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HomeMy WebLinkAbout272-22 RESOLUTION113 West Mountain Street Fayetteville, AR 72701 (479) 575-8323 Resolution: 272-22 File Number: 2022-1055 INTERLOCAL AGREEMENT FOR CONTINUATION OF AMBULANCE SERVICES: A RESOLUTION TO APPROVE AN INTERLOCAL AGREEMENT FOR CONTINUATION OF AMBULANCE SERVICES THROUGH THE WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY, AND TO AUTHORIZE THE AMBULANCE AUTHORITY TO OPERATE CENTRAL EMERGENCY MEDICAL SERVICE AS THE EXCLUSIVE EMERGENCY AND NON -EMERGENCY AMBULANCE SERVICE WITHIN THE CITIES WHEREAS, A.C.A. §14-14-910, and §14-266-102 and §25-20-101 authorize cities and counties to enter into interlocal contracts to provide services such as emergency and non -emergency ambulance services; and WHEREAS, Resolution No. 68-08, which was passed on March 18, 2008, approved an interlocal agreement creating an Ambulance Authority and establishing the Ambulance Authority and Central Emergency Medical Service (CEMS) as the exclusive emergency and non -emergency ambulance service within Fayetteville and the other participating cities; and WHEREAS, continuation of the Ambulance Authority is crucial for the continued health and safety of the residents of unincorporated Washington County and the cities that are covered by the Authority; and WHEREAS, in order to save taxpayer money and to reduce the need for taxpayer revenue to subsidize the furnishing of emergency ambulance service to our citizens, the Ambulance Authority and Central Emergency Medical Services should continue to be designated the exclusive provider of emergency and non -emergency ambulance service within all cities that are parties to this agreement. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Page 1 Printed on 1217122 Resolution: 272-22 File Number: 2022-1055 Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves the interlocal Agreement For Continuation of Ambulance Services through the Washington County Regional Ambulance Authority, a copy of which is attached to this Resolution, authorizes Mayor Jordan to sign this agreement, and authorizes the Ambulance Authority to continue to operate Central Emergency Medical Service as the exclusive emergency and non -emergency ambulance services provider throughout Fayetteville and every other city which is a party to this agreement as broadly as authorized in A.C.A. § 14-266-102 and 105. PASSED and APPROVED on 12/6/2022 Attest: `��t1urrnuj'..'i ERK Kara Paxton, City Clerk Treasurer �4. ;p,� Page 2 Printed on 1217122 City of Fayetteville, Arkansas 113 West Mountain Street Fayetteville, AR 72701 e (479) 575-8323 Text File File Number: 2022-1055 Agenda Date: 12/6/2022 Version: 1 Status: Passed In Control: City Council Meeting File Type: Resolution Agenda Number: A.3 INTERLOCAL AGREEMENT FOR CONTINUATION OF AMBULANCE SERVICES: A RESOLUTION TO APPROVE AN INTERLOCAL AGREEMENT FOR CONTINUATION OF AMBULANCE SERVICES THROUGH THE WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY, AND TO AUTHORIZE THE AMBULANCE AUTHORITY TO OPERATE CENTRAL EMERGENCY MEDICAL SERVICE AS THE EXCLUSIVE EMERGENCY AND NON -EMERGENCY AMBULANCE SERVICE WITHIN THE CITIES WHEREAS, A.C.A. §14-14-910, and §14-266-102 and §25-20-101 authorize cities and counties to enter into interlocal contracts to provide services such as emergency and non -emergency ambulance services; and WHEREAS, Resolution No. 68-08, which was passed on March 18, 2008, approved an interlocal agreement creating an Ambulance Authority and establishing the Ambulance Authority and Central Emergency Medical Service (CEMS) as the exclusive emergency and non -emergency ambulance service within Fayetteville and the other participating cities; and WHEREAS, continuation of the Ambulance Authority is crucial for the continued health and safety of the residents of unincorporated Washington County and the cities that are covered by the Authority; and WHEREAS, in order to save taxpayer money and to reduce the need for taxpayer revenue to subsidize the furnishing of emergency ambulance service to our citizens, the Ambulance Authority and Central Emergency Medical Services should continue to be designated the exclusive provider of emergency and non -emergency ambulance service within all cities that are parties to this agreement. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves the interlocal Agreement For Continuation of Ambulance Services through the Washington County Regional Ambulance Authority, a copy of which is attached to this Resolution, authorizes Mayor Jordan to sign this agreement, and authorizes the Ambulance Authority to continue to operate Central Emergency Medical Service as the exclusive emergency and non -emergency ambulance services provider throughout Fayetteville and every other city which is a party to this agreement as broadly as authorized in A.C.A. § 14-266-102 and 105. City of Fayetteville, Arkansas Page 1 Printed on 121712022 City of Fayetteville Staff Review Form 2022-1055 Legistar File ID 12/6/2022 City Council Meeting Date - Agenda Item Only N/A for Non -Agenda Item Brad Hardin 11/15/2022 FIRE (300) Submitted By Submitted Date Division / Department Action Recommendation: Staff recommends approving The Interlocal Agreement for Continuation of Ambulance Services and for Membership in the Washington County Regional Ambulance Authority for the term January 1, 2023 through December 31, 2025 with automatic renewals for additional five year terms. This new agreement provides for participating cities to pay $9.94 per capita based on the prior year's projection by the NWA Regional Planning Commission and will be updated annually. Account Number Project Number Budgeted Item? No Does item have a cost? No Budget Adjustment Attached? No Budget Impact: Current Budget Funds Obligated Current Balance Item Cost Budget Adjustment Remaining Budget Fund Project Title 5 5 - $ 5 5 5 V20210527 Purchase Order Number: Previous Ordinance or Resolution # Res 32-21; 192-22 Change Order Number: Original Contract Number: Comments: Approval Date: CITY OF FAYETTEVILLE ARKANSAS MEETING OF DECEMBER 6, 2022 TO: Mayor and City Council THRU: Brad Hardin, Fire Chief FROM: Granville Wynn, Financial Analyst DATE: November 15, 2022 CITY COUNCIL MEMO SUBJECT: A resolution approving The Interlocal Agreement for Continuation of Ambulance Services and for Membership in the Washington County Regional Ambulance Authority by and with the City of Fayetteville, Washington County, Elkins, Elm Springs, Farmington, Goshen, Greenland, Johnson, Lincoln, Prairie Grove, Tontitown, West Fork, and Winslow for emergency and non -emergency ambulance services. RECOMMENDATION: Staff recommends approving The Interlocal Agreement for Continuation of Ambulance Services and for Membership in the Washington County Regional Ambulance Authority for the term January 1, 2023 through December 31, 2025 with automatic renewals for additional five year terms. This new agreement provides for participating cities to pay $9.94 per capita based on the prior year's projection by the NWA Regional Planning Commission and will be updated annually. BACKGROUND: City Council approved Res. 68-08 on March 18, 2008, approving an Interlocal Agreement for Ambulance Services with the City of Fayetteville, Washington County, Elkins, Farmington, Goshen, Greenland, Lincoln, Prairie Grove, West Fork, Winslow, and Johnson and to establish the Ambulance Authority and Central Emergency Medical Services as the exclusive emergency and non -emergency ambulance service within the cities. This agreement was amended and approved by City Council through Res. 202-11 on November 15, 2011. An Interlocal Agreement was approved in December 1, 2015 by Council via Res. 221-15 which added Elm Springs and Tontitown and changed the payment amounts paid by each city and the county. Res. 32-21 was approved by Council on 1-19-21 with an updated agreement and later amended via Res. 192-22 on 9-6-22. DISCUSSION: The current Interlocal Agreement was approved on September 6, 2022 via Res. 192-22 which approved an addendum to the Interlocal agreement to provide additional funding. Per Article 4. Term of the new agreement: "...This Agreement shall be automatically renewed with possible changes to Article 3 Financing for an additional five year term unless any party notifies the Authority in writing of its refusal to participate in the Authority and this Agreement by September 1, 2025. A second automatic renewal shall occur on December 31, 2030 unless any party notifies the Authority in writing of its refusal to participate in the Authority and this Agreement by September 1, 2030." Mailing Address: 113 W. Mountain Street www.fayetteville-ar.gov Fayetteville, AR 72701 BUDGET/STAFF IMPACT: Approval of the proposed new Interlocal Agreement for Ambulance Services will result in the current $969,974 annual subsidy. This increase is due to the payment requirement of $9.94 per capita based on the prior year's population projection by the NWA Regional Planning Commission. This new agreement reflects the following future subsidy amounts: 2023- $969,974 2024- $988,555 2025- $1,007,492. Funds for ambulance services are included each year in the Annual Budget and Work Program. ATTACHMENTS: Agreement for Continuation of Ambulance Services AGREEMENT FOR CONTINUATION OF AMBULANCE SERVICES THROUGH THE WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY THIS INTERLOCAL AGREEMENT FOR CONTINUATON OF AMBULANCE SERVICES THROUGH THE WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY ("Agreement") is made and entered into by and between the WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY ("Authority" or "WCRAA"), WASHINGTON COUNTY, ARKANSAS, ("County") and the cities of ELKINS, ELM SPRINGS, FARMINGTON, FAYETTEVILLE, GOSHEN, GREENLAND, JOHNSON LINCOLN, PRAIRIE GROVE, TONTITOWN, WEST FORK, and WINSLOW ("Cities"). WHEREAS, A.C.A. §14-14-910, A.C.A. §25-20-101, and A.C.A. §14-266-102 authorize cities and counties to enter into contracts to co-operate or join with each other to provide emergency and non - emergency medical services and to specify the responsibilities of all parties; and, WHEREAS, all parties acknowledge that the continued provision of ambulance service is crucial for the continued health and safety of the residents of the named Cities and the County; and, WHEREAS, said Authority should consist of representatives of all of the above named Cities and the County; and, WHEREAS, all parties agree to replace the population values and reference from the Northwest Arkansas Council annual population estimates to the Northwest Arkansas Regional Planning Commission annual population estimates; and, WHEREAS, the Agreement for Continuation of Ambulance Services and Membership in the WCRAA is set to renew on its own terms in December 31, 2025 unless a patty to that Original Agreement notifies the other parties of its intent to withdraw by September 1, 2025; and WHEREAS, all parties agree to review population accuracy and financial position of the WCRAA on an annual basis at the end of the second quarter each year to maintain appropriate funding for the ambulance service to serve the residents of the named Cities and the County; and, WHEREAS, all parties intend for the WCRAA to continue in operation and administration beyond said December 31, 2025 renewal, with the WCRAA continuing to exist as it does today; and WHEREAS, the parties acknowledge that their financial contributions to the WCRAA as set forth in this Agreement and previous Agreements funding the WCRAA is for and in consideration of (a) ambulance service coverage within each of their respective cities, for the cities, and in the unincorporated areas of Washington County for the County, and (b) continued participation in the WCRAA; and WHEREAS, all parties acknowledge that the continuation of the WCRAA will demand close and continued cooperation of all parties. NOW, THEREFORE, IT IS AGREED: ARTICLE 1. AUTHORITY ORGANIZATION. (a) The chief executive officer of each entity shall represent said entity on the Board of Directors of the Authority to be known as the Washington County Regional Ambulance Authority. (b) The Board shall meet no less than annually to transact all business associated with the powers and responsibilities conferred upon it. However, the Board shall reserve to itself the right to meet on whatever basis it determines is appropriate. (c) The Board shall employ an executive director/chief to manage a regional ambulance system. (d) In order to ensure maximum efficiency and effectiveness of the operation, an executive committee shall be formed to be charged with the oversight of the day-to-day operation of the system. The members of said executive committee shall be as follows: (1) The County appointee who shall reside in the unincorporated service area. (2) The Fayetteville City Council appointee; (3) A second Fayetteville appointee (Both City Council appointees shall serve at the pleasure of the City Council and can be removed and replaced by different representatives by City Council Resolution,); (4) A small city appointee to be chosen by the aforestated cities, excluding the City of Fayetteville; (5) A Nursing Home or medical profession representative who shall reside in the City of Fayetteville to be chosen by the County appointee; the Fayetteville appointees, and the small city appointee. (6) A Hospital representative who shall reside in the City of Fayetteville to be chosen by the County appointee; the Fayetteville appointees, and the small city appointee. (7) A representative of the financial community residing in the service area to be chosen by the County appointee, the Fayetteville appointees and the small city appointed. 2 ARTICLE 2. PURPOSES, POWERS. RIGHTS, OBLIGATIONS AND RESPONSIBILITIES OF THE CREATED ENTITY. (a) All parties acknowledge that the need to create an entity to own, operate and manage an ambulance service is necessary and appropriate. (b) The Authority created herein shall have the following powers: (1) To provide advanced and basic life support emergency ambulance service, medical standbys and Mobile Integrated Health -Community Paramedicine (MIH-CP) in the designated area; (2) To provide emergency medical dispatch including pre -arrival instructions in accordance with approved dispatch protocols; (3) To set ambulance user fees; (4) To own system revenues; (5) To provide exclusive emergency and non -emergency (within the cities only) ambulance service; (6) To enter into mutual aid and automatic aid Agreements with neighboring ambulance services for emergency services; (7) Comprehensive regulatory powers over the ambulance system performance; (8) Ownership of or access to key components of the system infrastructure; (9) Centralize medical direction and clinical oversight of the ambulance system to the extent deemed necessary; (10) To promulgate rules and regulations to fiuther effectuate the purposes of this Agreement; (11) To purchase, own and dispose of real and personal property; (12) To adopt and oversee comprehensive system performance on an annual basis to include periodic revisions to comply with emerging technologies and changes in clinical and operational standards. 3 (c) Washington County Regional Ambulance Authority's Specific Duties. The Authority created herein shall have the following specific duties and responsibilities in addition to the statutory and administrative requirements of §14-266-109, the Arkansas Medical Practices Act, and any other government or professional standards. (1) Response time metrics shall be analyzed no less than monthly to determine the need for additional ambulances and staff to maintain agreed upon service levels. (2) Reporting Requirements. (A) Fayetteville. On the third Tuesday of July each year, the Washington County Regional Ambulance Authority by the two Fayetteville representatives on the Executive Committee shall appear before the Fayetteville City Council to present: (i) The written annual, audited report of the previous year's financial and response data reports; (ii) A written report of the financial and response data for the first half of the current year; (iii) Plans and projections to replace or enlarge capital property and equipment within the next 18 months; (iv) Plans and justifications for any personnel increases within the next 18 months; and (v) Revenue/expense projections for the next 18 months. (B) Any Other Member of This Authority. Upon written request by any other member of this authority, the Board Member representing that entity shall provide the frill written and oral report referred to in (A) to that City or to the County during its regular July or August meeting. ARTICLE 3. FINANCING: TRAINING: COMPLIANCE WITH A.C.A. 420-13-301 ET SEQ. (a) All parties acknowledge that the need for a guaranteed revenue source independent of and in addition to fees for service is necessary in order to ensure the continued viability of said service. (b) The annual regional ambulance service -funding source for all parties of this Agreement shall be based upon the prior year's population projection by the NWA Regional Planning Commission. 4 (1) All Cities shall pay $9.94 per capita based on the prior year's population projection by NWA Regional Planning Commission and will be. updated annually, (2) Washington County shall pay $34.14 per capita for the unincorporated population of Washington County based on the prior year's population projection by NWA Regional Planning Commission and will be updated annually. Additionally, Washington County shall pay the amount of $223,000, previously paid to Springdale Fire Department for ambulance coverage, to the Authority for a period of five years starting in January 2021 and ending in December 31, 2025. Subsidy based on NWA Planning Commission Population Estimates 2022 2023 2024 2025 2026 City 1 Couu # Per Capila Rate Actual2022 Subsid , 2023 Subsidy 2024 SUISI h';127,504 2026 SulssldY 2027 Subsidy 3,817 3,929 4,044 4163 4,286 Elkins S 9.94 S 32,785 $ 37 939 S 39.054S 41384 S 42 600 2,556 2.659 2.767 2,879 2,995 EIm Sarin S 9.94 S 25,691 S 25.406 S 26,434S 28.617 $ 29,775 8,032 8,265 8,506 8,753 9,008 lFaridngtoa S 9.94 1 S 74,220 S 79i834 1 S 82,156 S 84,546 S 67 OOS S 89,536 97,583 S2 101357 , 103 9 t 988555 1 $ 1;007A92 $ 1,026 792 $ 1046AI4 2193 2,240 2,288 2,337 2,387 Goslien S 9.94 S 18127 $ 21.798 $ 22,264 $ 22,741 S 23,227 S 23,725 1369 1,455 1,546 1,643 1745 Greedand S 9.94 S 14,954 S 13.612 S 14A62 S 15,366 S 16,327 S 17,347 3,771 3,855 3,941 4,028 4,118 Unison S 9.94 S 38,950 S 37,487 S 38,320 S 39,172 S 40,043 S 40,933 2,399 2,453 2,508 2,565 2,623 ILincoln S 9.94 1S 26,234 S 23 843 $ 24,381 S 24931 $ 25,493 S 26,068 7,283 7,405 7,529 7,655 1783 Prairie Grove S 9.94 S 65,006 S 72,391 $ 73,692 S 14 834 $ 76,087 S 77,360 4,767 5,018 5,283 5,561 5,855 'Pontilown S 9.94 S 35190 S 47,381 1 $ 49,880 S 52,511 $ 55,281 S 58197 2,541 2,654 2,771 2,893 3,021 West Fork S 9.94 S 27,063 S 25,262 S 26,318 S 27,543 "S 28,759 S 30.029 378 385 1 391 398 1 405 Winslow S 9,94 S 4,410 S 3 757 S 3.823 S 3,891 $ 3,959 S 4929 41899 42,638 43,390 44155 44,933 1 Cormt y Rlual :g S 34.14 $ 1374,206 S 1,651439 S 1678,659 $ 1704,323 $ 13A4410 S 1757,017 178,588 r 182,408 186,321 1 190,329 194,436 1 TOTAL S 2,649,016 53;01242 S 3,067,970 S 3125W: S 3183,414 S 3;243,078 ** County Subsidy includes $223,000 lands previously provided Io Springdale. (c) The Authority shall continue to seek a sustainable finding source with the goal of reducing subsidies proportionately across the board. (d) Except as stated above, no party to this Agreement may be financially obligated without the approval of its governing body. (e) All governing bodies who are parties to this Agreement must approve any increases in subsidy. (f) A percentage of these funds shall be set aside for replacement of capital items. (g) The ambulance service owned or under contract with the Authority shall be required to provide, at no additional charge, the Arkansas Department of Health 24 hour basic refresher course to all EMT certified firefighters that act as first responders with said ambulance service. (h) The financing provided by the parties hereto shall be from general revenues; furthermore, the financing and this Agreement are contingent upon compliance with A.C.A. §20-13-301 et. seq, by the County and all the parties will cooperate to the extent necessary in complying with such. ARTICLE 4. TERM. This initial term of this Agreement shall be from January 1, 2023 at 12:00 a.m. (midnight) through December 31, 2025 at 11:59 p.m. This Agreement shall be automatically renewed with possible changes to Article 3 Financing for an additional five year term unless any party notifies the Authority in writing of its refusal to participate in the Authority and this Agreement by September 1, 2025. A second automatic renewal shall occur on December 31, 2030 unless any party notifies the Authority in writing of its refusal to participate in the Authority and this Agreement by September 1, 2030. Notwithstanding the above terms, all parties to this Agreement may withdraw from this Agreement upon six months' written notice to the Authority and shall only be responsible to pay its per capita fee for that pro-rata portion of the year. ARTICLE 5. CONTINUATION OI+' (.)WNieItSI111' Ol+' l OUIPMENT BELONGING TO AND OPERATION OF WASHINGTON ('OI1N'I'Y R AVIONAL AMBULANCE AUTHORITY. Property currently owned by WCRAA and all other property and resources of the Authority purchased during its existence or owned by it on July 2, 2011, or thereafter shall remain the Authority's exclusive property throughout the Authority's existence. It is the intent of all parties that WCRAA's current operations, administration, policies, practices and procedures as they now exist shall continue for the length of this Agreement. Furthermore, it is the intent of all parties that all legal obligations of and rights now belonging to the WCRAA shall continue to bind or inure to the benefit of, as the case may be, the WCRAA during the length of this Agreement. The WCRAA shall continue to exist as a corporate body as it has since the first Interlocal Agreement forming the WCRAA, with the sole exception that the Cities of Elm Springs and Tontitown became full members of the WCRAA upon execution of THE AGREEMENT FOR CONTINUATION AND EXPANDED MEMBERSHIP IN THE WASHINGTON CONTY REGIONAL AMBULANCE AUTHORITY on November 19, 2015 this Agreement and while they honor their obligations hereunder, as any other participating entity. This Agreement shall be construed to effectuate this intent. ARTICLE 6. SEVERABILITY. The provisions of this Agreement are declared to be severable. If any provision hereof shall be held to be invalid or to be inapplicable to any person or circumstance, such holdings shall not affect the ability or the applicability of the remainder hereof 2 ARTICLE 7. EFFECTIVE DATE. the law. This Agreement shall not be effective until approved and signed by all parties in accordance with APPENDIX TO AGREEMENT APPENDIX DEFINITION OF TERMS WHEN AND IF USED. Ambulance Authority: Quasi -governmental entity created to oversee and deliver ambulance service in a specified geographical service area. Ambulance Service: Means emergency and non -emergency response and transport services offered by the Authority, including management, supervision, mass gatherings, community events and Mobile Integrated Health -Community Paramedic (MIII-CP). Exclusivity: Sole provider emergency and non -emergency ambulance rights granted by ordinance or resolution by each party to the extent allowed by State Law, Per Capita: Funding structure set forth by this Agreement based on population. Cities contribute at $9.94 per capita due to the increased number of calls generated within their city limits. The County contributes at $34.14 per capita due to the increased coverage area and decreased density of call volume in the unincorporated areas of the County. No reduction of any entity's gross subsidy shall occur during the initial term of this Agreement. Subsidy: Government funds requested by the Authority to provide ambulance service. User Nees: Fees charged to patients treated or transported by the ambulance service, or fees charged to an individual or an organization for ambulance standby coverage. Signed this / a day of &, 2023. CITY OF ELM SPRINGS, ARKANSAS Harold Douthit, Mayor ATTEST: By: 010thc Twila TvSlor, City Cle Signed thism"day of -DES- , 2022. CITY OF FARMINGTON, ARICANSAS : BY Ernie Penn, Mayor ATTEST: By: Kelly Penn, t Clerk Signed this J I day of A�C 2022. CITY OF ELKINS,ARKANSAS By: _ 7 =mot aj--, _ L_ Bruce Ledford, Mayor ATTEST: By: a&ci�e L Delih Foster, City le&, Signed this --&— day of _Opp, 2022. CITY OF I'AYF TI;Vj I.LI;, ARKANSAS AT" 0 Signed this — day oi'_:DeL_, 2022. CITY Or GOSHEN,ARKANSAS By: P Max Poye, Ma ATTEST: By: 4 City corder/Treasurer Signed this & A day of kPl4i, 2023. CITY OF GREENLAND,ARKANSAS By: ATTEST: By: Misty Melffard, City Recorder/Treasurer Signed this �3 day of ti0y, 2022. CITY Or JOHNSON,ARKANSAS By: Chris 7AWY, ff3— ATTEST: Signed this ) v day of &L-I J 2022 CITY OIL LINCOLN,ARICANSAS By: Doug ibehens, Mayor ATTEST: Y Belluda BeasleY, Clerk ti. A Signed this I I day of, t w �, 2022 CITY OF ATTEST: By: &Lkk Christine Kelly, City Clerk Signed this day oPff—, 2022. CITY OF TONTITOWN, ARKANSAS By: u[2u-& Angela Mssell, Mayor ATTEST: Z/ By: �X� Rhonda Ardemagni, Ci Ierk/Treasurer Signed this 1 -7 day of 6 , , 2023. CITY Or WEST FORK, ARKANSAS By: Heith Candle, Mayor ATTEST: By: ( , � fk—e�— Ann tpton, City i •rk Signed this 15 day of f'S , 2021.3 CITY OF WINSLOW,ARKANSAS By: Randy.k 4-nagaMayor ATTEST: By: 7Ann M ity Clerk Signed this(P N-day of/la 023. WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY By: AL --� Steve Harrison, Chief By: Ernie Penn, Chairman of the Board Signed this I # 7_ day of WASHINGTON COUNTY, ARKANSAS By: -04-e'- littrick Deakins, County Judge Al -TEST: By: I Becky Lewalie , Wuntj Clerk