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Item 13 - Consideration of Agreements For Backup Emergency Ambulance TransporationAGENDA ITEM NO. 13 AGENDA STAFF REPORT City of West Covina I Office of the City Manager DATE: August 20, 2019 TO: Mayor and City Council FROM: David Carmany Interim City Manager SUBJECT: CONSIDERATION OF AGREEMENTS FOR BACKUP EMERGENCY AMBULANCE TRANSPORTATION RECOMMENDATION: It is recommended that the City Council authorize the City Manager to negotiate and execute agreements through June 30, 2020, and accept the following actions: 1. A one-year agreement with four one-year renewal options with Premiere Ambulance, Emergency Ambulance Service, Medic 1 Ambulance, First Rescue Ambulance to provide back emergency ambulance transportation services; and 2. A one-year renewal option with American Medical Response, and CARE Ambulance Service to provide backup emergency ambulance transportation services. BACKGROUND: The West Covina Fire Department ("Fire Department") is the primary responder for all 9-1-1 emergencies within City limits that involve fire, rescue, hazardous materials, and/or emergency medical services (EMS). Over the past few years, the Fire Department has averaged approximately 9,000 emergency 9-1-1 calls for service per fiscal year. In total, EMS calls account for over 70% of the total call volume. Not all EMS calls result in the transportation of a patient. Type of Call FY 2015-16 FY 2016-17 FY 2017-18 FY 2018-19 EMS 6,609 F 74% 6,6201 71% 6,636 70% F6,45 J 69% Good Intent 1,109 12% 1,290 14% 1,252 13% 1,432 15% Service 657 _ 7% 800 9% 948 10% 760 8% False Alarm 291 3% 285 3% 258 3% 333 4% Fire F 162 2% 177 2% 134 2% 151 2% Hazardous Conditions 132 1% 144 2% 147 2% 149 2% Severe Weather 11 F=Fo 23 0% © 0% =7 0% Special Incident C F=Fo =9 0% � 0% F= 0% Total 8,973 100% 9,348 100% 9,383 100% 9,289 100% DISCUSSION: The West Covina Fire Department operates three ambulances that provide basic life support (BLS) and advanced life support (ALS) services for the community. In the EMS industry, BLS services are typically provided by certified Emergency Medical Technicians (EMTs). ALS services are provided when a patient is in critical condition and a paramedic is required to assist in the treatment of the patient before and/or during transportation to the hospital. The Fire Department's three ambulances are staffed with two Firefighter/Paramedic positions per ambulance; capable of providing BLS and ALS services. In the City's current dispatch system, 9-1-1 calls are received through the communications center. City dispatchers receive the call and dispatch a Fire Department engine and ambulance within thirty seconds. If there are no available Fire Department resources, City dispatchers must then call private ambulance companies to provide backup emergency ambulance transportation services. To ensure the private ambulance companies will provide backup emergency ambulance transportation services, the Fire Department proposes entering into agreements for the provision of backup emergency ambulance transportation services with four private ambulance companies that routinely provide service within the local area. The agreements will help develop a streamlined response model for backup transport of ALS and BLS patients, via ambulance, to the most appropriate receiving facility and/or designated hospital. The goal is to use the private ambulance companies to respond to and transport BLS calls when the City's ambulances are unavailable. The agreements will initially be effective through June 30, 2020, with the option to renew for up to four one-year terms for a maximum of five years. The private ambulance companies will be responsible for transporting the patient and billing for the transportation services provided. The City will not receive any revenue from the patients transported by the private ambulance companies. As previously discussed, ambulance subscription program subscribers who are transported by a private ambulance company will not incur any out-of-pocket cost. By entering into these agreements, the Fire Department will preserve necessary local control over the quality of emergency ambulance transportation services provided within the City's jurisdiction, referred to by Los Angeles County as West Covina's Exclusive Operating Area. OPTIONS: The City Council has the following options: 1. Approve Staffs recommendation; or 2. Provide alternative direction. Prepared by: Mike Hambel, Acting Fire Chief Fiscal Impact FISCAL IMPACT: Entering into backup emergency ambulance transportation agreements with the private ambulance companies will not cost the City any money. The private ambulance companies will bill the transported patient(s) and keep 100% of the revenue received. Attachments Attachment No. 1 - Memorandum of Agreement with Premiere Ambulance Service Attachment No. 2 - Memorandum of Agreement with Emergency Ambulance Service Attachment No. 3 - Memorandum of Agreement with Medic 1 Ambulance Service Attachment No. 4 - Memorandum of Agreement with First Rescue Ambulance Service Attachment No. 5 - Amendment No. 1 to MOA with American Medical Response Inc. Attachment No. 6 - Amendment No. 1 to MOA with CARE Ambulance Service Inc. CITY COUNCIL GOALS & OBJECTIVES: Enhance Public Safety ATTACHMENT NO. 1 I►yjIpluto] tymIn11► [uOImlIa�I�lul�l►`YY BETWEEN THE CITY OF WEST COVINA AND PREMIER MEDICAL TRANSPORT, INC. DBA PREMIER AMBULANCE FOR MEDICAL TRANSPORTATION This Memorandum of Agreement (MOA) is entered into by the City of West Covina (City) and Premier Medical Transport, Inc. dba Premier Ambulance (Ambulance Service) for the purpose of developing a streamlined response model for back up transport of BLS patients, via ambulance, to the most appropriate receiving facility and/or designated hospital. TERM AND TERMINATION OF AGREEMENT This MOA is effective on 12019, and shall terminate upon the mutual agreement between the City and Ambulance Service, or upon notice as provided for herein. PURPOSE OF THE AGREEMENT This MOA specifies guidelines and the responsibilities of the City and the Ambulance Service when transporting patients who have been deemed to be stable for transportation at the BLS level. In the event the patient requires ALS intervention, Ambulance Service will assist the City's Fire Department and the patient in providing the most appropriate transportation to the patient. MISSION OF THE OPERATION The purpose of this MOA is to create a direct line of communication between the City Fire Department and the Ambulance Service to streamline the process of requesting an ambulance to respond to the scene where a patient is being treated and prepared for transportation. This process is intended to eliminate the unnecessary deployment of additional resources. RESPONSE PROCEDURES West Covina Fire Department paramedics will contact the City communication center and request a BLS ambulance when necessary. The communication center will then contact the Ambulance Service to respond to any calls involving an individual who has been evaluated and determined that services are the most appropriate level of service for the patient. The communication center may request a Code 2 (w/o lights or sirens) or Code 3 (with lights and sirens) whichever is in the best interest of the patient and the community. LICENSES & EQUIPMENT The Ambulance Service will comply with all state and federal rules and regulations with regard to the licensing of the ambulances, company and employees (CHP, LADHS, State of California, etc.). In the event of disruption in service due to a licensing related issue(s) Ambulance Service will notify the City of West Covina Fire Department of such disruption within twenty-four (24) hours. BILLING PROCEDURES The Ambulance Service will bill and collect payment from the appropriate payer(s) (patient, family, insurance company(ies), State and or Federal entity(ies) for services rendered, utilizing the County of Los Angeles approved ambulance service published rates. The Ambulance Service will employ the same usual and customary billing practices used by the ambulance industry, including but not limited to the use of collection services. Under no circumstances shall City be responsible for fees relating to Ambulance Services' provision of care or transportation. TERM OF THE AGREEMENT This agreement will remain in effect from 2019 to June 30, 2020, and shall be renewable for up to four additional, one-year terms (for a maximum term of five years) by mutual agreement of the parties, upon approval of a written extension. The agreement may be terminated by either party, with or without cause, upon thirty (30) days' prior written notice to the other party. MISCELLANEOUS The City understands and agrees to use the Ambulance Service in a manner that enables the Ambulance Service to bill and collect for services rendered. The City shall not bill or collect for services rendered by Ambulance Service. It is the intent of this Agreement to work together on providing an additional asset to the City Fire Department's services to the citizens and visitors of West Covina, by providing emergency back up ambulance services when City ambulances are unavailable to respond or need alternative BLS transport to respond to other emergency calls. A quarterly audit will assist in the review of claims and provide necessary information to keep the agreement financially feasible. The signatures below indicate that the named representative of each individual party has read and understands this Memorandum of Agreement. City of West Covina Premier Medical Transport, Inc. dba By: Lloyd Johnson Mayor Premier AmbuI nce Date �`✓ Date /3 / Paul Scarborough President ATTACHMENT NO.2 MEMORANDUM OF AGREEMENT BETWEEN THE CITY OF WEST COVINA AND EMERGENCY AMBULANCE SERVICE, INC. FOR MEDICAL TRANSPORTATION This Memorandum of Agreement (MOA) is entered into by the City of West Covina (City) and Emergency Ambulance Service, Inc. (Ambulance Service) for the purpose of developing a streamlined response model for back up transport of BLS patients, via ambulance, to the most appropriate receiving facility and/or designated hospital. TERM AND TERMINATION OF AGREEMENT This MOA is effective on 2019, and shall terminate upon the mutual agreement between the City and Ambulance Service, or upon notice as provided for herein. PURPOSE OF THE AGREEMENT This MOA specifies guidelines and the responsibilities of the City and the Ambulance Service when transporting patients who have been deemed to be stable for transportation at the BLS level. In the event the patient requires ALS intervention, Ambulance Service will assist the City's Fire Department and the patient in providing the most appropriate transportation to the patient. MISSION OF THE OPERATION The purpose of this MOA is to create a direct line of communication between the City Fire Department and the Ambulance Service to streamline the process of requesting an ambulance to respond to the scene where a patient is being treated and prepared for transportation. This process is intended to eliminate the unnecessary deployment of additional resources. West Covina Fire Department paramedics will contact the City communication center and request a BLS ambulance when necessary. The communication center will then contact the Ambulance Service to respond to any calls involving an individual who has been evaluated and determined that services are the most appropriate level of service for the patient. The communication center may request a Code 2 (w/o lights or sirens) or Code 3 (with lights and sirens) whichever is in the best interest of the patient and the community. LICENSES & EQUIPMENT The Ambulance Service will comply with all state and federal rules and regulations with regard to the licensing of the ambulances, company and employees (CHP, LADHS, State of California, etc.). In the event of disruption in service due to a licensing related issue(s) Ambulance Service will notify the City of West Covina Fire Department of such disruption within twenty-four (24) hours. BILLING PROCEDURES The Ambulance Service will bill and collect payment from the appropriate payer(s) (patient, family, insurance company(ies), State and or Federal entity(ies) for services rendered, utilizing the County of Los Angeles approved ambulance service published rates. The Ambulance Service will employ the same usual and customary billing practices used by the ambulance industry, including but not limited to the use of collection services. Under no circumstances shall City be responsible for fees relating to Ambulance Services' provision of care or transportation. TERM OF THE AGREEMENT This agreement will remain in effect from , 2019 to June 30, 2020, and shall be renewable for up to four additional, one-year terms (for a maximum term of five years) by mutual agreement of the parties, upon approval of a written extension. The agreement may be terminated by either party, with or without cause, upon thirty (30) days' prior written notice to the other party. MISCELLANEOUS The City understands and agrees to use the Ambulance Service in a manner that enables the Ambulance Service to bill and collect for services rendered. The City shall not bill or collect for services rendered by Ambulance Service. It is the intent of this Agreement to work together on providing an additional asset to the City Fire Department's services to the citizens and visitors of West Covina, by providing emergency back up ambulance services when City ambulances are unavailable to respond or need alternative BLS transport to respond to other emergency calls. A quarterly audit will assist in the review of claims and provide necessary information to keep the agreement financially feasible. The signatures below indicate that the named representative of each individual party has read and understands this Memorandum of Agreement. City of West Covina Emergency Ambulance Service, Inc. By: Lloyd Johnson Mayor 1 Date�irC// f'� Date Charles A. Drut , Jr. Chief Operatin Officer ATTACHMENT NO.3 MEMORANDUM OF AGREEMENT BETWEEN THE CITY OF WEST COVINA AND RESCUE SERVICES INTERNATIONAL, LTD. DBA MEDIC-1 AMBULANCE FOR MEDICAL TRANSPORTATION This Memorandum of Agreement (MOA) is entered into by the City of West Covina (City) and Rescue Services International, Ltd. dba Medic-1 Ambulance (Ambulance Service) for the purpose of developing a streamlined response model for back up transport of BLS patients, via ambulance, to the most appropriate receiving facility and/or designated hospital. TERM AND TERMINATION OF AGREEMENT This MOA is effective on 2019, and shall terminate upon the mutual agreement between the City and Ambulance Service, or upon notice as provided for herein. PURPOSE OF THE AGREEMENT This MOA specifies guidelines and the responsibilities of the City and the Ambulance Service when transporting patients who have been deemed to be stable for transportation at the BLS level. In the event the patient requires ALS intervention, Ambulance Service will assist the City's Fire Department and the patient in providing the most appropriate transportation to the patient. MISSION OF THE OPERATION The purpose of this MOA is to create a direct line of communication between the City Fire Department and the Ambulance Service to streamline the process of requesting an ambulance to respond to the scene where a patient is being treated and prepared for transportation. This process is intended to eliminate the unnecessary deployment of additional resources. RESPONSE PROCEDURES West Covina Fire Department paramedics will contact the City communication center and request a BLS ambulance when necessary. The communication center will then contact the Ambulance Service to respond to any calls involving an individual who has been evaluated and determined that set -vices are the most appropriate level of service for the patient. The communication center may request a Code 2 (w/o lights or sirens) or Code 3 (with lights and sirens) whichever is in the best interest of the patient and the community. LICENSES & EQUIPMENT The Ambulance Service will comply with all state and federal rules and regulations with regard to the licensing of the ambulances, company and employees (CHP, LADHS, State of California, etc.). In the event of disruption in service due to a licensing related issue(s) Ambulance Service will notify the City of West Covina Fire Department of such disruption within twenty-four (24) hours. `l4 . BILLING PROCEDURES The Ambulance Service will bill and collect payment from the appropriate payer(s) (patient, family, insurance company(ies), State and or Federal entity(ies) for services rendered, utilizing the County of Los Angeles approved ambulance service published rates. The Ambulance Service will employ the same usual and customary billing practices used by the ambulance industry, including but not limited to the use of collection services. Under no circumstances shall City be responsible for fees relating to Ambulance Services' provision of care or transportation. TERM OF THE AGREEMENT This agreement will remain in effect from , 2019 to June 30, 2020, and shall be renewable for up to four additional, one-year terms (for a maximum term of five years) by mutual agreement of the parties, upon approval of a written extension. The agreement may be terminated by either party, with or without cause, upon thirty (30) days' prior written notice to the other party. MISCELLANEOUS The City understands and agrees to use the Ambulance Service in a manner that enables the Ambulance Service to bill and collect for services rendered. The City shall not bill or collect for services rendered by Ambulance Service. It is the intent of this Agreement to work together on providing an additional asset to the City Fire Department's services to the citizens and visitors of West Covina, by providing emergency back up ambulance services when City ambulances lare unavailable to respond or need alternative BLS transport to respond to other emergency calls. A quarterly audit will assist in the review of claims and provide necessary information to keep the agreement financially feasible. The signatures below indicate that the named representative of each individual party has read and understands this Memorandum of Agreement. City of West Covina By: Lloyd Johnson Mayor Rescue Services International, Ltd. dba Medic-1 Ambulance Date �� -� Date Jim arras Vice President and Chief Operating Officer ATTACHMENT NO.4 MEMORANDUM OF AGREEMENT BETWEEN THE CITY OF WEST COVINA AND FIRST RESCUE AMBULANCE, INC. FOR MEDICAL TRANSPORTATION This Memorandum of Agreement (MOA) is entered into by the City of West Covina (City) and First Rescue Ambulance, Inc. (Ambulance Service) for the purpose of developing a streamlined response model for back up transport of BLS patients, via ambulance, to the most appropriate receiving facility and/or designated hospital. TERM AND TERMINATION OF AGREEMENT This MOA is effective on 12019, and shall terminate upon the mutual agreement between the City and Ambulance Service, or upon notice as provided for herein. PURPOSE OF THE AGREEMENT This MOA specifies guidelines and the responsibilities of the City and the Ambulance Service when transporting patients who have been deemed to be stable for transportation at the BLS level. In the event the patient requires ALS intervention, Ambulance Service will assist the City's Fire Department and the patient in providing the most appropriate transportation to the patient. MISSION OF THE OPERATION The purpose of this MOA is to create a direct line of communication between the City Fire Department and the Ambulance Service to streamline the process of requesting an ambulance to respond to the scene where a patient is being treated and prepared for transportation. This process is intended to eliminate the unnecessary deployment of additional resources. West Covina Fire Department paramedics will contact the City communication center and request a BLS ambulance when necessary. The communication center will then contact the Ambulance Service to respond to any calls involving an individual who has been evaluated and determined that services are the most appropriate level of service for the patient. The communication center may request a Code 2 (w/o lights or sirens) or Code 3 (with lights and sirens) whichever is in the best interest of the patient and the community. LICENSES & EQUIPMENT The Ambulance Service will comply with all state and federal rules and regulations with regard to the licensing of the ambulances, company and employees (CHP, LADHS, State of California, etc.). In the event of disruption in service due to a licensing related issue(s) Ambulance Service will notify the City of West Covina Fire Department of such disruption within twenty-four (24) hours. BILLING PROCEDURES The Ambulance Service will bill and collect payment from the appropriate payer(s) (patient, family, insurance company(ies), State and or Federal entity(ies) for services rendered, utilizing the County of Los Angeles approved ambulance service published rates. The Ambulance Service will employ the same usual and customary billing practices used by the ambulance industry, including but not limited to the use of collection services. Under no circumstances shall City be responsible for fees relating to Ambulance Services' provision of care or transportation. TERM OF THE AGREEMENT This agreement will remain in effect from , 2019 to June 30, 2020, and shall be renewable for up to four additional, one-year terms (for a maximum term of five years) by mutual agreement of the parties, upon approval of a written extension. The agreement may be terminated by either party, with or without cause, upon thirty (30) days' prior written notice to the other party. MISCELLANEOUS The City understands and agrees to use the Ambulance Service in a manner that enables the Ambulance Service to bill and collect for services rendered. The City shall not bill or collect for services rendered by Ambulance Service. It is the intent of this Agreement to work together on providing an additional asset to the City Fire Department's services to the citizens and visitors of West Covina, by providing emergency back up ambulance services when City ambulances are unavailable to respond or need alternative BLS transport to respond to other emergency calls. A quarterly audit will assist in the review of claims and provide necessary information to keep the agreement financially feasible. The signatures below indicate that the named representative of each individual party has read and understands this Memorandum of Agreement. City of West Covina First Rescue AmjaLncInc. Date By: Lloyd Johnson Mayor of Operations Date 06-14-2019 ATTACHMENT NO.5 AMENDMENT NO. 1 TO MEMORANDUM OF AGREEMENT BETWEEN THE CITY OF WEST COVINA AND AMERICAN MEDICAL RESPONSE, INC. FOR MEDICAL TRANSPORTATION This Amendment No. 1 to the Memorandum of Agreement (MOA) effective on February 20, 2018, is entered into by the City of West Covina (City) and American Medical Response, Inc. (Ambulance Service) for the purpose of developing a streamlined response model for back up transport of BLS patients, via ambulance, to the most appropriate receiving facility and/or designated hospital. TERM AND TERMINATION OF AMENDMENT This Amendment is effective on ,2019, and shall terminate upon the mutual agreement between the City and Ambulance Service, or upon notice as provided for herein. PURPOSE OF THE AMENDMENT This Amendment specifies guidelines and the responsibilities of the City and the Ambulance Service when transporting patients who have been deemed to be stable for transportation at the BLS level. In the event the patient requires ALS intervention, Ambulance Service will assist the City's Fire Department and the patient in providing the most appropriate transportation to the patient. MISSION OF THE OPERATION The purpose of this Amendment is to create a direct line of communication between the City Fire Department and the Ambulance Service to streamline the process of requesting an ambulance to respond to the scene where a patient is being treated and prepared for transportation. This process is intended to eliminate the unnecessary deployment of additional resources. West Covina Fire Department paramedics will contact the City communication center and request a BLS ambulance when necessary. The communication center will then contact the Ambulance Service to respond to any calls involving an individual who has been evaluated and determined that services are the most appropriate level of service for the patient. The communication center may request a Code 2 (w/o lights or sirens) or Code 3 (with lights and sirens) whichever is in the best interest of the patient and the community. LICENSES & EQUIPMENT The Ambulance Service will comply with all state and federal rules and regulations with regard to the licensing of the ambulances, company and employees (CHP, LADHS, State of California, etc.). In the event of disruption in service due to a licensing related issue(s) Ambulance Service will notify the City of West Covina Fire Department of such disruption within twenty-four (24) hours. BILLING PROCEDURES The Ambulance Service will bill and collect payment from the appropriate payer(s) (patient, family, insurance company(ies), State and or Federal entity(ies) for services rendered, utilizing the County of Los Angeles approved ambulance service published rates. The Ambulance Service will employ the same usual and customary billing practices used by the ambulance industry, including but not limited to the use of collection services. Under no circumstances shall City be responsible for fees relating to Ambulance Services' provision of care or transportation. TERM OF THE AMENDMENT This Amendment will remain in effect from , 2019 to June 30, 2020, and shall be renewable for up to three additional, one-year terms (for a maximum term of five years) by mutual agreement of the parties, upon approval of a written extension. The Amendment may be terminated by either party, with or without cause, upon thirty (30) days' prior written notice to the other party. MISCELLANEOUS The City understands and agrees to use the Ambulance Service in a manner that enables the Ambulance Service to bill and collect for services rendered. The City shall not bill or collect for services rendered by Ambulance Service. It is the intent of this Amendment to work together on providing an additional asset to the City Fire Department's services to the citizens and visitors of West Covina, by providing emergency back up ambulance services when City ambulances are unavailable to respond or need alternative BLS transport to respond to other emergency calls. A quarterly audit will assist in the review of claims and provide necessary information to keep the agreement financially feasible. The signatures below indicate that the named representative of each individual party has read and understands this Amendment. City of West Covina American Medical Response, Inc. Date .Date By: Lloyd Johnson Ken Liebman Mayor Regional Director ATTACHMENT NO.6 AMENDMENT NO.1 TO MEMORANDUM OF AGREEMENT BETWEEN THE CITY OF WEST COVINA AND CARE AMBULANCE SERVICE, INC. FOR MEDICAL TRANSPORTATION This Amendment No. 1 to the Memorandum of Agreement (MOA) effective on February 20, 2018, is entered into by the City of West Covina (City) and CARE Ambulance Service, Inc. (Ambulance Service) for the purpose of developing a streamlined response model for back up transport of BLS patients, via ambulance, to the most appropriate receiving facility Vor desi ated hospital. TERM AND TERMINATION OF AMENDMENT This Amendment is effective on 19, anhall termina pon the mutual agreement between the City and Ambulance Service, o n noprovided for herein. PURPOSE OF THE AMENDMENT This Amendment specifies guidelines and the responsibilities ofity and the Ambulance Service when transporting patients who have been deemed to be stable fjg transportation at the BLS level. hi the event the patient requires ALS intervention bulanervice will assist the City's Fire Department and the patient in pro ding the most aWriate transportation to the patient. MISSION OF THE OPEID N The purpose of this Amen'Went is to create a direct fine of communication between the City Fire Department and the Ambulance Service to streamline the process of requesting an ambulance to respond to the scene wheiWaLpatient is being treated and prepared for transportation. This process is intended to eliminate the ufflT ssary deployment of additional resources. RESPONSE PROCEDURES West Covina Fire DVartme amedics will contact the City communication center and request a BLS ambulance wheThe communication center will then contact the Ambulance Service to respond to any caan individual who has been evaluated and determined that services are the most appropriate level of service for the patient. The communication center may request a Code 2 (w/o lights or sirens) or Code 3 (with lights and sirens) whichever is in the best interest of the patient and the community. LICENSES & EQUIPMENT The Ambulance Service will comply with all state and federal rules and regulations with regard to the licensing of the ambulances, company and employees (CHP, LADHS, State of California, etc.). In the event of disruption in service due to a licensing related issue(s) Ambulance Service will notify the City of West Covina Fire Department of such disruption within twenty-four (24) hours. BILLING PROCEDURES The Ambulance Service will bill and collect payment from the appropriate payer(s) (patient, family, insurance company(ies), State and or Federal entity(ies) for services rendered, utilizing the County of Los Angeles approved ambulance service published rates. The Ambulance Service will employ the same usual and customary billing practices used by the ambulance industry, including but not limited to the use of collection services. Under no circumstances shall City be responsible for fees relating to Ambulance Services' provision of care or transportation. TERM OF THE AMENDMENT This Amendment will remain in effect from , 2019 to June 30, 2020, and shall be renewable for up to three additional, one-year terns (for a maximum term of five years) by mutual agreement of the parties, upon approval of a written extension. The Amendment may be terminated by either party, with or without cause, upon thirty (30) days' prior writ n notice to the other party. MISCELLANEOUS The City understands and agrees to use the Ambu e Servi in a manne that enables the Ambulance Service to bill and collect for services r ed. kity shall not bill or collect for services rendered by Ambulance Service. It is the intent of this Amendment to work together on providing an additional asset to the City Fire Department's services to the citizens and visitors of West Covina,'y providing emergency back up ambulance services when City ambulances are unavailable to respond or need alternative BLS transport to respond to other emerge calls. erly audit will assist in the review of claims and provide necessary information to�greem mancially feasible. The signatures below understands this Amet City of West By: Lloyd Mayor of each individual party has read and CARE Ambulance Service, Inc. Troy M. Hagen CEO Date