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Res 169-2007 11/20/2007 � . , RESOLUTION NO. �� _� n n � RESOLUTION OF THE CITY COUNCIL OF THE CITY OF WICHITA FALLS, TEXAS, AUTHORIZING THE CITY MANAGER TO EXECUTE AN AGREEMENT WITH AMERICAN MEDICAL RESPONSE AMBULANCE SERVICE, INC. FOR AMBULANCE SERVICE IN WICHITA FALLS; FINDING AND DETERMINING THAT THE MEETING AT WHICH THIS RESOLUTION WAS PASSED WAS OPEN TO THE PUBLIC AS REQUIRED BY LAW. WHEREAS, Wichita County and the cities of Wichita Falls, Burkburnett and lowa Park ("the entities") are currently parties to an agreement with American Medical Response Ambulance Service, Inc. ("AMR"); and WHEREAS, the current agreement expires in February, 2008; and WHEREAS, to ensure the continuation of services, representatives of the entities conducted a selection process, and are recommending AMR for continued ambulance service to the entities. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF WICHITA FALLS, TEXAS, THAT: SECTION 1. The City Manager is hereby authorized to execute the attached contract for Ambulance Services with AMR. SECTION 2. The current agreement, as approved by Resolution #48-2003, is hereby terminated. SECTION 2. It is hereby officially found and determined that the meeting at which this resolution was passed was open to the public as required by law. PASSED AND APPROVED this the 20 day of November, 2007. , MA OR ATTEST: y Clerk , . AGREEMENT FOR EMERGENCY AMBULANCE SERVICE TO WICHITA COUNTY AND THE CITIES OF WICHITA FALLS, BURKBURNETT AND IOWA PARK, TEXAS This Agreement, made and entered into this the 20�' day of November, 2007, by and between Wichita County, acting by and through its County Judge, the City of Wichita Falls, Texas, the City of Burkburnett, Texas, and the City of Iowa Park, Texas, acting by and through their respective Executive Officers, hereinafter referred to as "Entities," and American Medical Response Ambulance Service, Inc., d/b/a American Medical Response, hereinafter referred to as "Contractor," WITNESSETH: For and in consideration of the mutual covenants and conditions herein contained, the parties hereto do hereby agree as follows: I. Contract Term A. The term of this Agreement shall be for a five year period beginning November 20, 2007, and ending November 20, 2012, subject to satisfactory performance by the Contractor as outlined herein. If Contractor does not desire to renew this agreement beyond November 20, 2012, it shall give written notice of its intent not to renew at least 90 days before November 20, 2012. Failure to give such required notice within the time specified shall forfeit the performance bond referenced in paragraph IX unless the parties negotiate an extension of this Agreement. B. Contractor agrees to furnish emergency ambulance service as an independent contractor for the purpose of making emergency medical service calls within the limits of Wichita County. C. It is expressly understood and agreed by and between Entities and Contractor, that Contractor is an independent contractor in its relationship to the Entities, and that nothing contained herein shall at any time or in any manner be construed as an agreement of partnership or j oint venture or render any party hereto the employer or master of any other party andlor its employees, agents or representatives. D. Nothing in this Agreement is intended, nor shall be used to prevent the Contractor from securing non-emergency transportation contracts with area facilities. It is expressly understood that the Contractor may, at its sole discretion, choose to contract at discounted rates or increased rates completely independent of the rates specified within this Agreement. PAGE 1 OF 17 PAGES sole discretion, choose to contract at discounted rates or increased rates completely independent of the rates specified within this Agreement. II. Service Level Contractor shall provide emergency medical service, twenty-four (24) hours per day, seven (7) days per week. Emergency medical service is defined as response to situations wherein notice is given to Contractor by Entities' Police Departments, Wichita Falls Fire Department, Wichita County Sheriff's Department, or by anyone, that circumstances exist in Wichita County which require immediate aid in a medical emergency wherein the person or persons are transported to the Emergency Room for treatment. Emergency medical service specifically does not include any call involving routine, non- emergency transfers to or from an inpatient clinic, nursing homes or hospitals, or transportation outside Wichita County. Emergency medical service includes: A. Advanced life support - emergency pre-hospital care provided by a specially skilled emergency medical technician or a paramedic emergency medical technician using invasive medical acts. The provision of advanced life support shall be under the medical supervision and control of a licensed physician. The physician shall operate out of an office located within the jurisdictional boundaries of the Region. B. Basic life support - emergency pre-hospital care provided by an emergency care attendant or basic emergency medical technician using non- invasive medical acts. The provision of basic life support shall be under the medical supervision and control of a licensed physician. C. In all instances, Contractor shall attend to emergency medical service calls prior to all other calls, and Contractor shall schedule its resources to have emergency medical service capability at all times to any point within Wichita County. D. Emergency medical service crews, vehicles and equipment shall be located at a base station and, if deemed necessary, substations to respond with utmost urgency to possible emergency medical service calls, except un�er severe weather conditions such as ice on the streets or unavailability of units because of other emergency medical service calls, within the following maximum response times with a 90% minimum response time compliance (response times begin at the receipt of the 9-1-1 call): 1. Within the city limits of Wichita Falls - 10 minutes; 2. Within the city limits of Burkburnett - 18 minutes; 3. Within the city limits of Iowa Park - 15 minutes; 4. Outside the city limits of an incorporated city, but within Wichita County - 25 minutes PAGE 2 OF ] 7 PAGES The 90% compliance standard may be evaluated by the Entities on a monthly basis. Contractor's failure to satisfy the 90% standaxd shall be considered a breach of this agreement and amounts payable to Contractor may be reduced as following the procedures by Section XXIII. III. Personnel A minimum of two persons shall comprise the ambulance crew required to be on each vehicle. All ambulance attendants shall hold and maintain, as a minimum standard, current certification by the Texas State Boaxd of Health as an Emergency Medical Technician and possess a current City of Wichita Falls permit and a valid Class C Texas Drivers License. Every ambulance will be staffed and equipped to provide Advanced Life Support. IV. Location of Base and Substations The emergency vehicles, equipment and crews shall be located at a base station and at substations as may be necessary to provide service within the response time specified herein. The location of the base station and any substations, except for the existing location, must be in an area zoned either General Commercial or Heavy Commercial. Contractor shall notify Entities in writing thirty (30) days in advance of any changes in location. V. Vehicles Contractor shall assume full responsibility for all maintenance, repair and replacement of any ambulances owned or operated by Contractor. All replacement ambulances purchased by Contractor shall be able to be approved by the Texas Department of Health's rules regarding certification of ambulances, and designed, constructed and maintained to meet or exceed these standards. Contractor shall ensure that all vehicles used for the purpose of providing ambulance service be maintained to meet or exceed lhe most recent standards as set out in KKK-1822B, dated November 1994, or as superseded or amended, GSA Federal Specifications, to adequately transport ill, sick or injured persons in comfort and safety, and shall be maintained in clean, sanitary, and in first-class mechanical condition at all times. Contractor shall maintain a minimum of four ambulances in first-class mechanical condition at all times. Entities may inspect any ambulances operated by Contractor at any time, with reasonable notice to Contractor. PAGE 3 OF 17 PAGES VI. MedicaVEmer�ency Supplies Contractor, at its own expense, shall fully stock each ambulance with equipment and supplies as required by the State of Texas. In addition, the ambulance provider shall reimburse the first-responding entity for disposable, consumable and/or billable medical supplies. VII. Dispatchin� Contractor shall be responsible for dispatching all emergency medical service calls. Contractor may maintain, at its own expense, a twenty-four (24) hour manned dispatch service for all ambulances and a direct telephone connection between its base station and the City of Wichita Falls Police Department, and direct communications between its base station and any substations. On receipt of an emergency call, Contractor shall, to the extent reasonably possible, promptly notify the City of Wichita Falls Police Dispatcher and, if the call is within the city limits of Burkburnett or Iowa Park, the Police Department of that City of the location and probable route of the emergency ambulance answering such call and shall notify the Police Dispatcher of the involved City of the time when the ambulance reaches the location. VIII. Insurance A. It is expressly intended and understood that an independent contractor relationship is required under this contract. Contractor covenants and agrees to indemnify, hold harmless, and defend Entities and their respective agents, servants and employees from and against and assume all liability and responsibility for any and all claims for damages or injuries to persons or property of whatsoever kind or character, whether real or asserted, arising out of or incident to the operations of Contractor's ambulance service and all other of its operations arising under or otherwise incident to the provisions of this contract. B. Contractor shall provide, at its own expense, the following insurance coverage: 1. Comprehensive automobile insurance coverage extended for fire, theft or any other physical loss of ambulance except by collision or upset. 2. Collision and upset insurance for a11 ambulances with value no less than current value of vehicle and contents with not more than One Thousand ($1,000) Dollars deductible. 3. Automobile liability insurance coverage as required by State Law as may be amended from time to time. Current requirements are in amounts of at least One Million ($1,000,000) Dollars bodily injury per PAGE 4 OF 17 PAGES person; One Million ($1,000,000) Dollars bodily injury per incident; and One Million ($1,000,000) Dollars property damage. 4. Professional malpractice liability policy in a minimum amount of Five Hundred Thousand ($SOO,OOU) Dollars. C. Insurance must be written by companies licensed to do business in the State of Texas. D. Contractor agrees to name Entities as additional insured in the Automobile and Professional insurance policies. E. All insurance policies must contain a provision that the policy shall not be canceled, modified, expired or otherwise terminated until after at least thirty (30) days written notice to that effect is given to Entities. F. All insurance policies shall be in form and content satisfactory to Entities and should be submitted to the City of Wichita Falls at the time of contract execution. IX. Performance Bond Contractor shall provide a performance bond in the amount Five Hundred Thousand ($500,000) Dollars payable to the City of Wichita Falls for the benefit of the Entities, guaranteeing the full and faithful execution and performance of the contract at the time of contract execution. Said bond shall be executed by the Contractor and one corporate surety authorized to do business in the State of Texas. The surety shall designate a resident agent in Wichita County, Texas, to whom any requisite notices may be delivered and on whom service of process may be had in matters rising out of such suretyship. A duplicate original of the performance bond shall be provided to each Entity. The performance bond shall remain in effect during the entire term of this agreement or any extension thereof. In the event Contractor of a breach of this Agreement and Contractor fails to cure that breach within thirty (30) days of receipt of the written notice from the City of Wichita Falls, the performance bond may be called by the City of Wichita Falls. Upon receipt of the proceeds of the performance bond by the City ot Wichita Falls, such amount shall be utilized to provide ambulance service to the governmental entities on an interim basis, the manner and method of providing such service to be agreed upon by the parties until a permanent provider of such service is operational. Any remaining funds not utilized to operate and equip an interim ambulance service shall be divided among the governmental entities in proportion to the respective populations that reside in the areas identified in paragraph II. D. 1-4 and served by the ambulance provider. PAGE 5 OF 17 PAGES X. Use of Emer�encv Warning Devices A. An ambulance may respond to a call using red lights and siren. B. After an ambulance has responded to a call and arrived at the point of pickup, the ambulance shall not proceed to the hospital or other destination with the use of such emergency warning equipment except in the case of dire emergency. Dire emergency includes, but is not limited to: acute respiratory distress, impaired breathing, airway blockage; bleeding beyond control; poisoning; immediate and pending childbirth; and orders or recommendation of a licensed physician. XI. Dead on Arrival Procedure The following procedure shall be followed by Contractor when the subject of the emergency call is dead on the arrival of the ambulance. Dead on arrival, as used herein, shall mean a determination of death by a medical examiner or medical doctor. Where there is not any instruction given by the next of kin, or other responsible person related to the deceased, as to where the body shall he delivered, the ambulance driver shall deliver it to a hospital until a medical examiner or licensed medical doctor formally pronounces the subject dead. XII. Trip Lo� Contractor shall maintain records of the time, place of origin, destination and charges and attendants for each trip made. The Contractor shall retain this information for a minimum of two years and the information shall be available to the City-County Health Officer or representatives of the Entities on request. XIII. FinancialInformation A. Contractor shall maintain all financial records in a manner consistent with generally accepted accounting principles, practices, procedures and standards as defined by the American Institute of Certified Public Accountants. B. Within one-hundred twenty (120) days of the prior year's close, Contractor shall, at its own expense, employ an independent certified public accountant to be approved in advance by Entities to audit the Contractor's books and financial statements related specifically to this Agreement. Contractor shall also provide the Entities with unaudited monthly financial statements that include income statement, balance sheet, statement of changes in cash position and statement of changes in financial position. The financial statements for each month shall be PAGE 6 OF 17 PAGES provided to the representatives of Entities serving as the liaison between the entities and Contractor by the 20 of the month following. C. Entities shall have the right, at all reasonable times during normal business hours, to inspect and/or audit all financial records and books of Contractor. D. Contractor shall maintain a complete and separate record of all revenues and expenses concerning this Agreement. XIV. License of Public Convenience and Necessity Prior to execution of the contract, Contractor shall obtain and at all times maintain a current license of public convenience and necessity and a permit issued by the City Clerk of the City of Wichita Falls in accordance with the City's Code of Ordinances as it may be amended from time to time. XV. Relationship with Entities A representative of Entities shall be assigned to serve as a liaison between Entities and Contractor and to monitor the contract on behalf of Entities. XVI. Rates A. Rates for emergency ambulance services shall be as specified in Addendum A. No items or charges can be invoiced to the patient for goods or services not included in Addendum A. Any changes in Addendum A proposed by Contractor must be reasonable and necessary and have prior approval of Entities. The parties to this contract recognize that changes to the health care industry and/or federal, state and local law may necessitate a review of the rates specified in Addendum A. To that end, Contractor reserves the right to request a change to the rates specified in Addendum A. The Entities are under no obligation to approve such request. The Entities shall approve or reject Contractor's request for a change to Addendum A within ninety (90) days of Contractor's written notice. B. The rates to be charged shall be posted in every ambulance in a conspicuous place, readily visible to the occupants. XVII. Assignment of Contract Contractor shall not assign this contract or any rights or responsibilities hereto in whole or in part to any person, firm or corporation without prior written consent by Entities. PAGE 7 OF 17 PAGES XVIII. Execution of Contract No contract shall be binding on Wichita County and the Cities of Wichita Falls, Burkburnett and Iowa Park until it has been approved by the governing bodies of the Entities and has been executed by the Chief Executive Officers of Entities and delivered to the Contractor. XIX. EqualOpportunitv Contractor shall not discriminate against any employee or applicant for employment because of race, religion, color, sex, natural origin, or age. Contractor shall take affirmative action to insure that applicants are employed, and that employees axe treated during employment without regard to their race, religion, color, sex, national origin, or age. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other compensation; and selection for training, including apprenticeships. Contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth their policies of non-discrimination. XX. Exclusivity Contractor shall have the exclusive rights within the jurisdictional boundaries of the entities to provide emergency medical services when the call stems from a 9-1-1 call. Exclusivity shall not apply to non-emergency ambulance services. XXI. Subsidy A. The Entities covenant and agree to pay Contractor for providing emergency and transfer service in Wichita County, Texas, as provided in this contract, the sum of Fifty Thousand ($50,000) Dollaxs annually, payable as follows: l. Une-twelfth (1/12) of the annual subsidy, Four Thousand One Hundred Sixty-Six Dollars and Sixty-Seven Cents ($4,166.67) shall be payable on the last day of each month. 2. The Entities shall retain the right to seek adjustments in the subsidy at any such times the other collections by the Contractor are increased to the extent the Entities feel reconsideration of the subsidy amount paid by Entities is merited. The Entities will provide Contractor with ninety (90) days prior written notice of any decrease in the subsidy. PAGE 8 OF 17 PAGES - � ; ' . 3. The Entities agree to pay subsidy amounts to the City of Wichita Falls an amount(s) as allocated below. The City of Wichita Falls shall then pay to the Contractor the amounts due as specified in Al above. • Wichita County 50% or $25,000.00 annually • City of Wichita Falls 42% or $21,000.00 annually • City of Burkburnett 5% or $2,500.00 annually • City of Iowa Park 3% or $1,500.00 annually B. Contractor shall provide to Entities, at no additional charge, services to persons who are wards of Entities. The term "ward" shall mean a person who is in the custody, care and protection of one of the Entities. XXII. Liabili The sole shareholder, American Medical Response, Inc., of Contractor shall be liable for any debts or obligations of Contractor. XXIII. Remedies for Non-Performance A. Either Contractor or Entities may terminate this contract at any time due to the continued failure of the other to comply with any or all material terms of the contract, or habitual neglect or continued incapacity to perform other obligations herein. The non-defaulting party shall provide to the other parties its intent in writing, certified mail, return receipt requested, to terminate this contract. Such notice shall include a recitation of the specific failures on the part of the defaulting party, and, upon receipt of such notice, such defaulting party shall have thirty (30) days to rectify such defaults and fully comply with all requirements set forth herein. Should the defaulting party not rectify such defaults within the thirty (30) day period, the non-defaulting party may terminate this contract. Notice provided by paragraph B. of this section shall conform to these requirements and shall serve and satisfy the requirement for notice contained herein if the violations continue for a thirty (30) day period after receipt of notice. Notwithstanding the above, the following shall be ground for immediate termination of the contract: 1. Dissolution of Contractor. 2. Sudden or substantial and permanent inability of the Contractor to meet its obligations under the contract, such that the purposes of this contract are frustrated. 3. Voluntary bankruptcy. PAGE 9 OF 17 PAGES . • �, • •. 4. Involuntary bankruptcy, and same is not dismissed within ninety (90) days from the date of filing. Entities retain the right, however, to continue the contract on a month-to- month basis until such time as Entities see fit to fully terminate this contract. B. It is further agreed by the parties that actual damages which might be sustained by Entities by reason of a breach by Contractor of its promise to perform the obligations contained in the following Sections would be uncertain and difficult to ascertain: l. Section II. Service Level 2. Section III. Personnel 3. Section V.D. Vehicle Inspection 4. Section VIII. Insurance 5. Section IX. Performance Bond 6. Section XIII.B. Monthly Financial Statements 7. Section XIV. License 8. Section XXV. Compliance with Laws It is agreed that the Entities may deduct an amount equal to a per diem of the monthly subsidy ($138.86) multiplied by the number of days any material breach of these certain sections continued after five (5) days receipt by Contractor of written notice of default ("Per Diem Damages"). For example, if the Entities provide Contractor with a five day notice for the Personnel requirement and Contractor did not correct the requirement for another two (2) days, Contractor would owe $277.72 ( 2 X$138.86) as liquidated damages. It is agreed that such amount is reasonable and just for such delay in performance, that timely performance of such obligations is of the essence, and that Contractor shall bear such deduction as liquidated damages, and not as a penalty. Pursuit of the remedies described above shall not preclude pursuit of any other remedies provided in this contract or any other remedies provided by Iaw, nor shall pursuit of any remedy herein provided constitute a forfeiture or waiver of the violation of any of its terms, provisions, and covenants. No waiver of any violation shall be deemed or construed to constitute a waiver of any other violation or a breach of any other terms, provisions and covenants contained in this agreement, and forbearance to enforce one or more of the remedies provided upon an event of default shall not be deemed or construed to constitute a waiver of such default. For violations of Section II, "Service Level," two conditions must exist before the Per Diem Damages will apply. First, the Contractor must fall PAGE 1 O OF 17 PAGES under the 90% compliance threshold on emergency transports for the month. Second, the Per Diem Damages shall only apply to transports where the Contractor's response time exceeds the response time standard by five (5) minutes. The Entities may deduct an amount equal to a per diem ratio of their monthly subsidy contribution. In determining whether a transport is exempt from the response time standard, the Committee shall consider such factors including, but not limited to: • Calls where information on medical need is not immediately available (this situation exists when an Ambulance is not originally dispatched after the PSAP receives the call, but is subsequently requested by on-scene public safety personnel); • Ambulances blocked by a train (Ambulances will immediately notify the Contractor dispatcher when an Ambulance is blocked by a train and when the train is cleared and travel resumes); • In the event of a Multiple-Casualty Incident ("MCI"), all Ambulances responding to the MCI call other than the first Ambulance on the scene; • Severe weather conditions including dense fog, heavy rain or flooding, snow, or ice, except if inclement weather was predicted sufficiently in advance that levels of preparedness should have been increased and such steps were not taken; • Situations where the dispatch center received false or inaccurate information or was unable to obtain adequate response information; • Calls for standby at fire service calls. • Calls for standby at law enforcement incidents. Pursuit of the remedies described above shall not preclude pursuit of any other remedies provided in this Agreement or any other remedies provided by law, nor shall pursuit of any remedy herein provided constitute a forfeiture or waiver of the violation of any of its terms, provisions, and covenants. No waiver of any violation shall be deemed or construed to constitute a waiver of any other violation or a breach of any other terms, provisions and covenants contained in this Agreement, and forbearance to enforce one or more of the remedies provided upon an event of default shall not be deemed or construed to constitute a waiver of such default. C. Any notice required or permitted by this Agreement shall be in writing and shall be delivered as follows: by certified or registered mail, return receipt PAGE 11 OF 17 PAGES requested, upon verification of receipt. Notice shall be sent to the following addresses: TO CITIES: City of Wichita Falls P. O. Box 1431 Wichita Falls, Texas 76307 Attention: City Manager City of Iowa Park P. O. Box 190 Iowa Park, Texas 76367 Attention: City Administrator City of Burkburnett 500 Sheppard Road Burkburnett, Texas 76354 Attention: City Manager TO COUNTY: Wichita County Wichita County Courthouse, Room 202 Wichita Falls, Texas 76301 Attention: County Judge TO CONTRACTOR: American Medical Response Ambulance Service, Inc. 3302 Seymour Highway Wichita Falls, Texas 76309 Attention: General Manager With Mandatory Copy to: Legal Department American Medical Response, Inc. 6200 South Syracuse Way, Suite 200 Greenwood Village, CO 80111 XXIV. Venue PAGE 12 OF 17 PAGES It is expressly agreed and understood by the parties to this contract that venue for any disputes arising out of the rights or obligations contained in this contract shall lie in Wichita County, Texas. XXV. Compliance with Law If any paragraph, sentence, phrase or word of this contract requires a lesser standard than is required under Chapter 773 of the TExAs HEALTx & SAFETY CoDE and the rules and regulations promulgated thereunder, or as such statute, rules, and regulations are amended during the life of this contract, then the provisions of said statute, rules and regulations shall be deemed the minimum standard required by Contractor. The parties will comply in all material respects with all applicable federal and state laws and regulations including, the federal Anti- kickback statute. Contractor has made available to each party a copy of its Code of Conduct, Anti-kickback policies and other compliance policies, as may be changed from time-to-time, at Contractor's web site, located at: www.amr.net, and each party acknowledges receipt of such documents. Contractor warrants that its personnel shall comply with Contractor's compliance policies, including training related to the Anti-kickback Statute. Each party represents and certifies that neither it nor any practitioner who orders or provide Services on its behalf hereunder has been convicted of any conduct that constitutes grounds for mandatory exclusion as identified in 42 U.S.C.§ 1320a-7(a). Each party further represents and certifies that it is not ineligible to participate in Federal health care programs or in any other state or federal government payment program. Each party agrees that if DHHS/OIG excludes it, or any of its practitioners or employees who order or provide Services, from participation in Federal health care programs, the party must notify the other party within five (5) days of knowledge of such fact, and the other party may immediately terminate this Agreement, unless the excluded party is a practitioner or employee who immediately discontinues ordering or providing Services hereunder. It is not the intent of either party that any remuneration, benefit or privilege provided for under the Agreement shall influence or in any way be based on the referral or recommended referral by either party of patients to the other party or its affiliated providers, if any, or the purchasing, leasing or ordering of any services other than the specific services described in this Agreement. Any payments specified herein PAGE 13 OF 17 PAGES . - r • � r are consistent with what the parties reasonably believe to be a fair market value for the services provided. XXVI. Entire Agreement The parties to this contract agree that they have read all provisions of this contract. Said contract are the complete and exclusive statements of the terms agreed upon, superseding all prior agreements or statements, either written or oral. No modification, amendment, or additional to this contract is valid unless in writing and signed by all parties hereta XXVII. Severability If any of the provisions of this contract shall be invalid or unenforceable, same shall not invalidate or affect the validity and enforceability of any other provision, which provisions shall remain in force and effect. XXVIII. �'ermination Either party may terminate this contract without cause with a minimum of one-hundred-eighty (180) days written notice to the other party. If all terms and conditions of the contract have been met by the party requesting termination up to the time of cessation of services, such termination shall be without penalty to either party. This Agreement made and entered into as of the date and year set out above. [Signature Pages Follow] PAGE 14 OF 17 PAGES . - ,. ' . CI OF HITA FAL S By: Cit ger ATTEST: 'ty Clerk APPROVED AS TO FORM: i� City Attorney CITY OF BURKBURNETT By: �S�-e.. �Z� Mayor ATTEST: ; � � �J City Clerk CITY OF IOWA PARK By: City ministra r ATTEST: City Clerk PAGE 15 OF 17 PAGES . � .� ' ,. , . WICHITA COUNTY, TEXAS B �'�/� County Judge ATTEST: County Clerk American Medical Response Ambulance Service, d/b/a AMERICAN MEDICAL RESPONSE B �..� �3 .l PAGE 16 OF 17 PAGES ' .� •` . Addendum A Rate Schedule Emer�encx BLS ALS Milea�e Eme encX EmergencX Rate Rate Rate Current $ 6.13 $ 28231 $ 415.80 Year 1 $ 8.12 $ 385.23 $ 495.42 %+ 32.5% 36.5% 19.1% Year 2 $ 8.93 $ 400.64 $ 515.23 %+ 10.0% 4.0% 4.0% Year 3 $ 9.83 $ 416.66 $ 535.84 %+ 10.1% 4.0% 4.0% Year 4 $10.81 $ 433.33 $ 557.28 %+ 10.0% 4.0% 4.0% Year 5 $11.89 $ 450.66 $ 579.57 %+ 10.0% 4.0% 4.0% PAGE 17 OF 17 PAGES