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CITY OF HOPE
BOARD OF DIRECTORS MEETING
TUESDAY, JUNE 3, 2008 7 P.M.
CITY HALL BOARD ROOM
ITEM 1: INVOCATION
ITEM 2: CALL TO ORDER
ITEM 3: REVIEW MINUTES OF MAY 20, 2008 BOARD MEETING
ITEM 4: REVIEW AMBULANCE FRANCHISE PROPOSALS
ITEM 5: UPDATE ON LAUREL/GREENING STREET SEWER PROJECT
ITEM 6: UPDATE ON NORTHSIDE PARK
ITEM 7: CITY MANAGER’S REPORT
ITEM 8: CITIZENS REQUEST
CITY OF HOPE
BOARD OF DIRECTORS MEETING
7:00 P.M., TUESDAY, MAY 20, 2008
CITY HALL BOARD ROOM
The City Board of Directors met at 7:00 p.m., Tuesday,
May 20, 2008, with the following present:
Catherine Cook, City Manager
Joe Short, City Attorney, absent
Carol Almond, City Clerk
Directors: Dennis Ramsey, Mayor
David Johnson, Vice-Mayor
Doodle Franklin, absent
Willie Walker
Steve Montgomery
Don Still
Don Hall
Mayor Ramsey called the meeting to order. Director Don
Still opened the meeting with prayer.
Minutes of the May 6, 2008 meeting were reviewed and
approved on a motion by Don Hall, seconded by Willie
Walker. All present voted “Aye.” Motion carried.
The Governmental Accounting Standards Board (GASB) is
the body which oversees accounting standards for
governmental entities and part of the recognized authority
for what is and is not considered generally accepted
accounting principles (GAAP).
A few years ago GASB imposed a new statement referred
to as GASB Statement No. 34. This statement established new
financial reporting requirements for governmental entities
that dramatically change the audit report you are
accustomed to seeing. There are no allowances by GASB for
small entities or large ones; the City of Dallas and the
City of Hope are the same in regards to the financial
reporting.
In order to decrease the burden on cities, counties,
and school districts in Arkansas, the state legislature
passed Act 499 last year. Act 499 allows audit reports in
Arkansas to be presented in a regulatory basis format,
leaving the financial report presentation much as it has
been in previous years. However, this financial statement
presentation, the guidance for which was not provided until
late last year, still does not allow for the basis of
accounting that we use in our proprietary funds.
Since the state does not audit proprietary funds, the
legislation enacted and the guidance that followed simply
centered around the audits they do, not encompassing ones
like ours.
Although the City originally planned to follow the
state’s regulatory basis, it has become necessary to bite
the bullet and adopt a GASB 34 presentation for our audit.
The state requires that the governing body pass a
resolution each year if a municipality chooses a
presentation other than the regulatory basis.
Finance Director, Debbie Hall explained the audit
procedures will not change. The audit of the records of the
City of Hope will continue to be conducted by certified
professionals following generally accepted government
auditing standards.
After some discussion, Catherine Cook read the
proposed resolution.
RESOLUTION NO. 2008-07
WHEREAS, the Governmental Accounting Standards Board
issued Statement No. 34, dramatically affecting the audit
presentation of the City of Hope; and
WHEREAS, State of Arkansas Act 499 of 2005 provides
for a municipal audit report to be presented on a
regulatory basis of accounting; and
WHEREAS, State of Arkansas Act 499 of 2005 requires
the governing body of a municipality to adopt a resolution
in order for the City of Hope’s independent auditors to
follow the guidelines established by the Governmental
Accounting Standards Board rather than those prescribed by
the State of Arkansas.
NOW, THEREFORE, BE IT RESOLVED by the City Board of
Hope, Arkansas that the audit of the books and records of
the City of Hope for the year 2007 is to be performed in
accordance with the guidelines and format prescribed by the
Governmental Accounting Standards Board, the American
Institute of Certified Public Accountants, and the United
States Government Accountability Office.
Don Hall made a motion to pass the resolution,
seconded by Steve Montgomery. All present voted “Aye.”
Motion carried.
Bids were opened on Thursday, April 24, 2008. The
following bid was received:
Columbia Curb & Gutter $22,635
After a short discussion Don Hall made a motion to
accept the bid from Columbia Curb & Gutter in the amount of
$22,635, seconded by Steve Montgomery. All present voted
“Aye.” Motion carried.
The following bid was opened on May 15, 2008 on
asphalt for City street overlays for the 2008 Proposed
Street Program. Last year’s price was $78 Per Ton.
R. K. Hall Construction Ltd. $97.19/Ton.
After a short discussion Don Still made a motion to
accept the bid from R. K. Hall Construction Ltd. in the
amount of $97.19/Ton, seconded by Steve Montgomery. All
present voted “Aye.” Motion carried.
The Proposed 2008 Street Program has been prepared for
the Board’s consideration by the Street Committee. Some
items considered when the Street Committee approved the
2008 Street program were:
1) Because of our ongoing street overlay program over the
last fifteen years, there are fewer streets to overlay this
year. We are seeing initial signs that some of the streets
that were overlaid in the first few years of our program
are going to start needing a second pass.
2) The cost of petroleum products has continued to rise
dramatically over the last several months. Asphalt has
risen as follows over the last several years:
2005 $51.50/Ton
2006 $68.80/Ton
2007 $78.00/Ton
2008 $97.19/Ton
3) Under Item II, A is the total for streets proposed to
be overlaid with asphalt this year.
4) Under Item II, B, are items to be included in the
sidewalk contract for this year, which at this time we are
proposing to forego for one year unless the Street
Committee and Board have areas that they know (such as
routes to Public Building, Schools, etc. that need
attention.
5) Included in the proposed programming under Item II, C
is $0 for additional drainage projects.
6) Included in the proposed programming under Item II, D
is $58,565 for concrete, pipe, gravel, and miscellaneous
other materials.
2008 Proposed Street Program
I. Revenue Available
Budget Item 40562.........................$ 322,000
Total revenue available for programming...$ 322,000
II. Programming Proposed
A) Hot Mix Overlay .....................$ 253,800
Milling..............................$ 22,635
Concrete.............................$ 0
B) Sidewalks & Curbcuts.................$ 0
C) Drainage Projects....................$ 0
D) Miscellaneous Pipe, Concrete, Gravel.$ 45,565
II. A) Hot Mix Overlay......................$ 253,800
(We use $100 per ton just to cover any differences in
measurement, etc.)
Overlay
1. W 15th to Forest Lane 300 Tons
2. E 17th from Caroline to Sammy Cr. 405 Tons
3. S Edgewood from Yerger to 6th. 400 Tons
4. S Laurel from 3rd to Railroad 263 Tons
5. Temple Rd. 420 Tons
6. S Fulton 13th to 16th 340 Tons
7. S Greening from 3rd to Short 6 280 Tons
TOTAL TONS 2408
OTHER OPTIONAL LOCATIONS
1. Animal Shelter 130 Tons $13,000
(We will need to do this one.)
2. Dairy 900 feet of widening
Milling
1. W 15th to Forest Lane 2488 SQ YDS
2. E 17th from Caroline to Sammy Cr. 3378 SQ YDS
3. S Edgewood from Yerger to 6th. 3334 SQ YDS
4. S Laurel from 3rd to Railroad 2178 SQ YDS
5. Temple Rd. 1800 SQ YDS
6. S Fulton 13th to 16th 2800 SQ YDS
7. Greening from 3rd to Short 6th Dependent on
completion of
sewer job
II, B) Sidewalks & Curb cuts...............$ 0
Unless the Street Committee and Board wish to add
sidewalks, we would propose to delete this item this one
year.
II, C) Miscellaneous Drainage projects.....$ 0
II, D) Miscellaneous Pipe, Concrete & Gravel$ 45,565
After some discussion David Johnson made a motion to
accept the 2008 Street program as proposed, seconded by
Willie Walker. All present voted “Aye.” Motion carried.
Wesley Woodard was present to ask the Board to
consider a resolution that will allow CPI Holdings LLC,
which took over operation of the Champion facility, to
participate in the Tax Back Program. CPI has plans to hire
approximately 150 employees in the next 18 – 24 months.
Catherine Cook read the proposed resolution.
RESOLUTION NO. 2008-08
A RESOLUTION OF THE CITY OF HOPE CERTIFYING LOCAL
GOVERNMENT ENDORSEMENT OF CPI HOLDINGS, LLC TO
PARTICIPATE IN THE ARKANSAS TAX BACK PROGRAM (AS
AUTHORIZED BY SECTION 15-4-2706(4) OF THE
CONSOLIDATED INCENTIVE ACT OF 2003).
WHEREAS, in order to be considered for participation
in the Tax Back Program, the local government must endorse
a business to participate in the Tax Back Program, and
benefit from the sales and use tax refunds as provided in
the Consolidated Incentive Act of 2003, and
WHEREAS, CPI Holdings, LLC, located at 2500 West
Avenue B, Hope, Hempstead County, Arkansas has sought to
participate in the program and more specifically has
requested benefits accruing from installation of equipment
and modernization of the specific facility, and
WHEREAS, CPI Holdings, LLC has agreed to furnish the
local government all necessary information for compliance,
WHEREAS, The City of Hope recognizes the positive
impact that job creation and business expansion have for
the local community, and
NOW, THEREFORE, BE IT RESOLVED BY, THE CITY BOARD OF
HOPE, ARKANSAS, THAT
1. CPI Holdings, LLC be endorsed by Board of Directors
of the City of Hope, Arkansas, for benefits from the
sales & use tax refunds as provided by Section 15-4-
2706(d) of the Consolidated Incentive Act of 2003.
2. The Arkansas Department of Finance and
Administration is authorized to refund local sales
and use taxes to CPI Holdings, LLC.
3. This Resolution shall take effect immediately.
Steve Montgomery made a motion to pass the resolution,
seconded by David Johnson. All present voted “Aye.” Motion
carried.
The Northside Community Center project is almost
complete. Mrs. Cook is in the process of hiring for the two
positions. WIA told the Association they would be able to
utilize WIA workers as long as they are supervised by City
employees. The School Resource Officer will also be
utilized at Northside during the summer months while school
is out.
AHTD has notified the City that a $6500 deposit will
be required to begin the signalization process at Yerger &
the Bypass. This deposit does not mean the signal will be
placed immediately but it is a start.
After a short discussion Don Still made a motion to
pay the deposit, seconded by Don Hall. All present voted
“Aye.” Motion carried.
The Animal Control Facility had its final walkthrough.
A punch list was prepared and the items on it are being
addressed.
The Greenwood Street project is progressing faster
than expected. Mrs. Cook asked the Board to consider a
proposed agreement for engineering services from Glen
Spears. Joe Short reviewed the agreement and found it to be
correct in form and content.
After a short discussion Don Hall made a motion to
accept the agreement, seconded by Willie Walker. All
present voted “Aye.” Motion carried.
The City-Wide cleanup was held on May 17, 2008. There
was a grand total of 310.00 cubic yards of trash and debris
brought out to the landfill. Citizens brought 24 loads
totaling of 190.5 cubic yards and City employees picked up
18 loads totaling 119.5 cubic yards. 105 cubic yards of
limbs and brush were also picked up. The next cleanup is
scheduled for July 26, 2008.
Paul Henley made contact with the Airport Committee.
Several of the members would like to be replaced. Staff is
working on a list of recommended replacements for the
Board’s review.
The meeting adjourned at 7:40 p.m.
______________________
Dennis Ramsey, Mayor
__________________________
Carol Almond, City Clerk
AGENDA INFORMATION FOR BOARD MEETING 6/3/2008
ITEM 4: REVIEW AMBULANCE FRANCHISE PROPOSALS
The current ambulance franchise agreement with Pafford Ambulance expired on May 31, 2008.
In response to the City’s advertisement for proposals, one proposal was received:
Pafford Ambulance
The current provider is Pafford Ambulance Service located here in Hope. Pafford has held the
franchise for the past 10 years.
A complete copy of the proposal is attached for your information as well as any supporting
material that has been received in my office.
One change was made to the RFP this year. The previous RFP said that the franchise would be
awarded for two years with an option to renew for an additional two years. I have changed
that number to three years, with an option to renew for three years.
We have not received any complaints this year. Any concerns we have relayed to Pafford have
been promptly addressed.
CTTY OF HOPE
AIttBttLANCE FRANCHI SE AppLICe,Tf ON
This application must be completed and submitted before a company can
be considered for an ambulance franchise with the city of Hope,
Arkansas.
1. N a m eo f A p p l i c a n t , .
A, Trade Name:
(If other than above.)
B. corporations must attach hereto copies of the following:
Articles of fncorporation
certificate of good standing by the secretary of state
Address of principal place of business
Names of principal officers and residence addresses
C. Partnerships, Associat.ions or unincorporated companies must
attach hereto the following:
Names of the partners or persons comprising the association
or company
Business and residence addresses of each partner or person
2. A11 applicants must attach hereto the following:
A. Descripti-ons of each ambulance and vehicl-es used or proposed
to be used as follows:
Name of the manufacturer
Type of engine and serial # of vehicl_e
State motor vehicl_e license number
Safety certification
Equipment iist as required to meet. the minimum requiremenrs
of the state of Arkansas and the Arkansas Department of
Heal-th
Address and description of the premises from which
applicant will maintain and operation such ambul_ance
service
A complete schedule of all rates and fares proposed by
applicant
A copy of applicant's written policy manual
Policy of fnsurance
PAFFORDEMS
v
May27,2008
CatherineCook,CityManager
Cityof Hope
PO Box667
206 WestAvenueA
Hope, AR 71802
First,let me say, it has beenan honorto serveas yourexclusiveambulance
provider of
since1997makingover20,000callsto the residents Hopeand
Hempstead County. enjoybeinga partof the community.
We
PaffordMedical Services, the
submits following
Inc.,respectfully proposalfor
exclusiverightsfor the Ambulance Service for
Contract the Cityof Hope.
* A minimum threefullyequipped
of Arkansas Department Health
of
certifiedambulances; Two of whichwill be staffedtwenty-fourhoursa day,
sevendaysa weekat the Advanced SupportParamedic
Life level,with
additionalunitsavailable a "standby" basis.
on
* Carryinsurancecoverage with one milliondollarpersonally
injuryand
provide five million
a dollarumbrella.
* Will abideby all stateand federallawsand workwith the localMedical
Centerto ensurea goodworkingrelationship.
i. Sell annualambulance memberships the residents Hopeat the rate
to of
of $45.00for individual $49.00for familyto assistin offsetting cost
and the
of ambulance services.
are
Attached the requested documents information your
alongwith additional for
review. Pleasecontactme if you haveany questions 777-7660.
at
President
p.O. Box ll29 . Hope,Arkansas 71802 . (800)451-8036
A Private Servicein the Public Interest since1967.
PAFFORDEMS
v
PrincipalPlaceof Business
PaffordMedicalServicescorporateoffice is locatedat 3509West 16thstreetin
Hopeand all correspondence be
should mailed PO Box 1120Hope,
to AR
71802.
PAFFORD unitsare housedat 508 EastThirdstreetin Hope. PaffordEMSalso
mansa"day truck"from 3509West 16th
streetduringthe weekdays.All medical
and is
documents billinginformation housedat 3509West 16th street.
Principal Officers
JamiePafford-Gresham,
President
3317West 16thStreet
Hope,AR 71081
870-777-7UO
JamesPafford,
Vice President
2905West 16th
Street
Hope,AR 71801
870-777-1915
Ben Gresham,Secretary-Treasurer
3317West 16th Street
AR
Hope, 71801
870-777-76/'0
p.O. Box ll20 . Hope,Arkansas 71802 . (800)451-8036
A Private Servicein the Public Interest since1967.
ArkansasSecretaryof State
Charlie Daniels
|
StateCapitol Building . Little Rock,Arkansas72201-1094 501-682-3409
Gertificateof Good Standing
I, Charlie Daniels, Secretary of State of the State of Arkansas, and as such, keeper of the
records of domestic and foreign corporations, do hereby certiff that the records of this office
show
PAFFORD MEDICAL SERVICES,INC.
in
authorizedto transactbusiness the Stateof Arkansasas a For Profit Corporation,filed
in
Articles of Incorporation this office July 15, 1999.
in
Our recordsreflect that said entity, having compliedwith all statutoryrequirements the State
of Arkansas,is qualified to transactbusiness this State.
in
In Testimony Whereof,I have hereunto set my hand
and affixed my ofiEcial Seal. Done at my office in the
City of Little Rocl this 27th day of May 2008.
QJ[^*.L-C*=-S..
CharlieDaniels
of
Secretary State
Online Certificate Authorization Code: I 7e9blad4bb733e
To veri$ the Authoriziation Code,visit sos.arkansas.gov
11Pt<-L4--&14 >vt j'tb '(t4'(
UZt46 ?.VZ
@TWW-@Ww6,q.s
Sncnnrertv OF S:IETB
s&m*,W,,{t
{o Aff t o'Wftom TTre ?r es ent Sfntr Cotttc'Qreetbrg :
se s s
do
I, SharonMest, Secretary of Stateof ArEansas, ftereby
certifu tfiat tfiefo$n ing anf hereto attached instrttment of writing ts
aftue antyerfect coyy of
i ARTTCLES OF INCORPORATION
i
t
OF
PAFFORD MEDICAL SERVICES, INC.
ORIGINALARTICLESFILED:
July15,1999
^l+tftueoJ
In Tutimony I ftate frereuttto
setmy fnnd and affixed my officiat Seaf
Donc at my office in tfte City of Littfe R-ocfr.,
tftts stfi day of Ju(y rygg.
/'1"*,-,4^;*
j'lb '(t44'(
?PR-L4-2994 g?t4? HYDEN FOSTER
I"IIRON' sgL v.t4J
I
Piltr:"?
nnrlcips oF INcoRPoRATIoN JuLl5
99
OF ':!i i.ri'.,'" r-i.ir-:i i...
INc.
sERvIcEs, f{11,.
MEDIcAL
rAFFoRD ttil^*{.f'.T!
THE UNDERSIGNED, octing as the incorporator(s)in ori{Ur'-taffi'ffi
Arkansas B'siness
corporation for'the purpqses statd pr:rsuant.t9 ft. provisions of the
CorporationAct, Ark CodeAnn. $ 4-27'101,certifiesasfollows:
I. NAME OX'THE CORPORATION
The nameof the corporationis PaffordMedical Services,Inc,(the "Corporation").
U. DURATION OF CORPORATION
The periodof druationof the corporationshallbe perpetual.
M. PURPOSESOX'CORPORATION
the
The pqrposeot purposesfor which the Corporationis organize4 the nattue of
proposed be transacted,
-a the objectsor PurPoses to promoted or
business the Corporation
of
carriedon by it are:
To operateandmanagean ambulanceservice'
to
To do any and all things or actsincidental,necessary senvenientaspermitted by law
sl
t the accomplishment theseitems andpuqposes'
of
r
tr To exercise powersnecessary set forth in the Uniform BusinessCorporation
all as Act
underthe laws of the Stateof Arkansas, samebeing incorporated
and all powersenumerated the
$ by reference theseArticles of Incorporation'
into
Fr
fti
F
Stateor
$r' To e.ngage any laurfirlbusiness the purpose making a profit either in this
in for of
b any other Stateor country.
F
*:
E The foregoingpurposes the Colporatiol th.n be liberally constnredboth
of as to objects
F and powers,and it is-trireUyexpressly ani specificallyprovidedthat the foregoing enurneration
F of siecific por"rrr,-*J putporc. of tie Corporation shall not be held to limit or restict in any
manner,Urepowersof the iorporation confered by law, wbethertbe samebe set forth hereinor
B not.
ry. STOCK
CAPITAL
AUTHORIZED
numberof shares
The aggregate which the Corporationshall have authority to issue is
100,000Shares Commonstockat $.01par value'
of
nrn-I9-auut lJa. r I rrt vctt I llAuttrruJ I gR JUL Jte tstt rtl)\
V. ADDITIONAL POWERS AND LIMITATIONS
A. Power of Board of Directorsto Resticl Share Transfers: The Eoard of Directors
ofthe Coqporation shall from tirne to time in connection with thc saleor issuance sharesof the
of
Corporation have the authority to limit or restrict the samefrom sale, assignmcnt" pledge or
hlpothecation.in suchmannerand according suchprice or termsas the Board of Directors, in
to
its sole discretion,shall iieem fit, so long as any suchlimitation or restrictionshall be evidenced
by a notation to such effect on any certificateevidencingownershipof such shares issuedupon
which suchlimitation or restrictionmay exist.
B. Power to Enter Partnership Limited Liability Company: The Corporation,
or
acting through is Board of Directors,shall be authorized enter into any generalor limited
to
partrership, or limited liability company,with any other persorufirm or corPorationfor the
oI of
pu{poses carryingout any of the objects Purposes the Corporation.
of
C. Quorumat Shareholder Meeting: Unlessthe Bylaws of the Corporationotherwise
provide for a greaiernumber,a guorumat any meetingof the shareholders the Corporation
of
shall consist of fiffy-one percent(51%) of the sharesentitled to votG thereat represcntedin
personor by duly authorizedproxy at suchmeeting.
D. Authorization of Board of Directors to Repurchase Sharesof the Corporation:
The Board of Directorsof the Corporation as
shall be authorized it deemsfit within its discretion
to authorizcthe Corporation repurchase redeemshares the Corporationwhetherthe same
ro or of
be done from earned surplus or capital surplus, other than revaluation surplus, of the
by
Corporation, long asthe sameshallotherwisebe authorized law and in conformity with the
so
or
provisions of the Articles of Incorporation the Corporation any amendment
of thereof. The
methodof price determination the Corporation's
for purchase redemptionof its shares
or shall be
suchprice or methodasmay, from time to timc, be agreed in writing by the Corporationand
to
the shareholders, any one or moreof them, and in the absence
or thereofshall be as providedby
law. The foregoingprovisionshall not be constnted a right of the Corporationto purchase
as or
tedeem the capital stock of this Corporation without the consentof the holder of such stock
unlesssuchshares shallhavebeenissued with a right of redemption to
reserved the Corporation.
E. Informal Action of the Board of Directors: Action taken by a majority of the
Board of Directors without a meetingshall be valid with respect any corporatematter as the
to
action of the Board of Directorsif, eitherbeforeor after sucbactionis taken, all membersof the
Board of Directorssign and file with the Secretary the Corporation inclusion in the minutc
of for
book, a memorandumshowing the natute of the actiontaken and their rrritten consentto the
Board of Directors actinginformally with respectto suchmatters, such witten consentshall
but
.$n* wbetheror not suchdirectorapproves the actionto be takenby the Board of Directorsso
of
lbe Seeretaryshall note in the minutes of the Corporationthe names of those directors
the actionof the Boardof Directors the narnes thoseopposing
and of it.
v: JUJ. J 19 r.UJ
--
I
,:d
I
vI. REGISTERED ANDAGENT TIIE CORPORATION
OFFICE OF
I The registered
agentof the Corporation Philip Miron. The address the registered
is of
officeof thecorporation 200 Louisiana,
is Linle Roch Arkansas?zzol.
I VII. - NUMBEROF DIRECTORSOF INITIAL BOARD OT'DIRECTOIIS
t The number directorsconstituting initial Boardof Directorsof the Corporation
of the
who arc to serveas direstorsuntil the next Annual Meaing of Shareholders until their
or
F successors elected qualifiedis one. Thenumber directors be elected the Boardof
be
Directors anyAnnualMceting(or special
at
and
nextfollowingthe time whenthe shares the Corporation
of
meeting
of
for
to
called thatpurpose) the Shareholders
become
of
as
ownedof recordby two or
more Persorsshall be one, two, tluee or such greater numberas may be determined in
conformitywith OreBylawsof theCorporation.
Ix. INCORPORATOR
Thename address the incorporator the Coqporation Philip Miron of Hyden,
and of of is
Miron & Foster,
PLLC,200Louisian4Linle RoclqArkansas
zzzol-
Nil-WITNESS
W}
-J REOF,the incorporator the Corporatiouhereuntosets his hand
of
this \f dayof 1999.
PAFFORDEMS
v
PAFFORDMEDICAL SERIVCES
CHARGES 2OO8
AdvancedLifeSupportBaseRate - $700.00
AdvanceLife SupportLevel2 Base Rate - $800.00
Specialty BaseRate
CareTransport - $800.00
Oxygen - $ 40.00
Mileage(loadedpatient) - per
$ 11.00 mile
(Base Rates are inclusiveof a// ancillarysupplies and equipment)
provider Medicare
PaffordMedicalServicesis a participating for and Medicaidpatients.
Approximately 54o/o patients
of in
transported Hempstead Countyare coveredby Medicare,
12o/obyMedicaid, 16%by private
and 18%are *no pay"in whichthe
insuranc,e. remaining
The
after a periodof time.
balanceis written-off
ratesare:
allowable
cunentfee-schedule
Medicare's
ALS Non-Emergency - $218.04
ALS Emergency - $345.23
SpecialtyCareTransport - $590.53
Mileage - $ 6.42
Although typicalbaseratechargeis $700.00,
our Medicare pay$276.00
will (80%)with a
copayment amountof $69.00(2oo/o') the baseratealone.
on
All costscan be offsetby the purchase a membership $45.00 an individual $49.00
of for for and
for a familyon a yearlybasis.(*) Our membership program enables PaffordMedicalServices to
collectfrom any third partyinsurance.lf the patientdoes not have insurance coverageor the
charges deniedby Medicare, patient then responsible 50%of the totalcharges.
are the is for
(*) - Notice to Medicaid Recipients: Please understandthis is a voluntary contribution,and the inability to purchase a
membership will not affecl your access to receive medical transportationto the nearest medical facility.
P.O.Box ll20 . Hope,Arkansas 71802 . (800)451-8036
A Private Servicein the Public Interest since1967.
PAFFORDEMS
v
Event MedicalServices
As a part of the community, PaffordEMSwill provide eventmedical at
services
high schoolfootballgames rodeos. Pafford also provide
and will eventmedical
at
services community eventssponsored the Citywhen requested.Events
by
that are for profitinsidethe city limitsof HopeshouldcontactPaffordEMSfor a
reduced quotefor theseservices.
PaffordEMSparticipates all emergency
in disasterdrillsand attendsregional
meetings,
biohazard keeping medicsabreast the latestchanges.
our of
Manytimeswe are contactedin the face of disastersand are able to assist
othersdue to our wealthof EMT'sin our billingofficeand a surplusof spareunits
available Hope. The abilityto placeextratruckson the roadat a very short
in
notice,allowsPaffordEMSto be readywhensystems overlourdened. plus
are (A
for the Cityof Hope,outsideof the threetrucksalready designated your area).
for
Paffordis proudto be a partof the community with properplanning be
and will
happyto provide coverage planned
at eventsfor the residents Hope.
of
P.O.Box l\20 . Hope,Arkansas71802 . (800)451-8036
A Private Servicein the Public Interest since1967.
\\
ftrustea
Anderson-Frazier Insurance w.
Your Independent
Agent
P.O.Box 489
Hope, 71E02-04E9
AR
(E7O) 777-34E1
FAX(870)
777-5579
5t27t2008
City of Hope
Hope, AR 71801
RE: Pafford Medical Services.Inc.
InsuranceCertificate
Dear Mayor Ramsey:
I have enclosedthe certificate of insurancefor Pafford Medical Services,Inc. providing certification of
their businessauto, general liability, professionalliability and workers corrpensation coverage. It has been
our pleasure to provide these insurance policies for Jamie and her company since they have had the contract
for the City of Hope. Their record in providing these services and handling their insurance coverage has
been impeccable.
Pleasefeel free to contact me if you have any questionsregarding their coverage.
Sincerely,
G.
Steven Buelow,CIC
President
Home Office Hot SpringsOffice
910 S. Main 199 SummerSweetTrail
Hope, AR 71801 Royal,AR 71968
(870) 777-3481 (501 760-2s66
)
DATE ([T'DD'YYYT')
pRooucER
GERTIFIGATE LIABILITY
OF IN$URANGE 05/27/2ffi8
(E7O>777-34EL FA)( (670)777-5579 IS
THIS CERTIFICATE ISSUEDAS A IIATTER OF INFORTATION
Anderson Frazier Insurance Agency of llope, Inc. NO
ONLYAIID COT{FERS RIGHTSUPO.I THE CERTIFICATE
HOLDERTHISCERTIRCATE DOESNOTATEND,EXTEND OR
91O South l.lain ALTERTHE COVERAGE AFFORDED THE POLICIESBELOW.
BY
P. O. Box 4E9
Hope, AR 71EO2-04t9 INSURERSAFFORDING COVERAGE #
NArc
INSURED TNSURERA:
Ettpire Fire & l{arine Ins. Co.
Pafford lledical Services, Inc. INSURERB: Travelers
The Indermity C-O-
P. O. Box ll20 tNsuRERc:
ROCkhiIl fnsurance Conpany
Hope, AR 7lEO2-1120 INSURER
D:
INSURERE:
THE POLICIESOF INSURANCELISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITIONOF ANY CONTRACT OR OTHER DOCUMENTw|TH RESPECT TO WHEH THIS CERTIFICATEI'AY BE ]SSUED OR
MAY PERTAIN,THE INSURANCEAFFORDED BY THE POLICIESDESCRIBEDHEREIN IS SUBJECT TO ALL THE TERMS, EXCLUS]ONSAND COND]rPNS OF SUCH
POLICIES.AGGREGATE LilrS SHOWN MAY HA\G BEEN REDUCED BY PAID CLAl,lS.
FOIJCY EFFECNVE PIOI.JCYEXPIRAIIOI
rYPC OF IIISURAI'CE POITYTUIBER NAE'TINW h^Grrrnndu UTITS
GEIIEMLUAAIUTY cL3r.413E
oll2E/ZOOE ot/2E/2OO9 EACH OCCURRENCE E I,Oo0.O(X
x I COMMERCIALGENERALLABILfi
I
DAMAGE TO RENTED $ loo.00(
j-l cr-erusunoe occun
lTl MED EXP (Any m p€rson) 3 5.00(
A x l-ProfessionaTTiab PERSONAL& ADV INJURY r I.ooo.fix
GENERAL AGGREGAIE i 2.000.00(
GEN'LAGGREGATELN'TTAPPLIES PER: PROOUCTS.COMP'OPAGG r 2.(x)o.(Xx
Fl por-'c"
Tll|"q [-l roc
Alr'l,OTOBILEUABUTY COMBINEDSINGLELIMIT
$
nruvnuro cL31413i oL/zE/2@E oL/zt/200,9 (€aacd(bnt)
1.fin.ofi
I
ALL OWNEDAUTOS
EODILYINJURY
A
x I scHEouLED
AUrOS (Per person) $
IHTREDAUTOS BODILYINJURY
$
I ro"o*"roouros (Psraqi(|€nO
PROFERTY DAI/|AGE
(Psdtd€nt) $
GAIWGEUABIUTY AUTO ONLY - EA ACCIDENT $
ANYAUTO EAAcc $
oTHERTHAN
AUTOONLY AGG $
I'IIBRELUI BINDEN os/27/?U)E oL/2E/2OO9 EACH OCCURRENCE E 5.OOO,O(X
! o"cr* l*l c*'rrs*ot AGGREGATE o S.OOO.Ofl
c _l t
o.orcr'",-, s
Xlnereunon 6 lO,O0 g
YIPRXERS COf PEI{SATION AIID tgg-srflk I x toJs.
EXPLOYERS UABIUTY
B
orlot/2@E
SKUB-1293C0E-3-OE oLlo?/2009 E.L. EACHACCIDENT r l.fl[.Ofl
OFFICER/MEMBER
lf y€8, dffiibe undtr
EXCLUDED?
E.L. OFEASE - EA EMPLOYEI r 1.000.0(x
SPECIAL PROVSIONS bdil E.L. DISEASE- POLICYLMTT $ l.ooo.00(
OTHER
DESCRIPnOil OF OPERAnOilS ' lOCr[nOilS ' VEHTCLES' EXCUTS()I{S ADO€D By ETaOORSEXEI{T' SPEC|AL pR(tt FitOilS
SHOI'LD AT'IYOF IHE AAOVE DESCRIBED POIJCIES BE CAI{CEI I ID BEFIORETHE
EXPTRAI!(IT OAIE IHEREOf, ilE|sSUrilGrilSURERWtl- EilOEA\rOR TO XA|L
lO oew mrrrEr{ NorEE l(, THE cERnEcATE HourER rArED To rHE LEFT,
BUTFAIIURE TO TAILSI'CH IIOIICE SHAIIIXFGE I'IOOBUGAIX'IiI OR UABUTY
City of lfope
P. O. Box 567 OF AT'IYK|ilO UF()t{ THE INSURE& ITS AGENTS OR REPRESENTATIVES.
Hope, AR 71EO2-0667
ACORD (Zxrr/o8)
25 '988
@ACORDCORPORANON
IMPORTANT
lf the certificate
holderis an ADDITIONAL INSURED, policy(ies)
the A
mustbe endorsed. statement
on this certificate holderin lieuof sucfrendorsement(s).
doe notconferrightsto the certificate
lf SUBROGATION WAIVED,
lS subject the termsandconditions the policy,certainpolicies
to of may
requirean endorsement. statement this certificatedoesnot conferrightsto the certificate
A on
holderin lieuof suchendorsement(s).
DISCI.AIMER
The Certificate lnsurance the reverseside of this form doesnot constitutea contrac't
of on between
the issuinginsurer(s), representative producer, the certificate
authorized or and nor
holder, doesit
aftrmatively negatively
or amend, or
extend alterthecoverage afiorded the policies
by listedthereon.
Additional C-overagesand Factors 0L/TE/2008
Line of Business Coverages for General Liability
Coverage Limits Ded/Ded Type Rate Preniun Factor
General Aggregate 2 ,000,000
Products/Compl
eted Ops 2, 0 0 0 , 0 0 0
Aggregate
Personal & Advertising 1,000,000
Inj u ry
Each Occurrence L,000,000
Fi re Damage 100,000
Medical Expense 5, 0 0 0
PAFFORDEMS
v
of
Description Units
FordE 350Type ll
AmericanEmergencyVehicle"TraumaHawk"
1FDSS34P75HPQ3923
ADOH Paramedicdecal #5197
FordE350Type ll
American Vehicle"Trauma
Emergency Hawk"
1FDSS34F13H858027
ADOHParamedicdecal #5047
FordE350Type ll
Vehicfe"TraumaHawk"
AmericanEmergency
1FDSS34F5YHB64677
ADOHParamedicdecal #5047
1999 FordE350Type lll
MarquisAmbulance
1FDWF36FOXED331 18
Remount
ADOHParamedicdecal #45/13
List
Equipment
Attachedis the equipment required the Aftansas Department Health.
list by of
The unitsare checked changefor supplies.
daily/shift
p.O.Box LL20 . Hope,Arkansas71802 . (800)451-8036
A Private Servicein the Public Interest sinceL967.
-y '19'
REGISTMTION E
FE nrplacEuENlt
VEHICLE REGISTRATIONCERTIFICATE 46.00
T
CREDI rmNsrrn
riE
STATEOF ARKANSAS
DEPARTMENT FINANCEAND ADMIMSTRATION
OF
AODIlIOilAL
FEES TITLI FEI
999405H1960
PRO FEES
"RATED L I E NF E E
D
P A F F O RM E D I C A L E R V I C E SN C
S I
3 5 0 9 W E S Tr 6 T H S T
HOPE AR 71801 S P E C I AF I E ( I )
L PENALTY
S P T C I AF E I ( 2 )
L POSTAGE
,25
,tt
:TIISEPLATENO LICENSE
TYPE/UST DECAL
NUMBER EXPIR$TIoi,l SPECIAL (3)
FIE TOTAL FIgd
REG
oATE VEHTCLE,IDEflTIFTCATToil
NtfiBER
, rl
:"
i
-i i;
, ,r,'.,
I28KAF": . 'r "t' '
, AMLP-AM I 860289D 10/ 31/ 2OO8i;, 1FDSS34F : i'ii
iR MAKEd tl0DtL ,; B00Y .!Ot0R 75{,e3g2s * J !
2.50 48.75
FUEL cYt UTILADENI,'EI6HTi. AXLES JITLE I{UMBER i.t
CI-o5;4t'FoRE 3SD AM .i' G8 ' ".5992'.:. ,oq
OO 999405H1960
',.i
ffieRs coliNry = .gHer'gdreao t. l :- z1-\
r{
Eiil-o-iiFpiTc-frTo]i'?0-f
If Ni![L-Ef
e-rSimi
ilERS) q 5' 1FDSS34P75HA23g23
,FFORD EDICAL ERVICESNC ..J
M S I ,-.* ,
FEt REPLACEI4I.I{T
BrGrsTRATloil F[q/
09 WEST 15TH ST
b.r
r.L -dolrrro *ii
,.AR..IA8ol 'ffi'" . -
nim{nro. t uo,.oo ' ;:i
Ifli{@II -. .
';.-.-... TMI1SFER
. a- ---4
FEE . fjr
Ia9
eoiilrrbHnL
rres TITLI
FrE
,lr
.{ PRORATEO
FEES LIE}I FEE
$
,$
SPICIALFEE (1.)
.
PEI{ALTY
f SPECTALZt .$'eoslnor
F E rt
E r J: '25
{:
""'t ::
{r-! Y
SPECTAL (3) fr
FEE REG
.,*..,. .f'
Jfil*..1, ,TOTAT FEES
.:,iiiil, .1"
!i
2.5oi,t. 48.75
!di
, i.$
{:
ri. I .?;l
''1,
:i: "
'"i :f.
Arkansas State Health Department \ .5.
;ir;, ,
fnspection Decal # 5197 r,ft "*ii
L
'r Jtr Ir \1 \
(-A/rl't\ 62\16' RENEWAL
G
I . I A I L I NA D O R T S S )
ocToBER 11, 2007
'l8:
02:22: 52:rl p .1,,1
.
MAILING DDRESS)
A HOPE 29-O1
MARGIE DOOLEY
116 EAST 12TH
( E 7 o ) 7 1 7 - 3 1 3 1 RXLKRET
2007-10-1 1
ARKANSASINSURANCEIDENTIFICATTON
CARD
(srArE)
COMPANY
NUMBER COMPANY
THOMCO
POLCY NUMBER EFFECNVEDATE EXPTRATION
DATE
cL314r37 01t28t2008 01/28'2009
YEAR MAKE/MODEI VEHICLEIDENIIFICATION
NUMBER
2005 FordlE3il rFDSS34P75HA23923
AGENCY/COMPANY
ISSUINGCARD
AndersonFrazierInsurance
Agencyof Hope,Inc.
910 South Main (OtOl77I-3i91
P. O. Box 489
Hope,AR 718024489
INSURED
Pafford MedicalServices,Inc.
P. O. Box 1120
Hope,AR 71902-1120
SEE IMPORTANT
NOTICEON REVERSESIOE
,24Hour GfaimPhone# $tAlZO3-2144
THISCARDMUST KEPT THEINSURED
BE IN
VEHICLE
ANDPRESENTEDUPONDEMAND
lN CASE ACCTDENT:
OF Report accidents yourAgenVCompany
all to as
soonas possible.
Obtain following
the information:
1. Name address eachdriver,
and of passenger witness.
and
2. Name Insurance
of Company policy
and number each
for
vehicle
involved.
ACORD 50 (1A31
@ACOROCORPORATTON
1983
Yl+ A \J t'JIt".v r'ri,'!'wr
ON
R E G I S T R A T IF E E REPLACEI4EI{T
FET
46.00
- YEHICLE REGISTRATION CERTIFICATE T
CREDI TMNSFER
FEE
STATE OF ARKANSAS
DEPARTMENT OF FINAIICE AI\D N)MINISTRATION
ADt)ITI()T'IAL
FitS T
T I T LF I E
KEEP THIS DOCUMENT IN YOUR VEHICLE 9994OIIG8I79
RATIO
PRO FEES F
tIEN EE
PAFFORD EDICAL ERVICES NC
M S I
PO BOX 't120
HOPE AR 71802-1120 FT (
SPECIAL E 1) PTI{AI.
TY
FE (
SPECIAL E2) P()STAGE
.25
F (
sPtctAr EE3) RE6
TOTAL FTTS
LICITISE LATE O
P N TYPE/USE DECAL
LICENST I{UIIEER TXPIRATIOI{
DATE VTHICLT I,IUI{BTR
IDEI,ITIFICATIOII
658 | GN AMLP-AM 8602860 09/30/2008 13H858027
lFDSS34F 2.50 48.75
YEAR IIAKE I{ODTL BODY COLOR FUET CYL IIEIGHTAXLES
UIILADEI{ TITLE
I{UI{8TR
2OO3 FORD 3SD AM G 8 5977 00 999404c8179
OWNERSCOUNTY = HEIIPSTEAD
OWNERSSIGNATI.'REi
.Efi
nEti-lpT'6'r-iFfridA:Ti6'l'-?5'f
IE-f At-Fr-e-rTifi
iiorf 1 F D S S 3 4rF H B 5 8 0 2 7
(0xr{tRs 999404G8179 3
)
P A F F O R DM E D I C A L S E R V I C E S I N C REGISTRATIOl{FEE EPLACEI.IEI{TF
R
PO BOX 1120
HOPE AR 71802-1120 46.OO
(ODOI{ITER
READING) CREOIT TMIISFER
FTE
97632
OD ACTUAL
FTES
ADDITIO[{AL T I T L TF T €
(SAFETY
IIISPICTION)
PRORATIDFEES L I E NF E E
S P E C I AF E E( 1 )
L PEiIAtTY
S P T C I AF E E( 2 )
T POSTAGT
.25
Arkansas State Health Department
S P E C I AF E E( 3 )
L TOTAL FEES
REG
fnspection Decal #z 5047
2.50 48.75
I4AILINGDDRESS)
RENEWAL
A
ocToBER 11, 2OO7
02:18:40:42:8 P.M.
I T L T I . I A IIT GA D D R E S S )
N
HOPE
M A R G I ED O O L E Y
116 EAST12TH
(870)777-313r RXLKRET
2007-10-11
ARKANSAS INSUMNCE]DENTIFICATION
CARD
(srArE)
COMPANYNUMBER COMPANY
THOMCO
POLICY
NUMBER EFFECTIVE DAIE EXPIRATIONOATE
cL314t37 0112812008 01t28t2009
YEAR MAKE/MODEI- VEHICLEIOENTIFICATION
NUMBER
2003 Ford/E350 I FDSS34Fi3HB58027
AGENCYTOMPAI.IY|SSU|NGCARO
AndersonFrazbr Insurance
Agencyof Hope,Inc.
910 SouthMain (870,)717-3491
P. O. Box 489
Hope,AR 71802-0489
INSUREO
PaffordMedicalServices,
Inc.
P. O. Box 1{20
Hope,AR 71802-1120
SEE IMPORTANT
NOTICEON REVERSESIDE
24Hour GfaimPhone#(8701t03-2i44
THISCARDMUSTBE KEPTIN THE INSURED
VEHICLEANDPRESENTED UPON DEMAND
lN CASE ACCTDENT:
OF Report accidents yourAgenUCompany
alt to as
soonas possible.Obtain following
the information:
1. Name address eachdriver,
and of passenger witness.
and
2. Name Insurance
of Company policy
and number each
for
vehicleinvolved.
AcoR!!g(!a3l @ACOROCORPORAflON1983
rYPt rel
& ff ,\ tJ
En
lmo FORD 3SD Vtr WHI G E 007515 dxno m Ee$n^tlilFft tffflctma{rftt vtHptmilsfpffi t(r^tlAxri
o$fnscotflY ooJt[lEn DAIt6SIE0
4o.m 0.00 0.00 0,00
c8ttfl nAiBFE Ftt AurtrttvtFq tc t IAIr2]
HEMPSTEAD 152664 200E-04-tt4
15016196 0.m
nruu*$t${@t$tfll Fsmt^|I:
0.m 0.m 0.00 JI
rrftfptrflsr^lus t{ol T0 8E PnilIED ^tn.lna{tEts rluFtt t,Es$n^firr |Irrll XE
|{if$ trEl|lflD||Iill{tlm€RFlr v€Ff,rlDil@(E 0.00 0.00 0.m 0.m
rt5900l s10 PmnftoFErs IIIFEE Tlt Bupmt LGALtlXa)
(ltEF$) ilItIm^lDs 0.m 0.00 0.00 0.00
iFFOtD AMEUT SrC
$tct sP€AltFtttri PEI lry Sllttr x rcIA[tAEs
0 00x llm Pr.Ft s€0 0.00 0.00 0.00 0.m
,ru ARndz {I'ITSTDTALTS
USTD SptoltFEfpl PGr^G€ slATrlxp€r{lrw rol^rnEolt€s
0.m .25 0.00 48.75
SFtCsLFEftI L(aAtlAXpEt|^uy TOTltprD
zil 0.00 48.75
PAFFORD
AIIIBULAilGT
SVC rFMtl-[fns!
P0 Box1120 fnsl sTttt tlltx lr umnEt
AR
HOPT 718(P
0tFtutf,o
rcrtutr
2@0+01l5:O:23?.t
ilr[ 290|
lrmf lxxfft
"Orna nrd sign h lhc:ef. hd.dcd o bd( d thb sstilaGdc-
116 EISI ?Dl
prq'narrl
IUnXIl 2m0+01
Arkansas State Health Department
fnspection Decal #24543
ARKANSASINSURANCEIDENTIFICATION
CARD
(STATE)
COMPANYNUMBER COMPANY
THOMCO
POLCY NUMBER EFFECTIVEOATE EXPIRATIONDATE
cL314137 01t28t2008 01t28t2009
YEAR MAKE/MODEL VEHICLEIDENNFEATON NUMBER
2000 Ford/E350 1FDSS34F5YHB64677
AGENCY/COMPANY
ISSUING
CARD
AndetsonFrazbr InsuranceAgencyof Hope,Inc.
910 South Main l870ltt7-3481
P. O. Box 489
Hope,AR 71802-0489
INSURED
PaffordMedicalServices,
Inc.
P. O. Box 1120
Hope,AR 71802-1120
SEE IMPORTANT
NOTCE ON REVERSESIDE
24 Hour CfaimPhone# (B7OI7O3-2144
THISCARDMUSTBE KEPTIN THE INSURED
VEHICLEANDPRESENTED UPONDEMAND
lN CASE ACCTDENT:
OF Report accidents yourAgenUCompany
ail to as
soonas possible.
Obtain following
the information:
1. Name address eachdriver,
and of passenger witness.
and
2. Narne Insurance
of Company policynumber each
and for
vehicle
involved
ACORD _60(1183)
@ACORDCORPORANON1983
REGISTBAT!O'{
VE}ItCLC
OF
STATE ABKANSAS
CTRTIFICATE w-w +Al
OF
DEPARTME}'IT FINA''ICE
AND ADMINISTRATION
KEEPTHISDOCUMENT YOURVEHICLE
IN
v€ttu tr{IFcrrn n FEn
1FDWF36F0XED33118
u)tllstPult rEfa{s€ryftilst ofcttom flpn nt{oarE trcrrrp
437LwH AMLP AM B 2lxr$ll4-30 '|37LWH
Gin MA(E rm€t &0v c0 m FLE| cYt {IJPuctlcm --
uurlrrGgr
ft Pucfifrrr Ftt vEHptF{tst pEt urrtrulrl
999 FoBD F3D CB WHt c. 8 m75@ dIno m EGBINAilN 'tT
46.m 0.00 110m.00 0.00
ot{l[f66t|XlY o(rf,ItR BS{.fo
DA1E
ctrul Iilil6fEn FtE PTIB €XI WAM tclt l^lzl
HEmPSTEAD 000m0 ar0&s-301158{t4076 0.00 0.00 0.00 0.00
rEiumR29t)10792044 Flxsun tTlupnilTsrnF ilol T0 BE PRlllTEo ADftrril r tl€s IftuFtE tfsslR^tfil ltrrlr^ri
J
|€r{€yrt trr{rf E/|lFir t{|,EQ rmtr vtFc/t lIJl{ cfix 0.00 0.00 0.00 0.m
trltltf,53 tlu PR) FAIEOFEES t[t{EE rm&"Em tot lA!0
(}ti€R3)
,AFFMO MTDIGALS€RI'IGTSIiIC
mum$E 0.{xt 0.00 11000,00 0.00
$!{CUI, FEE ptutw $^ltl^x rottt TAxEs
,0 Box
1120
ttl
PUm{S€0 0.00 0.00 0.m 0.00
AR
IOPE 71f,P otn
ustD sTilOrDau Ftt
SPECSI t2l PfJSIIGI SIAlETtJ(Ptl{AtlY torAt ffe Ff€s
0.00 .fi 0.00 8.75
SPtCtlt fEE Fl TMAL I X PEMTTY IOTAI P D
2.50 0.00 6.7s
PAIIORD MEDICAL I}IC
SIRVICES t-Ei#|I-oEAs,
P 0 80x 1120
AR
HOPE 718IP
off.lulx0
ifitwfl-
2ogo+tt 11:5&01A.I
t{tft 2901
iltmtrxlxfl
-Ouna 116ttsl 12nl
mrd rign in lhc rFGG iillc.lad ar !€Gl d lbb ccrlatia.tc"
Frqtn flsl
u[lmE 2qF0+a,
Arkansas State Health Department
fnspection Decal # 5495
INSUMNCEIDENTIFICATION
ARKANSAS CARD
(STATE)
COMPAI,IYNUMBER COMPANY
THOMCO
POLICY
NUMBER EFFECNVE
DATE EXPIRATION
OATE
cL3l4137 01t28t2008 01128/2009
YEAR MAKE/MOOEL VEHICLEIDENTIFICATION
NUMBER
1999 Ford/E350 1FDWF36FOXED33I
I8
AGENCY/COMPANY
TSSUING
CARD
Anderson Frazbr fnsuranceAgency of Hope, tnc.
910 South l,fain (8701771-3!,81
P. O. Box 489
Hope,AR 71802-0489
INSURED
. Pafford lttledical Services,Inc.
P .O . B o x . l t 2 0
Hope,AR 71802-1120
SEE IMPORTANT
NOTICEON REVERSESIDE
24.Hoq-r
Cfaim Phone{ (tt0'lt0_3-2144
THISCARDMUSTBE KEPTIN THE INSURED
VEHICLE PRESENTED
AND UPON DEMAND
lN CASE ACCTDENT:
OF Report accidents yourAgenUCompany
all to as
soonas possible.
Obtain following
the information:
1. Name address eachdriver,
and of passenger witness.
and
2. Name Insurance
of Company policy
and number each
for
vehicle
involved.
ACORD (r/831
60 @ACORDCORPORANON1983
OF
SECTION EMSAND TRAUMA SYSTEMS
INSPECTION
REQUIRED PARAMEDIC EQUIPMENT LIST
I.D.
SERVICE INSPECTION
DATE BODYTYPE (TI) (T2) (T3) RESCUE
VIN MODELYEAR FD CH DD INT OTHER
DECAL -PA VEHICLE
LICENSENUMBER INITIALS
INSPECTOR'S
STRETCHER.
ELEVATING (l) *X MASTTROUSERS
_(l)
BANDAGE/EMTSHEARS _(l) rv STARTSETS/TOURNTQUET _(6)
HEMOSTAT _(l) lV CATH l6ga _(3)
WINDOWPLNCH/ENTRY DEVICE (I) IV CATH l8ga l'lt
SCALPEL _(l) IV CATH 20ga r1r
Child,Adult,& Lg. Adult)_(l
B/P CUFF/MANOMETER(Infant, ea.)by Ocr 2008 lY CATH 22ga _(3)
STETHOSCOPE _(l) lv CATH 24ga _(3)
EXAM GLOVES _(l Box) SYRINGE lcc _(l)
ANTISEPTIC HAND CLEANSER (I) SYRINGE 3/5cc _(3)
ISOLATIONKITS _(2 SYRINGE l0/l2cc _(3)
NEBULIZER _(l) SYRINGE 60cc _(1)
BETADINESOLUTION _(l BOTTLE) NEEDLE l8ga _(6) OR
OBKIT _(l) Demonstrate abilityto administer IM, SQ and IV piggyback
INTRAOSSEOUS NEEDLES(Ped|) _(2) EMESIS BASINOR EQUIVALENT _(l)
STERILE GLOVES _(4 PArR) CRICKIT or l0ll2ga NEEDLE _(l)
oPA SET0-l-2-3-4 _(r EACH) MICRODRIPINFUSION SETS _(2) AND)
LARYNGOSCOPE HANDLES _(2) MACRODRIPINFUSION SETS _(2) OR
LARYNG.BLADES(l-4 OR 0-3) _(r EACH) ADJUSTABLE DRIPSETS _(4)
ET TUBE 3 or 3.5mnr _(l) 0 . 9 %S A L I N EI N F U S I O N _(4L)
ET TUBE 4 or 4.5mm _(l) RINCERS LACTATEINFUSION ULI
ET TUBE 5 or 5.5mm _(l) STERILE SALINEIRRIGATION _(2L)
ET TUBE 6 or 6.5mm _(l) PORTABLE SUCTION _(l)
ET TUBE 7 or 7.5mm _(2) ON-BOARDSUCTION _(l)
ET TUBE 8 or 8.5mm _(2) SUCTION TUBINC _(2)
Esophageal TrachealMulti-Lumen Airway _(l) by Oct 2008 SUCTION CATH 8 or l0 FR _(l)
MAGILLFORCEPSADULT&PEDI (IEACH) SUCTION CATH 14or l8 FR _(2)
ADULT & PEDIET STYLETTE _(r EACH) CERVICALCOLLARSADULT : _(3)
PEDIDRUGCHARToTTAPE PEDI (')\
_(l)
MONITOR/DEFIBRILLATOR _(l) INFANT _(l)
PATIENTCABLES _(2 SETS) 4X4 PADS
PEDIDEFIB PADDLES PADS OR _(l sET) ABD DRESSING (PADS) S
ADULT ELECTRODES (6 SETS) TRAUMA DRESSING IOX3O -tzs
PEDI ELECTRODES _(2 SETS) ROLLERGAUZE _(6)
EKG PAPER _(2) BOARDSPLINTS:
ON-BOARDOXYGEN LONC AND SHORT _(2 EACH)OR
PORTABLE OXYGEN FRACTURE PACK _(l sEr)
BAC VALVE: TRACTIONSPLINT _(l)
ADULT _(t) KED/SHORT SPINEBOARD _(l)
PEDI _(l) LONGSPINE BOARD _(2)
INFANT _(l) SPINE BOARDSTRAPS _ (2 SETS)
NASAL CANNULAE ()\ FOLDING STRETCHER SCOOP or
OXYCENMASKS: S T R E T C H EO T T A I RC H A I R
RS
NON REBREATHER _(2) TriageTags/Tape (Color coded
PEDI-02 Mask _(l) Black, Red, Yellorv,Creen) - (25)
INFANT-02 Mask (l) If tape utilized: one roll of each color required.
RadioFrequencies: PulseOxirnetry (By October 2008) (l)
Enrouteto scene: 155.235mHz. ADULT& PEDIETCO2 DETECTOR -( I EACH)
At scene: 155.280mHz. (ca Monitor Acce
Departing scene:155.340 mHz.
* Gaugepressure 200 X cylinderfactor = minutes Optional Skills:
-
Adult Intraosseous (Tibial & Humerus)
lMust be ableto supplyoxygenflow at l5 LPM for a periodof 30 rnin.) 2 Adult needles
Cylinderfactors: Continuous PositiveAinvav Pressure (CPAP)
D c y l i n d e r= . 1 6 M cylinder: 1 . 5 6 Huber Needles
', Al
E c y l i n d e r: . 2 8 G c y l i n d e r- CentralVenousDevice Access
H ,K cyl.= 3.14 Cardiac Thrombolytic Medications -
t * Mast trousers
to be carried andlor used at medicaldirector's discretion
Refer to Mass CasualtyRules & Regulationsfor requiredradio frequenci Theabove skillsareoptional: sen'ice's
arrrbulallce tlredical
will
direc(or select equiprnent Protocol
utilized.
RevisedJune by Section EMS required
subnrission/approval of priorto
inlPlenlentatloll.
OFFICE EMSAND TRAUMASYSTEMS
SECTION OF
ADVAI\CEDRESPONSE
REQUIRED INSPECTION
EQUIPMENT LIST
MEDICATIONS
Medication for Advanced
SeeRequired List Air. VehicleReqistratron Opttonal
Response. andParamedic and Medicatron
. List for Advanced AIR.
Response. andParamedicLevelServices.
CONTROLLED DRUGS
* * InjectableNarcotic Analgesic
Completed Section: Type:
by Amount:
Completed Section: Type:
by Amount: Optional Skills:
Adult Intraosseous (Tibial & Humerus)
* *lnjectableBenzodiazapine 2 Adult needles _
Continuous PositiveAirway Pressure (CPAP)_
Completedby Section: Type: Amount;
Huber Needles _
Completed Section: Type:
by Anrount: Central Venous Device Access
CardiacThronrbolyticnredications _-
* MastTrousers becarried
to used medical
and/or at discretion
director's The aboveskills are optional:ambulance service's
medicaldirectorwill select utilized.
eqr.ripnrent
** Not required Advanced
for if
ResponseParamedic responds
service Protocolsubnrission/approval required Sectionof
by
EMS prior to inrplenrentation.
Referto Mass radiofrequencres
Rules Regulations required
Casualty & for
*Gaugeoressure 200X cylinderfactor = minutes
-
lsLPM
(Must be ableto supplvoxvsenat 15LPM for a periodof 20 min.)
D cylinder = .16 M cylinder = 1.56
E cylinder = .28 G cylinder = 2.41
H,K cyl. :3.14
RevisedJune
SECTION EMS AND TRAUMA SYSTEMS
OF
OPTIONAL
LIST FORADVANCEDRESPONSE.
MEDICATTON AIR. AND PARAMEDIC
LEVEL SERVICES
Page of2
1
AdvancedCardiacLife Supportprotocolsor
Any Drug listedin the AmericanHeartAssociation's
AdvancedLife SupportProtocols
Pediatric (suchas Amiodarone,
Adenosine, Vasopressin,Isuprel,
Verapamil, Lopressor,MagnesiumSulfate,or Procainamide)
Inj ectableanticoagulant
Injectable betablocker
Injectable antipsychotic
Injectablesteroids
H2
Injectable blocker
Hl
Injectable blocker
Injectableinotropic agent
Injectableantiepilepticagent
Injectableantidotes
Injectableantiemetic
Injectablebeta agonist
Injectable calcium
Inj ectableantihypertensives
Inj ectable benzodiazepineantagonist
Injectable calciumchannel blocker
IV Solutions(suchas LactatedRingers,Lactated D5W, D5 % NS, D5NS)
Ringerswith Dextrose,
InhaledBataAgonist
Aminophylline
AmylNitrite
Atrovent
Hydroxyzine
Mannitol
NitrousOxide
Oxytocin (Pitocin)
Prescribeextemalclottingagents
Monitoring of blood or blood products
are by
medications not regulated the Department.
Over-the-counter
Junel, 2008
Revised
AGENDA INFORMATION FOR BOARD MEETING 6/3/2008
ITEM 5: UPDATE ON LAUREL/GREENING STREET SEWER PROJECT
The Laurel and Greening Street sewer job is finished except for resolving one problem that has
arisen with crossing the Union Pacific Railroad. The line under the railroad is old, but
operational and has a sag in it. The initial determination was that a new bore under the
railroad would need to be made and the line replaced. Our engineer Glen Spears and our
contractor, Bobo & Bain worked to get prices together for boring the 100’ railroad right-of-way
in the same location. Prices were in the $360/foot range or a total of $36,000 just for the bore.
An additional problem is that we cannot tell if there is casing around the already existing line.
The following are the various alternatives:
1) If the contractor tries to bore in the current location, then hits an old casing, we are shut
down. The line will not carry sewage and we are in trouble. We would have to pump
sewage from one manhole to another, until a solution could be found. We would still
owe the contractor for at least part of the boring cost and we would be in crisis mode.
2) If we move the line location east slightly, bore under the railroad and replace the line,
the cost is at least $36,000 for the bore, and we have a line with a zig zag in it, on a very
flat grade, that may easily cause future problems.
3) Explore the options for rerouting this sewer line and abandon this railroad sewer
crossing completely. Glen Spears thinks this may be possible and we could choose to
complete this option now or in next year’s sewer line work contract. If the Board
chooses to wait until next year, there is the possibility the line crossing could cause
problems in the interim, but if we go ahead and check out this possibility, we would at
least be one step ahead. The cost for rerouting the line is going to be similar to the bore
under the railroad options.
Glen Spears is working on shooting some grades for option #3 and will be prepared to make a
recommendation to the Board Tuesday evening.
AGENDA INFORMATION FOR BOARD MEETING 6/3/2008
ITEM 6: UPDATE ON NORTHSIDE PARK
I would like to update the Board on the Northside Park project. We have run into one snag
with the building on some of the bathroom replacements. The partitions will not be in until
sometime next week, so the bathrooms will not be operational.
We plan to have all the equipment in place and the building finished by Friday, June 6. The
program will start Monday, June 9 at 10:00 a.m. We will have a registration on May 31, 2008 at
10:00 a.m.
AGENDA INFORMATION FOR BOARD MEETING 6/3/2008
ITEM 7: CITY MANAGER’S REPORT
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