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Home My WebLink About2004 04 26 Consent 200 COMMISSION AGENDA ITEM 200 CONSENT X INFORMATIONAL PUBLIC HEARING REGULAR April 26, 2004 Meeting MGR f/ IDEPT --51 .:iv f Authorization REQUEST: Fire Department Requesting Authorization to Purchase Chest Compression Devices from State of Florida Matching Grant Funds by a sole source vendor Revivant Corporation. PURPOSE: The purpose of this Commission item is to request authorization to expend a $57,165 total grant by a sole source vendor, for chest compression devices and supplies from Revivant Corporation for each response unit. CONSIOERATI0NS: The Fire Department applied and received a State of Florida Department of Health matching grant for emergency medical services. The State of Florida's match is 75% or $42,874 and the City of Winter Springs' match is 25% or $14,291 for a total grant of $57, 165. The grant was awarded to provide chest compression devices and supplies that will allow uninterrupted cardio pulmonary resuscitation of medical patients. These devices will give paramedic's and EMT's additional time to perform other life saving interventions. The Fire Department has available funds in the Medical Transport budget in Capital Expenditures - Other Equipment Line Code # ] 70-64000 for this purpose. April 26, 2004 Consent Agenda Item 200 Page 2 FUNDING: This is a matching grant with the State of Florida's match of75% or $42,874, and the City of Winter Springs' match of25% or $14,291 for a total grant of$57, 165. The City's portion of the grant is available in the Fire Department - Medical Transport Fund - Capital Expenditures - Other Equipment Line Code # 170-64000. Expenditure of funds will occur within 60 days. RECOMMENDA TION: It is recommended that authorization be granted to purchase the chest compression devices from Revivant Corporation as a sole source vendor not exceeding $57,165. IMPLEMENTATION SCHEDULE: The delivery of the equipment will occur within the next 60 days. ATTACHMENTS: Grant Letter COMMISSION ACTION: FLORIDA DEPARTMENT OF Jeb Bush Governor HEALT John O. Agwunobi, M.D., M.B.A. Secretary BUREAU OF EMERGENCY MEDICAL SERVICES April 12, 2004 RECEIVED APR 1 9 2004 Mr. Ron McLemore Winter Springs Fire Department 1126 SR 434 Winter Springs, FL 32708 ~~ ~~ 1 CITY OF WINTER SPRINGS City Manager Dear Mr. McLemore: Secretary Agwunobi informed you in his letter dated March 31,2004 of the approval of your emergency medical services matching grant in the amount of $42,874.00 in state funds. The state 10 code for this project is M4014. Your grant began on March 31,2004 and will end on June 30, 2005. No costs may be incurred before or after these dates. Should additional time be required to complete the project you must submit a written ending date extension request prior to the ending date. Further, all costs that exceed the limits of the grant award, in accordance with Section 401.113 (2)(b), Florida Statutes, are the sole responsibility of the grantee. Your acceptance of all the grant terms and conditions is acknowledged when funds are drawn or otherwise obtained through the department's payment system. A major requirement is that you must submit financial and narrative reports on the grant project activities as follows. 1. Activities from 3/31/2004 through 8/31/2004, report due by 10/4/2004; 2. Activities from 9/1/2004 through 1/31/2005, report due by 3/7/2005; 3. Activities from 2/1/2005 through 6/30/2005. This is the final report and is due no later than 8/15/2005. It must include copies of all invoices, receiving reports and cancelled checks pertaining to the grant expenditures. If the grant activities and expenditures are completed prior to the. ending date, a final report may be submitted at that time and no further reports will be required. Failure to meet these reportin.g requirements will jeopardize the funding of any future grant applications submitted by your organization. Should you need further assistance, please contact me at (850) 245-4440. Sincerely, <1 {j~U~~/-' -- ~rd L. Wilson, Jr. Program Administrator G s Unit Enclosures: Approved Budget Florida Single Audit Act Form Change Request Form Expenditure Report Form cc: Marc Baumgart Phone (850) 245-4440 4052 Bald Cypress Way, C-18, Tallahassee, FL 32399-1738 FAX (850) 488-2512 18. Budaet: . -. Salaries and Benefits: For each Costs Justification: Provide a Drief justification position title, provide the amount of why each of the positions and the numbers salary per hour,.FICA per hour, of hours.are necessary for this project. fringe benefits,and the total number of hours.. N/A' . . TOTAL: O/V' Expenses: These are travel costs Costs: List the price' Justification: Justify why each of the and the usual, ordinary, and and source(s) of the expense items and quantities are incidental expenditures by an price identified. necessary to this project. agency, such as, commodities and supplies of a consumable nature, excludinq expenditures classified as operating capital outlay (see next cateqo~rv). N/A . -. TOTAL: $ DH Form 1767, Rev. 2002 8 Vehicles, equipment, and other Costs: List the price Justification: State why each of the items operating capital outlay means of the item and the and quantities listed is a necessary equipment, fixtures, and other source(s) used to .. component of this project. tangible personal property of a non. identify the. price. consumable and non expendable. nature, and the normal expected life of which is 1 year or more. Chest compression devices $29,835 One device for each specified response Revivant Corp. unit Spare batteries $2,970 . Three batteries for each device Revivant Corp. Disposable chest straps $18,750 One chest strap for each anticipated patient Revivant Corp. during the grant cycle Battery Charger $4,425 One battery charger per device. . Revivant Corp Carry Case $1185 One carry case per device Revivant Corp TOTAL: $57,165 ~/~ State Amount (Check applicable program) [2gMalching: 75 Percent $42.874 o Rural: 90 Percent $ Local Match Amount - (Check applicable program) [2gMatching: 25 Percent $14.291 o Rural: 10 Percent $ Grand Total $57,165 DH Form 1767, Rev. 2002 9 Checklist for Nonstate Organizations Note: This form is to be used to evaluate the applicability of the Florida Single Audit Act to local governments (excluding district school boards and community colleges), and nonprofit organizations with which the agency has contracts/agreements. This form does not need to be completed for local governments and nonprolits under contracts/agreements which only provide for the procurement of commodities, or which only provide federal or state matching funds. Given that for-profit organizations, including sole-proprietors, generally have vendor relationships with state agencies, completion of the form for such organizations is optional. Nonstate Organization(J): Winter Springs Fire Department State Project: EMS Matching Grant Program M4014 Agency: Florida Department of Health CSFA(2) Number: 64.003 Contract/Agreement Period: March 3 I. 2004-June 30, 2005 Completed by: Edward L. Wilson, Jr. Authorizing Statute: Chapter 401. Part II Date: April 12. 2004 (I) Nonstate Organization does 1I0t include universities within the State University System. m Catalog of State Financial Assistance es, the nOllstate or allization is a 1. Does State lawllegislative proviso establish or create the nonstate organization to carry out the state project? 2. Does the nonstate organization determine final program eligibility? Yes_ No----L.. Yes_ No--X- Part B: Complete the followin/! table. A yes" allswer is indicative of tIre tl'De relationship bein!: reviewed Recipient , Yes No Comments -- ',; :Vendor .. Yes No Coriuneots " , .; , .' ; , . \. Does state statute or legislative proviso n F.S. 401, I. Does the nonstate organization provide establish the state project and authorize the X Part II its services within the nonnal course of X agency to provide funding for the project? business operations? . 2. Is the nonstate organization required to 2. Does the nonstate organization operate provide matching funds? X in a competitive environment? X 3. Does the nonstate organization make 3. Does the nonstate organization provide programmatic decisions on behalf of the X similar services to many different X State? purchasers? 4. Are the funds provided to the nons tate 4. Does the contract agreement specifY organization for it to carry out its own X payment on a per unit or per deliverable X program or operations? basis? 5. If the nons tate organization receives S. Was the contract/agreement All EMS federal funds under a similar program, is it N/A awarded based on free and open X organizations and designated as a recipient by your agency for competition? providers may that program? applv 6. Is the nonstate organization organized 6. If the nons tate organization receives primarily for a public purpose? X federal funds under a similar program, is X it designated as a vendor by your agency for that program? Part C. Conclusion. Based. on your analysis of the responses to Parts A and/or B, and discussions with appropriate agency personnel, indicate your evaluation of the nonstate organizatioQfor this contract: (check one) Recipient..K...:.. Vendor _ Note that it is possible to have a contractual agreement with a IlOnstate organization under Chapter 287, Florida Statutes, alld still consider the nonstate organization a recipient under the Florida Single Audit Act COMMENTS: Part D: Questiolll7Vew Proiects. I f you have questions regarding the evaluation of a nonstate organization or if you determined that the nonstate organization is a recipient and the project has not been assigned a CSFA number, contact the Executive Office of the Governor, Office of Policy and Budget, at 487-1880. Department of Health EMS GRANT PROGRAM CHANGE REQUEST Name of Grantee: Grant 10 Code: BUDGET LINE ITEM CHANGE FROM CHANGE TO TOTAL $ $ Justification For Change: Siqnature of Authorized Official Date For department use only Approved Yes DNo D Change No: Department's Authorized Representative Date DH Form 1684C, Rev. June 2002 12 Department of Health EMS GRANT PROGRAM EXPENDITURE REPORT Name of Grantee: Grant 1D Code: Time Period Covered: Beginning Date: Ending Date: Earned Interest: Amount $ ;asof_ Day Month Year Final Report (Check one): DYes DNo Major Line Items Approved Budget Expenditure by Major Line ltem(s) TOTAL $ TOTAL BUDGETED EXPENDITURES $ Actual Expenditure to Date by Major Line Item(s) $ TOTAL EXPENDITURES $ BALANCE Bud eted Less Actual Ex enditures $ Include with the progress notes an explanation of how project personnel, equipment, and any problems or barriers ma im act on the rant ro ress. I certify the above reports are true and correct. Expenditures were made only for items allowed by the above referenced grant. Si nature of Authorized Official DH Form 1684A, Rev. June 2002 Date 13