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Home My WebLink About32-21 RESOLUTION113 West Mountain Street Fayetteville, AR 72701 (479) 575-8323 Resolution: 32-21 File Number: 2020-1187 WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY: 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 1120121 Resolution: 32-21 File Number.' 2020-1187 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 1/19/2021 Attest: 0 Kara Paxton, City E��a� tea urer . ) 0 FAYETTEVILLE; CA KAIA �iz�/ LNG j WA Page 2 Printed on 1120121 City of Fayetteville, Arkansas 113 West Mountain Street Fayetteville, AR 72701 (479) 575-8323 / Text File File Number: 2020-1187 Agenda Date: 1/19/2021 Version: 1 Status: Passed In Control: City Council Meeting File Type: Resolution Agenda Number: A 4 WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY: 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 112012021 City of Fayetteville Staff Review Form 2020-1187 Legistar File ID 1/19/2021 City Council Meeting Date - Agenda Item Only N/A for Non -Agenda Item Brad Hardin 12/31/2020 Submitted By Submitted Date Action Recommendation: FIRE (300) Division / Department Staff recommends approving The Interlocal Agreement for Continuation of Ambulance Services and for Membership in the Washington County Regional Ambulance Authority. This new agreement provides for participating cities to pay $6.06 per capita based on the prior year's projection by the NWA Council and for Washington County to pay $17.56 per capita for the unincorporated population based on the NWA Council Population Projections throughout the five-year term of renewal (2021-2025). Budget Impact: Account Number Fund Project Number Project Title Budgeted Item? NA Current Budget $ - Funds Obligated $ - Current Balance $ Does item have a cost? NA Item Cost Budget Adjustment Attached? NA Budget Adjustment Remaining Budget V20180321 Purchase Order Number: Previous Ordinance or Resolution # 221-15 Change Order Number: Approval Date: Original Contract Number: Comments: CITY OF FAYETTEVILLE wr ARKANSAS MEETING OF JANUARY 19, 2021 TO: Mayor and City Council FROM: Brad Hardin, Fire Chief DATE: December 31, 2020 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. This new agreement provides for participating cities to pay $6.06 per capita based on the prior year's projection by the NWA Council and for Washington County to pay $17.56 per capita for the unincorporated population based on the NWA Council Population Projections throughout the five-year term of renewal (2021-2025). 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. DISCUSSION: The current 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. 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 (2021-2025) will result in the current $445,895 annual subsidy to increase. This increase is due to the payment requirement of $6.06 per capita based on the prior year's population projection by the NWA Council. This new agreement reflects the following future subsidy amounts: 2021- $540,951 2022- $554,943 2023- $563,545 2024- $572,336 2025- $581,264. Funds for ambulance services are included each year in the Annual Budget and Work Program. 2021 Funds were approved by City Council in the 2021 Budget and Work Program on November 17, 2020 (Resolution 295-20). Attachments: Agreement for Continuation of Ambulance Services City of Fayetteville, Arkansas 2021 Operating Budget Outside Agency Funding Actual Budgeted Estimated Budgeted General Fund (1010): 2019 2020 2020 2021 Fayetteville Boys & Girls Club $ 225,000 $ 225,000 $ 225,000 $ 225,000 Community Access Television (Your Medid) 165,779 170,095 170,095 205,095 AAANWA (Senior Center) 103,887 109,080 109,080 109,080 Arkansas Air & Military Museum 23,600 26,000 26,000 26,000 7Hills Homeless Center 108,000 113,400 113,400 113,400 *NWA Regional Planning 51,506 51,506 51,506 51,506 * tral Emer ency Medical Service 445,895 445,895 445,895 540,951 Total General Fund 1,123,667 1,140,976 1,140,976 1,271,032 Street Fund (2100): Ozark Regional Transit $ 486,608 $ 532,228 $ 532,228 $ 514,348 Razorback Transit 260,000 273,000 273,000 273,000 Total Street Fund 746,608 805,228 805,228 787,348 Total Outside Agency Funding $ 1,870,275 $ 1,946,204 $ 1,946,204 $ 2,058,380 * These Outside Agencies Have Interlocal Governmental Agreements. 295 AGREEMENT FOR CONTINUATION OF AMBULANCE SERVICES THROUGH THE WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY THIS 1NTERLOCAL 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 Decennial Federal Census to the Northwest Arkansas Council annual population estimate. The NWA Council annual estimate provides for smaller incremental changes to the parties' subsidy contribution instead of potentially larger increases when done in ten (10) year increments; and, WHEREAS, the Agreement for Continuation of Ambulance Services and for Expanded Membership in the WCRAA is set to renew on its own terms in December 31, 2020 unless a party to that Original Agreement notifies the other parties of its intent to withdraw by September 1, 2020; and WHEREAS, all parties intend for the WCRAA to continue in operation and administration beyond said December 31, 2020 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 appointee. 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 further effectuate the purposes of this Agreement; (11) To 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 full 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. 820-13-301 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 Council. 4 (1) All Cities shall pay $6.06 per capita based on the prior year's population projection by NWA Council and will be updated annually. (2) Washington County shall pay $17.56 per capita for the unincorporated population of Washington County based on the prior year's population projection by NWA Council 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 202land ending in December 31, 2025. 020 2021 2022 2023 2024 City County 2021 Subsidy 2022 Subsidv 2023 Subsidv 2024 Subsidv 2025 Subsidy 3025 3355 3421 3489 3557 Elkins $18,332 $20 332 $20,732 $21,141 $21,557 2514 2531 2600 2670 2743 ElmSprings $15,236 $15,336 $15,753 $16,183 $16,624 7156 7461 7599 7739 7883 Farmington $43,365 $45,211 $46,048 $46,901 $47.770 89266 91575 92994 94445 95918 Fayetteville $540,951 $554,943 $563,545 $572,336 $581,264 1736 1778 1812 1846 1881 Goshcn $10,521 $10,776 $10980 $11189 $11,402 1502 1510 1536 1564 1592 Greenland $9,103 $9,149 $9,311 $9,476 $9,645 3962 3967 4040 4115 4191 Johnson $24 012 $24 039 $24,484 $24,937 $25,398 2591 2618 2655 2693 2732 Lincoln $15,638 $15,865 $16,091 $16.321 $16,555 6125 6639 6782 6929 7077 Prairie Grove $37,115 $40,235 $41100 $41,983 $42,886 3423 3367 3434 3503 3573 Tontitown $20,744 $20,401 $20,809 $21,226 $21,650 2647 2727 2770 2813 2857 West Fork $16,038 $16,527 $16.784 $17,045 $17,311 437 448 454 460 466 Winslow $2,649 12 717 $2,752 $2.788 $2,824 34282 34838 35399 35.947 36510 County $824,985 $834 749 $844,598 $854.233 $864,111 158656 162813 165496 168212 170979 TOTAL $1,578,689 $1,610,278 $1,632,989 $1,655.759 $1,678,997 (c) The Authority shall continue to seek a sustainable funding 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, 2021 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 OF OWNERSHIP OF EQUIPMENT BELONGING TO AND OPERATION OF WASHINGTON COUNTY REGIONAL 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. ARTICLE 7. EFFECTIVE DATE. This Agreement shall not be effective until approved and signed by all parties in accordance with the law. G'7 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 (MIH-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 $6.06 per capita due to the increased number of calls generated within their city limits. The County contributes at $17.56 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 Fees: Fees charged to patients treated or transported by the ambulance service, or -fees charged to an individual or an organization for ambulance standby coverage. 7 Signed this 1 day of 20. CITY OF FAYETTEVILLE, ARKANSAS ATTEST: B Y"11 :l MIA,�Iyj Kara Paxton, City Cler U. FAYETTEVILLE. ��1�ii W�� Signed this jl� day of OC,1 2020. CIW OF LLKINS, ARKANSAS Bv: Bruce Ledford, r ATTEST: Delia Signed this I day of 2020. CITY OF GREENLAND, A RKANSAS By: 1 t Bill room, Mayor ATTEST: By: Misty McCard, City Recorder/Treasurer 10 ' � Signed this L day of 2020 CITY OF LINCOL.N, ARKANSAS By: Doug H chens, Mayor ; - 4 3 ATTEST+ -By. Beeky C City Clerk Signed this 19 01 day of_, 2020 CITY OF PRAIRIE GROVE, ARKANSAS ATTEST: By: C nstine Kelly, City Clerk 13 Signed this 1 day of ()C+ , 2020. CITY OF WEST FORK, ARKANSAS By: Heith Caudle, Mayor ATTEST: By: &== \�' I a Ann Upton, Cit Clerk 14 Signed this is Aday of &4. , 2020. CITY OF GOSHEN, ARKANSAS By: -;�� ptrv--,-- Max t oye, MaCaf ATTEST: By: inda Moore, City Recorder/Treasurer 15 Signed this 1 �tday of0�b—e6olo. CITY OF JOHNSON, ARKANSAS By: Chris ene�, Mayor ATTEST: By: u1 (, (Jennifer .Allen, C irk 16 Signed this 5— day of "�2020. CITY OF WINSLOW, ARKANSAS By: L Chuck Dwyer, Mayor 17 Signed this jqtL day of , 2020. CITY OF ELM SPRINGS, ARKANSAS (� By: cam'. arold Douthit, Mayor ATTEST: By:d . .1 f. . An I Twila Taylor, CityFrk l8 Ord Signed this day of �OY., 2020. CITY OF TONTITOWN, ARKANSAS r By: Paul Colvin, Mayor ATTEST: By: Rhonda Ardemagni, Deputy R&4der 19 uul anj11 CII wouva Iu.t-awnuJr I"11 lu'YHr 1`OOC:1-/uJrVV:JrrO io Signed this day of , 2020. WASHINGTON COUNTY, ARKANSAS Docu Gigned by: (Wd Dec 21, 202014:35 PM CST By: 34F1g4827574441 Joseph Wood, County Judge ATTEST: M. DocuSiyned by: EI32E8027FD9469 Becky Lewallen, County Clerk CDocuSigned by: A8F7527CDF8845C 20 Signed this ' day of � 2020. WASHINGTON COUNTY REGIONAL AMBULANCE AUTHORITY i By. — Becky Ste art, ChieVExecutive Director By: Bill Groom, Chairman of the Board ATTEST: By: rule Penn, Secretary of the Board 21