportation Services the Mutual Aid Provider must meet the same RFP requirements, response times, and otherwise provide the same level of service, as Contractor is required to provide under the Contract. The Mutual Aid Contract must be approved by the OCFA prior to provision of any service by Contractor, such approval not to be unreasonably withheld. The intent of this RFP is that Contractor will provide a sufficient level of coverage under the First Tier and Mutual Aid Services, such that services under the Mutual Aid Service will only be needed in rare circumstances, if at all. Bids submitted in response to this RFP should be designed to provide a sufficient level of First and Mutual Aid coverage as to meet all of the demands for 9-1-1 Emergency Transportation Service calls within the City of Santa Ana. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 13 June 14, 2012 25F-22 City of Santa Ana 1.2.3 BLS and ALS Services All Transportation Personnel assigned to perform 9-1-1 Emergency Transportation Services under this Contract, whether under the First Tier Service and Mutual Aid Service, will provide Basic Life Support ("BLS") services and transport patients to medical facilities when required. OCFA, in cooperation with the Transportation Personnel, will provide on-scene Advanced Life Support ("ALS") services. 1.2.4 Minimum Qualifications of Transportation Personnel All Transportation Personnel assigned to perform 9-1-1 Emergency Transportation Service under this Contract, whether under the First Tier Service and Mutual Aid Service, must at all times meet the minimum qualifications as listed in Section 5 of this RFP. 1.2.5 Compensation. A. The winning Contractor's bid shall include the cost to provide both the First Tier and Mutual Aid Service. Contractor's sole compensation for providing all of the 9-1-1 Emergency Transportation Services under both the First Tier and Mutual Aid Service will be the amount bid. Contractor will not be entitled to bill City, or OCFA, or any of its customers any additional amount for any services provided under this Contract, unless it is first approved in writing by City of Santa Ana and the OCFA. B. Contractor's bid will include the provision of the Mutual Aid Service to the degree those services are required. Contractor will be solely responsible for compensating the Mutual Aid Provider for any 9-1-1 Emergency Transportation Services it may provide in the City of Santa Ana under this Contract, which compensation will be at the rate set forth in the Mutual Aid Contract or as otherwise required by law. Contractor and the Mutual Aid Provider will not have any recourse against the City of Santa Ana or OCFA to recover for any 9-1-1 Emergency Transportation Services provided under either the First Tier Service or Mutual Aid Service, except as specifically authorized in the Contract. Contractor's sole compensation will be the amount of its winning bid. In the event of a dispute between the Mutual Aid Provider and Contractor, the Mutual Aid Provider's sole remedy will be against Contractor. This fact will be clearly stated in the Mutual Aid Contract, and Contractor must agree to indemnify and defend City of Santa Ana and OCFA Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 14 June 14, 2012 25F-23 City of Santa Ana against any claims or demands arising out of, or which are in any way related to, any services provided under the Mutual Aid Service. 1.2.6. Billing - A. City of Santa Ana will be solely responsible for the billing and collection of amounts owed by customers/patients provided 9-1-1 Emergency Transportation Services in the City, whether for services provided by Contractor, the Mutual Aid Provider, OCFA, City, or their respective employees, agents, volunteers, or subcontractors. As part of its billing process, City, in its discretion, will also bill for services provided by City of Santa Ana or OCFA personnel. Contractor and the Mutual Aid Provider will actively cooperate with City of Santa Ana to provide whatever information or assistance City of Santa Ana may reasonably require so that it can process customer/patient billings in a timely manner. This will include, but is not limited to, Contractor providing City of Santa Ana with a detailed list of all the 9-1-1 Emergency Transportation Services provided by both the Contractor and the Mutual Aid Provider during the preceding month. The specific information to be provided by Contractor in the monthly reports will be determined by City, and may be modified by City of Santa Ana from time to time to meet its reasonable needs. B. The entire proceeds of all such billings or collection efforts will be the sole property of the City of Santa Ana. Neither Contractor nor the Mutual Aid Provider will have any right to the proceeds of any billings or collections for services provided under the First Tier Service or Mutual Aid Service, or for any other services provided under the Contract, unless specifically authorized in writing by City of Santa Ana. Contractor must design its bid so that the amount bid will be sufficient to provide the required level of services under both the First Tier Service and the Mutual Aid Service, without expecting any additional amounts. C. Optional Billing Component. Proposers may submit a proposal to perform billing on behalf of the City of Santa Ana. Such proposal should include cost methodology based on an annual or per transport basis. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 15 June 14, 2012 25F-24 0 City of Santa Ana 1.2.7. Term The Contract awarded under this UP is for an initial three (3) year term, with 9-1-1 Emergency Transportation Service beginning at 0800 hours on the contract effective date and ending on three years thereafter at 0800 hours, with two (2) optional one-year extensions. 1.2.8. Annual Review The Contract is subject to annual review based on the criteria specified in the Contract and as outlined herein. The City's intent is to contract with and hold accountable those parties working with and on behalf of the City of Santa Ana and OCFA in providing 9-1-1 Emergency Transportation Service to the citizens and visitors of Santa Ana. The Contractor is required to provide type III emergency transport (ambulance) vehicles (including all costs related to maintenance, fuel, insurance, repair costs and communication equipment) for all 9- 1-1 Emergency Transportation Services provided under the First Tier and Mutual Aid Service. The Mutual Aid Service shall also be required to meet the same personnel and vehicle requirements as are required for the First Tier and Mutual Aid Service. 1.3 NOTICE INVITING PROPOSALS Only contractors qualified under the Phase I RFP are allowed to submit a Phase II proposal. 1.4 REJECTION OF BIDS At the sole discretion of City, City of Santa Ana reserves the right to reject any or all prequalification applications and RFP bids, in whole or in part, and is not bound to accept any. The RFP bid may be rejected by the City of Santa Ana if it is in any way incomplete, irregular or if it contains material misrepresentations of fact or omits material information required. 1.5 COST OF PREPARATION Proposers assume all costs associated with the preparation of their bid proposals and any oral presentations that may be necessary or required throughout the procurement process. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 16 June 14, 2012 25F-25 City of Santa Ana 1.6 UNDERSTANDING PROPOSAL It is the responsibility of each Proposer to inquire about any criteria, condition, term, provision, or requirement of the RFP that the Proposer does not understand. Responses to inquiries, if they significantly change or clarify the RFP requirements or any aspect of the procurement process, will be forwarded by addenda to all Proposers. The City of Santa Ana will not be bound by any oral responses to inquiries. By submitting bid proposals, Proposers assert that they have fully read the RFP and any addenda issued by City, the proposed Contract and any other Contract Documents, and affirm that the terms and conditions stated therein are fully understood and are acceptable to the Proposer. Each Proposer accepts the terms and conditions of the Contract Documents and indicates their ability and willingness to perform the requested services under such terms and conditions. Any exceptions to the terms and conditions set forth in the Contract Documents should be clearly noted in each Proposer's proposal. Please direct all questions regarding the procurement process to: Scott Brown, EMS Battalion Chief Email: scottbrown(a)ocfa.org Phone: 714-573-6071 OR Jim Ruane, Finance Manager Email: jimruane(a,ocfa.org Phone: 714-573-6304 OR Eva Goods, Buyer Email: e2oods(&santa-ana.or2 Phone: 714-647-6584 1.7 CONTRACTOR SELECTION AND AWARD The award of contract under this RFP will be made by the City of Santa Ana. All Proposers will be notified in writing at the conclusion of the procurement process as to the results of the bid proposal evaluation process and the final award recommendation. Proposers will receive mailed award/non- award notification, which will include the name of the Proposer awarded a contract. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 17 June 14, 2012 25F-26 rv City of Santa Ana SECTION 2 ADMINISTRATION 2.1 BID PROPOSAL SUBMISSION PROCESS The City of Santa Ana is committed to providing and maintaining the highest levels of emergency response service possible to the public. In conjunction with OCFA, the provision of the 9-1-1 Emergency Transportation Service pursuant to this RFP process is a critical part of the City's continuing efforts to achieve this objective. 2.2 MANDATORY BID PROPOSAL PRE-SUBMISSION CONFERENCE A bid proposal pre-submission conference will be held at the Orange County Fire Authority on Wednesday, June 27, 2012 at 1:00 P.M. Attendance at the bid proposal pre-submission conference is mandatory for all ambulance service operators who are approved during the Phase I process and wish to submit a bid proposal and compete in the RFP Phase 2 process. The conference will be held in the OCFA Board Breakout Room. The purpose of the conference is for City of Santa Ana staff to respond to any questions, concerns, comments and/or suggestions concerning the procurement process, which have been submitted in advance and in writing to the OCFA Clerk of the Authority. All questions must be submitted by Wednesday, June 20, 2012 to Scott Brown. The conference is also an opportunity for City of Santa Ana staff and OCFA to clarify bid specifications and requirements before submission. All written inquiries submitted by Proposers and the answers given by City of Santa Ana staff during the bid proposal pre-submission conference will be presented at the Phase 11 Mandatory Bid Conference. Proposers who do not attend the bid proposal pre-submission conference, or who do not make arrangements to send a representative to attend the conference, will not be eligible to continue in the RFP process. 2.3. BID PROPOSAL SUBMISSION REQUIREMENTS 2.3.1 Bid Proposal Submission Due Date In order to compete in the RFP process, all bid proposals must be completed and received by the Clerk of the Authority no later than 3:00 P.M., on Monday, July 9, 2012 ("Submission Due Date" J. Bid proposals must be hand-delivered or sent via courier/messenger to the OCFA Clerk of the Authority. Do not send bid proposals via U.S. Mail. All proposals must be sealed and submitted Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 18 June 14, 2012 25F-27 ~.; City of Santa Ana to the Clerk of Authority in accordance with the required format and in the manner prescribed herein by the Submission Due Date. A signed original bid proposal plus five (5) copies and one electronic copy on a CD or flash drive of the proposal must be received by the Clerk of the Authority no later than 3:OOP.M. on Monday, July 9, 2012 for public opening. Proposers are strongly encouraged to submit their bid proposals in advance of the due date to avoid the possibility of missing the 3:00 P.M deadline due to unforeseen circumstances. Proposers assume the risk of the methods of dispatch chosen. City of Santa Ana or OCFA assumes no responsibility for any delays whatsoever caused by any courier, delivery, or messenger service. Bid proposals must be date and time stamped by the Clerk of the Authority on time by the 3:OOP.M. Submission Due Date in order to be considered. Additional time will not be granted to any single Proposer; however, additional time may be granted to all Proposers when, at its sole discretion, the City of Santa Ana or OCFA determines that circumstances require additional submission time. Bid proposals sent to OCFA via U.S. Mail, Fax, or E-mail will NOT be accepted. No amendments, additions, deletions, or alterations to submitted bid proposals will be accepted by the Clerk of the Authority after the Submission Due Date. Bid proposals received after 3:00 P.M. on the Submission Due Date will be returned unopened. 2.3.2 Bid Proposal Submission Instructions: Required Format All bid proposals must be submitted in accordance with the following requirements: A. Proposal Binders: All bid proposals must be submitted in three-ring binders, which are not larger than twelve inches by twelve inches (12"x12"); B. Original + Copies: The original signed bid proposal shall be clearly marked "ORIGINAL" and five (5) copies and one electronic of the bid proposal, including any attachments, must be sent under seal to the OCFA Clerk of Authority by the Submission Due Date and time; C. Early Bids: Bid proposals received by OCFA prior to the Submission Due Date will be date and time stamped and secured by the Clerk of the Authority; D. Title Pave: All bid proposals must be clearly marked on the outside binder cover with a title page containing the following information: i. Name of ambulance transportation service operator (i.e., the Proposer); Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 19 June 14, 2012 25F-28 0 City of Santa Ana ii. Name of RFP and RFP #JRSB002; iii. Proposer address and telephone number; iv. Proposer authorized contact person; v. Proposer authorized contact person's signature; vi. Bid proposal submission date; and vii. Marked as original submitted copy E. Bid Format To facilitate the bid proposal review process, all bid proposals must strictly adhere to the format, table of contents, titles, page limits, and numbering for requested information items as set forth in Section VII, Bid Proposal Submission Forms. Any deviation from the Section VII format and the required Bid Proposal Submission Forms may result in disqualification, at the City's discretion. All Proposers must strictly adhere to the following rules in preparing their bid proposals, and any deviation may result in disqualification: i. Use only standard one inch (1") margins; ii.Use only size 12 font; iii. Use only single-sided pages; iv. Observe all page limit requirements, as specified; v. Use proposal binders no larger than 12"x 12"; vi. Use tabs or dividers to separate bid response sections. F. Complete Answers & Responses All bid proposals must provide answers to all questions and provide complete responses to each and every requested item and category as specified in Section VII. Specific submission data have been provided for your convenience for each submission item. Proposers are required to supply, at a minimum, the items listed for specific submission. Proposers are permitted, within the prescribed page limits, to submit additional information that they deem helpful in the evaluation and grading process. Failure to provide answers to all questions and complete responses to all requested item categories may result in disqualification, at the City's discretion; Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 110 June 14, 2012 25F-29 ^r City of Santa Ana y G. Table of Contents Bid proposals must include a table of contents listing the individual information as requested by section and set forth in Section VII, Bid Proposal Submission Forms, and their corresponding page numbers. Tabs or dividers must be used to clearly separate each of the individual sections; H. Cover Letter Bid proposals must include a cover letter on official letterhead describing the Proposer, and must include the following information: i. The official name of the Proposer, and stating the Proposer's interest in participating in the RFP; ii. The Proposer's organizational structure (e.g. corporation, partnership, limited liability corporation, or otherwise); iii. The jurisdiction in which the Proposer is organized and the date of such organization; iv. The address and telephone number of the Proposer's headquarters and of any local office involved in the bid proposal; v. The Proposer's Federal Tax Identification Number; vi. The name, address, telephone, fax numbers, and e-mail address of the person(s) who will serve as the authorized contact(s) to the City/OCFA with regards to the bid proposal, the RFP process, the Contract Documents, and the administration of the contract, if awarded, with authorization to make representations on behalf of and to bind the Proposer; vii. Provide applicable authorized signature documentation, pursuant to Proposer's organizational structure/bylaws, verifying the authority of the person signing the original bid proposal to commit to the proposal on behalf of the Proposer; viii. A representation that the Proposer is in good standing in the State of California and has obtained all necessary licenses, permits, certifications, approvals, and governmental authorizations necessary in order to perform all of the required performance obligations specified herein; Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 11 June 14, 2012 25F-30 x . City of Santa Ana ix. A representation that the Proposer is in good standing in the Medicare and Medi-Cal programs and is not the subject of any pending actions, investigations, or prosecutions, whether civil, criminal, or administrative, relating to their billing or reimbursement practices, and that Proposer has not been excluded from any state or federal healthcare program or employs any individual who has been excluded from any state or federal healthcare program. x. Statement of acceptance of all terms, conditions, requirements, and performance criteria contained in the Contract Documents; and xi. Any additional information Proposer deems relevant for consideration during the selection process. 1. Photographs Proposers may submit, as part of their bid proposal, a maximum of three (3) pages of color photographs or other renderings depicting their ambulance service facilities, operation, and/or personnel. Such photographs are to be inserted at the end of the bid proposal; J. Non-Collusion Certificate Each Proposer must execute and submit with each bid proposal the Non-Collusion Certificate in Section 7; and K. Compliance Bid proposals that do not strictly adhere to the format requirements and rules set forth herein may be disqualified at the sole discretion of the City of Santa Ana and OCFA. 2.4. PUBLIC OPENING OF BID PROPOSALS 2.4.1 Bid Proposal Opening. All bid proposals received on time by the Submission Due Date will be publicly opened. The public opening will be held at the OCFA site time on Monday, July 9, 2012 at 3:OOP.M. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 12 June 14, 2012 25F-31 ' .; City of Santa Ana 2.4.2 Late Submission. Bid proposals received after 3:00 P.M. on Monday, July 9, 2012 on the Submission Due Date will be returned unopened and will not be considered. 2.5 BID PROPOSAL EVALUATIONS 2.5.1 Competitive Process. The Proposal Grading Panel will evaluate and rate each bid proposal according to established criteria. The primary competitive bid criteria for this RFP are: A. Experience of the Proposer; B. Financial strength/stability of the Proposer; C. Cost to City; D. Quality of service to be provided; E. Level of service to be provided; F. Experience and qualifications of the Transportation Personnel who will provide services to the City of Santa Ana under the proposed contract; G. Training of replacement Transportation Personnel when one or more leaves; and H. Whether a Proposer is responsible. The term "responsible" refers not only to the attribute of trustworthiness, but also to the quality, fitness, and capacity of the Proposer to perform the proposed services satisfactorily and in accordance with the specifications and delivery criteria set forth herein. At the conclusion of the evaluation process, the Proposal Grading Panel will make a final contract award recommendation(s), which will be presented to the Santa Ana City of Santa Ana Council. The City of Santa Ana Council may accept the professional Grading Panel's award recommendation and award the contract pursuant to that recommendation. Alternatively, the City of Santa Ana Council may award the contract to another prequalified Proposer upon conducting its own review and evaluation of the grading criteria, scoring materials, final scores, bid proposals submission materials, and other pertinent information. 2.5.2 Proposal Grading Panel. Bid proposals will be reviewed and evaluated by a Proposal Grading Panel. City/OCFA staff will participate and appoint the members of the Proposal Grading Panel. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 13 June 14, 2012 25F-32 0 City of Santa Ana Following an initial bid proposal evaluation process, the grading panel will select finalists for possible onsite visits and oral presentations. Oral presentation concerning the Proposer's proposal, all of which may be videotape recorded, will be limited to 30 minutes per presentation. During the oral presentations the Proposal Grading Panel will listen to the Proposer's presentation and may ask questions of the Proposers and/or request amplification, explanation, or further information regarding their proposal. Additional presentation time may be allotted at the sole discretion of the panel. 2.6 ADMINISTRATIVE 2.6.1 Bid Proposal Deposit. All bid proposals must include a $2,500 deposit in the form of a cashier's check made payable to the City of Santa Ana ("Bid Proposal Deposit"). Bid Proposal Deposits will be refunded in their entirety to all Proposers that voluntarily withdraw their proposal prior to the Public Opening, and to all Proposers who complete the process but are not ultimately selected. Bid Proposal Deposits are due by 3:OOPM on Monday, July 9, 2012. 2.6.2 Oral Presentations. Oral presentations may be requested of all Proposers at any time throughout the procurement process. 2.6.3 Proprietary Information. All bid proposals and documents submitted in response to this RFP shall become the property of the City. It is the responsibility of each Proposer to clearly identify any and all information contained in their bid proposal that it considers to be confidential and/or proprietary. To the extent that City of Santa Ana agrees with that designation, and it is consistent with the Public Record Act requirements, the City of Santa Ana will seek to protect that information from disclosure. All other information will be considered public. However, all information regarding the procurement process will not be disclosed to the public or be subject to disclosure pursuant to the California Public Records Act (Government Code §6250 et seq.) during the deliberative process, until such time as evaluations have been completed and final award recommendations have been made to the Council. In the event that a demand is made for disclosure of Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 14 June 14, 2012 25F-33 x~ City of Santa Ana information designated by a Proposer as being "confidential and/or proprietary," City of Santa Ana will notify the Proposer in writing of such demand and shall furnish a copy of City's written response to the requestor. If the City of Santa Ana intends to disclose documents which Proposers believe to be confidential, Proposers may then pursue, at their sole cost and expense, all appropriate legal action necessary to maintain the confidentiality of those documents. 2.6.4 Voluntary Withdrawal of Bid Proposal A Proposer may, upon written notice to City of Santa Ana and OCFA, voluntarily withdraw their bid proposal at any time prior to the Public Opening. Withdrawal of a bid proposal will be subject to verification of the identity of the requestor and confirmed with the Proposer's authorized representative. A receipt for the return of any unopened bid proposal will be prepared by the OCFA Clerk of Authority and signed by the Proposer's authorized representative. Proposers requesting to withdraw their bid proposal prior to the Public Opening will be entitled to a full refund of their Bid Proposal Deposit. Proposers requesting to withdraw their bid proposal after the Public Opening will forfeit their Bid Proposal Deposit. 2.6.5 Cancellation of RFP Process The City, in its sole and absolute discretion, may cancel this RFP at any time if it determines cancellation is in the best interest of the City of Santa Ana or OCFA. 2.7 BID PROPOSAL REJECTION 2.7.1 At the sole discretion of the City, City of Santa Ana and OCFA reserves the right to reject any and all bid proposals, in whole or in part, and is not bound to accept the lowest proposal (or the proposal prices for services). In such event the City of Santa Ana Council, in its discretion, may direct the issuance of a new RFP. 2.7.2 A bid proposal may be rejected by the City of Santa Ana and OCFA, in its sole discretion, for failure to comply with the requirements set forth in this RFP, for providing inaccurate or false information, or for other reasons that the City of Santa Ana determines create or may create a hindrance or impairment to the objective evaluation of such proposal. 2.7.3 The City of Santa Ana and OCFA reserves the right, in its sole discretion, to waive any and all bid proposal irregularities or informalities that the City of Santa Ana deems correctible or Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 115 June 14, 2012 25F-34 N LA. City of Santa Ana otherwise not relevant. In the event of a bid proposal irregularity or informality, the Proposer may be required to immediately correct and/or resubmit, in whole or in part, its bid proposal. 2.7.4 A bid proposal may be rejected by the City of Santa Ana and OCFA, in its sole discretion, if it is in any way incomplete, irregular, or if it contains material misrepresentations of fact or omits material information required. Bid proposals that do not strictly adhere to the format requirements set forth in this RFP may be rejected. 2.7.5 A bid proposal may be rejected or disqualified by the City of Santa Ana and OCFA upon evidence that the Proposer may have engaged in corrupt, fraudulent, and/or illegal practices involving the performance, administration, or award of a similar contract in another jurisdiction. 2.7.6 Bid proposals that take exception to the RFP specifications and/or delivery criteria, or terms and conditions of the Contract Documents may be rejected. 2.7.7 Bid proposals that do not provide all information requested in this RFP may be rejected as incomplete. 2.7.8 In the event a bid proposal is rejected, the City of Santa Ana and OCFA will notify the Proposer in writing, which shall explain the specific reason(s) for the rejection. 2.8 AWARD PROTEST The award of contracts under this RFP will be made by the City of Santa Ana at the recommendation of OCFA. All protests shall be made in writing, signed and addressed to: Eva Goods, Buyer 20 Civic Center Plaza, Rm 429 Santa Ana, California 92702 Protests shall state the reason(s) for the protest, citing the law, rule, regulation or procedure on which the protest is based. If a protest is based on what appears to be an erroneous assessment of the ability Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 16 June 14, 2012 25F-35 D City of Santa Ana of a Proposer to meet the RFP specifications and requirements, the protester must provide facts and evidence to support the claim. If the protest is sent via U.S. mail, it must be sent certified or registered. All protests shall be submitted no later than ten (10) working days from notification. 2.9 PROPOSED SCHEDULE OF EVENTS Action Date A Final RFP Issued Thursday, June 14, 2012 B Deadline for receipt of all questions regarding the RFP Wednesday, June 20, 2012 C Mandatory Bid Proposal Pre- Submission Conference Wednesday, June 27, 2012 at 1:00 P.M. in the OCFA Board Breakout Room D • Bid Proposal Submission Due Date Deposit Due • Bid Proposal Monday, July 9, 2012 at 3:00 P.M. E Bid Proposal Submission Public Opening Monday. July 9. 2012 F F Proposal Grading Panel Evaluation Process 2 Tuesday, .luly 10, 2012 Proposal Grading Panel- Recommendations Tuesday. July 24, 2012 (Tentative) H Final Recommendations, Selection and Contract Award Monday, August 6, 2012 (Tentative) I Final date for submission of Award Protests TBD J Execution of Contract TBD K Contract Performance Start Date TBD Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 17 June 14, 2012 25F-36 0 City of Santa Ana SECTION 3 GENERAL TERMS AND CONDITIONS 3.1 PROPOSED CONTRACT The proposed Contract is attached to this RFP as Attachment No. 1. Please review the terms of the proposed Contract carefully (the "Contract" or the "Agreement"). Where there is a discrepancy in the terms of this RFP and the terms of the Contract, the terms of the Contract shall prevail. 3.2 CONTRACT DOCUMENTS The Contract entered into by the successful Proposer shall consist of the: 3.2.1 Executed Contract between the City of Santa Ana/OCFA and Contractor attached as Attachment No. 1 to this RFP. 3.2.2 RFP 3.2.3 Signed, original bid proposal(s) submitted by the successful Proposer ("Bid Proposal") The Executed Contract, the RFP, and the Bid Proposal(s), submitted by the successful Proposer will be incorporated and made a part of the Contract and shall be hereinafter collectively referred to as the "Contract Documents." All provisions of the RFP, the Bid Proposal(s), and the contract shall be binding on the parties. Should any inconsistency or ambiguity occur or exist in the Contract Documents, the provisions of the Contract, then the provisions of the Proposal, then the provisions of the RFP shall control. For purposes of this section the successful Proposer shall be referred to as the "Contractor." 3.3 CONTRACT MODIFICATION AND AMENDMENTS Once a Contract has been awarded and executed, the parties may adjust the specific terms of the Contract Documents from time to time where circumstances beyond the control of either party require modification or amendment. Any modification or amendment proposed by the Contractor must be submitted in writing to the City of Santa Ana, OCFA, and OCEMS for consideration. The decision to modify or amend any term or condition of the Contract Documents shall be at the sole discretion of the City of Santa Ana and OCFA and will require concurrence from OCEMS. Any agreed upon modification or amendment must be in writing, approved by all parties. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 118 June 14, 2012 25F-37 0 City of Santa Ana 3.4 CONTRACT ADMINISTRATION The OCFA Fire Chief, or his designee, shall be the authorized representative in all matters pertaining to the RFP process. The contract awarded pursuant to this RFP for the provision of 9-1 -l Emergency Transportation Service to the City of Santa Ana shall be administered by the OCFA Fire Chief, or his designee. 3.5 CONTRACT EFFECTIVE DATE The effective date of the contract awarded pursuant this RFP shall be TBD, ("Effective Date") at which time Contractor will assume full responsibility for the provision of 9-1-1 Emergency Transportation Service within the City of Santa Ana, as outlined in this RFP. The Effective Date may be postponed at the sole discretion of the OCFA Fire Chief or designee in order to protect public health and safety or in the event a successful Proposer/Contractor is for any reason unable to commence performance at that time. 3.6 CONTRACT TERM 3.6.1 Term The exclusive contract awarded pursuant to this RFP are for an initial three (3) year term, ending at TBD. The contract shall automatically expire at the end of the initial three year term, unless extended as provided below. 3.6.2 Contract Extension Upon the mutual written agreement of the parties, the contract may be extended for up to two (2) additional one (1) year periods (for a possible total of 5 years). Successful past performance during the initial contract period will be a critical factor in the decision to grant an extension. The decision to either grant or deny a contract extension(s) shall be final. The decision to grant an extension shall be made by the City of Santa Ana and OCFA. At the end of the initial contract term, or if extended at the end of the extended term, the Contract awarded pursuant to this RFP shall automatically terminate. 3.6.3 Termination. Once the Agreement is executed, it may be terminated as follows: Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 19 June 14, 2012 25F-38 0 City of Santa Ana A. The Agreement may be terminated by either party, with or without cause, upon ninety (90) days prior written notice to the other party. B. CITY OF SANTA ANA or OCFA may terminate the Agreement for Cause by providing CONTRACTOR thirty (30) days prior written notice of termination for Cause and the factors constituting Cause. CONTRACTOR will have thirty (30) days to cure any alleged breach, prior to termination for cause under this section. C. CITY OF SANTA ANA or OCFA may terminate the Agreement immediately if the OCFA Fire Chief or designee (in their reasonable discretion) determines that continued operations by CONTRACTOR following the breach would constitute a danger to the public health, safety or general welfare. 3.7 INSURANCE Contractor must provide, to the satisfaction of the City of Santa Ana and OCFA, insurance in accordance with the following requirements: 3.7.1 Prior to beginning the provision of 9-1-1 Emergency Transportation Service under this Agreement, CONTRACTOR must provide to the satisfaction of the CITY OF SANTA ANA and OCFA, certificates of insurance and endorsements evidencing the policy or policies of insurance in the types and amounts set forth below. CONTRACTOR shall at all times during the term of this Agreement carry, maintain, and keep in full force and effect, the following minimum scope of insurance coverage: A. Commercial General Liability Insurance in an amount not less than $10,000,000 per occurrence, written on an occurrence form. If the policy carries an annual aggregate, such aggregate shall be in an amount not less than $10,000,000 per occurrence. B. Ambulance Medical Malpractice Insurance in an amount not less than $3,000,000 per occurrence. If the policy carries an annual aggregate, such aggregate shall be in an amount not less than $6,000,000 per occurrence. Such insurance coverage may be Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 20 June 14, 2012 25F-39 4j- City of Santa Ana combined with either the general or automobile liability coverage; provided, however, if the insurance coverage is so structured, the combined coverage shall be in an amount not less than $5,000,000 per occurrence, with an annual aggregate of not less than $10,000,000. C. Comprehensive Business Automobile Liability Insurance in an amount not less than $3,000,000 per occurrence, covering owned, non-owned and hired vehicles, written on an occurrence form. If policy carries an annual aggregate, such aggregate shall be in an amount not less than $6,000,000 per occurrence. Contractor understands that it must provide Business Automobile Liability coverage for all vehicles. D. Workers' Compensation and Employers' Liability Insurance in a statutory amount for workers' compensation and in an amount not less than $1,000,000 for employers' liability. Such insurance shall contain a waiver-of-subrogation clause in favor of the CITY OF SANTA ANA and OCFA, and their respective officers, officials, employees and agents. 3.7.2 CONTRACTOR shall also comply with the following requirements: A. If the above-required insurance coverage does not provide for an annual aggregate which is twice the per-occurrence limit, in the alternative the insurance policy (policies) shall be amended (by appropriate ISO endorsements) so that the policy limits apply solely to this Agreement. B. The above-required liability insurance shall be in a form which supports coverage for the provisions of the indemnification clause required under this Agreement, including a claim brought against the CITY OF SANTA ANA and/or OCFA for the injury to, or death of an employee or agent of CONTRACTOR. C. In the event of a claim (claims) against the above-referenced liability policies which reasonably may deplete one-half or more of the aggregate limits, CONTRACTOR shall immediately notify CITY OF SANTA ANA and/or OCFA. In the event a claim (claims) against the above-referenced liability policies which are reasonably expected to deplete 90% of the aggregate limits, CONTRACTOR shall, at CONTRACTOR's Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 121 June 14, 2012 25F-40 - City of Santa Ana U 4 U;_ expense, reinstate the aggregate limits at least to an amount equal to one-half of the face amount of the aggregate limits on the policies. D. All insurance required pursuant to this section shall be issued by a company authorized by the Insurance Department of the State of California and rated A-VII or better by the latest edition of Best's Key Rating Guide. E. No insurance required herein shall provide for a deductible in excess of $5,000 or a self-insured retention in any amount, without prior written consent of the CITY OF SANTA ANA and OCFA; and, the granting or denying of such consent shall be at the sole and absolute discretion of the CITY OF SANTA ANA and OCFA. 3.7.3 ENDORSEMENTS A. All insurance required herein shall be endorsed to state that "Coverage shall not be suspended, voided, canceled, reduced in coverage or in limits except after thirty (30) days prior to written notice by certified mail, return receipt requested, has been given to the CITY OF SANTA ANA and OCFA." B. The liability policies required herein, except for professional liability (if a stand-above coverage), workers compensation and employers' liability, shall, by endorsement, contain the following provisions: i. "The CITY OF SANTA ANA and OCFA, and their respective officers, officials, employees, representatives, and volunteers are hereby declared to be additional insureds as respects the operations, activities, work, errors, or omissions of the named insured arising out of or in connection with any contract or agreement with the CITY OF SANTA ANA and OCFA." ii. "This insurance is primary to, and shall not contribute with, any insurance or self- insurance maintained by the City of Santa Ana or OCFA, or by any of the designated additional insureds." iii. "This insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability." Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 22 June 14, 20]2 25F-41 City of Santa Ana C) Worker's Compensation and Professional Liability policies shall be endorsed state that the insurer waives all rights of subrogation against the CITY OF SANTA ANA and OCFA, and their respective officers, officials, agents, employees, and volunteers for losses arising from work performed by the CONTRACTOR under this Agreement. 3.7.4 All insurance coverages shall be confirmed by execution of endorsements and certificates of insurance. CONTRACTOR is required to file the completed policy endorsements and certificates with CITY OF SANTA ANA and OCFA on or before the Effective Date of this Agreement, and to thereafter maintain current endorsements on file with CITY OF SANTA ANA and OCFA. The completed endorsements and certificates of insurance are subject to the approval of CITY OF SANTA ANA and OCFA. 3.7.5 Nothing in this section shall be construed as limiting in any way; the Indemnification and Hold Harmless clause contained in this Contract, or the extent to which CONTRACTOR may be held responsible for payments of damages to persons or property. 3.7.6 CITY OF SANTA ANA or OCFA shall have the right at any time to review the coverage, form, and limits of insurance required herein. If, in the sole and absolute discretion of the CITY OF SANTA ANA and/or OCFA, the insurance provisions in this Agreement do not provide adequate protection for the CITY OF SANTA ANA and/or OCFA, shall have the right to require CONTRACTOR to obtain insurance sufficient in coverage, form, and limits to provide adequate protection, and CONTRACTOR shall promptly comply with such requirement. The CITY's and OCFA's requirements shall not be unreasonable, but shall be adequate in the sole opinion of the CITY OF SANTA ANA and OCFA to protect against the kind and nature of risks which exists at the time a change of insurance is required, or thereafter. 3.7.7 Alternate forms of insurance, that meet the above requirements, must be approved by the CITY's and OCFA's Risk Manager prior to submitting a proposal for any work under this Agreement. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 123 June 14, 2012 25F-42 ?? City of Santa Ana :tip 3.7.8 The Mutual Aid provider shall be required to meet all of the insurance requirements in this Section to the same degree as Contractor, and those requirements will be included in the Mutual Aid Contract. 3.8 ASSIGNMENT Except as provided herein, Contractor may not delegate, transfer or assign its rights or otherwise transfer its obligations, in whole or in part, under the proposed contract to any other person or entity without first obtaining the prior written consent of the City of Santa Ana and OCFA and not for 180 days after the formal contract award. Any such assignment or transfer without the prior written consent of the City of Santa Ana and OCFA shall be void, the attempted assignment shall constitute a breach of the Contract, and if discovered during the bidding process will be grounds for rejection of the bid. For purposes of this section, the following will be considered to be a "transfer" or "assignment": 3.8.1 Any change in the business structure, including but not limited to, changes from or to: (a) a sole proprietorship; (b) a partnership, including any change in the partners; (c) a corporation, including any change in the shareholders, whether by operation of law or otherwise; 3.8.2 Bankruptcy, an assignment for the benefit of creditors, or the appointment of a receiver; or 3.8.3 A transfer by any of the owners, shareholders or members (whichever is applicable) of Contractor of greater than ten percent (10%) of the ownership interest, stock or membership interest (whichever is applicable) in Contractor's business, issued as of the Effective Date by the Contractor, or the sale or transfer of over twenty-five percent (25%) of the assets of the Contractor. In the event a Contractor experiences regular stock exchanges in excess of the ten percent (10%) threshold, a separate agreement may be negotiated to set a threshold that still provides the City of Santa Ana and OCFA with the protections intended. The stock sale of a publicly traded corporation that does not constitute a change in majority ownership will not be deemed a transfer of ownership for purposes of this Section. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 24 June 14, 2012 25F-43 0 City of Santa Ana 3.9 AUDITS AND INSPECTIONS 3.9.1 Business Office. At any time during normal business hours, and as often as may reasonably be deemed necessary by the City of Santa Ana or OCFA, the City of Santa Ana or OCFA may observe and inspect Contractor's business office, and Contractor must make promptly available to the City of Santa Ana or OCFA for its examination all of Contractor's records that pertain to performance of the Contract. The City of Santa Ana or OCFA may audit, examine, and copy any and all Contractor records pertaining to their performance of the contract, including but not limited to, personnel records, daily logs, conditions of employment, and all other data. The City of Santa Ana or OCFA's right to inspect Contractor's business office and any and all records pertaining to their performance of the Contract will be restricted to normal business hours and reasonable notice shall be given to Contractor in advance of such inspection. 3.10 COOPERATION Contractor must cooperate with the City of Santa Ana and OCFA and take all actions necessary to ensure that all terms and conditions, and required performance levels, set forth in the Contract Documents are satisfied at all times throughout the contract term. 3.11 NON-COLLUSION CERTIFICATE Each Proposer must execute and submit with each bid proposal the Non-Collusion Certificate in Section 7. If there is reason to believe that collusion exists among Proposers, all bid proposals submitted will be rejected and none of the participants in such collusion will be considered in any future RFP. 3.12 INDEPENDENT CONTRACTOR Both parties in the performance of the Contract shall be acting in an independent capacity of Santa Ana one from the other, and not as agents, employees, partners, or pursuant to a joint venture with one another. The parties understand and agree that Contractor and its employees (which term specifically includes, but is not limited to, the Transportation Personnel) are not employees of the City, the County or OCFA, and are not entitled to any of the rights, benefits, or Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 25 June 14, 2012 25F-44 City of Santa Ana privileges of City, County or OCFA, employees including, but not limited to, medical, unemployment, or workers' compensation insurance. 3.13 INDEMNIFICATION CONTRACTOR agrees to defend, indemnify, hold free and harmless the CITY OF SANTA ANA and OCFA, and their respective officers, officials agents, employees and volunteers, at CONTRACTOR's sole expense, from and against any and all claims, actions, suits or other legal proceedings brought against the CITY OF SANTA ANA or OCFA, or their respective officers, officials, agents, employees or volunteers, arising out of the performance of the CONTRACTOR, its employees, agents and/or authorized subcontractors, of the work undertaken pursuant to the Agreement, specifically including but not limited to the 9-1-1 Emergency Transportation Service. The defense obligation provided for hereunder shall apply without any advance showing of negligence or wrongdoing by the CONTRACTOR, its employees, agents and/or authorized subcontractors, but shall be required whenever any claim, action, complaint, or suit asserts as its basis the negligence, errors, omissions or misconduct of the CONTRACTOR, its employees, agents and/or authorized subcontractors, and/or whenever any claim, action, complaint or suit asserts liability against the CITY OF SANTA ANA or OCFA, or their respective officers, officials, agents, employees or volunteers, based upon the work performed by the CONTRACTOR, its employees, agents and/or authorized subcontractors under this Agreement, whether or not the CONTRACTOR, its employees, agents and/or authorized subcontractors are specifically named or otherwise asserted to be liable. Notwithstanding the foregoing, the CONTRACTOR shall not be liable for the defense or indemnification of the CITY OF SANTA ANA or OCFA for claims, actions, complaints or suits arising out of the sole negligence or willful misconduct of the CITY OF SANTA ANA or OCFA. The Mutual Aid Provider shall be required to include the same language in the Mutual Aid Contract, indemnifying the City of Santa Ana and OCFA to the same degree as Contractor. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 26 June 14, 2012 25F-45 City of Santa Ana 3.14 COMPLIANCE WITH LAWS All services provided by Contractor pursuant to the Contract Documents must be rendered in full compliance with all applicable federal, state, and local laws, rules, statutes, and regulations. It will be Contractor's sole responsibility to determine which federal, state, and local laws, rules, statutes, and regulations apply to the services to be performed pursuant to the Contract Documents, and to maintain compliance at all times throughout the Contract term. 3.15 RESPONSIBILITY Except as may be specifically stated herein to the contrary, it shall be the responsibility of Contractor to provide all Transportation Personnel with whatever resources and equipment are necessary to perform the 9-1-1 Emergency Transportation Service, and to otherwise satisfy all of the terms and conditions set forth in the Contract Documents at all times during the Contract term. Except where it may be specifically permitted in the Contract, Contractor may not use any outside ambulance service providers or other resources to satisfy its obligations to provide 9-1-1 Emergency Transportation Service to the City of Santa Ana and OCFA, without first obtaining the prior written consent of the City of Santa Ana. Notwithstanding the granting of any such approval by the City of Santa Ana and OCFA, nothing stated herein shall relieve Contractor of its duties and responsibilities under the Contract, and any additional cost incurred shall not be charged to the County, City of Santa Ana or OCFA. 3.16 ACTS OR OMISSIONS OF REPRESENTATIVES The acts and/or omissions of the owner(s), officers, operators, officials, employees, agents, and representatives of the Contractor in the performance of the services and obligations under the Contract Documents shall constitute the acts and/or omissions of the Contractor. 3.17 INSOLVENCY Contractors shall not, without the prior written consent of the City of Santa Ana or OCFA, suffer either the appointment of a receiver to take possession of all, or substantially all of the assets of Contractor, or make a general assignment of such assets for the benefit of creditors. Any such action taken or suffered by Contractor under any insolvency or bankruptcy proceeding constitutes a breach of contract by Contractor, and all property, equipment or materials assigned by OCFA, the City of Santa Ana and/or the County to Contractor related to ---------- - - ---- Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 27 June 14, 2012 25F-46 (9) City of Santa Ana the provision of services under this contract shall be automatically "released" by Contractor and returned back to the possession and control of the City of Santa Ana and OCFA. Following the occurrence of any such event, the City of Santa Ana or OCFA may assign such property, equipment or materials to another assigned service provider, in the City of Santa Ana's or OCFA's sole discretion. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 28 June 14, 2012 25F-47 0 City of Santa Ana SECTION 4 OPERATIONAL STANDARDS, PROCEDURES AND PERFORMANCE REQUIREMENTS 4.1 EMERGENCY RESPONSE COMMUNICATIONS SYSTEM 4.1.1 Communications Requirements Contractors must comply with the following requirements concerning the installation, use, operation, and maintenance of their Emergency Response Communications System: A. Emergency Response Communications System must be operated and maintained by Contractor twenty-four (24) hours per day, seven (7) days per week; B. Contractor dispatch centers must be equipped with a secondary, emergency back-up electrical system to insure uninterrupted twenty-four (24) service; and, C. Contractor must provide and maintain, at its sole cost and expense, a dedicated point-to- point telephone ring-down line between the OCFA Emergency Communications Center and the Contractor's ambulance dispatch center. D. All 9-1-1 Emergency Transport units assigned to the City of Santa Ana must at a minimum be equipped with an 800 MHz communication device that allows communication between OCFA personnel, OCFA dispatch center, and contractor dispatch center. Tier 2 mutual aid units must meet same requirements. E. At the City of Santa Ana and OCFA's discretion, AVL may be required on all 9-1-1 Emergency Transport units at contractors expense. F. GPS/Route navigation is desirable. 4.1.2 Vehicle Communications A. 800 MHz Mobile Radio Contractors must install and maintain at their sole cost and expense, an OCFA approved 800MHz mobile radio in the front passenger area (with a remote head in the rear patient area) of each ambulance that will be used for patient transport in the performance of the contract. The 800MHz mobile radios with a pre-identified radio identifier and at the discretion of the OCFA, configured to send status and message data, are to be used by Contractors' EMTs and ambulance personnel to communicate response status with OCFA Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 29 June 14, 2012 25F-48 v City of Santa Ana dispatch and by OCFA paramedics to communicate with base and receiving hospitals during patient transport. Contractors must comply with the following 800 MHz mobile radio requirements: i. Contractors must obtain all necessary licenses, permits, and/or approvals from OCC (and any other applicable licensing or permitting agency) to operate and maintain their 800 MHz mobile radios as required herein in conjunction with the 800 MHz C.C.C.S.; ii. Contractors must comply with all federal, state, and local laws, rules, statutes, and regulations governing the operation of 800 MHz mobile radios, including compliance with 800 MHz C.C.C.S. Standard Operating Procedures; iii. Contractors must ensure that their 800 MHz mobile radios are pre-assigned to a vehicle with a pre-identified radio identifier and are configured to send status and message data compatible with OCFA SmartNet Information Management System (SIMS), and must include an OCFA approved and issued Motorola DEKbox with 8 status/message keys to transmit unit status (e.g., en route, on scene, and available status functions); OCFA will configure the SIMS system to enable this feature on all Contractor radios enabled on the 800 MHz C.C.C.S.; and iv. All Contractor 800MHz mobile radios must meet OCFA, OCC, ECC, 800 MHz C.C.C.S., and OCEMS specifications and requirements. B. Mobile Data Computer System Contractors must install and maintain, at their sole cost and expense, an OCFA approved and issued mobile data radio at Contractors' dispatch center for purposes of sending and receiving electronic emergency dispatch information, instructions, and call status. Contractors must comply with the following mobile data radio system requirements: i. MDC Radio Upon the award of a contract and prior to the Effective Date, Contractors must pay OCFA a onetime, non-refundable communications start-up fee of $3,500, Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 30 June 14, 2012 25F-49 "IN x? City of Santa Ana which shall cover the following: (a) OCFA-issued and owned mobile data radio; (b) OCFA-issued mobile data application software; (c) mobile data installation; (d) mobile data programming; and (e) Mobile Data Radio and antenna to be installed at the Contractor's expense, as specified by OCFA. All communications equipment issued to Contractors by OCFA pursuant to this Section shall remain the property of OCFA. The communications systems described in this Section must be installed and fully operational prior to the Effective Date. Upon contract termination, all OCFA-issued communications equipment must be returned to OCFA within thirty (30) days. This fee may be waived by OCFA if Contractor currently meets the specified requirements of this paragraph. ii. Annual MDC Fee Contractors must pay OCFA a $250 annual fee for MDC system operation and maintenance, which shall be due and payable upon contract award and annually thereafter. iii. Personal Computer Contractors must provide, at their sole cost and expense, and as part of their Emergency Response Communications System, a personal computer having the following minimum specifications: Intel Pentium 500 MHz or greater; 10.0 GB Hard Drive; 256 Mb SDRAM; 2000XP OS; Color display VGA; Com Ports - 1 serial, 1 USB, 1 Parallel; CD ROM; and, Keyboard - Standard Qwerty 104. iv. Mobile Application Software Motorola Tx Messenger v3.0 software or greater as specified by OCFA. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 31 June 14, 2012 25F-50 R; City of Santa Ana 4.2 SERVICE HOURS 4.2.1 Service Contractor must provide, at a minimum: A. Transportation Personnel to fully staff the First Tier Service ambulances as provided by the Contractor as part of this contract, such that those vehicles are able to provide twenty- four (24) hour emergency ambulance transportation within the City, seven (7) days a week, for the duration of the term of the contract. B. A sufficient number of fully equipped Mutual Aid units, such that Contractor is able to respond to all 911 and other emergencies calls in the City of Santa Ana and meet the response time requirements set forth in Section IV(C) below. C. Except to the degree that the RFP specifically provides for an exemption, during the term of the Contract, Contractor shall provide sufficient resources such that Contractor is able to respond to 100% of all 911 and other emergency calls in the City of Santa Ana by means of the combined efforts of the First Tier Service and Mutual Aid Service within the response time requirement. 4.2.2 Field Supervisor Contractor must have an authorized field supervisor available to the City of Santa Ana and OCFA personnel, either by radio or in person, on a twenty-four (24) hour, seven (7) day per week basis during the term of the contract. The Field Supervisor must be assigned and staffed in a separate non-transport unit. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 32 June 14, 2012 25F-51 x ,. City of Santa Ana 4.3 RESPONSE TIMES 4.3.1 General Requirements Contractors must respond to OCFA's requests for emergency ambulance transportation service within the response times set forth in this Section. Response times will be calculated as the actual elapsed time in minutes from the moment the request is received by the Contractor's dispatch center to the time that the Contractor's first ambulance arrives on scene. Where multiple ambulances are dispatched to the same emergency scene, only the response time of the ambulance arriving first will be counted for purposes of calculating the response time. 4.3.2 Response Time Measurement Response times are measured in full minutes, rounded upward. For purposes of measuring compliance and for the imposition of any penalties, any partial minute will be rounded to the next full minute. For example, a response time of 10:01 or 11:00 is counted as eleven minutes. 4.3.3 Response Times Required Contractor must strictly adhere to the following required response times at a quarterly compliance rate of ninety percent (90%) in each Code 2 and Code 3 categories, which shall be reported separately: Metro/Urban Requirements: a. Code 3- Response time must not exceed ten (10) minutes, zero (0) seconds. b. Code 2- Response time must not exceed fifteen (15) minutes, zero (0) seconds. 4.3.4 Response Time Reporting Contractor must provide quarterly response time reports to the OCFA ("Quarterly Response Time Reports"). If the Quarterly Response Time Reports are not submitted to the OCFA as prescribed herein two (2) or more times in a single 12-month period, such omissions may constitute breach of contract. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 33 June 14, 2012 25F-52 k City of Santa Ana 4.3.5 Call Cancellation in the event a call for service is cancelled prior to arrival, the response will be considered to be within the response time requirement so long as the elapsed time between the call for service and the cancellation does not exceed the applicable response time requirement. In the event the elapsed time between the call for service and the cancellation is in excess of the applicable response time requirement, the call will be considered late. 4.3.6 Quarterly Response Time Report - Format The Quarterly Response Time Reports must be submitted by Contractor using an electronic spreadsheet format. Whenever response times in either Code 2 or Code 3 categories fall below the 90% compliance rate in any given quarter, Contractor shall include a narrative assessment as to the cause of any response delay, and, if requested, shall meet and confer with the OCFA Fire Chief or designee for purposes of establishing a plan for avoiding such delay in the future. 4.3.7 Exemptions to Response Time Requirements The response time requirements set forth in this Section may be suspended and not enforced, at the sole discretion of the OCFA, in unusual circumstances. There shall be no exemption for response delays due to vehicle mechanical problems, driver error, traffic, weather, or mistake. The response time requirements set forth in this Section will be suspended and not enforced under the following limited circumstances: A. High Call Volume: Responses to calls for service during periods of unusual system overload or high call volume, which shall be determined at the sole discretion of the OCFA; B. Disasters: Responses to calls for service during an OCFA or city-declared disaster occurring during a declared disaster in a neighboring jurisdiction, which has requested emergency ambulance transportation or other mutual aid assistance from OCFA or the City of Santa Ana. For purposes of this Section, a "declared disaster" means any condition of disaster as declared or affirmed by the OCFA Fire Chief or his designee; Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 34 June 14, 2012 25F-53 0 City of Santa Ana C. Multiple Ambulance Response: For responses to calls for service where more than one ambulance is dispatched to the same incident, only the response time of the ambulance first to respond will be required to meet the required response time requirements; D. Response Up/Downgrade: For Code 3 calls where the response priority code is downgraded to Code 2 by OCFA while the ambulance is en route to the scene, the response time standard for that call shall be recorded as a Code 2 call. If the response priority code is upgraded from Code 2 to Code 3 by OCFA while the ambulance is en route to the scene, the response time standard for that call shall be recorded as the number of minutes for a Code 3 call plus the number of minutes already elapsed, not to exceed the original total minutes for a Code 2 call;. E. Return of OCFA Personnel: In the event that an ambulance is delayed in responding to a call for service, or is hindered from providing a timely response, due to the need to comply with the requirement that it return all OCFA personnel to their respective fire stations, as described herein, the response time requirement for that call will be suspended. This exemption will only apply for a call for service dispatch that occurs while the ambulance is waiting for or actually returning OCFA personnel. It shall be the Contractor's responsibility to document such circumstances, including the length of time and the affected call(s) for service. Contractor must apply for a specific exemption as provided below. Calls for service dispatches that occur after the ambulance has returned OCFA personnel and while returning to any ambulance post location are not eligible for this exemption. 4.3.8 Procedures to Request Response Time Exemption Applications for receiving an exemption to the response time requirements must be submitted by Contractor to the OCFA for approval. Such requests must accompany the Quarterly Response Time Report for the period in which the exemption is requested. Requests for exemptions outside of the current quarterly reporting period will not be considered. Each request for exemption must include the following information: A. The incident date; B. The OCFA Incident Number(s); C. A narrative summary of the incident; D. Explanation for the cause of the response time delay; and Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 35 June 14, 2012 25F-54 City of Santa Ana E. The specific exemption requested. The decision to either grant or deny a response time exemption request will be made by the OCFA within thirty (30) days; the decision to deny may be appealed to the Santa Ana OCFA Fire Chief or his designee, whose decision shall be final. 4.3.9 Use of Alternative Methods to Meet Response Time Requirements For purposes of maintaining compliance with the response time requirements established herein, Contractor must negotiate and enter into a Mutual Aid Contract with an ambulance service operator for the provision of 9-1-1 Emergency Transportation Service ("Mutual Aid Provider"). Any ambulance provider selected to provide such services, and any agreement to provide such services pursuant to this Section, must satisfy the following requirements: A. The Mutual Aid Contract must be reviewed and approved by the City of Santa Ana and OCFA prior to execution of the Contract awarded pursuant to this RFP and a copy of the Mutual Aid Contract must be sent to the OCFA EMS Section Battalion Chief; B. Mutual Aid Providers will be expected to perform 9-1-1 Emergency Transportation Service in the City of Santa Ana in accordance with all of the operational standards, procedures, and performance requirements set forth in the Contract Documents. Prior to Contractor providing any 9-1-1 Emergency Transportation Service under the Contract, the Mutual Aid Provider must acknowledge this obligation in writing to the City of Santa Ana and OCFA. C. Mutual Aid Providers and their employees must cooperate with the City of Santa Ana and OCFA and must participate in any audit requested by the City of Santa Ana or OCFA concerning their performance; and D. Notwithstanding the above, Contractor, and not the Mutual Aid Provider will be primarily responsible for ensuring compliance with all terms, conditions, standards, and performance requirements set forth in the Contract Documents, including but not limited to, the primary obligation to pay any penalties which may be imposed by the OCFA and the payment of all fees and reimbursements. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page j 36 June 14, 2012 25F-55 C City of Santa Ana 4.3.10 Disciplinary Actions for Failure to Meet Response Time Requirements/ Performance Deficiency A. Meet and Confer Should a Contractor fail to meet the response time requirements set forth in this section in any quarterly period, either for any single Code category or for the cumulative total of Code 2 and Code 3 calls as outlined in section 4.3.3 -Response Times Required of this RFP, the OCFA representative shall notify the Contractor and meet and confer with said Contractor regarding performance and response time deficiencies. The purpose of this meeting is to notify the Contractor of its deficiencies and to work with the Contractor to ensure proper response time performance in the immediate future. B. Penalties At the discretion of the OCFA, monetary penalties may be assessed against a non- compliant Contractor for failure to meet the response time requirements set forth in this Section. Quarterly aggregate response times (i.e., in any quarterly period for any single Code category) that are not in compliance with the response time requirements set forth in this Section may result in the OCFA assessing the non-compliant Contractor with a monetary penalty according to the following compliance and fine schedule: Quarterly Responses That Are In Compliance with Response Time Requirements: Penalty Imposed*: 90% or Better None 85%-89.9% $5,000 80%-84.9% $7,000 Less than 79.9% $10,000 *Note: Penalties are for Code 21Code 3 reported separately and calculated separately. In addition to the above response time penalties, the OCFA may assess monetary penalties against Contractor for the following: i. Turned Call Penalties Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 37 June 14, 2012 25F-56 ' : City of Santa Ana I%Wior Any calls for service that are not handled by the Contractor through the First Tier or Mutual Aid Service, that require OCFA to request service from another ambulance service operator, will result in the assessment of a "Turned Call" penalty in the amount of $1,000 per occurrence. Contractor is to immediately notify the OCFA EMS Chief of said occurrence within 24 hours. Failure to report within 24 hours will result in an additional penalty of $500. ii.Late Report/Late Payment Penalties Any reports, fees, or reimbursements that are required to be submitted to the OCFA Contractor pursuant to the Contract Documents (e.g., Quarterly Response Time Reports, CQI, etc.) and that are not submitted on time may result in the imposition of a $500 penalty per occurrence. C. Corrective Action Plan Situations which come to the attention of, or are reported to, the OCFA EMS Section Battalion Chief and which appear to constitute a Contractor service or performance deficiency or substantial inadequacy, as determined by the OCFA, shall be immediately investigated by the OCFA. An example of such situation might be the Contractor's failure to achieve at least a 90% response time performance in any single Code category for a quarterly reporting period. At the discretion of the OCFA, a Corrective Action Plan may be imposed on the Contractor to correct identified and verified performance deficiencies and inadequacies. The OCFA authorized representative shall meet to develop a written Corrective Action Plan (CAP) within fifteen (15) working days of the identification and verification of the service or performance deficiency, or substantial inadequacy, in accordance with the following CAP requirements: i.CAP Format The CAP shall describe the following: (1) The service or performance deficiency, or substantial inadequacy shall be identified; and (2) The method by which Contractor is to correct the service or performance deficiency, or substantial inadequacy, shall be outlined. Contractor shall sign Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 38 June 14, 2012 25F-57 C) City of Santa Ana the CAP, thereby agreeing to the corrective action set forth in the CAP, with any areas of disagreement noted in writing. A copy of the signed CAP shall be furnished to Contractor at the conclusion of the CAP meeting. ii.Correction Period Correction of the service or performance deficiency, or substantial inadequacy, shall occur within a period of not to exceed sixty (60) days from the development of the CAP, unless the OCFA representative determines that correction cannot be accomplished within the specified time frame. When correction will take longer than sixty (60) days from the development of the CAP, the CAP shall specify interim dates by which specific steps toward correction of the service or performance deficiency, or substantial inadequacy, will take place with the total time period not to exceed three (3) months. iii.CAP Inspection/Compliance The Fire Chief or his designee, shall visit and inspect Contractor's business office, facilities, vehicles, personnel, and/or records to review and document actions taken by Contractor to implement the CAP and shall document any continuing service or performance deficiency, or substantial inadequacy, which is not corrected within the specified time frame. In the event Contractor fails to correct the service or performance deficiency, or substantial inadequacy identified in the CAP within the time frame provided, OCFA may find Contractor to be in material breach of the Agreement. D. Timely Performance Required Assessment of penalties or the imposition of a CAP, pursuant to this Section will not relieve Contractor of the responsibility to meet all performance expectations as set forth in the Contract Documents. Substandard cumulative response time performance (i.e., below the 90% compliance rate for combined Code 2 and Code 3 calls) in any two (2) quarters in a single twelve (12) month period will constitute breach of contract, resulting in the imposition of a Remedial Action Plan (RAP). Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 39 June 14, 2012 25F-58 ?°?' ,.. City of Santa Ana o Failure to timely correct and cure any response time deficiency, after having been given notice and a reasonable opportunity to cure such violation in accordance with an established Corrective Action Plan (CAP) or failure to cure a breach of contract after the imposition of a Remedial Action Plan (RAP), may constitute a material breach of the Agreement. Additionally, consistent problems in meeting and/or maintaining the response time requirements will be a key factor in determining whether to grant contract extensions. This RFP requires the highest levels of performance, reliability, and compliance with the established performance criteria and service delivery criteria, and the mere demonstration of effort, even diligent and well-intentioned effort, will not substitute for proper compliance. E. Waiver Any monetary penalty that may be imposed pursuant to this Section may be waived, upon a showing of good cause, at the sole discretion of the OCFA whose decision shall be final. 4.3.11 Emergency On-Scene Procedures A. Contractors must perform as a part of the patient care team and must be able to perform all BLS treatment modalities within their scope of practice, as required by OCEMS. B. All ambulance Transportation Personnel assigned by Contractor to perform 9-1-1 Emergency Transportation Service under the contract must: i. Be trained in Orange County EMS protocol and procedure; ii. Work under the direction of the OCFA Incident Commander and/or the OCFA EMT- Paramedic in charge of the patient(s) and/or incident; iii. Fully cooperate with and abide by the instructions of the OCFA Incident Commander and/or the OCFA EMT-Paramedic in charge of the patient(s) and/or incident; Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 40 June 14, 2012 25F-59 C) City of Santa Ana iv. Place their apparatus and equipment at the scene in a safe location or as deemed appropriate by the OCFA Incident Commander and must be mindful of the need for safe operations, including the avoidance of exhaust fumes; v. Not interfere with or assist OCFA personnel in any fire fighting or emergency rescue operation; vi. Request a secondary ambulance and/or field supervisor immediately upon determining that their unit has suffered a mechanical failure or is or may become disabled, or upon the request of an OCFA Incident Commander, and must likewise immediately inform the OCFA Incident Commander of any mechanical failures; and, vii. Be aware that safety is the responsibility of all personnel on scene; ambulance personnel shall not enter or operate in unsafe environments. 4.3.12 Disaster Assistance During a disaster, declared locally or in a neighboring jurisdiction, strict application of the performance standards set forth in the Contract Documents may be temporarily suspended by the OCFA in order to provide an appropriate response. While disaster coordination shall be provided by OCFA, Contractor is expected to be actively involved in the planning and response to any declared disaster. Upon notification of a disaster by OCFA, Contractor must immediately commit any and all available resources and assist OCFA and the City of Santa Ana in accordance with disaster plans and protocols applicable in the locality where the disaster has occurred. In the event of a disaster, the following shall apply: A. During such periods, Contractor will be released from the response time requirements until notified by the OCFA Duty Officer that disaster assistance is no longer needed; B. When disaster assistance is no longer needed, Contractor must resume performance pursuant to the Contract Documents as quickly as is practical considering personnel exhaustion, medical supply restocking needs, and other relevant considerations; Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 141 June 14, 2012 25F-60 0 City of Santa Ana C. While performing disaster assistance, Contractor shall provide supervisory assistance at the command post or emergency operations center as requested and are to use best efforts to provide local emergency coverage; Contractor must also suspend non-emergency transport services as necessary, informing persons requesting non-emergency transport of the reason for the temporary suspension; D. During the course of a disaster, OCFA will work with Contractor to utilize mutual aid providers who are authorized to perform such services within the County to meet the service demands of the disaster. 4.3.13 Standard of Performance Contractors must perform all work and services pursuant to the Contract Documents in a skillful and workmanlike manner, and consistent with the standards generally recognized as being employed by professionals in the private, emergency ambulance transportation field in the State of California. Contractor must warrant that they are skilled in the professional calling necessary to perform all work and services under the Contract Documents. Contractor must warrant, and from time to time may be required by the OCFA to demonstrate, that all employees and authorized subcontractors shall have sufficient skill and experience to perform the work and services assigned to them under the Contract. Finally, Contractor must further represent that they, their employees, and authorized subcontractors have all licenses, permits, qualifications and approvals of whatever nature that are legally required to perform the work and services under the contract, and that such licenses and approvals shall be maintained at all times during the term of the contract. 4.3.14 General Provisions A. Return of OCFA Personnel OCFA provides Advanced Life Support ("ALS") services from a variety of delivery platforms, including engine and truck companies. In cases where OCFA personnel accompany patients in the ambulance en route to hospitals or to other receiving facilities, and the OCFA ALS unit does not follow-up to the hospital/receiving facility, the Contractor/ or Mutual Aid Provider shall return those personnel to their assigned fire station(s) within 30 Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 42 June 14, 2012 25F-61 City of Santa Ana minutes from the conclusion of the run. The conclusion of the run is defined as the moment when the patient has been transferred into the care of hospital/medical staff, the ambulance crew has completed all required documentation, and the ambulance has been restocked and is ready to be placed back in service. At the conclusion of the run, the ambulance crew is to advise the accompanying OCFA personnel that they are ready to return them to their station. If while returning OCFA personnel to their station, the ambulance receives another 9-1-1 emergency call, the ambulance may accept that call for service and take those returning OCFA personnel to the new call at the discretion of the OCFA personnel on board. B. 911 Calls for Service/Referral The 9-1-1 Emergency Transport Ambulances must be able to respond 24 hours a day 7 days a week to all 911 and other emergencies as required. C. Performance Contractor must demonstrate a continuous effort to detect and correct service level performance deficiencies, as determined by the OCFA, and to continuously upgrade the performance and reliability of the EMS system. Clinical and response time performance must be extremely reliable, with equipment failure and human error held to an absolute minimum through constant attention to performance, protocol, procedure, performance auditing, proper management oversight, employee training, continuing education, and prompt and definitive service level corrective actions plans. D. Conflict of Interest Proposers must certify that they are not, and will not be, violating either directly or indirectly any conflict of interest statute, rule, or regulation by their performance of the services described herein. E. Complaints Contractor must immediately notify the OCFA in writing of any complaints, inquiries, or investigations initiated by OCEMS, the California Emergency Medical Services Authority, and/or any other federal, state, or local regulatory agency regarding Contractor's services performed pursuant to the Contract Documents, including but not limited to: level of service; service delivery; service quality; billing practices; medical training; and personnel. Nothing Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 43 June 14, 2012 25F-62 r- City of Santa Ana .Ike . Iftwor, in the Contract Documents shall be construed as superseding the authority of OCEMS or any other duly empowered regulatory agency from separately and/or concurrently exercising its authority to provide regulatory oversight and to take action to ensure that emergency ambulance response services are administered according to law. F. HIPAA Business Associate Assurances Effective April 14, 2003, or such other implementation date established by law, to the extent that the parties have a "business associate" relationship, the parties shall carry out their obligations under the Contract Documents in compliance with the privacy regulations published at 65 Federal Register 82462 (December 28, 2000) (the "Privacy Regulations") pursuant to Public Law 104-191 of August 21, 1996, known as the Health Insurance Portability and Accountability Act of 1996, Subtitle F - Administrative Simplification, Sections 261, et seq., as amended ("HIPAA"), to protect the privacy of any personally identifiable, protected health information ("PHI") that is collected, processed or learned as a result of the services provided pursuant to the Contract. In conformity therewith, both parties must agree that they will: i. Not use or further disclose PHI except: (a) As permitted under the Contract (that is, for the purpose of maintaining accurate records of the services provided pursuant to the Contract and for the billing of such services to patients, guarantors, insurers, carriers or other responsible parties; the issuance of reports to the other party pertaining to same; and related administrative functions pertaining to these activities); (b) As required for the proper management and administration of ALS and BLS in their capacity of Santa Ana as HIPAA "Business Associates" of each other; or (c) As required bylaw; ii. Use appropriate safeguards to prevent use or disclosure of PHI except as permitted by the Contract; Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 44 June 14, 2012 25F-63 xt City of Santa Ana iii. Report to each other any use or disclosure of PHI not provided for by the Contract of which a party becomes aware; iv. Ensure that any agents or subcontractors to whom either party provides PHI, or who have access to PHI, agree to the same restrictions and conditions that apply to both parties with respect to such PHI; v. Make PHI available to the individual who has a right of access as required under HIPAA; vi. Make available for amendment and incorporate any amendments to PHI when notified to do so by either party; vii. Make available to either party the information required to provide an accounting of the disclosures of PHI made by the one party on the other party's behalf, provided such disclosures are of the type for which an accounting must be made under the Privacy Regulations; viii.Make their internal practices, books and records relating to the use and disclosure of PHI available to the Secretary of the Department of Health and Human Services for purposes of determining either party's compliance with HIPAA and the Privacy Regulations; and ix. At the termination of the Contract, return or destroy all PHI received from, or created or received by one party on behalf of the other party. In the event the return or destruction of such PHI is infeasible, both parties' obligations under this Section shall continue in full force and effect so long as either party possesses any PHI, notwithstanding the termination of the Contract for any reason. G. Medicare/Medi-Cal Participation Contractor must warrant and represent that they are enrolled providers in good standing in the Medicare and Medi-Cal programs and are not the subject of any pending actions, investigations or prosecutions, whether civil, criminal or administrative, relating to their billing or reimbursement practices, and that Contractor shall not employ or utilize individuals Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 45 June 14, 2012 25F-64 0 City of Santa Ana for the performance of services hereunder who have been excluded from any state or federal health care program. Contractor must agree to notify the OCFA of any imposed exclusions or sanctions covered by this warranty and the OCFA in consultation with the City of Santa Ana reserves the right to immediately terminate the Contract upon receipt of such notice. 4.3.15 External Medical Quality Control Contractor must fully comply with all federal, state, and local medical standards, protocols, and rules and regulations applicable to the provision of private, emergency BLS ambulance transportation, including those established by OCEMS. Contractor must at all times during the contract term cooperate with the OCEMS program managers and the OCEMS Medical Director in the monitoring, regulation, management, oversight, and administration of the County EMS system. The OCEMS Medical Director, or his designee, has both the authority and responsibility to routinely establish and monitor private, emergency ambulance system performance, including but not limited to: ambulance equipment standards; medical protocols; personnel standards; training standards; medical dispatch procedures; first responder practices and training; medical control; and to effect corrective and disciplinary action as necessary. 4.3.16 Internal Medical Quality Control Contractors must establish a Continuous Quality Improvement ("CQI") program directed at, but not limited to, effective administration and management of clinical performance, response time performance, driver performance, dispatch performance, and for all other BLS service levels. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 46 June 14, 2012 25F-65 City of Santa Ana 4 y, SECTION 5 PERSONNEL 5.1 PERSONNEL REQUIREMENTS 5.1.1 Employee Performance Contractor must employ only competent and trained personnel, and shall provide a sufficient number of employees to perform the services provided under the Contract Documents. Contractor must comply with all the following personnel requirements: A. All of Contractor's Transportation Personnel and employees shall be sufficiently trained and capable to ensure the safe and proper discharge of their service responsibilities; B. All Contractor ambulance personnel must possess valid California Driver's Licenses in the proper class, including any required certifications, and must be compliant with all relevant provisions of the California Vehicle Code, Health and Safety Code, and all other laws applicable to private, emergency ambulance response personnel; C. Contractor must have an employee alcohol and drug program that includes at a minimum, an alcohol and drug free workplace policy, and an employee alcohol/drug-testing program that complies with the U.S. Department of Transportation requirements to the extent allowed by law, including random alcohol and drug testing. Any Contractor employee found working under the influence of alcohol or drugs must be immediately removed from performing any further duties under the Contract Documents. The alcohol and drug program must meet the following requirements: i. A contract with a program administrator and authorized lab certified by the U.S. Department of Transportation; ii. Procedures and components substantially as in Part 40 of Title 49 of the Code of Federal Regulations for pre-employment; iii. Procedures and components substantially as in Part 382 of Title 49 of the Code of Federal Regulations for rehabilitation, return-to-duty and follow up testing; iv. Procedures and components for random testing following U.S. Department of Transportation guidelines, and additional tests as required following accidents, Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 47 June 14, 2012 25F-66 (9) City of Santa Ana rehabilitation, return-to-service, and other circumstances providing reasonable suspicion to test; v. Upon request by the OCFA, yearly reports of the random testing component must be filed by the program administrator, in redacted form concealing employee identifiable information, with OCFA; vi. Contractors and program administrator's alcohol and drug program records shall be made available, in redacted form concealing individual employee identities, to OCFA upon request; vii. Contractor employees must show a valid California driver's license at the time and place of testing; and viii. All test results are kept confidential except that OCFA is authorized to receive copies, in redacted form concealing individual employee identities, for its administrative purposes, and except as otherwise authorized or required by law. E. Contractor must participate in the California Department of Motor Vehicles (DMV) Employer Pull Notice Program; F. Contractor must not employ in the performance of services pursuant to the Contract Documents any ambulance operator or attendant or employee convicted of or having pled nolo contendere to a crime involving a stolen vehicle, stolen property, violence, drugs or moral turpitude, fraud, or misdemeanor or felony driving while under the influence of alcohol or drugs. If any Contractor employee is charged with any of the above listed crimes, Contractor must immediately suspend that employee from performing any further duties under the Contract Documents pending the outcome of the criminal case; G. Contractor's employees must maintain acceptable standards of dress, including uniforms, and cleanliness while on duty in the community and must at all times conduct themselves in a professional manner; H. Contractor's employees must fully cooperate with and abide by the instructions of OCFA personnel while on scene; Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 48 June 14, 2012 25F-67 City of Santa Ana 1. If any employee becomes ineligible to provide services under the Contract Documents, Contractor must immediately notify the OCFA EMS Section Battalion Chief in writing of such ineligibility and the reason(s) therefore; J. Contractors must ensure that all of its employees and ambulances are, at all times during the term of the contract, in full compliance with all federal, state, and local laws, rules, statutes, and regulations, including but not limited to: the California Vehicle Code; the California Health & Safety Code; Orange County Ambulance Ordinance; applicable City of Santa Ana ambulance ordinances; and any and all OCEMS or State EMS Authority policies, standards, procedures, regulations, and/or protocols. All Contractor employees must have in their possession, at all times while on duty, applicable licenses, certifications, and/or permits, as may be required by the agencies and authorities listed above; K. Contractor's emergency response personnel must carry and furnish to OCFA personnel upon request any required licenses, certifications, and/or permits, including proper identification, for purposes of verifying validity, ensuring compliance with licensing, certification, and permitting requirements, and for the proper reporting of employee performance-related issues to Contractor; L. The OCFA EMS Section Battalion Chief may request Contractor to participate in emergency response joint training exercises to improve the capability and coordination of both OCFA and Contractor's response to a given emergency or disaster. Such training will be scheduled and mutually coordinated by the OCFA EMS Section Battalion Chief and the Contractor. Such training shall not exceed twenty (20) hours per year/per shift and not billable to the City of Santa Ana; M. Any additional training that may be deemed necessary by OCFA shall be attended by Contractor's personnel upon reasonable notice and at the sole cost and expense of Contractor. Such additional training may include, but is not limited to, mass casualty, weapons of mass destruction, and/or other emergency response training; N. Contractors must make available to the OCFA EMS Battalion Chief upon request any and all Contractor personnel training records for those employees who perform services pursuant to the Contract Documents; Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 49 June 14, 2012 25F-68 rv; City of Santa Ana 0. Contractor employees shall perform the duties required under the Contract Documents in an ethical, professional, and orderly manner and shall endeavor at all times to obtain and keep the confidence of the public. P. Contractor must utilize management practices that ensure that its Transportation Personnel, working extended shifts, part-time jobs, voluntary overtime or mandatory overtime, are not exhausted, overworked, or exhibiting impaired judgment or motor skills. 5.1.2 Employee Removal At the request of the OCFA (in the sole discretion of either) and based on a demonstrated pattern of either poor performance, misconduct, or service complaints, Contractor shall remove any Transportation Personnel designated by the OCFA from performing further duties under the Contract. 5.2 CONTROL Neither the County, the City of Santa Ana or OCFA, or any of their respective officers, elected officials, agents, representatives, or employees, shall have any control over the conduct of Contractor's employees except as specifically set forth in the Contract Documents. Under no circumstances shall Contractor or any of its employees represent that they are in any manner agents or employees of the City of Santa Ana, County or OCFA, it being understood that Contractor its agents and employees are as to the City of Santa Ana, County and OCFA, wholly independent contractors and that Contractor's obligations to the City of Santa Ana and OCFA are solely those prescribed by the Contract Documents. Contractor further acknowledges and agrees that the City of Santa Ana, the County, and OCFA have no responsibility whatsoever for the payment of any wages, salary, health benefits, retirement benefits, taxes, or any other benefits that may be due to Contractor employees. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 50 June 14, 2012 25F-69 y. City of Santa Ana SECTION 6 SUPPLIES, EQUIPMENT AND VEHICLES 6.1 Standards All equipment and supplies furnished by Contractors to perform BLS services under the Contract Documents must comply with all federal, state, and local laws, rules, statutes, and regulations applicable to the provision of emergency ambulance transportation, including but not limited to, those BLS equipment and supply standards and protocols established by the OCEMS Medical Director. Such equipment and supplies must be stocked at all times on each ambulance performing services under the Contract Documents. 6. 1.1 Standard Inventory In addition to the above equipment and supply standards, Contractors must carry and stock at all times throughout the contract term on each ambulance performing services within an assigned EOA the following emergency medical equipment, which shall all be readily available and accessible from the interior portions of the patient transportation compartment: A. Bag valve mask resuscitator, adult with variable mask sizes; B. Bag valve mask resuscitator, pediatric with variable mask sizes; C. Heavy gloves to be used for blood or body fluid protection; D. Disposable Latex gloves, medium, large and x-large, two (2) boxes; E. Suction unit that complies with OCEMS policies and procedures; F. Non-invasive blood pressure device (various cuff sizes, including thigh cuff); G. Child safety seats (when approved by federal agencies). 6.1.2 Required, Equipment Automated External Defibrillator (in conjunction with trained and qualified employees). Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 151 June 14, 2012 25F-70 0 City of Santa Ana 6.1.3 Personal Safety Equipment Contractors shall provide personal safety equipment for all employees in accordance with applicable federal and state laws or standards. It shall be the sole responsibility and expense of the Contractor to maintain or replace, or cause to be maintained or replaced, any personal safety equipment required. Contractors are solely responsible for ensuring that all of its personnel abide by all federal, state and local safety standards. To ensure that each ambulance responder has emergency scene personal protective equipment they may need to keep them safe in a potentially hazardous environment, Contractors shall comply with State OCEMS Guideline 216 regarding recommended PPE for Ambulance Personnel (OSHA's General Description and Discussion of the levels of Personal Protective Gear, 29CFR 1926 65, App. B, Part IV, Level D) for each ambulance dedicated to 911 emergency transportation, including: Full-length blue (EMS) jacket with reflective stripes. (NFPA 1999, EMS Standards) ii. Hard hat, Work Helmet Blue iii. Leather gloves Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 52 June 14, 2012 25F-71 City of Santa Ana SECTION 7 BID PROPOSAL SUBMISSION FORMS PROPOSER CHECKLIST ? BINDER (ORIGINAL + 5 COPIES + 1 ELECTRONIC FILE OF THE PROPOSAL PACKAGE SAVED ON A CD OR FLASH DRIVE) ? ONE BID PROPOSAL ? PAGE SIZE, FONT SIZE, PAGE LIMITS ? TITLE PAGE ? BID PROPOSAL DEPOSIT ? TABLE OF CONTENTS ? ITEM I - COVER LETTER ? ITEM 2: GENERAL OVERALL DESCRIPTION OF PLAN TO PROVIDE 9-1-1 EMERGENCY TRANSPORTATION SERVICE IN CITY OF SANTA ANA ? ITEM 3 - OVERALL OPERATIONAL SYSTEM ? ITEM 4 - DRIVER TRAINING ? ITEM 5 - INTERNAL MEDICAL QUALITY CONTROL ? ITEM 6 - MUTUAL AID PROVIDER ? ITEM 7 - PERSONNEL AND TRAINING ? ITEM 8 - HIPAA COMPLIANCE PLAN ? ITEM 9 - CORPORATE COMPLIANCE PLAN ? ITEM 10 - PLAN FOR TAKEOVER OF SERVICE/START-UP ? ITEM l 1 - EMS RESUME ? ITEM 12 - PHASE I APPROVAL NOTIFICATION ? ITEM 13 - PRICE WORKSHEET ? ITEM 14 - CONFLICT OF INTEREST CERTIFICATION ? ITEM 15 - STATEMENT OF TRUTH ? ITEM 16 - NON-COLLUSION CERTIFICATION ? ITEM 17 - PHOTOGRAPHS (OPTIONAL) Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 53 June 14, 2012 25F-72 City of Santa Ana TITLE PAGE/COVER SHEET (1 PAGE LIMIT) City of Santa Ana Request for Proposals for Emergency Ambulance Transportation and Related Services RFP # JRSB002 Insert Proposer Name Insert Proposer Address Insert Proposer Authorized Contact/Representative Signature of Authorized Contact/Representative Insert Proposer Telephone Number Insert Date of Bid Proposal Submission Designate as "Original" or Copy Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 54 June 14, 2012 25F-73 s City of Santa Ana BID PROPOSAL DEPOSIT (1 PAGE LIMIT) Please attach below (either staple or otherwise affix) the required $2,500.00 Bid Proposal Deposit made payable to the City of Santa Ana. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 55 June 14, 2012 25F-74 City of Santa Ana TABLE OF CONTENTS Please include in the Bid Proposal a Table of Contents listing the following requested items and submission forms in the order provided: ITEM 1: COVER LETTER ITEM 2: GENERAL OVERALL DESCRIPTION OF PLAN TO PROVIDE 9-1-1 EMERGENCY TRANSPORTATION SERVICE IN CITY OF SANTA ANA ITEM 3: OVERALL OPERATIONAL SYSTEM ITEM 4: DRIVER TRAINING ITEM 5: INTERNAL MEDICAL QUALITY CONTROL ITEM 6: MUTUAL AID PROVIDER ITEM 7: PERSONNEL AND TRAINING ITEM 8: HIPAA COMPLIANCE PLAN ITEM 9: CORPORATE COMPLIANCE PLAN ITEM 10: PLAN FOR TAKEOVER OF SERVICE/START-UP ITEM 11: EMS RESUME ITEM 12: PHASE I APPROVAL NOTIFICATION ITEM 13: PRICE WORKSHEET ITEM 14: CONFLICT OF INTEREST CERTIFICATION ITEM 15: STATEMENT OF TRUTH ITEM 16: NON-COLLUSION CERTIFICATION ITEM 17: PHOTOGRAPHS (OPTIONAL) Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 56 June 14, 2012 25F-75 0 City of Santa Ana ITEM 1: COVER LETTER (4 PAGE LIMIT) Please include a cover letter, on official Proposer letterhead, that describes the Proposer and its qualifications. A. The official name of the Proposer; B. The Proposer's organizational structure (e.g. corporation, partnership, limited liability corporation, or otherwise); C. The jurisdiction in which the Proposer is organized and the date of such organization; D. The address and telephone number of the Proposer's headquarters and of any local office involved in the bid proposal; E. The Proposer's Federal Tax Identification Number; F. The name, address, telephone, fax numbers and e-mail address of the person(s) who will serve as the authorized contact(s) to the City of Santa Ana and OCFA with regards to the bid proposal, the RFP process, the Contract Documents, and the administration of the contract, if awarded, with authorization to make representations on behalf of and to bind the Proposer; G. Provide applicable authorized signature documentation, pursuant to Proposer's organizational structure/bylaws, verifying the authority of the person signing the original bid proposal to commit to the proposal on behalf of the Proposer (attach to cover letter); H. A representation that the Proposer is in good standing in the State of California and has obtained all necessary licenses, permits, certifications, approvals and governmental authorizations necessary in order to perform all of the required performance obligations specified in the RFP; 1. A representation that the Proposer is in good standing in the Medicare and Medi-Cal programs and is not the subject of any pending actions, investigations or prosecutions, whether civil, criminal or administrative, relating to their billing or reimbursement practices, and that Proposer has not been excluded from any state or federal healthcare program or employs any individual who has been excluded from any state or federal healthcare program; J. Statement of acceptance of all terms, conditions, requirements, and performance criteria contained in the Contract Documents; and, K. Any additional information Proposer deems relevant for consideration during the selection process. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 57 June 14, 2012 25F-76 -,, City of Santa Ana ITEM 2: GENERAL OVERALL DESCRIPTION OF PLAN TO PROVIDE 9-1-1 EMERGENCY TRANSPORTATION SERVICE IN CITY OF SANTA ANA (3 PAGE LIMIT) 1. Provide a general description of how Proposer proposes to provide the 9-1-1 Emergency Transportation Service contemplated by this Request for Proposals. This specifically includes, but is not necessarily limited to, the provision of the First Tier Service, and Mutual Aid Service. This section is intended to provide Proposer with an opportunity to provide a general overview of how their company will be able to provide the various levels of 9-1-1 Emergency Transportation Service, and to provide any other information that Proposer believes will be helpful to City of Santa Ana and OCFA in making its decision. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 58 June 14, 2012 25F-77 ?-? City of Santa Ana ti? ITEM 3: OVERALL OPERATIONAL SYSTEM (3 PAGE LIMIT) 1. Provide description of supervisory plan of crews, including number and location of supervisory personnel. 2. Provide an overall summary of Proposer's Southern California system operations including: a. Total number of ambulances in fleet; b. Total number of employees including line staff, supervisors, managers, administrative, billing, etc.; and Contact information for medical director; contact information for continuing education program, driver training, etc. Phase 2 REP: Emergency Ambulance Transportation and Related Services Page 59 June 14, 2012 25F-78 C) City of Santa Ana ITEM 4: DRIVER TRAINING (2 PAGE LIMIT) Please provide a description of the Driver Training Program Proposer proposes for its provision of the 9-1-1 Emergency Transportation Service and describe in detail how the proposed Driver Training Program will either meet or exceed the performance expectations and requirements. Additional Specific Submission Data: 1. Provide a detailed course syllabus or curriculum for driver training program offered to employees; 2. Provide the total number of course hours per course offered; 3. Describe the internal training plan, including timeframe for completion and retraining; and 4. Provide the name of the institution providing the training, if applicable. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 60 June 14, 2012 25F-79 °- , City of Santa Ana ITEM 5: INTERNAL MEDICAL QUALITY CONTROL (3 PAGE LIMIT) Please provide a description of Proposer's Internal Medical Quality Control and Continuous Quality Improvement ("CQI") Programs. Additional Specific Submission Data: 1. Provide a description of Proposer's quality assurance/improvement process, including time frames for process completion; and 2. If your proposed Internal Medical Quality Control and Continuous Quality Improvement ("CQI") Programs will exceed the standards and requirements set forth in this RFP, please clearly explain in a description how such requirements will be exceeded Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 161 June 14, 2012 25F-80 0 City of Santa Ana ITEM 6: MUTUAL AID PROVIDER (2 PAGE LIMIT) Please provide a description of the Proposer's Mutual Aid Service Provider Agreement. Additional Specific Submission Data: Provide a copy of all current or proposed Mutual Aid Contracts that would include: a. Name of mutual aid provider(s) (if known); b. Location of mutual aid provider(s); c. Staffing capabilities of mutual aid provider, if known. d. Expiration date of the mutual aid provider contracts. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 62 June 14, 2012 25F-81 q4 t`?• City of Santa Ana 4:. ITEM 7: PERSONNEL AND TRAINING (A).ASSIGNED PERSONNEL PROFILE (3 PAGE LIMIT) Please provide a detailed spreadsheet of the individual personnel, including proposed management team, employee names, current certification/license level of service, certificate/license number, and number of years as an employee of Proposer, proposed by Proposer for the performance of services under the Contract Documents. (B). FIELD TRAINING OFFICERS 1PAGE) Please provide the ratio of field training officers to EMTs or other ambulance personnel that Proposer proposes to commit, and provide a detailed explanation of Proposer's proposed Field Supervisor and Training Programs and management/field supervisor oversight plan. (C). PRIMARY PERSONNEL (5 PAGE LIMIT) Please provide the resumes of no more than five (5) proposed key personnel (maximum one page each) whose job duties for Proposer's Orange County operations will relate solely and exclusively to the fulfillment of the terms, conditions, performance expectations, and obligations relative to Proposer's performance under the Contract Documents. (D).EMPLOYEE RECRUITMENT, SCREENING AND ORIENTATION (2 PAGE LIMIT) Please provide description of the current personnel Recruitment, Screening, and Orientation Program Proposer currently employs and modifications Proposer proposes to utilize in connection with its provision of 9-1-1 Emergency Transportation Service and describe in detail how the proposed Recruitment, Screening, and Orientation Program will enable Proposer to consistently and continuously meet or exceed the training standards, personnel requirements, and performance expectations set forth in Section 5. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 63 June 14, 2012 25F-82 ~` ,, City of Santa Ana %Z?Of ITEM 7: PERSONNEL AND TRAINING (CONTINUED) (E).CONTINUING EDUCATION PROGRAMS (2 PAGE LIMIT) Please provide a description of any and all continuing education programs, including continuing medical education programs, that will be provided to all employees who perform services under the Contract Documents, as well as a discussion of Proposer's commitment to providing such programs at all times throughout the contract term. (F). HIPAA TRAINING PROGRAMS (2 PAGE LIMIT) Please provide a description of Proposer's HIPAA training program that has been provided to all employees and will be provided to all new employees who perform services under the Contract Documents. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 64 June 14, 2012 25F-83 City of Santa Ana •t ITEM 8: HIPAA COMPLIANCE PLAN (1 PAGE LIMIT) Please provide a description and explanation of Proposer's HIPAA Compliance Plan, including Proposer's certification that all personnel have signed a confidentiality agreement and have undergone HIPAA Privacy Training. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 65 June 14, 2012 25F-84 xx?. City of Santa Ana t A ITEM 9: CORPORATE COMPLIANCE PLAN (2 PAGE LIMIT) Please provide a summary and explanation of Proposer's Corporate Compliance Plan, if applicable. A Corporate Compliance Plan should include those elements identified in the Office of Inspector General's Compliance Program Guidance for Ambulance Suppliers [Federal Register: March 24, 2003 (Volume 68, Number 56)]. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 66 June 14, 2012 25F-85 C) City of Santa Ana ITEM 10: PLAN FOR TAKEOVER OF SERVICE/START-UP (4 PAGE LIMIT) Please describe in detail Proposer's proposed implementation plan for the takeover of services/start-up, or resumption of services under the new Contract, as applicable, within the City of Santa Ana by the Effective Date; including but not limited to: (a) Proposer's transition or implementation management team; (b) proposed start-up schedule for ensuring timely commencement of services on TBD, at TBD hours; and (c) proposed initial service response and coverage plan, including deployment plans, post locations, housing, and staffing plans. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 67 June 14, 2012 25F-86 0 City of Santa Ana ITEM 11 EMS RESUME (5 PAGE LIMIT) Please provide a detailed resume of Proposer's 9-1-1 Emergency Transportation Service experience. Minimum Qualifications: Proposer meets the experience required outlined in RFP. 1. Complete the 911/Fire/EMS Contracts chart found in the following page and include the following information: • List the city(ies) or Fire Department(s) Agencies for which provider has provided emergency ambulance transportation services during the past ten (10) years that can be used to meet one of the "experience" requirement in the RFP. Provide contact information including contact person, telephone number and address. • Provide 911 emergency ambulance transportation annual call volume by operating area or equivalent. • Indicate whether the provider was the primary or back-up 911 provider. • Indicate the contractual or agreed upon response time requirements for each of the listed contracts. • List the duration, in years, that the provider held a contract as a primary or back-up provider. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 68 June 14, 2012 25F-87 D City of Santa Ana ITEM 11 EMS RESUME (continued) (5 PAGE LIMIT) Ten (10) Years 911/Fire/EMS Experience Primary Response Time Cities/Fire Depts. For Contact Name Monthly 8 or 911 Requirement which bidder has provided And Calendar years Back-up status Call Volume 911 ambulance services in Phone Number that provider M=Metroltlrban past five years held contract. P=Primary S=Suburban/naal B=Back- W--Wilderness M= S= W= M= S= W= M= S= W= M. S= W= M= S= W= The experience requirements this applies to: ? At least three (3) consecutive years experience providing 9-1-1/Fire/EMS services as a rip marX 9-1-1 provider in a system comparable to the City of Santa Ana system (which meets a minimum qualification based on 80% of the 2011 Santa Ana Response Data in Appendix G) within the last 10 years; or ? A current commission on Accreditation of Ambulance Services ("CAAS") Certification and two (2) consecutive years experience as a back-up or primary 9-1-1 provider in a system comparable (based on 80% of the 2011 Santa Ana call volume) to the City of Santa Ana system within the last five (5) years 2. Provide a description of the EMS system as it relates to ambulance deployment for those areas where contracts are/were held. (2 pages.) Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 69 June 14, 2012 25F-88 City of Santa Ana ITEM 12 PHASE I APPROVAL NOTIFICATION Please provide a copy of the Phase I approval notification. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 70 June 14, 2012 25F-89 City of Santa Ana ITEM 13: PRICE WORKSHEET CITY OF SANTA ANA RFP # JRSB002 FOR EMERGENCY AMBULANCE TRANSPORTATION AND RELATED SERVICES 1 9-1-1 EMERGENCY TRANSPORTATION SERVICE FOR PERIOD OF: 9/1/12-9/30/13* Annual Contract Price $ Not to exceed $ per month Optional Billing: (Price Per Transport) 1 9-1-1 EMERGENCY TRANSPORTATION SERVICE FOR PERIOD OF: 9/1/13-9/30/14 Annual Contract Price $ Not to exceed $ per month Optional Billing: (Price Per Transport) 1 9-1-1 EMERGENCY TRANSPORTATION SERVICE FOR PERIOD OF: 9/1/14-9/30/15 Annual Contract Price $ Not to exceed $ per month Optional Billing: (Price Per Transport) Optional 1-Year Extension: 9-1-1 EMERGENCY TRANSPORTATION SERVICE FOR PERIOD OF: 9/1/15-9/30/16 Annual Contract Price $ Not to exceed $ per month Optional Billing: (Price Per Transport) Optional 1-Year Extension: 9-1-1 EMERGENCY TRANSPORTATION SERVICE FOR PERIOD OF: 9/1/16-9/30/17 Annual Contract Price $ Not to exceed $ per month Optional Billing: (Price Per Transport) *Dates assume a September 1, 2012 contract effective date. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 71 June 14, 2012 25F-90 (9) City of Santa Ana ITEM 14: CONFLICT OF INTEREST CERTIFICATION The undersigned hereby certifies on behalf of ("Proposer"), and hereby declares under penalty of perjury under the laws of the State of California, that Proposer is not, and will not be violating either directly or indirectly any conflict of interest statute, rule, or regulation if awarded a contract and if authorized to perform the services described in this RFP. Signed, this day of , 2012 in , California. IF SOLE OWNER: Signature of Owner Date Print Name IF PARTNERSHIP UPA or merge Signature of Partner (General Partner) Date Print Name IF CORPORATION: Signature of President Date Print Name Signature of Secretary Date Print Name Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 72 June 14, 2012 25F-91 r City of Santa Ana ITEM 15: STATEMENT OF TRUTH The undersigned hereby certifies on behalf of ("Proposer"), and hereby declares under penalty of perjury under the laws of the State of California, that the information provided by Proposer and contained in this bid to the (TBD) EMS 9-1-1 Emergency Transportation Service RFP is accurate, complete, true and correct to the best of our knowledge. We are aware that should any of the information contained herein be found to be false, incorrect, or otherwise untruthful, or if the information contained herein contains material misrepresentations and/or material omissions of fact, the City of Santa Ana of Santa Ana may, at its sole discretion, pursue any and all remedies available as authorized by law, which may include the right, at the option of the City, to either reject or disqualify this bid proposal from further consideration in the course of the procurement process and/or to declare any contract awarded as the result thereof void. Signed, this day of , 2012 in , California. In the event that one of the above events occurs during the bid submittal date and contract award, the new corporation/stockholder must provide a notarized statement stating their agreement to the terms and conditions of the contract and prior to bid submittal without exceptions. This must be received within 5 business days of the change IF SOLE OWNER: Signature of Owner Date Print Name IF PARTNERSHIP UPA or merger): Signature of Partner (General Partner) Date Print Name IF CORPORATION: Signature of President Date Print Name Signature of Secretary Date Print Name Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 73 June 14, 2012 25F-92 ??, ^ City of Santa Ana a ITEM 16: NON-COLLUSION CERTIFICATION The undersigned hereby certifies on behalf of ("Proposer"), and hereby declares under penalty of perjury under the laws of the State of California, that this (TBD) EMS 9-1-1 Emergency Transportation Service RFP is genuine and not sham or collusive, nor made in the interest of or on behalf of any person not herein named; the Proposer has not directly or indirectly induced or solicited any other Proposer to put in a sham proposal nor solicited any other person, firm or corporation to refrain from submitting a proposal; the Proposer has not communicated, directly or indirectly, with any other Proposer regarding the amount, price, and/or service rates proposed herein; and Proposer has not in any manner sought by collusion to secure for himself/herself/itself any advantage over any other Proposer. We declare the foregoing is true and correct under penalty of perjury under the laws of the State of California. Signed, this day of , 2012 in _ , California. IF SOLE OWNER: Signature of Owner Date Print Name IF PARTNERSHIP UPA or merger): Signature of Partner (General Partner) Date Print Name IF CORPORATION: Signature of President Date Print Name Signature of Secretary Date Print Name Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 74 June 14, 2012 25F-93 City of Santa Ana ITEM 17: PHOTOGRAPHS (OPTIONAL) (3 PAGE LIMIT) Proposers may provide, at their option, any color photographs or other renderings depicting Proposer's emergency ambulance service facilities, operations, vehicles, equipment, performance and/or personnel. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 75 June 14, 2012 25F-94 City of Santa Ana ATTACHMENT NO. I SAMPLE CONTRACT WITH CITY AGREEMENT FOR EMS EMERGENCY TRANSPORTATION SERVICES This agreement ("Agreement") is made and entered into this day of , 2012, by and between the CITY OF SANTA ANA of Santa Ana, a municipal corporation located in the County of Orange ("CITY OF SANTA ANA") and , with principal offices at ("CONTRACTOR"). RECITALS WHEREAS, CITY OF SANTA ANA issued a Request for Proposals on February 22, 2012 (Phase 1) and on July 14, 2012 (Phase 2) related to the provision of emergency transportation services in the CITY OF SANTA ANA (the "UP"). A copy of the RFP is attached hereto and incorporated herein by this reference as Exhibit "A"; and WHEREAS, in response to the RFP, CONTRACTOR submitted a Proposal dated , 2012 (the "Proposal"), a copy of which is attached hereto and incorporated herein by this reference as Exhibit "B"; and WHEREAS, CONTRACTOR is an ambulance provider fully licensed and otherwise qualified to perform the work required by this Agreement, and was selected by CITY OF SANTA ANA following evaluation of proposals submitted in response to the RFP; and WHEREAS, CITY OF SANTA ANA desires to utilize the services of CONTRACTOR to provide primary ambulance transportation services and other related services in accordance with the terms of the RFP and applicable federal, state and local laws; and WHEREAS, at its meeting of , 2012, the Santa Ana CITY OF SANTA ANA Council accepted CONTRACTOR's Proposal and authorized CITY OF SANTA ANA staff to negotiate an Agreement with CONTRACTOR to provide emergency transportation services described in the RFP and in the Proposal. NOW, THEREFORE, in consideration of the mutual promises, covenants and conditions herein contained, the parties hereby agree as follows: Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 76 June 14, 2012 25F-95 _j. City of Santa Ana AGREEMENT 1. Contract Documents and Order of Precedence A. This Agreement shall consist of the following documents: (a) this Agreement; (b) the CITY OF SANTA ANA's RFP, (c) and the CONTRACTOR's Proposal. This Agreement, the RFP, and the Proposal, shall be hereinafter collectively referred to as the "Contract Documents". The Contract Documents constitute the entire agreement between the parties. This Agreement contemplates that CONTRACTOR will do whatever is required to perform the work in accordance with the terms of the Contract Documents and in accordance with any applicable governmental laws and regulations, whether specifically identified in the Contract Documents or not. Should any inconsistency be found to exist between the aforesaid Contract Documents and this written Agreement, the provisions of this Agreement shall control. B. All provisions of the Contract Documents shall be binding on CONTRACTOR. In the event there is any discrepancy between the terms and conditions of one or more of the aforementioned Contract Documents, the Order of Precedence shall be used to resolve the discrepancy unless both parties mutually agree in writing to an alternative decision. The Order of Precedence for these documents shall be as follows: 1) First, this Agreement (together with any Amendments thereto). 2) Second, the RFP 3) Third, the Proposal. 2. Scope of Work A. In exchange for the compensation to be provided by CITY OF SANTA ANA to Contractor, Contractor will perform all of the services described in this Section for CITY OF SANTA ANA. The details of the services to be provided by CONTRACTOR are described in detail in the Contract Documents. Those services shall include the provision of all 9-1-1 Emergency Transportation Services, including but not limited to the First Tier Service and the Mutual Aid Service (as defined below), together with the provision of any labor, material, supplies and equipment related to the provision of those services, and any other duties, obligation or services required of Contractor in the Contract Documents. (All of the services to be provided by CONTRACTOR under this Agreement shall be hereinafter collectively referred to as the "9- 1-1 9-1-1 Emergency Transportation Services"). CONTRACTOR shall perform the 9-1-1 Emergency Transportation Services in accordance with the terms and conditions contained in this Agreement, and as described in Contract Documents. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 77 June 14, 2012 25F-96 ~City of Santa Ana B. All emergency transportation personnel assigned by CONTRACTOR or by the Mutual Aid Provider to perform 9-1-1 Emergency Transportation Services under this Agreement shall be hereinafter referred to as the "Transportation Personnel". C. Without limiting CONTRACTOR's obligation to comply with all of its duties and obligations under the Contract Documents, the 9-1-1 Emergency Transportation Services to be provided by CONTRACTOR shall include, but shall not be limited to, each of the following: 1. First Tier Service. Contractor will provide with its own forces a sufficient number of fully equipped ambulances and Transportation Personnel, so as to provide, in accordance with industry standards and this RFP, all of the CITY OF SANTA ANA's needs for 9-1-1 Emergency Transportation Service, being able to respond 24 hours a day 7 days a week to all 911 and other emergencies as required (the "First Tier Service" or "First Tier"). The First Tier Service will be designed by Contractor so as to ensure that there are enough of Contractor's own ambulances and Transportation Personnel available to meet 100% of the anticipated number of calls for 9-1-1 Emergency Transportation Service in the CITY OF SANTA ANA. The First Tier Service shall meet the response times and all other requirements of this RFP for the 9-1-1 Emergency Transportation Service. Each year thereafter, for the duration of the Term of the proposed Contract, Contractor will be required to re-evaluate the level of coverage being provided, so as to ensure it is providing the required level of coverage. 2. Mutual Aid Service. Contractor will also enter into a mutual aid agreement with a separate qualified ambulance service provider doing business in Orange County, to provide backup services in the event the First Tier Service is unable to respond to a call for Emergency Services (hereinafter "Mutual Aid Contract," "Mutual Aid Service," "Mutual Aid Service" or "Mutual Aid"). The company providing the ST Mutual Aid Service will be hereinafter referred to as the "Mutual Aid Provider." In providing 9-1-1 Emergency Transportation Services the Mutual Aid Provider must meet the same RFP requirements, response times, and otherwise provide the same level of service, as Contractor is required to provide under the Contract. The Mutual Aid Contract and the Mutual Aid Provider must be approved by the CITY OF SANTA ANA and the OCFA prior to provision of any service by Contractor, such approval not to be unreasonably withheld. The intent of this RFP is that Contractor will provide a sufficient level of coverage under the First Tier Service, such that services under the Mutual Aid Service will only be needed in rare circumstances, if at all. Contractor will be solely responsible for paying the Mutual Aid Provider for any services rendered under the Mutual Aid, which amount will be the Mutual Aid Provider's sole compensation for services rendered under the Mutual Aid. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 78 June 14, 2012 25F-97 9,, City of Santa Ana D. BLS and ALS Services. All Transportation Personnel assigned to perform 9-1-1 Emergency Transportation Services under this Contract, whether under the First Tier Service or Mutual Aid Service, will provide Basic Life Support ("BLS") services and transport patients to medical facilities when required. OCFA, in cooperation with the Transportation Personnel, will provide on-scene Advanced Life Support ("ALS") services. E. All Transportation Personnel assigned to perform 9-1-1 Emergency Transportation Service under this Contract, whether under the First Tier Service or Mutual Aid Service, must at all times meet the minimum qualifications as listed in Section V of the RFP. F. The Agreement is subject to annual review based on the criteria specified in the Contract and as outlined herein. The CITY OF SANTA ANA's intent is to contract with and hold accountable those parties working with and on behalf of the CITY OF SANTA ANA of Santa Ana and OCFA in providing 9-1-1 Emergency Transportation Service to the citizens and visitors of Santa Ana. G. Contractor and the Mutual Aid Provider will provide type III emergency transport (ambulance) vehicles (including all costs related to maintenance, fuel, insurance, repair costs and communication equipment) for all 9-1-1 Emergency Transportation Services provided under the First Tier Service and the Mutual Aid Service. 3. Contract Price and Payment A. CITY OF SANTA ANA shall pay CONTRACTOR for furnishing the material and doing the prescribed work at the unit prices or lump sum prices set forth in CONTRACTOR's Proposal ("Contract Price"). 1. Contractor's sole compensation for providing all 9-1-1 Emergency Transportation Services, specifically including but not limited to the First Tier Service and Mutual Aid Service will be the Contract Price. Contractor will not be entitled to bill CITY OF SANTA ANA or any of its customers any additional amount for any services provided under this Contract, unless it is first approved in writing by CITY OF SANTA ANA. 2. The payment of the Contract Price includes the provision of the Mutual Aid Service. Contractor will be solely responsible for compensating the Mutual Aid Provider for any 9-1-1 Emergency Transportation Services it may provide in the CITY OF SANTA ANA under this Contract, which compensation will be at the rate set forth in the Mutual Aid Contract or as otherwise required by law. Contractor and the Mutual Aid Provider will not have any recourse against the CITY OF SANTA ANA to recover for any 9-1-1 Emergency Transportation Services provided under either the First Tier Service or the Mutual Aid Service, except as specifically authorized in the Contract. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 79 June 14, 2012 25F-98 ~" City of Santa Ana Contractor's sole compensation will be the Contract Price it receives from CITY OF SANTA ANA. In the event of a dispute between the Mutual Aid Provider and Contractor, the Mutual Aid Provider's sole remedy will be against Contractor. This fact will be clearly stated in the Mutual Aid Contract, and Contractor must agree to indemnify and defend CITY OF SANTA ANA against any claims or demands arising out of, or which are in any way related to, any services provided under the Mutual Aid Service. The Mutual Aid Contract will include similar provisions requiring the Mutual Aid Provider to indemnify CITY OF SANTA ANA for any claims or demands made by Contractor or other parties related to the 9-1-1 Emergency Transportation Services it may provide. 4. Billing A. CITY OF SANTA ANA will be solely responsible for the billing and collection of all amounts owed by customers/patients provided 9-1-1 Emergency Transportation Services in the CITY OF SANTA ANA, whether for services provided by Contractor, the Mutual Aid Provider, OCFA, CITY OF SANTA ANA, or their respective employees, agents, volunteers, or subcontractors. CITY OF SANTA ANA, in its discretion, will be free to bill for these services in whatever manner it may deem appropriate, and may combine billings for various services provided. Contractor and the Mutual Aid Provider will actively cooperate with CITY OF SANTA ANA to provide whatever information or assistance CITY OF SANTA ANA may reasonably require so that it can process customer/patient billings in a timely manner. This will include, but is not limited to, Contractor providing CITY OF SANTA ANA with a detailed list of all the 9-1-1 Emergency Transportation Services provided by both the Contractor and the Mutual Aid Provider during the preceding month. The specific information to be provided by Contractor in the monthly reports will be determined by CITY OF SANTA ANA, and may be modified by CITY OF SANTA ANA from time to time to meet its reasonable needs. Failure to provide accurate information in a timely manner will constitute a material breach of this Agreement. B. The entire proceeds of all such billings and collection efforts will be the sole property of CITY OF SANTA ANA. Neither Contractor nor the Mutual Aid Provider will have any right to the proceeds of any billings or collections for services provided under the First Tier Service, the Mutual Aid Service or for any other services provided under this Agreement, unless specifically authorized in writing by CITY OF SANTA ANA. Contractor must design its bid so that the amount bid as the Contract Price will be sufficient to provide the required level of services under both the First Tier Service and the Mutual Aid Service, without expecting any additional amounts in compensation. C. CITY OF SANTA ANA may amend this contract in the event the City of Santa Ana elects an optional bid proposal submitted by a contractor as part of the Phase II RFP process. S. Term Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 80 June 14, 2012 25F-99 0 City of Santa Ana A. Effective Date. The effective date of this Agreement shall be TBD hours on TBD, ("Effective Date"), at which time CONTRACTOR will assume full responsibility for the provision of 9-1-1 Emergency Transportation Services within the CITY OF SANTA ANA. At the sole discretion of the OCFA on behalf of the City of Santa Ana, the Effective Date may be postponed in order to protect public health and safety, or in the event CONTRACTOR is for any reason unable to commence performance at that time. B. Initial Term. This Agreement is for an initial three (3) year term, beginning on the Effective Date and ending on TBD hours on TBD (the "Initial Term"). The contract shall automatically expire at the end of the Initial Term unless extended as provided below. C. Extension. Upon the mutual written agreement of the parties, the contract may be extended for up to two (2) additional one (1) year terms (for a possible total of 5 years). Successful past performance during the initial contract period will be a critical factor in the decision to grant an extension. The OCFA's decision to either grant or deny a contract extension(s) shall be final. The decision to grant an extension shall be made by the OCFA on behalf of the City of Santa Ana. At the end of the Initial Term, or at the end of contract extension term(s) if granted, this Agreement shall automatically terminate (the Initial Term together with any contract extension(s), if any, shall hereinafter be collectively referred to as the "Term"). 6. Termination This Agreement may be terminated by the parties as hereinafter provided: A. This Agreement may be terminated by either party, with or without cause, upon ninety (90) days prior written notice to the other party. B. OCFA on behalf of the CITY OF SANTA ANA may terminate this Agreement for Cause by providing CONTRACTOR seven (7) days prior written notice of termination for Cause and the factors constituting Cause. C. OCFA on behalf of the CITY OF SANTA ANA may terminate this Agreement immediately if the OCFA Fire Chief or designee (in their reasonable discretion) determine that continued operations by CONTRACTOR following the breach would constitute a danger to the public health, safety or general welfare. 7. Breach of Agreement A. Factors Constituting Breach and Cause. Factors constituting a breach of this Agreement and also warranting Cause for termination include but are not limited to each of the following: Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 181 June 14, 2012 25F-100 C) City of Santa Ana 1. A failure by CONTRACTOR's to perform the covenants and requirements set forth in the Contract Documents in the time and manner specified, and as required by this Agreement. 2. Failure of CONTRACTOR to perform the 9-1-1 Emergency Transportation Services in a manner which enables the CITY OF SANTA ANA/OCFA or CONTRACTOR to remain in compliance with the requirements of the County of Orange Emergency Medical Services ("OCEMS") ambulance ordinance and related rules and regulations. 3. Supplying the CITY OF SANTA ANA/OCFA with materially false or misleading information during the RFP process or during the course of producing any required reports to the CITY OF SANTA ANA or OCFA. 4. Willful falsification or unreasonable withholding of data supplied to the CITY OF SANTA ANA or OCFA or to OCEMS during the Term of this Agreement, including but not limited to: dispatch data, patient report data, response time data, financial data, or omission of other data required under this Agreement. 5. Failure to meet the minimum vehicle deployment plan for ambulance service as described in the RFP. 6. Failure of CONTRACTOR's employees to conduct themselves in a professional and courteous manner, and to present a professional appearance. 7. Failure of CONTRACTOR to maintain all required vehicle maintenance schedules and records as set forth as described in the RFP or as reasonably required by CITY OF SANTA ANA or OCFA. 8. Failure of CONTRACTOR to maintain all training and continuing education as required in the RFP, and as required by OCFA and OCEMS policies and procedures and State regulations. 9. CONTRACTOR's failure or refusal to respond to any request by CITY OF SANTA ANA or OCFA concerning the manner or means by which CONTRACTOR is providing the operation of 9-1-1 Emergency Transportation Services in the CITY OF SANTA ANA under this Agreement and pursuant to the Contract Documents. 10. Transfer or assignment of ownership or other interest in CONTRACTOR contrary to the terms of this Agreement, including but not limited to Section 11 of this Agreement ["Assignment"]. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 82 June 14, 2012 25F-101 City of Santa Ana H. Disruption of service due to failure to maintain ambulance maintenance schedule. 12. The lapse of any license, permit or approval issued CONTRACTOR by a federal, state or local government, which license, permit or approval is/are reasonably necessary for the provision of the 9-1-1 Emergency Transportation Services contemplated by the Contract Documents. 13. CONTRACTOR becomes insolvent or unable to pay its debts as they mature, or makes an assignment for the benefit of creditors, or suffers or fails to pay and discharge within ninety (90) days of entry any final judgment (after exhaustion of any period of appeals) by any court in an amount of fifty thousand dollars ($50,000.00) or more. 14. CONTRACTOR files, or there is filed against CONTRACTOR, a petition to have CONTRACTOR adjudicated in a bankruptcy, or a petition for a reorganization or arrangement under any law relating to bankruptcy or insolvency. 15. CONTRACTOR is enjoined or prohibited by any court of competent jurisdiction from performing services under this Agreement. 16. The assets of CONTRACTOR are assumed by a trustee or other person pursuant to a judicial proceeding. 17. CONTRACTOR breaches or defaults in the performance of any of CONTRACTOR's material duties or obligations arising under this Agreement involving the payment of money, and after receiving written notice thereof from CITY OF SANTA ANA fails within seven (7) days from receipt of such notice or have fully cured and corrected such breach or default. 18. Lapse of insurance required under this Agreement. 19. Failure to manage and resolve citizen complaints to the satisfaction of the CITY OF SANTA ANA or OCFA. 20. Failure to meet the on-time performance criteria as required in the RFP. 21. The breach or default of, or a failure to comply with, any material provision of this Agreement, any material provision of the RFP, or of any covenant specifically contained herein or incorporated by reference. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 83 June 14, 2012 25F-102 City of Santa Ana B. Right to Cure. In the event of any dispute arising under this Agreement, the injured Party shall notify the injuring Party in writing of its contentions by submitting a claim therefore. The injured Party shall continue performing its obligations hereunder so long as the injuring Party cures any default within thirty (30) days after service of the notice; provided, however, if a breach of this Agreement creates an immediate danger to the health and safety or general welfare to the CITY OF SANTA ANA, in the reasonable discretion of the Fire Chief or designee, may take immediate action to remedy the breach itself and/or terminate this Agreement. Notwithstanding the preceding, if the Fire Chief or designee finds that CONTRACTOR is diligently proceeding with all steps necessary to cure such default, the Fire Chief or designee in conjunction with the CITY OF SANTA ANA may, in his sole discretion, extend the time period by which CONTRACTOR must cure such deficiencies, including the effective date of such termination. C. Waiver. No waiver of any Event of Breach or Default shall be valid or effective unless in writing and signed by CITY OF SANTA ANA. Any waiver of any one Event of Default or Breach shall not constitute, or be construed as creating, a waiver of any other Event of Default or Breach. D. Action Following Termination. Should this Agreement be terminated for breach, CONTRACTOR agrees that CITY OF SANTA ANA and/or OCFA, in their discretion, may take immediate possession of any CITY OF SANTA ANA or OCFA materials, equipment, and supplies CONTRACTOR may have used in the performance of the 9-1-1 Emergency Transportation Services. Notwithstanding the above, should this Agreement be terminated for breach, CITY OF SANTA ANA or OCFA shall have the option to take over the delivery of the 9-1-1 Emergency Transportation Services itself, using CITY OF SANTA ANA personnel or contractors; contract on a temporary emergency basis with other providers of emergency transport ambulance services; seek new proposals for service; or such other option as may be deemed necessary and legally available to CITY OF SANTA ANA. E. No Limitation on CITY OF SANTA ANA's Rights. Nothing herein shall act as any limitation upon the remedies available to CITY OF SANTA ANA whether at law, or otherwise, in the event of a breach or default of this Agreement. 8. Insurance A. Prior to beginning the provision of 9-1-1 Emergency Transportation Services under this Agreement, CONTRACTOR must provide to the satisfaction of the CITY OF SANTA ANA and OCFA, certificates of insurance and endorsements evidencing the policy or policies of insurance Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 84 June 14, 2012 25F-103 ~-" City of Santa Ana kAjl-:- in the types and amounts set forth below. CONTRACTOR shall at all times during the term of this Agreement carry, maintain, and keep in full force and effect, the following minimum scope of insurance coverage: 1) Commercial General Liability Insurance in an amount not less than $10,000,000 per occurrence, written on an occurrence form. If the policy carries an annual aggregate, such aggregate shall be in an amount not less than $10,000,000 per occurrence. 2) Ambulance Medical Malpractice Insurance in an amount not less than $3,000,000 per occurrence. If the policy carries an annual aggregate, such aggregate shall be in an amount not less than $6,000,000 per occurrence. Such insurance coverage may be combined with either the general or automobile liability coverage required above; provided, however, if the insurance coverage is so structured, the combined coverage shall be in an amount not less than $5,000,000 per occurrence, with an annual aggregate of not less than $10,000,000. 3) Comprehensive Business Automobile Liability Insurance in an amount not less than $3,000,000 per occurrence, covering owned, non-owned and hired vehicles, written on an occurrence form. If policy carries an annual aggregate, such aggregate shall be in an amount not less than $6,000,000 per occurrence. Contractor understands that it must provide Business Automobile Liability coverage for all vehicles under both the First Tier Service and the Mutual Aid Service. This specifically includes, but is not limited to, Contractor's obligation to provide Business Automobile Liability coverage for any vehicles provided by CITY OF SANTA ANA/OCFA for use by Contractor under the First Tier, as well as for any vehicles provided by Contractor directly. 4) Workers' Compensation and Employers' Liability Insurance in a statutory amount for workers' compensation and in an amount not less than $1,000,000 for employers' liability. Such insurance shall contain a waiver-of-subrogation clause in favor of the CITY OF SANTA ANA and OCFA, and their respective officers, officials, employees and agents. B. CONTRACTOR shall also comply with the following requirements: 1) If the above-required insurance coverage does not provide for an annual aggregate which is twice the per-occurrence limit, in the alternative the insurance policy (policies) shall be amended (by appropriate ISO endorsements) so that the policy limits apply solely to this Agreement. Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page j 85 June 14, 2012 25F-104 0 City of Santa Ana 2) The above-required liability insurance shall be in a form which supports coverage for the provisions of the indemnification clause required under this Agreement, including a claim brought against the CITY OF SANTA ANA and/or OCFA for the injury to, or death of an employee or agent of CONTRACTOR. 3) In the event of a claim (claims) against the above-referenced liability policies which reasonably may deplete one-half or more of the aggregate limits, CONTRACTOR shall immediately notify OCFA. In the event a claim (claims) against the above- referenced liability policies which are reasonably expected to deplete 90% of the aggregate limits, CONTRACTOR shall, at CONTRACTOR's expense, reinstate the aggregate limits at least to an amount equal to one-half of the face amount of the aggregate limits on the policies. 4) All insurance required pursuant to this section shall be issued by a company authorized by the Insurance Department of the State of California and rated A-VII or better by the latest edition of Best's Key Rating Guide. 5) No insurance required herein shall provide for a deductible in excess of $5,000 or a self-insured retention in any amount, without prior written consent of the CITY OF SANTA ANA and OCFA; and, the granting or denying of such consent shall be at the sole and absolute discretion of the CITY OF SANTA ANA and OCFA. C. Endorsements. 1) All insurance required herein shall be endorsed to state that "Coverage shall not be suspended, voided, canceled, reduced in coverage or in limits except after thirty (30) days prior to written notice by certified mail, return receipt requested, has been given to the CITY OF SANTA ANA and OCFA." 2) The liability policies required herein, except for professional liability (if a stand-above coverage), workers compensation and employers' liability, shall, by endorsement, contain the following provisions: (a) "The CITY OF SANTA ANA and OCFA, and their respective officers officials, employees, representatives, and volunteers, are hereby declared to be additional insureds as respects the operations, activities, work, errors, or omissions of the named insured arising out of or in connection with any contract or agreement with the CITY OF SANTA ANA." (b) "This insurance is primary to, and shall not contribute with, any insurance or self-insurance maintained by the CITY OF SANTA ANA, by OCFA, or by any of the designated additional insureds." Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 86 June 14, 2012 25F-105 0 City of Santa Ana (c) "This insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability." 3) Worker's Compensation and Professional Liability policies shall be endorsed to state that the insurer waives all rights of subrogation against the CITY OF SANTA ANA and OCFA, and their respective officers, officials, agents, employees, and volunteers for losses arising from work performed by the CONTRACTOR under this Agreement. D. All insurance coverages shall be confirmed by execution of endorsements and certificates of insurance. CONTRACTOR is required to file the completed policy endorsements and certificates with CITY OF SANTA ANA and OCFA on or before the Effective Date of this Agreement, and to thereafter maintain current endorsements on file with CITY OF SANTA ANA and OCFA. The completed endorsements and certificates of insurance are subject to the approval of CITY OF SANTA ANA and OCFA. E. Nothing in this section shall be construed as limiting in any way; the Indemnification and Hold Harmless clause contained herein in this Agreement, or the extent to which CONSULTANT may be held responsible for payments of damages to persons or property. F. CITY OF SANTA ANA or OCFA shall have the right at any time to review the coverage, form, and limits of insurance required herein. If, in the sole and absolute discretion of the CITY OF SANTA ANA and/or OCFA, the insurance provisions in this Agreement do not provide adequate protection for the CITY OF SANTA ANA and/or OCFA, the CITY OF SANTA ANA and/or OCFA shall have the right to require CONTRACTOR to obtain insurance sufficient in coverage, form, and limits to provide adequate protection and CONTRACTOR shall promptly comply with such requirement. The CITY OF SANTA ANA's and OCFA's requirements shall not be unreasonable, but shall be adequate in the sole opinion of the CITY OF SANTA ANA and OCFA to protect against the kind and nature of risks which exists at the time a change of insurance is required, or thereafter. G. Alternate forms of insurance, that meet the above requirements, must be approved by the CITY OF SANTA ANA's and OCFA's Risk Manager prior to awarding a contract and beginning any work under this Agreement. 9. Indemnification CONTRACTOR agrees to defend, indemnify, hold free and harmless the CITY OF SANTA ANA and OCFA, and their respective officers, officials, agents, employees and volunteers, at CONTRACTOR's sole expense, from and against any and all claims, actions, suits or other legal proceedings brought against the CITY OF SANTA ANA or OCFA, or their Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 87 June 14, 2012 25F-106 C) City of Santa Ana respective officers, officials, agents, employees or volunteers, arising out of the performance of the CONTRACTOR, its employees, agents and/or authorized subcontractors, of the work undertaken pursuant to the Agreement, specifically including but not limited to the 9-1-1 Emergency Transportation Services. The defense obligation provided for hereunder shall apply without any advance showing of negligence or wrongdoing by the CONTRACTOR, its employees, agents and/or authorized subcontractors, but shall be required whenever any claim, action, complaint, or suit asserts as its basis the negligence, errors, omissions or misconduct of the CONTRACTOR, its employees, agents and/or authorized subcontractors, and/or whenever any claim, action, complaint or suit asserts liability against the CITY OF SANTA ANA or OCFA, or their respective officers, officials, agents, employees or volunteers, based upon the work performed by the CONTRACTOR, its employees, agents and/or authorized subcontractors under this Agreement, whether or not the CONTRACTOR, its employees, agents and/or authorized subcontractors are specifically named or otherwise asserted to be liable. Notwithstanding the foregoing, the CONTRACTOR shall not be liable for the defense or indemnification of the CITY OF SANTA ANA or OCFA for claims, actions, complaints or suits arising out of the sole negligence or willful misconduct of the CITY OF SANTA ANA or OCFA. 10. Compliance with RFP Requirements for Operations, Personnel and Safety. Without limiting Contractor's duty to comply with other requirements of the RFP, Contractor understands that throughout the Term of this Agreement Contractor must remain in full compliance with the terms, conditions and requirements in each of the following sections of the RFP: A. Section IV of the RFP, entitled "Operational Standards, Procedures and Performance Requirements." B. Section V of the RFP, entitled "Personnel Rules and Requirements." C. Section VI of the RFP, entitled "Personal Safety Equipment." The failure of Contractor to abide by any of the requirements set forth in Sections listed above will be considered a breach of this Agreement, and will be grounds for termination. 11. Assignment. A. Except as provided herein, Contractor may not delegate, transfer or assign its rights or otherwise transfer its obligations, in whole or in part, under the proposed contract to any other person or entity without first obtaining the prior written consent of the OCFA and not for 180 days after the formal contract award. Any such assignment or transfer without Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 88 June 14, 2012 25F-107 r City of Santa Ana the prior written consent of the OCFA shall be void; the attempted assignment shall constitute a breach of the Contract. B. For purposes of this section, the following will be considered to be a "transfer" or `'assignment": 1. Any change in the business structure, including but not limited to, changes from or to: (a) a sole proprietorship; (b) a partnership, including any change in the partners; (c) a corporation, including any change in the shareholders, whether by operation of law or otherwise; 2. Bankruptcy, an assignment for the benefit of creditors, or the appointment of a receiver; or 3. A transfer by any of the owners, shareholders or members (whichever is applicable) of Contractor of greater than ten percent (10%) of the ownership interest, stock or membership interest (whichever is applicable) in Contractor's business, issued as of the Effective Date by the Contractor, or the sale or transfer of over twenty-five percent (25%) of the assets of the Contractor. In the event a Contractor experiences regular stock exchanges in excess of the ten percent (10%) threshold, a separate agreement may be negotiated to set a threshold that still provides the OCFA with the protections intended. The stock sale of a publicly traded corporation that does not constitute a change in majority ownership will not be deemed a transfer of ownership for purposes of this Section. 12. Audits and Inspections. At any time during normal business hours, and as often as may reasonably be deemed necessary by the OCFA, the CITY OF SANTA ANA may observe and inspect CONTRACTOR's business office, and CONTRACTOR must make promptly available to the CITY OF SANTA ANA or OCFA for its examination all of CONTRACTOR's records that pertain to performance of the Agreement. The CITY OF SANTA ANA or OCFA may audit, examine, and copy any and all CONTRACTOR records pertaining to their performance of the Agreement, including but not limited to, personnel records, daily logs, conditions of employment, and all other data. The CITY OF SANTA ANA's or OCFA's right to inspect CONTRACTOR's business office and any and all records pertaining to their performance of the Agreement will be restricted to normal business hours and reasonable notice shall be given to CONTRACTOR in advance of such inspection. 13. Independent Contractor. A. In the performance of this Agreement, CONTRACTOR shall be acting in an independent capacity OF SANTA ANA from the CITY OF SANTA ANA and OCFA, and not as Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 89 June 14, 2012 25F-108 City of Santa Ana an agent, employee, partner, or pursuant to any kind of joint venture or partnership with the CITY OF SANTA ANA or OCFA. The parties understand and agree that CONTRACTOR, its officers, agents and employees (which term specifically includes, but is not limited to, the Transportation Personnel) are not employees of the CITY OF SANTA ANA, the County, or OCFA, and are not entitled to any of the rights, benefits, or privileges of CITY OF SANTA ANA, County, or OCFA employees including, but not limited to, medical, unemployment, or workers' compensation insurance. B. Neither the County, the CITY OF SANTA ANA or OCFA, or any of their respective officers, elected officials, agents, representatives, or employees, shall have any control over the conduct of CONTRACTOR's agent's and employees except as specifically set forth in the Contract Documents. Under no circumstances shall CONTRACTOR or any of its agents or employees represent that they are in any manner agents or employees of the CITY OF SANTA ANA, County or OCFA, it being understood that CONTRACTOR its agents and employees are as to the CITY OF SANTA ANA, County and OCFA, wholly independent contractors and that CONTRACTOR's obligations to the CITY OF SANTA ANA and OCFA are solely those prescribed by the Contract Documents. C. CITY OF SANTA ANA, the County, and OCFA have no responsibility whatsoever for the payment of any wages, salary, health benefits, retirement benefits, taxes, or any other benefits that may be due to CONTRACTOR's employees and agents performing 9-1-1 Emergency Transportation Services under this Agreement, specifically including but not limited to the Transportation Personnel. CONTRACTOR further acknowledges and agrees that the CITY OF SANTA ANA, the County, and OCFA have no responsibility whatsoever for the filing of any employer related documentation (tax forms, payroll, or otherwise) with the federal, state or local governmental authorities, concerning those persons CONTRACTOR assigns to perform 9-1-1 Emergency Transportation Services under this Agreement. The preparation and filing of all employee related documentation shall be the sole responsibility of CONTRACTOR. 14. Compliance with Laws All services provided by CONTRACTOR pursuant to the Contract Documents must be rendered in full compliance with all applicable federal, state, and local laws, rules, statutes, and regulations. It will be CONTRACTOR's sole responsibility to determine which federal, state, and local laws, rules, statutes, and regulations apply to the services to be performed pursuant to the Contract Documents, and to maintain compliance at all times throughout the Term of this Agreement. 15. Responsibility Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 90 June 14, 2012 25F-109 ?- City of Santa Ana t\ Except as may be specifically stated herein to the contrary, it shall be the responsibility of CONTRACTOR to provide all Transportation Personnel with whatever resources and equipment are necessary to perform the 9-1-1 Emergency Transportation Services, and to otherwise satisfy all of the terms and conditions set forth in the Contract Documents at all times during the Term of this Agreement. Except where it may be specifically permitted in the Agreement, CONTRACTOR may not use any outside ambulance service providers or other resources to satisfy its obligations to provide 9-1-1 Emergency Transportation Services to the CITY OF SANTA ANA, without first obtaining the prior written consent of the CITY OF SANTA ANA. Notwithstanding the granting of any such approval by the CITY OF SANTA ANA, nothing stated herein shall relieve CONTRACTOR of its duties and responsibilities under the Agreement, and any additional cost incurred shall not be charged to the County, CITY OF SANTA ANA or OCFA. 16. Acts or Omissions of Representatives The acts and/or omissions of the owner(s), officers, operators, officials, employees, agents, and representatives of the CONTRACTOR in the performance of the services and obligations under the Contract Documents shall constitute the acts and/or omissions of the CONTRACTOR. 17. Insolvency CONTRACTOR shall not, without the prior written consent of the OCFA Fire Chief or designee, suffer either the appointment of a receiver to take possession of all, or substantially all of the assets of CONTRACTOR, or make a general assignment of such assets for the benefit of creditors. Any such action taken or suffered by CONTRACTOR under any insolvency or bankruptcy proceeding constitutes a material breach of this Agreement by CONTRACTOR, and all property, equipment or materials assigned by OCFA, the CITY OF SANTA ANA and/or the County to CONTRACTOR related to the provision of services under this contract shall be automatically "released" by CONTRACTOR and returned back to the possession and control of the CITY OF SANTA ANA and OCFA. Following the occurrence of any such event, the OCFA Fire Chief or designee may assign such property, equipment or materials to another 9-1-1 Emergency Transportation Services provider, in the CITY OF SANTA ANA's sole discretion. 18. Familiarity with Work By execution of this Agreement, CONTRACTOR warrants that: A. It has thoroughly investigated and considered the 9-1-1 Emergency Transportation Services to be performed; B. It possesses any and all licenses which are required under relevant local, State, or Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 91 June 14, 2012 25F-110 City of Santa Ana Federal law to perform the 9-1-1 Emergency Transportation Services contemplated by this Agreement, and shall maintain all appropriate licenses during the performance of this Agreement. C. It has expertise in the provision of 9-1-1 Emergency Transportation Services as that term is defined in this Agreement; D. It carefully considered how the 9-1-1 Emergency Transportation Services should be performed; and E. It fully understands the difficulties and restrictions attending the performance of the 9- 1-1 Emergency Transportation Services under this Agreement. 19. Validity The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any of the other provisions of this Agreement. 20. Governing Law This Agreement shall be governed by and construed in accordance with the laws of the State of California. Any legal action relating to or arising out of this Agreement shall be subject to the jurisdiction of the County of Orange, California. 21. Entire Agreement This Agreement supersedes any and all other agreements whether oral or written, between the parties hereto with respect to the subject matter hereof, and contains all of the covenants and agreements between the parties with respect to said matter, and each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein, and that any other agreement or modification of this Agreement shall be effective only if executed in writing and signed by both CITY OF SANTA ANA, OCFA, and CONTRACTOR. 22. Attorney's Fees In the event any legal proceeding is instituted to enforce any term or provision of this Agreement, the prevailing party in said legal proceeding shall be entitled to recover attorneys' fees and costs from the opposing party in an amount determined by the Court to be reasonable. 23. Representatives and Notices Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 92 June 14, 2012 25F-111 D City of Santa Ana The OCFA Fire Chief or his designee shall be the representative of OCFA on behalf of the CITY OF SANTA ANA for purposes of this Agreement and may issue all consents, approvals, directives and agreements on behalf of the CITY OF SANTA ANA, called for by this Agreement, except as otherwise expressly provided in this Agreement. shall be the representative of CONTRACTOR for purposes of this Agreement and may issue all consents, approvals, directives and agreements on behalf of CONTRACTOR, called for by this Agreement, except as otherwise expressly provided in this Agreement. All notices and written communications sent by one party to the other shall be personally delivered or sent by registered or certified U.S. Mail, postage prepaid, return receipt requested, to the following addresses indicated below: If to OCFA: Attn: Clerk of the Authority 1 Fire Authority Road Irvine, CA 92602 If to CONTRACTOR: Attn: The effective date of any notice or written communications sent by one party to the other shall be the date received if by personal service, or forty-eight (48) hours after deposit in the U.S. Mail as reflected by the official U.S. postmark. Either party may change its address by giving notice in writing to the other party. 24. Waiver No waiver of any provision of this Agreement shall be effective unless in writing and signed by a duly authorized representative of the party against whom enforcement of a waiver is sought, referring expressly to this Paragraph. The waiver of any right or remedy in respect to any occurrence or event shall not be deemed a waiver of any right or remedy in respect to any other occurrence or event, nor shall any waiver constitute a continuing waiver. 25. Rights and Remedies are Cumulative Except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the Parties are cumulative and the exercise by either Party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 93 June 14, 2012 25F-112 City of Santa Ana different times, of any other rights or remedies for the same default or any other default by the other Party. 26. Cooperation CONTRACTOR must cooperate with the CITY OF SANTA ANA and take all actions necessary to ensure that all terms and conditions, and required performance levels, set forth in the Contract Documents are satisfied at all times throughout the Term of the Agreement. 27. Legal Action In addition to any other rights or remedies, either Party may take legal action, in law or in equity, to cure, correct, or remedy and default, to recover damages for any default, to compel specific performance of this Agreement, to obtain injunctive relief, or to obtain any other remedy consistent with the purposes of this Agreement. 28. Amendment This Agreement may be amended only by the written mutual consent of CITY OF SANTA ANA and CONTRACTOR. 29. Additional Services CONTRACTOR shall not receive compensation for any services provided outside the scope of the Contract Documents unless such additional services are approved in writing by CITY OF SANTA ANA prior to CONTRACTOR performing the additional services. It is specifically understood that oral requests or approvals of such additional services, change orders, or additional compensation, and any approvals from the CITY OF SANTA ANA, shall be barred and are unenforceable. 30. Counterparts This Agreement may be executed in one or more counterparts by the parties hereto. All counterparts shall be construed together and shall constitute one Agreement. 31. Corporate Authority The persons executing this Agreement on behalf of the Parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said Parties and that by doing so the Parties hereto are formally bound to the provisions of this Agreement. [SIGNATURES TO FOLLOW ON NEXT PAGE] Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 94 June 14, 2012 25F-113 City of Santa Ana T By: By: IN WITNESS WHEREOF, the parties hereto have caused these presents to be duly executed with all formalities required by law on the respective dates set forth opposite their signatures. "CONTRACTOR" Title "CITY OF SANTA ANA" THE CITY OF SANTA ANA OF SANTA ANA a public agency By: By: CITY OF SANTA ANA City Manager ATTEST: CITY OF SANTA ANA City Clerk APPROVED AS TO FORM: By: CITY OF SANTA ANA Attorney Phase 2 RFP: Emergency Ambulance Transportation and Related Services Page 1 95 June 14, 2012 25F-114 AGREEMENT FOR EMS EMERGENCY TRANSPORTATION SERVICES This agreement ("Agreement") is made and entered into this 17`" day of September, 2012, by and between the CITY OF SANTA ANA of Santa Ana, a municipal corporation located in the County of Orange ("CITY OF SANTA ANA" or "CITY") and CARE Ambulance Service, Inc., a California corporation, with principal offices at 1517 W. Braden Court, Orange, California ("CONTRACTOR"). RECITALS WHEREAS, CITY issued a Request for Proposals on February 22, 2012 (Phase 1) and on June 14, 2012 (Phase 2) related to the provision of emergency transportation services in the CITY (the "UP"). A copy of the RFP is attached hereto and incorporated herein by this reference as Exhibit "A"; and WHEREAS, in response to the RFP, CONTRACTOR submitted a Proposal dated July 9, 2012 (the "Proposal"), a copy of which is attached hereto and incorporated herein by this reference as Exhibit "B"; and WHEREAS, CONTRACTOR is an ambulance provider fully licensed and otherwise qualified to perform the work required by this Agreement, and was selected by CITY following evaluation of proposals submitted in response to the RFP; and WHEREAS, CITY desires to utilize the services of CONTRACTOR to provide primary ambulance transportation services and other related services in accordance with the terms of the RFP and applicable federal, state and local laws; and WHEREAS, at its meeting of September 17, 2012, the City Council of the CITY OF SANTA ANA accepted CONTRACTOR's Proposal and authorized CITY staff to negotiate an Agreement with CONTRACTOR to provide emergency transportation services described in the RFP and in the Proposal. NOW, THEREFORE, in consideration of the mutual promises, covenants and conditions herein contained, the parties hereby agree as follows: AGREEMENT 1. Contract Documents and Order of Precedence A. This Agreement shall consist of the following documents: (a) this Agreement; (b) the CITY's RFP, (c) and the CONTRACTOR's Proposal. This Agreement, the RFP, and the Proposal, shall be hereinafter collectively referred to as the "Contract Documents". The Contract Documents constitute the entire agreement between the parties. This Agreement contemplates that CONTRACTOR will do whatever is required to perform the work in accordance with the terms of the Contract Documents and in accordance with any applicable governmental laws and regulations, whether specifically identified in the Contract Documents or not. Should any inconsistency be found to exist between the aforesaid Contract Documents and this written Agreement, the provisions of this Agreement shall control. Exhibit 3 ETS91712 Pagel 25F-115 B. All provisions of the Contract Documents shall be binding on CONTRACTOR. In the event there is any discrepancy between the terms and conditions of one or more of the aforementioned Contract Documents, the Order of Precedence shall be used to resolve the discrepancy unless both parties mutually agree in writing to an alternative decision. The Order of Precedence for these documents shall be as follows: 1) First, this Agreement (together with any Amendments thereto). 2) Second, the RFP 3) Third, the Proposal. 2. Scope of Work A. In exchange for the compensation to be provided by CITY to CONTRACTOR, CONTRACTOR will perform all of the services described in this Section for CITY. The details of the services to be provided by CONTRACTOR are described in detail in the Contract Documents. Those services shall include the provision of all 9-1-1 Emergency Transportation Services, including but not limited to the First Tier Service and the Mutual Aid Service (as defined below), together with the provision of any labor, material, supplies and equipment related to the provision of those services, and any other duties, obligation or services required of CONTRACTOR in the Contract Documents. (All of the services to be provided by CONTRACTOR under this Agreement shall be hereinafter collectively referred to as the "9-1-1 9-1-1 Emergency Transportation Services"). CONTRACTOR shall perform the 9-1-1 Emergency Transportation Services in accordance with the terms and conditions contained in this Agreement, and as described in Contract Documents. B. All emergency transportation personnel assigned by CONTRACTOR or by the Mutual Aid Provider to perform 9-1-1 Emergency Transportation Services under this Agreement shall be hereinafter referred to as the "Transportation Personnel". C. Without limiting CONTRACTOR's obligation to comply with all of its duties and obligations under the Contract Documents, the 9-1-1 Emergency Transportation Services to be provided by CONTRACTOR shall include, but shall not be limited to, each of the following: 1. First Tier Service. CONTRACTOR will provide with its own forces a sufficient number of fully equipped ambulances and Transportation Personnel, so as to provide, in accordance with industry standards and this RFP, all of the CITY 's needs for 9-1-1 Emergency Transportation Service, being able to respond 24 hours a day 7 days a week to all 911 and other emergencies as required (the "First Tier Service" or "First Tier"). The First Tier Service will be designed by CONTRACTOR so as to ensure that there are enough of CONTRACTOR's own ambulances and Transportation Personnel available to meet 100% of the anticipated number of calls for 9-1-1 Emergency Transportation Service in the City of Santa Ana. The First Tier Service shall meet the response times and all other requirements of this RFP for the 9-1-1 Emergency Transportation Service. Each year thereafter, for the duration of the Term of the proposed Contract, CONTRACTOR will be required to re-evaluate the level of coverage being provided, so as to ensure it is providing the required level of coverage. 2. Mutual Aid Service. CONTACTOR will also enter into a mutual aid agreement with a separate qualified ambulance service provider doing business in Orange County, to provide backup services in the event the First Tier Service is unable to respond to a call for Emergency ETS91712 Page 2 25F-116 Services (hereinafter "Mutual Aid Contract," "Mutual Aid Service," "Mutual Aid Service" or "Mutual Aid"). The company providing the Mutual Aid Service will be hereinafter referred to as the "Mutual Aid Provider." In providing 9-1-1 Emergency Transportation Services the Mutual Aid Provider must meet the same RFP requirements, response times, and otherwise provide the same level of service, as CONTRACTOR is required to provide under the Contract. The Mutual Aid Contract and the Mutual Aid Provider must be approved by the CITY and the OCFA prior to provision of any service by Contractor, such approval not to be unreasonably withheld. The intent of this RFP is that CONTRACTOR will provide a sufficient level of coverage under the First Tier Service, such that services under the Mutual Aid Service will only be needed in rare circumstances, if at all. CONTRACTOR will be solely responsible for paying the Mutual Aid Provider for any services rendered under the Mutual Aid, which amount will be the Mutual Aid Provider's sole compensation for services rendered under the Mutual Aid. D. BLS and ALS Services. All Transportation Personnel assigned to perform 9-1-1 Emergency Transportation Services under this Contract, whether under the First Tier Service or Mutual Aid Service, will provide Basic Life Support ("BLS") services and transport patients to medical facilities when required. OCFA, in cooperation with the Transportation Personnel, will provide on-scene Advanced Life Support ("ALS") services. E. All Transportation Personnel assigned to perform 9-1-1 Emergency Transportation Service under this Contract, whether under the First Tier Service or Mutual Aid Service, must at all times meet the minimum qualifications as listed in Section 5 of the RFP. F. The Agreement is subject to annual review based on the criteria specified in the Contract and as outlined herein. The CITY's intent is to contract with and hold accountable those parties working with and on behalf of the CITY and OCFA in providing 9-1-1 Emergency Transportation Service to the citizens and visitors of Santa Ana. G. CONTRACTOR and the Mutual Aid Provider will provide type III emergency transport (ambulance) vehicles (including all costs related to maintenance, fuel, insurance, repair costs and communication equipment) for all 9-1-1 Emergency Transportation Services provided under the First Tier Service and the Mutual Aid Service. 3. Contract Price and Payment A. CITY shall pay CONTRACTOR for furnishing the material and doing the prescribed work at the unit prices or lump sum prices set forth in CONTRACTOR's Proposal ("Contract Price"). 1. CONTRACTOR's sole compensation for providing all 9-1-1 Emergency Transportation Services, specifically including but not limited to the First Tier Service and Mutual Aid Service will be the Contract Price. CONTRACTOR will not be entitled to bill CITY or any of its customers any additional amount for any services provided under this Contract, unless it is first approved in writing by CITY. 2. The payment of the Contract Price includes the provision of the Mutual Aid Service. CONTRACTOR will be solely responsible for compensating the Mutual Aid Provider for any 9- 1-1 Emergency Transportation Services it may provide in the City of Santa Ana under this Contract, which compensation will be at the rate set forth in the Mutual Aid Contract or as otherwise required by law. CONTRACTOR and the Mutual Aid Provider will not have any recourse against the CITY to recover for any 9-1-1 Emergency Transportation Services provided ETS91712 Page 3 25F-117 under either the First Tier Service or the Mutual Aid Service, except as specifically authorized in the Contract. CONTRACTOR's sole compensation will be the Contract Price it receives from CITY. In the event of a dispute between the Mutual Aid Provider and CONTRACTOR, the Mutual Aid Provider's sole remedy will be against CONTRACTOR. This fact will be clearly stated in the Mutual Aid Contract, and CONTRACTOR must agree to indemnify and defend CITY OF SANTA ANA against any claims or demands arising out of, or which are in any way related to, any services provided under the Mutual Aid Service. The Mutual Aid Contract will include similar provisions requiring the Mutual Aid Provider to indemnify CITY OF SANTA ANA for any claims or demands made by CONTRACTOR or other parties related to the 9-1-1 Emergency Transportation Services it may provide. 4. Billing A. CITY will be solely responsible for the billing and collection of all amounts owed by customers/patients provided 9-1-1 Emergency Transportation Services in the City of Santa Ana, whether for services provided by CONTRACTOR, the Mutual Aid Provider, OCFA, CITY, or their respective employees, agents, volunteers, or subcontractors. CITY, in its discretion, will be free to bill for these services in whatever manner it may deem appropriate, and may combine billings for various services provided. CONTRACTOR and the Mutual Aid Provider will actively cooperate with CITY to provide whatever information or assistance CITY may reasonably require so that it can process customer/patient billings in a timely manner. This will include, but is not limited to, CONTRACTOR providing CITY with a detailed list of all the 9-1-1 Emergency Transportation Services provided by both the CONTRACTOR and the Mutual Aid Provider during the preceding month. The specific information to be provided by CONTRACTOR in the monthly reports will be determined by CITY, and may be modified by CITY from time to time to meet its reasonable needs. Failure to provide accurate information in a timely manner will constitute a material breach of this Agreement. B. The entire proceeds of all such billings and collection efforts will be the sole property of CITY OF SANTA ANA. Neither CONTRACTOR nor the Mutual Aid Provider will have any right to the proceeds of any billings or collections for services provided under the First Tier Service, the Mutual Aid Service or for any other services provided under this Agreement, unless specifically authorized in writing by CITY. CONTRACTOR must design its bid so that the amount bid as the Contract Price will be sufficient to provide the required level of services under both the First Tier Service and the Mutual Aid Service, without expecting any additional amounts in compensation. C. CITY OF SANTA ANA may amend this contract in the event the City of Santa Ana elects an optional bid proposal submitted by a contractor as part of the Phase II RFP process. 5. Term A. Effective Date. The effective date of this Agreement shall be TBD hours on September 20, 2012, ("Effective Date"), at which time CONTRACTOR will assume full responsibility for the provision of 9-1-1 Emergency Transportation Services within the CITY OF SANTA ANA. At the sole discretion of the OCFA on behalf of the City of Santa Ana, the Effective Date may be postponed in order to protect public health and safety, or in the event CONTRACTOR is for any reason unable to commence performance at that time. B. Initial Term. This Agreement is for an initial three (3) year term, beginning on the Effective Date and ending on TBD hours on September 20, 2015 (the "Initial Term"). The contract shall automatically expire at the end of the Initial Term unless extended as provided below. ETS91712 Page 4 25F-118 C. Extension. Upon the mutual written agreement of the parties, the contract may be extended for up to two (2) additional one (1) year terms (for a possible total of 5 years), by a writing executed by the City Manager and the City Attorney. Successful past performance during the initial contract period will be a critical factor in the decision to grant an extension. The CITY's decision to either grant or deny a contract extension(s) shall be final. The decision to grant an extension shall be made with the concurrence of OCFA. At the end of the Initial Term, or at the end of contract extension term(s) if granted, this Agreement shall automatically terminate (the Initial Term together with any contract extension(s), if any, shall hereinafter be collectively referred to as the "Term"). 6. Termination This Agreement may be terminated by the parties as hereinafter provided: A. This Agreement may be terminated by either party, with or without cause, upon ninety (90) days prior written notice to the other party. B. The CITY OF SANTA ANA may terminate this Agreement for Cause by providing CONTRACTOR seven (7) days prior written notice of termination for Cause and the factors constituting Cause. C. OCFA on behalf of the CITY OF SANTA ANA may terminate this Agreement immediately if the OCFA Fire Chief or designee (in their reasonable discretion) determine that continued operations by CONTRACTOR following the breach would constitute a danger to the public health, safety or general welfare. 7. Breach of Agreement A. Factors Constituting Breach and Cause. Factors constituting a breach of this Agreement and also warranting Cause for termination include but are not limited to each of the following: 1. A failure by CONTRACTOR to perform the covenants and requirements set forth in the Contract Documents in the time and manner specified, and as required by this Agreement. 2. Failure of CONTRACTOR to perform the 9-1-1 Emergency Transportation Services in a manner which enables the CITY OF SANTA ANA/OCFA or CONTRACTOR to remain in compliance with the requirements of the County of Orange Emergency Medical Services ("OCEMS") ambulance ordinance and related rules and regulations. 3. Supplying the CITY /OCFA with materially false or misleading information during the RFP process or during the course of producing any required reports to the CITY or OCFA. 4. Willful falsification or unreasonable withholding of data supplied to the CITY OF SANTA ANA or OCFA or to OCEMS during the Term of this Agreement, including but not limited to: dispatch data, patient report data, response time data, financial data, or omission of other data required under this Agreement. 5. Failure to meet the minimum vehicle deployment plan for ambulance service as described in the RFP. ETS91712 Page 5 25F-119 6. Failure of CONTRACTOR's employees to conduct themselves in a professional and courteous manner, and to present a professional appearance. 7. Failure of CONTRACTOR to maintain all required vehicle maintenance schedules and records as set forth as described in the RFP or as reasonably required by CITY or OCFA. 8. Failure of CONTRACTOR to maintain all training and continuing education as required in the RFP, and as required by OCFA and OCEMS policies and procedures and State regulations. 9. CONTRACTOR's failure or refusal to respond to any request by CITY or OCFA concerning the manner or means by which CONTRACTOR is providing the operation of 9-1- 1 Emergency Transportation Services in the CITY OF SANTA ANA under this Agreement and pursuant to the Contract Documents. 10. Transfer or assignment of ownership or other interest in CONTRACTOR contrary to the terms of this Agreement, including but not limited to Section II of this Agreement ["Assignment"]. 11. Disruption of service due to failure to maintain ambulance maintenance schedule. 12. The lapse of any license, permit or approval issued CONTRACTOR by a federal, state or local government, which license, permit or approval is/are reasonably necessary for the provision of the 9-1-1 Emergency Transportation Services contemplated by the Contract Documents. 13. CONTRACTOR becomes insolvent or unable to pay its debts as they mature, or makes an assignment for the benefit of creditors, or suffers or fails to pay and discharge within ninety (90) days of entry any final judgment (after exhaustion of any period of appeals) by any court in an amount of fifty thousand dollars ($50,000.00) or more. 14. CONTRACTOR files, or there is filed against CONTRACTOR, a petition to have CONTRACTOR adjudicated in a bankruptcy, or a petition for a reorganization or arrangement under any law relating to bankruptcy or insolvency. 15. CONTRACTOR is enjoined or prohibited by any court of competent jurisdiction from performing services under this Agreement. 16. The assets of CONTRACTOR are assumed by a trustee or other person pursuant to a judicial proceeding. 17. CONTRACTOR breaches or defaults in the performance of any of CONTRACTOR's material duties or obligations arising under this Agreement involving the payment of money, and after receiving written notice thereof from CITY OF SANTA ANA fails within seven (7) days from receipt of such notice to have fully cured and corrected such breach or default. 18. Lapse of insurance required under this Agreement. 19. Failure to manage and resolve citizen complaints to the satisfaction of the CITY or OCFA. ETS91712 Page 6 25F-120 20. Failure to meet the on-time performance criteria as required in the RFP, as amended by CONTRACTOR'S proposed 93% response time to Code 2 and Code 3 incidents. 21. The breach or default of, or a failure to comply with, any material provision of this Agreement, any material provision of the RFP, or of any covenant specifically contained herein or incorporated by reference. B. Right to Cure. In the event of any dispute arising under this Agreement, the injured Party shall notify the injuring Party in writing of its contentions by submitting a claim therefore. The injured Party shall continue performing its obligations hereunder so long as the injuring Party cures any default within thirty (30) days after service of the notice; provided, however, if a breach of this Agreement creates an immediate danger to the health and safety or general welfare to the CITY OF SANTA ANA, in the reasonable discretion of the Fire Chief or designee, may take immediate action to remedy the breach itself and/or terminate this Agreement. Notwithstanding the preceding, if the Fire Chief or designee finds that CONTRACTOR is diligently proceeding with all steps necessary to cure such default, the Fire Chief or designee in conjunction with the CITY OF SANTA ANA may, in his sole discretion, extend the time period by which CONTRACTOR must cure such deficiencies, including the effective date of such termination. C. Waiver. No waiver of any Event of Breach or Default shall be valid or effective unless in writing and signed by CITY OF SANTA ANA. Any waiver of any one Event of Default or Breach shall not constitute, or be construed as creating, a waiver of any other Event of Default or Breach. D. Action Following Termination. Should this Agreement be terminated for breach, CONTRACTOR agrees that CITY and/or OCFA, in their discretion, may take immediate possession of any CITY or OCFA materials, equipment, and supplies CONTRACTOR may have used in the performance of the 9-1-1 Emergency Transportation Services. Notwithstanding the above, should this Agreement be terminated for breach, CITY OF SANTA ANA or OCFA shall have the option to take over the delivery of the 9-1-1 Emergency Transportation Services itself, using CITY personnel or contractors; contract on a temporary emergency basis with other providers of emergency transport ambulance services; seek new proposals for service; or such other option as may be deemed necessary and legally available to CITY. E. No Limitation on CITY's Rights. Nothing herein shall act as any limitation upon the remedies available to CITY whether at law, or otherwise, in the event of a breach or default of this Agreement. 8.Insurance A. Prior to beginning the provision of 9-1-1 Emergency Transportation Services under this Agreement, CONTRACTOR must provide to the satisfaction of the CITY and OCFA, certificates of insurance and endorsements evidencing the policy or policies of insurance in the types and amounts set forth below. CONTRACTOR shall at all times during the term of this Agreement carry, maintain, and keep in full force and effect, the following minimum scope of insurance coverage: 1) Commercial General Liability Insurance in an amount not less than $10,000,000 per occurrence, written on an occurrence form. If the policy carries an annual aggregate, such aggregate shall be in an amount not less than $10,000,000 per occurrence. ETS91712 25F-1 21 Page 7 2) Ambulance Medical Malpractice Insurance in an amount not less than $3,000,000 per occurrence. If the policy carries an annual aggregate, such aggregate shall be in an amount not less than $6,000,000 per occurrence. Such insurance coverage may be combined with either the general or automobile liability coverage required above; provided, however, if the insurance coverage is so structured, the combined coverage shall be in an amount not less than $5,000,000 per occurrence, with an annual aggregate of not less than $10,000,000. 3) Comprehensive Business Automobile Liability Insurance in an amount not less than $3,000,000 per occurrence, covering owned, non-owned and hired vehicles, written on an occurrence form. If policy carries an annual aggregate, such aggregate shall be in an amount not less than $6,000,000 per occurrence. CONTRACTOR understands that it must provide Business Automobile Liability coverage for all vehicles under both the First Tier Service and the Mutual Aid Service. This specifically includes, but is not limited to, CONTRACTOR's obligation to provide Business Automobile Liability coverage for any vehicles provided by CITY /OCFA for use by CONTRACTOR under the First Tier, as well as for any vehicles provided by CONTRACTOR directly. 4) Workers' Compensation and Employers' Liability Insurance in a statutory amount for workers' compensation and in an amount not less than $1,000,000 for employers' liability. Such insurance shall contain a waiver-of-subrogation clause in favor of the CITY OF SANTA ANA and OCFA, and their respective officers, officials, employees and agents. B. CONTRACTOR shall also comply with the following requirements: 1) If the above-required insurance coverage does not provide for an annual aggregate which is twice the per-occurrence limit, in the alternative the insurance policy (policies) shall be amended (by appropriate ISO endorsements) so that the policy limits apply solely to this Agreement. 2) The above-required liability insurance shall be in a form which supports coverage for the provisions of the indemnification clause required under this Agreement, including a claim brought against the CITY OF SANTA ANA and/or OCFA for the injury to, or death of an employee or agent of CONTRACTOR. 3) In the event of a claim (claims) against the above-referenced liability policies which reasonably may deplete one-half or more of the aggregate limits, CONTRACTOR shall immediately notify CITY and OCFA. In the event a claim (claims) against the above-referenced liability policies which are reasonably expected to deplete 90% of the aggregate limits, CONTRACTOR shall, at CONTRACTOR's expense, reinstate the aggregate limits at least to an amount equal to one-half of the face amount of the aggregate limits on the policies. 4) All insurance required pursuant to this section shall be issued by a company authorized by the Insurance Department of the State of California and rated A-VII or better by the latest edition of Best's Key Rating Guide. 5) No insurance required herein shall provide for a deductible in excess of $5,000 or a self-insured retention in any amount, without prior written consent of the CITY and OCFA; and, ETS91712 Page 8 25F-122 the granting or denying of such consent shall be at the sole and absolute discretion of the CITY OF SANTA ANA and OCFA. C. Endorsements. 1) All insurance required herein shall be endorsed to state that "Coverage shall not be suspended, voided, canceled, reduced in coverage or in limits except after thirty (30) days prior to written notice by certified mail, return receipt requested, has been given to the CITY OF SANTA ANA and OCFA." 2) The liability policies required herein, except for professional liability (if a stand-above coverage), workers compensation and employers' liability, shall, by endorsement, contain the following provisions: (a) "The CITY OF SANTA ANA and OCFA, and their respective officers officials, employees, representatives, and volunteers, are hereby declared to be additional insureds as respects the operations, activities, work, errors, or omissions of the named insured arising out of or in connection with any contract or agreement with the CITY OF SANTA ANA." (b) "This insurance is primary to, and shall not contribute with, any insurance or self-insurance maintained by the CITY OF SANTA ANA, by OCFA, or by any of the designated additional insureds." (c) "This insurance shall apply separately to each insured against whom claim is made or suit is brought, except with respect to the limits of the insurer's liability." 3) Worker's Compensation and Professional Liability policies shall be endorsed to state that the insurer waives all rights of subrogation against the CITY OF SANTA ANA and OCFA, and their respective officers, officials, agents, employees, and volunteers for losses arising from work performed by the CONTRACTOR under this Agreement. D. All insurance coverages shall be confirmed by execution of endorsements and certificates of insurance. CONTRACTOR is required to file the completed policy endorsements and certificates with CITY OF SANTA ANA and OCFA on or before the Effective Date of this Agreement, and to thereafter maintain current endorsements on file with CITY and OCFA. The completed endorsements and certificates of insurance are subject to the approval of CITY and OCFA. E. Nothing in this section shall be construed as limiting in any way; the Indemnification and Hold Harmless clause contained herein in this Agreement, or the extent to which CONSULTANT may be held responsible for payments of damages to persons or property. F. CITY OF SANTA ANA or OCFA shall have the right at any time to review the coverage, form, and limits of insurance required herein. If, in the sole and absolute discretion of the CITY and/or OCFA, the insurance provisions in this Agreement do not provide adequate protection for the CITY OF SANTA ANA and/or OCFA, the CITY and/or OCFA shall have the right to require CONTRACTOR to obtain insurance sufficient in coverage, form, and limits to provide adequate protection and CONTRACTOR shall promptly comply with such requirement. The CITY's and OCFA's requirements shall not be unreasonable, but shall be adequate in the sole opinion of the CITY and OCFA to protect against the kind and nature of risks which exists at the time a change of insurance is required, or thereafter. ETS91712 Page 9 25F-123 G. Alternate forms of insurance, that meet the above requirements, must be approved by the CITY OF SANTA ANA's and OCFA's Risk Manager prior to awarding a contract and beginning any work under this Agreement. 9. Indemnification CONTRACTOR agrees to defend, indemnify, hold free and harmless the CITY OF SANTA ANA and OCFA, and their respective officers, officials, agents, employees and volunteers, at CONTRACTOR's sole expense, from and against any and all claims, actions, suits or other legal proceedings brought against the CITY OF SANTA ANA or OCFA, or their respective officers, officials, agents, employees or volunteers, arising out of the performance of the CONTRACTOR, its employees, agents and/or authorized subcontractors, of the work undertaken pursuant to the Agreement, specifically including but not limited to the 9-1-1 Emergency Transportation Services. The defense obligation provided for hereunder shall apply without any advance showing of negligence or wrongdoing by the CONTRACTOR, its employees, agents and/or authorized subcontractors, but shall be required whenever any claim, action, complaint, or suit asserts as its basis the negligence, errors, omissions or misconduct of the CONTRACTOR, its employees, agents and/or authorized subcontractors, and/or whenever any claim, action, complaint or suit asserts liability against the CITY OF SANTA ANA or OCFA, or their respective officers, officials, agents, employees or volunteers, based upon the work performed by the CONTRACTOR, its employees, agents and/or authorized subcontractors under this Agreement, whether or not the CONTRACTOR, its employees, agents and/or authorized subcontractors are specifically named or otherwise asserted to be liable. Notwithstanding the foregoing, the CONTRACTOR shall not be liable for the defense or indemnification of the CITY OF SANTA ANA or OCFA for claims, actions, complaints or suits arising out of the sole negligence or willful misconduct of the CITY OF SANTA ANA or OCFA. 10. Compliance with RFP Requirements for Operations, Personnel and Safety. Without limiting CONTRACTOR's duty to comply with other requirements of the RFP, Contractor understands that throughout the Term of this Agreement CONTRACTOR must remain in full compliance with the terms, conditions and requirements in each of the following sections of the RFP: A. Section 4 of the RFP, entitled "Operational Standards, Procedures and Performance Requirements." B. Section 5 of the RFP, entitled "Personnel Rules and Requirements." C. Section 6 of the RFP, entitled "Personal Safety Equipment." The failure of CONTRACTOR to abide by any of the requirements set forth in Sections listed above will be considered a breach of this Agreement, and will be grounds for termination. 11. Assignment. A. Except as provided herein, CONTRACTOR may not delegate, transfer or assign its rights or otherwise transfer its obligations, in whole or in part, under the proposed contract to any other person or entity without first obtaining the prior written consent of the CITY OF SANTA ANA and OCFA and not for 180 days after the formal contract award. Any such assignment or transfer without the prior written consent of the CITY and OCFA shall be void; the attempted assignment shall constitute a breach of the Contract. ETS91712 Page 10 25F-124 B. For purposes of this section, the following will be considered to be a "transfer" or "assignment": 1. Any change in the business structure, including but not limited to, changes from or to: (a) a sole proprietorship; (b) a partnership, including any change in the partners; (c) a corporation, including any change in the shareholders, whether by operation of law or otherwise; 2. Bankruptcy, an assignment for the benefit of creditors, or the appointment of a receiver; or 3. A transfer by any of the owners, shareholders or members (whichever is applicable) of CONTRACTOR of greater than ten percent (10%) of the ownership interest, stock or membership interest (whichever is applicable) in CONTRACTOR's business, issued as of the Effective Date by the CONTRACTOR, or the sale or transfer of over twenty-five percent (25%) of the assets of the CONTRACTOR. In the event a CONTRACTOR experiences regular stock exchanges in excess of the ten percent (10%) threshold, a separate agreement may be negotiated to set a threshold that still provides the OCFA with the protections intended. The stock sale of a publicly traded corporation that does not constitute a change in majority ownership will not be deemed a transfer of ownership for purposes of this Section. 12. Audits and Inspections. At any time during normal business hours, and as often as may reasonably be deemed necessary by the CITY and OCFA, the CITY may observe and inspect CONTRACTOR's business office, and CONTRACTOR must make promptly available to the CITY or OCFA for its examination all of CONTRACTOR's records that pertain to performance of the Agreement. The CITY or OCFA may audit, examine, and copy any and all CONTRACTOR records pertaining to their performance of the Agreement, including but not limited to, personnel records, daily logs, conditions of employment, and all other data. The CITY's or OCFA's right to inspect CONTRACTOR's business office and any and all records pertaining to their performance of the Agreement will be restricted to normal business hours and reasonable notice shall be given to CONTRACTOR in advance of such inspection. 13. Independent Contractor. A. In the performance of this Agreement, CONTRACTOR shall be acting in an independent capacity from the CITY OF SANTA ANA and OCFA, and not as an agent, employee, partner, or pursuant to any kind of joint venture or partnership with the CITY or OCFA. The parties understand and agree that CONTRACTOR, its officers, agents and employees (which term specifically includes, but is not limited to, the Transportation Personnel) are not employees of the CITY, the County, or OCFA, and are not entitled to any of the rights, benefits, or privileges of CITY, County, or OCFA employees including, but not limited to, medical, unemployment, or workers' compensation insurance. B. Neither the County, the CITY OF SANTA ANA or OCFA, or any of their respective officers, elected officials, agents, representatives, or employees, shall have any control over the conduct of CONTRACTOR's agent's and employees except as specifically set forth in the Contract Documents. Under no circumstances shall CONTRACTOR or any of its agents or employees represent that they are in any manner agents or employees of the CITY, County or OCFA, it being understood that ETS91712 Page 11 25F-125 CONTRACTOR its agents and employees are as to the CITY, County and OCFA, wholly independent contractors and that CONTRACTOR's obligations to the CITY and OCFA are solely those prescribed by the Contract Documents. C. CITY, the County, and OCFA have no responsibility whatsoever for the payment of any wages, salary, health benefits, retirement benefits, taxes, or any other benefits that may be due to CONTRACTOR's employees and agents performing 9-1-1 Emergency Transportation Services under this Agreement, specifically including but not limited to the Transportation Personnel. CONTRACTOR further acknowledges and agrees that the CITY, the County, and OCFA have no responsibility whatsoever for the filing of any employer related documentation (tax forms, payroll, or otherwise) with the federal, state or local governmental authorities, concerning those persons CONTRACTOR assigns to perform 9-1-1 Emergency Transportation Services under this Agreement. The preparation and filing of all employee related documentation shall be the sole responsibility of CONTRACTOR. 14. Compliance with Laws All services provided by CONTRACTOR pursuant to the Contract Documents must be rendered in full compliance with all applicable federal, state, and local laws, rules, statutes, and regulations. It will be CONTRACTOR's sole responsibility to determine which federal, state, and local laws, rules, statutes, and regulations apply to the services to be performed pursuant to the Contract Documents, and to maintain compliance at all times throughout the Term of this Agreement. 15. Responsibility Except as may be specifically stated herein to the contrary, it shall be the responsibility of CONTRACTOR to provide all Transportation Personnel with whatever resources and equipment are necessary to perform the 9-1-1 Emergency Transportation Services, and to otherwise satisfy all of the terms and conditions set forth in the Contract Documents at all times during the Term of this Agreement. Except where it may be specifically permitted in the Agreement, CONTRACTOR may not use any outside ambulance service providers or other resources to satisfy its obligations to provide 9-1-1 Emergency Transportation Services to the CITY OF SANTA ANA, without first obtaining the prior written consent of the CITY. Notwithstanding the granting of any such approval by the CITY, nothing stated herein shall relieve CONTRACTOR of its duties and responsibilities under the Agreement, and any additional cost incurred shall not be charged to the County, CITY or OCFA. 16. Acts or Omissions of Representatives The acts and/or omissions of the owner(s), officers, operators, officials, employees, agents, and representatives of the CONTRACTOR in the performance of the services and obligations under the Contract Documents shall constitute the acts and/or omissions of the CONTRACTOR. 17. Insolvency CONTRACTOR shall not, without the prior written consent of the CITY and OCFA Fire Chief or designee, suffer either the appointment of a receiver to take possession of all, or substantially all of the assets of CONTRACTOR, or make a general assignment of such assets for the benefit of creditors. Any such action taken or suffered by CONTRACTOR under any insolvency or bankruptcy proceeding constitutes a material breach of this Agreement by CONTRACTOR, and all property, equipment or materials assigned by OCFA, the CITY OF SANTA ANA and/or the County to CONTRACTOR related to the provision of services under this contract shall be automatically "released" by CONTRACTOR and ETS91712 25F-126 Page 12 returned back to the possession and control of the CITY OF SANTA ANA and OCFA. Following the occurrence of any such event, the OCFA Fire Chief or designee may assign such property, equipment or materials to another 9-1-1 Emergency Transportation Services provider, in the CITY OF SANTA ANA's sole discretion. 18. Familiarity with Work By execution of this Agreement, CONTRACTOR warrants that: A. It has thoroughly investigated and considered the 9-1-1 Emergency Transportation Services to be performed; B. It possesses any and all licenses which are required under relevant local, State, or Federal law to perform the 9-1-1 Emergency Transportation Services contemplated by this Agreement, and shall maintain all appropriate licenses during the performance of this Agreement. C. It has expertise in the provision of 9-1-1 Emergency Transportation Services as that term is defined in this Agreement; D. It carefully considered how the 9-1-1 Emergency Transportation Services should be performed; and E. It fully understands the difficulties and restrictions attending the performance of the 9-1-1 Emergency Transportation Services under this Agreement. 19. Validity The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any of the other provisions of this Agreement. 20. Governing Law This Agreement shall be governed by and construed in accordance with the laws of the State of California. Any legal action relating to or arising out of this Agreement shall be subject to the jurisdiction of the County of Orange, California. 21. Entire Agreement This Agreement supersedes any and all other agreements whether oral or written, between the parties hereto with respect to the subject matter hereof, and contains all of the covenants and agreements between the parties with respect to said matter, and each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein, and that any other agreement or modification of this Agreement shall be effective only if executed in writing and signed by both CITY OF SANTA ANA, OCFA, and CONTRACTOR. 22. Attorney's Fees In the event any legal proceeding is instituted to enforce any term or provision of this Agreement, the prevailing party in said legal proceeding shall be entitled to recover attorneys' fees and costs from the opposing party in an amount determined by the Court to be reasonable. ETS91712 Page 13 25F-127 23. Representatives and Notices The City Manager or his designee shall be the representative of CITY. The OCFA Fire Chief or his designee shall be the representative of OCFA. For purposes of this Agreement the City Manager and may issue all administrative consents, approvals, directives and agreements. The OCFA Fire Chief on behalf of the CITY OF SANTA ANA, may issue operational directives required by this Agreement, except as otherwise expressly provided in this Agreement. shall be the representative of CONTRACTOR for purposes of this Agreement and may issue all consents, approvals, directives and agreements on behalf of CONTRACTOR, called for by this Agreement, except as otherwise expressly provided in this Agreement. All notices and written communications sent by one party to the other shall be personally delivered or sent by registered or certified U.S. Mail, postage prepaid, return receipt requested, to the following addresses indicated below: To City: Clerk of the Council City of Santa Ana 20 Civic Center Plaza (M30) P.O. Box 1988 Santa Ana, CA 92702 With Courtesy copy to OCFA: Attn: Clerk of the Authority 1 Fire Authority Road Irvine, CA 92602 If to CONTRACTOR: CARE Ambulance Service, Inc. Mr. Rick Richardson 1517 W. Braden Court Orange, CA 92868 The effective date of any notice or written communications sent by one party to the other shall be the date received if by personal service, or forty-eight (48) hours after deposit in the U.S. Mail as reflected by the official U.S. postmark. Either party may change its address by giving notice in writing to the other party. 24. Waiver No waiver of any provision of this Agreement shall be effective unless in writing and signed by a duly authorized representative of the party against whom enforcement of a waiver is sought, referring expressly to this Paragraph. The waiver of any right or remedy in respect to any occurrence or event shall not be deemed a waiver of any right or remedy in respect to any other occurrence or event, nor shall any waiver constitute a continuing waiver. 25. Rights and Remedies are Cumulative Except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the Parties are cumulative and the exercise by either Party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other Party. ETS91712 Page 14 25F-128 26. Cooperation CONTRACTOR must cooperate with the CITY OF SANTA ANA and take all actions necessary to ensure that all terms and conditions, and required performance levels, set forth in the Contract Documents are satisfied at all times throughout the Term of the Agreement. 27. Legal Action In addition to any other rights or remedies, either Party may take legal action, in law or in equity, to cure, correct, or remedy and default, to recover damages for any default, to compel specific performance of this Agreement, to obtain injunctive relief, or to obtain any other remedy consistent with the purposes of this Agreement. 28. Amendment This Agreement may be amended only by the written mutual consent of CITY OF SANTA ANA and CONTRACTOR. 29. Additional Services CONTRACTOR shall not receive compensation for any services provided outside the scope of the Contract Documents unless such additional services are approved in writing by CITY OF SANTA ANA prior to CONTRACTOR performing the additional services. It is specifically understood that oral requests or approvals of such additional services, change orders, or additional compensation, and any approvals from the CITY OF SANTA ANA, shall be barred and are unenforceable. 30. Counterparts This Agreement may be executed in one or more counterparts by the parties hereto. All counterparts shall be construed together and shall constitute one Agreement. 31. Corporate Authority The persons executing this Agreement on behalf of the Parties hereto warrant that they are duly authorized to execute this Agreement on behalf of said Parties and that by doing so the Parties hereto are formally bound to the provisions of this Agreement. [SIGNATURES TO FOLLOW ON NEXT PAGE] ETS91712 Page 15 25F-129 IN WITNESS WHEREOF, the parties hereto have caused these presents to be duly executed with all formalities required by law on the respective dates set forth opposite their signatures. "CONTRACTOR" CARE AMBULANCE SERVICE, INC. By: Name Title CITY OF SANTA ANA By: ATTEST: By: Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: Sonia R. Carvalho, City Attorney By: Paul M. Walters City Manager Laura Sheedy Assistant City Attorney ETS91712 Page 16 25F-130 PRICE WORKSHEET CITY OF SANTA ANA RFP # JRSB002 FOR EMERGENCY AMBULANCE TRANSPORTATION AND RELATED SERVICES EMERGENCY TRANSPORTATION SERVICE FOR PERIOD OF 9/1/12-9/30/13 Annual Contract Price $ 2,881,675 Not to exceed $ per month $ 240,140 Optional Billing: (Price Per Transport) $ 17.50 per transport or $ 190,000 Annually EMERGENCY TRANSPORTATION SERVICE FOR PERIOD : 9/1113-9/30/14 Annual Contract Price $ 2,968,125 Not to exceed $ per month $ 247,344 Optional Billing: (Price Per Transport) $ 18.00 per transport or $ 195,480 Annually EMERGENCY TRANSPORTATION SERVICE FOR PERIOD 9/1/14-9/30/15 Annual Contract Price $ $ 3,057,169 Not to exceed $ per month $ 254,764 Optional Billing: (Price Per Transport) $ 18.50 per transport or $ 200,910 Annually Optional I -Year Extension: EMERGENCY TRANSPORTATION SERVICE FOR PERIOD: 9/1/15-9/30/16 Annual Contract Price $ $ 3,148,884 Not to exceed $ per month $ 262,407 Optional Billing: (Price Per Transport) $ 19.00 per transport or $ 206,340 Annually Optional 1-Year Extension: EMERGENCY TRANSPORTATION SERVICE FOR PERIOD : 9/1/15-9/30/16 Annual Contract Price $ $ 3,243,350 Not to exceed $ per month $ 270,279 Optional Billing: (Price Per Transport) $ 19.50 per transport or $ 21 1,770 Annually 'Dates assume a September 1, 2012 contract effective date. 43 25F-131 25F-132