CCR2011178-Agreement
AGREEMENT FOR AMBULANCE SERVICES
FOR 2012
1. Tess Corners Volunteer Fire Department, hereinafter referred to as TC Rescue,
hereby agrees to provide ambulance rescue services, in the common meaning of
those words, to the entire City of Muskego, hereinafter referred to as the City,
whenever called upon to do so for the duration of this agreement.
a. TC Rescue shall supply ambulance vehicles, together with the necessary
manpower to utilize said equipment and agrees to maintain 3 locations within
the City to house-said vehicles and other necessary rescue apparatus.
b. TC Rescue shall promptly respond, upon being notified by the City’s designated
Dispatcher, to any location within the City’s corporate limits, with the necessary
ambulance apparatus as well as sufficient manpower to operate said apparatus,
to render emergency medical services at the scene of such emergency. Said
service shall be provided as equally as possible throughout the City’s corporate
limits as it relates to both first responder and ambulance arrival times.
c. Rescue services shall include both emergency medical care on the scene of an
emergency, rendered by two (2) State certified emergency medical technicians
as well as transportation by ambulance to a medical facility by two (2) EMT’s or
other qualified state licensed parties. Rescue services shall be provided but are
not limited to instances involving trauma, medical emergencies, automobile
accidents and water and ice rescue operations. Rescue services shall not
include emergency response to incidents involving known “hazardous materials”
as that term is commonly used in the fire service unless such personnel are
qualified.
d. Services shall also include mutual aid response by fire departments or
ambulance services from surrounding communities to assist TC Rescue should
TC rescue request aid from such departments. The need for such response shall
be in the sole discretion of the TC Rescue official in charge at the time of call.
There shall be no additional charge to the City for mutual aid response.
2. TC Rescue agrees to provide State certified Basic level EMT’s on each of its
ambulance calls and further agrees to provide at least one (1) State certified EMT
Intermediate or higher on every first call. TC Rescue agrees to educate and finance
the education of all its EMT’s and to also finance their continuing education to
ensure that they maintain their respective State certifications.
3. TC Rescue shall obtain and maintain in full force and effect during the term of this
contract and pay the premium thereon for the following policies of insurance. TC
Rescue further agrees to secure vehicle, liability, property damage, and errors and
omissions insurance for any and all actions of the said EMT’s, officers, and
department as a whole.
Agreement for Ambulance Services – Page 2
a. Workers Compensation policy.
b. Commercial General Liability policy with a combined single limit of not less than
$2,000,000 per occurrence for bodily injury, personal injury and property
damage.
c. Automobile Liability policy for all vehicles with a combined single limit of not less
than $2,000,000 per occurrence for bodily injury and property damage.
d. Medical Malpractice policy for the rescue and ambulance services provided for in
this agreement with a limit of not less than $2,000,000 per occurrence.
e. A certificate of insurance naming the City as an additional insured shall be sent
to the City showing the above requirements have been complied with, providing
for written notice to the City 30 days in advance of full or partial cancellation on
the City’s approved form.
f. Memorandum copies of the insurance policies shall be provided to the City upon
request. No payment shall be made to this Fire Department under this contract
until the appropriate insurance certificate satisfactory to the City shall be provided
to the City Clerk’s office.
4. TC Rescue shall charge a fee to the City of $428.80 for each patient transported by
TC Rescue to a medical facility. TC Rescue shall charge the City a half fee of
$214.40 for each such patient that refuses transport to a medical facility. The City
shall have the right to recoup said monies paid to TC Rescue on behalf of the
patient.
5. This contract shall be in full force and effect starting on January 1, 2012 and ending
on December 31, 2012.
6. It is distinctly understood by all parties that the service contracted for in this
agreement is for emergency purposes only and that TC Rescue will not transport
patients to hospitals unless there is a true emergency as determined by the TC
Rescue official in charge at the time of the call.
7. TC Rescue shall keep an accurate and full report on all rescue calls made and shall
submit such report with monthly billing to the Public Safety Committee.
a. This report shall list all individual calls for service. This report shall include
response zone and overall response time calculated from time of page for rescue
response to first responder and ambulance arrival. The times listed shall be in
detail to the minute.
8. In consideration for the above services, the City agrees as follows:
a. The City shall agree to pay monthly in full for patient transports. Any monies
allotted to the City by Federal or State programs which are specifically
designated for use by ambulance providers shall not be included in said service
fee nor shall they serve to reduce said service fee provided hereunder.
Agreement for Ambulance Services – Page 3
Dated ______________, this_____ day of _____________, 20___.
By THE CITY OF MUSKEGO: By TESS CORNERS VOLUNTEER
FIRE DEPARTMENT:
__________________________ ____________________________
Title: Mayor Kathy Chiaverotti Title:
__________________________ ____________________________
Title: Clerk-Treasurer Title: