AMBULANCE SERVICES
For DeKalb County School District
RFP 23-544 | NOVEMBER 29, 2022
A Global Medical Response Solution
i
DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 ...
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TABLE OF CONTENTS
EXECUTED RFP ................................................................................................................................................................................... iii
ADDENDA ................................................................................................................................................................................................. 1
CERTIFICATE OF INSURANCE ..................................................................................................................................................... 3
COMPANY FINANCIAL STATEMENTS ..................................................................................................................................... 5
ATTACHMENT C - AMBULANCE SERVICE QUESTIONNAIRE ................................................................................. 30
ATTACHMENT D - COST PROPOSAL FORM .................................................................................................................... 33
ATTACHMENT E - CRITICAL PARAGRAPHS..................................................................................................................... 34
ATTACHMENT F - OFFEROR'S CLIENT REFERENCE FORM .................................................................................... 35
ATTACHMENT G - STATEMENT OF CONFIDENTIALITY AND NON-DISCLOSURE ..................................... 38
ATTACHMENT H - SUSPENSION AND DEBARMENT CERTIFICATION .............................................................. 39
ATTACHMENT I - IMMIGRATION & SECURITY CERTIFICATION ............................................................................40
ATTACHMEN T K - SIGNATURE PAGE ................................................................................................................................... 46
1.AMR COMPANY PROFILE .......................................................................................................................................................... 47
2.REFERENCES ................................................................................................................................................................................... 59
3. BROCHURES, CATALOGS, MAN UALS, WEBSITES, LITERATURE ..................................................................... .60
4.OPTIONAL AND VALUE-ADDED PRODUCTS AN D SERVICES ............................................................................ 64
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
ii
EXECUTED RFP
1701 MOUNTAIN INDUSTRIAL BOULEVARD, STONE MOUNTAIN, GEORGIA 30083
https://dekalbschoolsga.ionwave.net/Login.aspx
October 27, 2022
REQUEST FOR PROPOSALS (RFP) 23-544
AMBULANCE SERVICES
VIRTUAL PRE-PROPOSAL CONFERENCE – 1:00 PM, TUESDAY, NOVEMBER 8, 2022
PROPOSAL SUBMISSION DEADLINE - 2:00 PM, TUESDAY, NOVEMBER 29, 2022
VIRTUAL PUBLIC PROPOSAL ACKNOWLEDGEMENT - 3:00 PM, TUESDAY, NOVEMBER 29, 2022
DeKalb County School District
Purchasing/Finance Department
1701 Mountain Industrial Boulevard
Stone Mountain, Georgia 30083
PROPOSALS RECEIVED AFTER THE DEADLINE SHALL BE CONSIDERED
NON-RESPONSIVE AND REJECTED.
PROPOSALS TO BE ACKNOWLEDGED PUBLICLY AT THE FOLLOWING TIME/LOCATION:
3:00 PM, Tuesday, November 29, 2022
DeKalb County School District
Finance Conference Room
1701 Mountain Industrial Blvd.
Stone Mountain, Georgia 30083
RFP Contact Person is: Carla L. Smith at 678.676.0120 or Phyllis Jones at 678.676.0285
or email purchasing at solicitationquestions@dekalbschoolsga.org
THE PERSON SIGNING THIS RFP MUST BE LEGALLY AUTHORIZED TO BIND THE COMPANY.
Metro Ambulance Services, Inc DBA American Medical
COMPANY NAME ____________________________________________________ Response Christopher Valentin
_________________________________________________________
PRINT CERTIFYING/ENGAGING COMPANY OFFICIAL’S NAME
1380 Beverage Dr Suite D, Stone
ADDRESS ___________________________________________________________ _________________________________________________________
Mountain, Georgia 30083 SIGNATURE OF CERTIFYING/ENGAGING COMPANY OFFICIAL
___________________________________________________________________ Regional Director of Operations
_________________________________________________________
TITLE OF CERTIFYING/ENGAGING COMPANY OFFICIAL
909-841-2354
___________________________________________________________________
AREA CODE, TELEPHONE NO., AND EXTENSION 58-1036407
_____ _____ - ______ ______ _____ _____ _____ _____ _____
FEDERAL I.D. NUMBER
N/A
___________________________________________________________________ 11/29/2022
_________________________________________________________
OFFEROR FAX NUMBER DATE
chris.valentin@gmr.net
OFFEROR E-MAIL ADDRESS___________________________________________ www.amr.net
OFFEROR WEB ADDRESS___________________________________
iii
RFP 23-544 AMBULANCE SERVICES PAGE 2
ASAP
Time is of the essence. Specify your earliest __________ 01/01/2023 service commencement dates
and latest __________
after receipt of award letter.
Approval by the DeKalb County Board of Education
Official approval by the DeKalb County Board of Education is required for this procurement. No contract shall be
construed to be formed without the advance official approval of the DeKalb County Board of Education. The
successful offeror will be notified after DeKalb County Board of Education approval.
Funding Provisions
No award or contract will be made if funding is not approved by the DeKalb County Board of Education.
Compliance With Requirements
Offeror must indicate below whether or not their proposal is in complete compliance with the stated requirements.
If there are any deviations from these requirements, offeror must indicate in writing what the exact deviations
are and what actual services will be provided. Attach and label additional sheets if necessary.
X Proposal is in complete compliance with proposal requirements.
___
___ Proposal deviates from stated requirements as follows:
________________________________________________________________________________________
________________________________________________________________________________________
Cancellation
Awards, contracts, and renewals may be canceled for convenience by the DeKalb County School District (DCSD)
at any time. In the event of termination of contract by DCSD, the DCSD will be responsible only for those services
that have been delivered and accepted according to the RFP requirements. Any cancellation for convenience
by DCSD shall be effective three (3) business days after receipt of the Notice of Cancellation for convenience
from DCSD by the Offeror.
Fiscal Year Funding Implications
The fiscal year for DCSD begins July 1 and ends June 30. This solicitation and any resulting contract(s) may
contain renewal options. This solicitation, any resulting contract(s), and any renewal options shall terminate
absolutely without further obligation on the part of DCSD at the end of the fiscal year in which this solicitation
was issued and at each June 30 renewal anniversary date thereafter unless the successful offeror is notified
otherwise and agrees in writing to the exercise of renewal options.
Payment to Successful Vendor(s)
Payment for goods and services will be made by electronic funds transfer (EFT) or ACH Paymode.
Vendor(s)/Supplier(s) doing business with DCSD are required to provide payment information when registering
as a DCSD vendor at: https://www.dekalbschoolsga.org/purchasing/. Offerors must sign below acknowledging
the above statement.
Metro Ambulance Services, Inc
DBA American Medical Response
Signature of Engaging Official: ___________________________________________ 11/29/2022
Date: _____________
(Company Name / Certifying Official Signature)
Rights Reserved
DCSD reserves the right to accept or reject any and/or all parts of responsive proposals received and/or to reject
all proposals submitted. DCSD reserves the right to award any resulting contract in the manner that is in the
best interest of and most advantageous to DCSD. DCSD reserves the right to waive any technicalities or minor
irregularities in responses received and to award the contract in the most beneficial manner for DCSD. The
decision of DCSD shall be final. DCSD reserves the right to request and negotiate a “best and final” response
from offerors.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 3
Taxes
Purchases made by DCSD are not subject to federal, state, or local sales tax. A Sales Tax Exemption Certificate
will be furnished upon request.
F.O.B. Delivery
All prices are to be F.O.B. delivery to various DCSD locations.
Estimated Quantities
The quantities shown in this RFP document are estimates, which are provided for your information. However,
actual quantities purchased by DCSD may vary.
Exclusions of Trade Usages
This RFP contains all of the terms, conditions and obligations to which the parties agree, and shall not be
modified, controlled, explained, supplemented or affected in any way by any usage of trade not expressly
included in this agreement.
No Obligation/No Award Guaranteed/Cost to Propose
The contract, if any, will be awarded to the offeror whose proposal offers the best value to DCSD in meeting the
required scope of work described herein, if the appropriate funds are available and the contract is approved by
the DeKalb County Board of Education. No obligation or commitment is incurred by the DeKalb County Board
of Education from the receipt of any proposal, marketing materials, or presentations. There is no guarantee that
any offeror will receive an award as a result of submitting a proposal. Any/all costs incurred by the offeror in
preparation and submission of this proposal are the sole responsibility of the offeror. Expenses incurred by the
offeror will not be reimbursed by DCSD or become a reason for contracting with the offeror. Offeror must sign
below acknowledging the above statement:
Metro Ambulance Services, Inc DBA
American Medical Response
Signature of Engaging Official: ___________________________________________ 11/29/2022
Date: _____________
(Company Name / Certifying Official Signature)
Conditional Proposals
Proposals that are conditional and/or in any way qualify or vary from the terms of these instructions, conditions,
and specifications shall be considered non-responsive and disqualified.
Offeror Failure
In the event services to be furnished by the successful offeror should for any reason fail to conform to the scope
of work contained herein, DCSD reserves the right to reject the services and further reserves the right to
terminate the contract.
Failure of the successful offeror to perform contracted services may also result in the removal of that offeror from
doing business with DCSD for a period of not less than one year.
Georgia Open Records Act
All proposals submitted in response to DCSD solicitations may be subject to the Georgia Open Records Act,
which permits any member of the public to inspect and/or copy documents prepared and maintained or received
in the course of the operation of the public office or agency.
Metro Ambulance Services, Inc
DBA American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 4
No Assignment of Award
The successful offeror may not assign the award or contract to or subcontract with another party without the
express written permission of DCSD.
The Laws of the State of Georgia
This RFP and subsequent agreement are subject to the laws of the State of Georgia.
Additional Terms
In the event an award is made to an offeror, the resulting contract shall not depart from this document unless
agreed to in writing by DCSD and the successful offeror. DCSD shall not be bound by additional terms and
conditions and/or extraneous language added to this document by offerors.
2 CFR 200.322(a)
§ 200.322 Domestic preferences for procurements.
(a) As appropriate and to the extent consistent with law, the non-Federal entity should, to the greatest extent
practicable under a Federal award, provide a preference for the purchase, acquisition, or use of goods
products, or materials produced in the United States (including but not limited to iron, aluminum, steel,
cement, or other manufactured products).
ALL SOLICITATIONS ISSUED BY DCSD ARE ADVERTISED IN THE LEGAL SECTION OF THE
CHAMPION NEWSPAPER, (404) 373-7779, POSTED ON THE IONWAVE DCSD WEBSITE,
DEMAND STAR AND POSTED IN THE TEAM GEORGIA MARKETPLACE’S GEORGIA
PROCUREMENT REGISTRY. Offerors are solely responsible for reviewing and making
themselves aware of DCSD solicitations posted on the following website:
https://dekalbschoolsga.ionwave.net/Login.aspx
Proposal responses will be received in the Purchasing Office between the hours of 8:30 AM and
4:30 PM only, Monday through Friday, excluding DCSD holidays, furlough days, and inclement
weather closings.
DCSD is not responsible for misdirected mail, mail not received, and/or mail delivered late by
designated carriers.
PROPOSALS RECEIVED IN THE PURCHASING OFFICE AFTER THE STATED DEADLINE DATE
AND TIME SHALL BE CONSIDERED NON-RESPONSIVE AND REJECTED.
PROPOSALS DELIVERED TO ANY SCHOOL OR LOCATION OTHER THAN THE DCSD
PURCHASING DEPARTMENT SHALL BE CONSIDERED NON-RESPONSIVE AND REJECTED.
PROPOSALS THAT ARE DELIVERED BY EXPRESS CARRIER (e.g., FEDEX, UPS) AND
RECEIVED IN THE DCSD MAILROOM WITH VERIFYING SIGNATURE BEFORE THE SCHEDULED
PROPOSAL DEADLINE SHALL BE CONSIDERED RESPONSIVE AND ENTERED INTO THE
PROPOSAL TABULATION.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 5
LABELS WITH THE PROPER IDENTIFICATION INFORMATION ARE PROVIDED IN YOUR
REQUEST FOR PROPOSAL PACKAGE FOR YOUR CONVENIENCE AND USE. YOU MAY ALSO
DOWNLOAD LABELS FROM THE DCSD WEBSITE BY CHOOSING ATTACHMENT 1 AT:
https://dekalbschoolsga.ionwave.net/Login.aspx
SEALED PROPOSAL RESPONSES MUST BE CORRECTLY ADDRESSED AS SHOWN ON THE
REQUEST FOR PROPOSAL COVER SHEET.
BOXES OR EXPRESS CARRIER PACKAGES CONTAINING SEALED PROPOSALS MUST BE
CORRECTLY ADDRESSED AS WELL.
PROPOSALS RECEIVED BY TELEGRAM, FACSIMILE, E-MAIL, OR TELEPHONE WILL NOT BE
ACCEPTED.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 6
NOTICE TO OFFERORS
FOR SECURITY REASONS, ALL OFFERORS ATTENDING THE PUBLIC PROPOSAL
ACKNOWLEDGEMENT MUST REGISTER AT THE FIRST FLOOR FRONT DESK AT 1701
MOUNTAIN INDUSTRIAL BOULEVARD, STONE MOUNTAIN, GEORGIA 30083, BEFORE
ATTENDING THE PROPOSAL ACKNOWLEDGEMENT.
ALL OFFERORS SUBMITTING SEALED PROPOSALS IN PERSON TO THE PURCHASING
DEPARTMENT MUST HAVE THEIR SEALED PROPOSALS STAMPED WITH THE DATE AND
TIME BY A PURCHASING DEPARTMENT REPRESENTATIVE AND MUST LEAVE THEIR
SEALED PROPOSALS IN THE CARE OF A PURCHASING DEPARTMENT REPRESENTATIVE.
PURCHASING DEPARTMENT REPRESENTATIVES WILL ISSUE RECEIPTS FOR SEALED
PROPOSALS IF REQUESTED.
SEALED PROPOSALS LEFT RANDOMLY AT THE BUILDING, THE DIVISION OF FINANCE OR
THE PURCHASING DEPARTMENT WITHOUT BEING DATE AND TIME STAMPED OR WITHOUT
ENSURING A PURCHASING DEPARTMENT REPRESENTATIVE TAKES POSSESSION OF
SAME SHALL BE CONSIDERED NON-RESPONSIVE AND REJECTED.
ANY CLAIM BY PROPOSING ENTITY OF ERROR IN THEIR PROPOSAL MUST BE MADE
BEFORE PROPOSALS ARE OPENED, OR THE CLAIM SHALL BE DEEMED WAIVED. ANY
PROPOSING ENTITY MAY WITHDRAW THEIR PROPOSAL AT ANY TIME BEFORE THE TIME
AT WHICH PROPOSALS ARE DUE AND THE REQUEST FOR PROPOSALS IS CLOSED AND,
HAVING DONE SO, NO PROPOSING ENTITY WILL BE PERMITTED TO RESUBMIT A
PROPOSAL.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 7
1701 MOUNTAIN INDUSTRIAL BLVD, STONE MOUNTAIN, GEORGIA 30083
https://dekalbschoolsga.ionwave.net/Login.aspx
REQUEST FOR PROPOSALS
RFP 23-544
AMBULANCE SERVICES
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 8
TABLE OF CONTENTS
DCSD Solicitation Boilerplate ....................................................................................... 1-6
RFP Cover Page ............................................................................................................. 7
Table of Contents ......................................................................................................... 8-9
Attachments ............................................................................................................. 32-70
PART I – BACKGROUND AND INFORMATION
A. Objectives ............................................................................................................... 10
B. General Information ................................................................................................. 10
C. Procurement Process……………………………………………………………………...11
D. Addenda .................................................................................................................. 11
E. Proposal Deadlines .................................................................................................. 11
F. Schedule of Events ................................................................................................. 11
G. Format and Submission of Proposals ...................................................................... 11
H. Virtual Pre-Proposal Conference ............................................................................. 13
I. Proposal Contact Persons ....................................................................................... 14
J. Prohibited Contacts.................................................................................................. 14
K. Questions and Answers ........................................................................................... 14
PART II – GENERAL REQUIREMENTS
A. Offeror Performance ............................................................................................... 15
B. News Release ......................................................................................................... 15
C. Non-Discrimination .................................................................................................. 15
D. Drug Free Workplace .............................................................................................. 15
E. Smoke Free Workplace .......................................................................................... 15
F. Costs Incurred ......................................................................................................... 15
G. Insurance ................................................................................................................. 16
H. Indemnification ......................................................................................................... 18
I. Illegal Immigration Reform and Enforcement Act of 2011 ........................................ 19
J. Interviews ........................................................................................................ 20
K. Contract Terms ................................................................................................. 20
L. Permits and Applicable Laws ................................................................................... 21
M. Infringement ............................................................................................................. 21
N. Ownership Rights..................................................................................................... 21
O. Non-Collusion .......................................................................................................... 21
P. Conflict of Interest .................................................................................................... 21
Q. Financial Stability…………………………………………………………………………. 22
R. No Obligation/No Contract Guaranteed ................................................................... 22
S. Confidentiality and Non-Disclosure .......................................................................... 22
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 9
TABLE OF CONTENTS (CONT’D)
PART III – SCOPE OF WORK
A. Purpose/Project Overview ............................................................................. …23
B. Scope of Work.…………………………………………….…………………..…………...23
C. Specifications……………………………………………………………………………….23
D. Company Profile…………………………………………………………………….………25
E. Background Check………………………………………………………………………….25
F. References…………………………………………………………………..………………25
G. Brochures, Catalogs, Manuals, Websites, Literature…………….………………….….25
H. Added Value…………………………………………………………………………………25
I. Authorization to Sell…..…………………………………………………………………….25
J. Evaluation Criteria…………………………………………………………………… ....... 26
K. Payments .......................................................................................................... 27
L. Transition Plan .......................................................................................................... 27
M. Required Content / Document Checklist………………………………………….…......28
ATTACHMENTS
Attachment A – Estimated Number of Games and Graduations….…………………......29
Attachment B – List of Venues Athletic Events and Graduation Events…….…………. 30
Attachment C – Ambulance Service Questionnaire……………………………………31-33
Attachment D - Cost Proposal Form……………………………………………….............34
Attachment E – Critical Paragraphs..………………………………………………………..35
Attachment F – Offeror’s Client Reference Form…………………………………………..36
Attachment G – Statement of Confidentiality and Non-Disclosure……………………….37
Attachment H – Suspension and Debarment Certification………………………………..38
Attachment I – Illegal Immigration Reform and Enforcement Act of 2011
Certification………………………………………………………………39-44
Attachment J – Standard Form Agreement……………………………………………...45-63
Attachment K – Signature Page……………………………………………………………....64
Appendix I……………………………………………………………………………………..65
Final Page……………………………………………………………………………………….66
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 10
PART I
BACKGROUND AND INFORMATION
A. OBJECTIVES
The DeKalb County School District (DCSD) is seeking professional services from highly qualified and
capable ambulance service providers for services during athletic events and graduation events. Basic
life support equipment and services shall be as required by the State of Georgia Department of Public
Health Rules and Regulations 511-9-2 Emergency Medical Services for ground ambulance services.
B. GENERAL INFORMATION
DCSD is a metropolitan Atlanta public school system organized and existing under the Constitution and
laws of the State of Georgia. DCSD is located in the fourth largest county in Georgia. DeKalb County
is one of the most culturally diverse counties in the nation. DCSD has a student enrollment of
approximately 100,000 students in pre-kindergarten through grade 12. With 139 schools and centers,
DCSD educates the third largest pre-kindergarten through grade 12 student population in the State of
Georgia. DCSD is the second largest employer in DeKalb County with over 15,500 full and part time
employees.
DCSD is dedicated to giving every student the best possible education through an intensive core
curriculum and specialized, challenging instructional and career programs. DCSD is striving to become
the premier K-12 school system of choice and desires to significantly improve leadership, teaching, and
student learning to fulfill its mission as an organization for public education.
DCSD includes approximately:
• 79 Elementary Schools
• 19 Middle Schools
• 20 High Schools
• 9 Start-up Charter Schools
• 2 Conversion Charter Schools
• 13 Specialized Learning Centers
• 8 Administrative Centers; and
• 5 Athletic Stadiums
Currently, DCSD has 112 Title I Schools. DCSD’s wide-area network connects instruction and
administration sites to deliver technology and learning tools to every child. The main
administrative offices are located at 1701 Mountain Industrial Boulevard, Stone Mountain,
Georgia 30083. DCSD is governed by a seven-member Board of Education.
C. PROCUREMENT PROCESS
The procurement will be on a formally advertised basis. Proposals must be responsive to all aspects
of this RFP.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 11
D. ADDENDA
It is the responsibility of offerors to frequently check for any addenda, questions, and answers posted
on the Purchasing Bulletin Board on the DCSD website. Failure on the part of offerors to make
themselves aware of and comply with addenda requirements will not relieve them of this obligation, this
is a Mandatory Requirement. All posted addenda must be printed, signed by the offeror, and included
in the offeror’s RFP submission. Click on the following link to the Purchasing Bulletin Board:
https://dekalbschoolsga.ionwave.net/Login.aspx
E. PROPOSAL DEADLINES
Proposals in response to this RFP must be received by the DCSD Purchasing Department at 1701
Mountain Industrial Boulevard, Stone Mountain, Georgia 30083, no later than 2:00 PM, Tuesday,
November 29, 2022. Proposals received after the stated deadline will not be considered.
Proposals will be acknowledged publicly on Tuesday, November 29, 2022 at 3:00 PM.
F. SCHEDULE OF EVENTS
1st Consecutive Ad in Legal Organ Thursday, October 27, 2022
2nd Consecutive Ad in Legal Organ Thursday, November 3, 2022
Virtual Pre-Proposal Conference Tuesday, November 8, 2022, 1:00PM
Deadline for Offerors to Submit Questions Monday, November 14, 12:00 Noon
Posted Responses to Questions Friday, November 18, 2022, 4:30 PM
RFP Submission Deadline Tuesday, November 29, 2022, 2:00 PM
Virtual RFP Public Acknowledgment Tuesday, November 29, 2022, 3:00 PM
Responses to questions will not be posted on official DCSD holidays or furlough days.
G. FORMAT AND SUBMISSION OF PROPOSALS
The format requirements for RFP responses are designed to ensure uniformity in the responses,
provide the information necessary to understand each offeror’s proposal, and facilitate an efficient and
comprehensive evaluation of all responses. Proposals must comply with the specifications and detailed
instructions stated in this RFP document, be signed by the certifying company official, and be presented
to the DCSD Purchasing Department according to the detailed instructions stated in this document.
● Proposals must be presented in a three-ring binder with tabs separating the required sections. All
attachments must be identified properly for easy recognition and association.
Each page of the response must be numbered, and the offeror’s company name must
appear in the lower right-hand corner of each page.
● Each proposal must contain a detailed Table of Contents and must be organized in the same order
as the requirements are outlined in this RFP document. Each separate bullet point must be
addressed individually. A response that does not adhere to a “point-by-point” format may be
disqualified.
● Responses shall be organized simply and economically. Emphasis must be placed on
completeness and clarity. Proposals that do not include all required information may be
disqualified.
● RFP responses must be submitted in a sealed container plainly addressed as shown below.
Containers not properly labeled as shown below will not be opened or considered.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 12
SEE REQUIRED CONTENT / DOCUMENT CHECKLIST – PAGE 28.
Proposals must be sealed and clearly labeled and addressed as shown below:
SEALED PROPOSAL IDENTIFICATION LABEL: SEALED PROPOSAL ADDRESS LABEL:
This information must appear in the lower LEFT This information must appear in the mailing corner of your
sealed proposal container (whether address area of your sealed proposal container envelope,
box, express carrier package, etc.) (whether envelope, box, express carrier package.)
(SEALED PROPOSAL RESPONSE)
RFP Number: RFP 23-544 Ambulance Services
RFP Due Date: November 29, 2022 2:00 PM (EST)
Company Name: (SEALED PROPOSAL RESPONSE)
________________________________ DeKalb County School District
Purchasing Department
Company Mailing Address:
_________________________________ 1701 Mountain Industrial Blvd
Stone Mountain, GA 30083
Contact Person Name: ATTN: Carla L. Smith
_________________________________
Contact Telephone No.: (__)_______________________
Email Address:_______________________________________
Boxes, express carrier packages and any other containers enclosing sealed proposals must
ALSO be clearly labeled as shown above.
Sealed proposals MUST be received by the DCSD Purchasing Department by the DEADLINE
stated in this solicitation. Offerors submitting proposals in person must have the date and
time stamped on their sealed proposals by a Purchasing Department representative. Sealed
proposals must be placed in the care of a Purchasing Department representative.
Failure to follow these sealed proposal label and submission requirements may cause proposals to be
declared non-responsive and rejected.
Offerors are required to submit one (1) original, one (1) duplicate copy and (1) electronic copy
(flash drive) of the proposal. One (1) duplicate copy is required to be submitted with the original in
a sealed package. It is recommended that the copies be made after the original is complete and fully
executed (signed and initialed) by the offeror’s authorized representative.
The electronic copy (flash drive) shall be submitted in pdf format (OCR) and organized in the same
format as the original submission with each Chapter or Section of the original having a corresponding
Electronic File.
Submit all responses to:
Carla L. Smith, Executive Director Vendor Services
Purchasing Department
DeKalb County School District
1701 Mountain Industrial Boulevard
Stone Mountain, Georgia 30083
RFP responses will NOT be accepted at any other DCSD location.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 13
HAND DELIVERY SUBMISSION OF PROPOSALS: Prior to the submission deadline of Tuesday,
November 29, 2022 at 2:00PM EST, an appointment must be scheduled with the Purchasing
Department by submitting an email request to solicitationquestions@dekalbschoolsga.org. Please
enter “Proposal Submission Appointment – RFP 23-544 Ambulance Services” must be scheduled on
a Monday, Tuesday, Thursday or Friday between 9:00AM-12:00PM Noon, before the November 29,
2022 proposal deadline. A confirmation of the appointment will be sent via email.
VIRTUAL PUBLIC ACKNOWLEDGMENT: The public acknowledgment will be held virtually through
Microsoft Teams on Tuesday, November 29, 2022 at 3:00PM EST. Those who would like to attend
the acknowledgement, please register no later than Monday, November 28, 2022 by 4:00PM EST, by
sending an email to solicitationquestions@dekalbschoolsga.org. Please enter “Public
Acknowledgement - RFP 23-544 Ambulance Services” in the subject line of your email. An invitation
will be sent to those participants no later than Tuesday, November 29, 2022 by
10:00AM EST.
H. VIRTUAL PRE-PROPOSAL CONFERENCE
All prospective offerors are invited to attend a Virtual Pre-Proposal Conference. The pre-proposal
conference will be held on Tuesday, November 8, 2022 at 1:00PM via Microsoft Teams.
Offerors must pre-register to attend. When registering your attendance, please enter “RFP 23-544
Ambulance Services” in the subject line of your email.
Submit to solicitationquestions@dekalbschoolsga.org by 4:00PM, Monday November 7, 2022.
The following information must be included in your request:
• Individual Name and Title
• Company Name
• Telephone Number
• Email Address
If more than one individual from your company is attending, please submit information on all
attendees. The sign-in sheet for the pre-proposal conference will be compiled using this information
and will be posted to the DCSD website within two (2) business days after the pre-proposal meeting.
A link will be sent to all registrants to participants in the virtual conference no later than 9:00AM,
Tuesday, November 8, 2022.
I. PROPOSAL CONTACT PERSONS
The assigned contact persons for offerors are Carla L. Smith, Executive Director Vendor Services and
Phyllis Jones, Buyer, for the Department of Procurement. Ms. Smith can be reached at 678.676.0120
or by email at solicitationquestions@dekalbschoolsga.org. Ms. Jones can be reached at
678.676.0285.
J. PROHIBITED CONTACTS
Except with the consent of the proposal contact person, all offerors, including any persons affiliated
with or in any way related to the offeror, are strictly prohibited from contacting DeKalb County Board of
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 14
Education members and DCSD employees or consultants on any matter having to do in any aspect
with this RFP, other than as provided herein. Any and all contacts with such persons associated with
DCSD shall be in writing, in appropriate circumstances or cases, as directed by the contact person.
Furthermore, no employee, officer, or agent of the DeKalb County Board of Education or DCSD may
participate in the selection, award or administration of a contract if he or she has a real or apparent
conflict of interest.
Board Member Communication with Prospective Vendors
Vendors shall not contact Board members individually for the purpose of soliciting a purchase or
contract between the time a request for proposal is formally released and a recommendation is made
by the administration to the Board. If a vendor violates this prohibition during this timeframe,
consideration for the vendor for award shall be invalidated. Board members shall be notified of possible
violations and actions taken.
K. QUESTIONS AND ANSWERS
It is intended that this RFP be adequate for any offeror to respond to DCSD’s requirements. However,
should offerors have questions all questions shall be submitted electronically to: Carla L. Smith at
solicitationquestions@dekalbschoolsga.org. Questions submitted to any other mail box, voice mail or
e-mail address will not be considered for response. The deadline to submit questions is Monday,
November 14, 2022. Questions received after the deadline will not be considered. All questions
received by 12 Noon, on November 14, 2022 will be answered in writing and both the questions and
answers will be posted to the following website on or before Friday, November 18, 2022 at 4:30 PM.
https://dekalbschoolsga.ionwave.net/Login.aspx .
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 15
PART II
GENERAL REQUIREMENTS
A. OFFEROR PERFORMANCE
The successful offeror is required to perform and fulfill all the undertakings, covenants, terms,
conditions, and agreements of this RFP document and any negotiated contract(s). Specifications
contained herein and in the successful response will become contractual obligations, if an award
ensues. Failure of the offeror to fully perform these obligations may result in cancellation of the award
and contract.
DCSD will look to the offeror and his/her identified personnel to coordinate and deliver the services
described in this RFP. The services shall not be delegated to subofferors or assigned to any third party.
B. NEWS RELEASE
Any news release or publicity pertaining to any phase of this project must be cleared through the DCSD
Chief Communications and Community Relations Officer.
C. NON-DISCRIMINATION
DCSD does not discriminate on the basis of race, color, religion, sex, national origin, age, or disability
in any of its employment practices, education programs, services or activities.
DCSD supports an open, fair, and impartial free-market system which maximizes competition and
seeks to include all responsible businesses and to provide ample opportunities for business growth and
development. Minority businesses are encouraged and given the opportunity to bid on various projects;
however, all responses will be evaluated on the same criteria. It is not the intention or desire of DCSD
to restrict or impede competition, nor to increase the cost of the work.
D. DRUG-FREE WORKPLACE
By submission of a response to this RFP, the offeror certifies that he/she and his/her employees shall
not engage in the unlawful manufacture, sale, distribution, dispensation, possession, or use of
controlled substance or drugs during the performance of the contract.
E. SMOKE-FREE WORKPLACE
By submission of a response to this RFP, the offeror certifies that he/she and his/her employees shall
not use tobacco products on DCSD property at any time during the performance of this contract.
F. COSTS INCURRED
DCSD is not liable for any costs incurred by an offeror in preparing and/or submitting a response to this
RFP or for any interview if requested. Any and all costs incurred by the offeror in preparing and/or
submitting a response to this RFP and interviewing with DCSD (if requested) shall be the sole
responsibility of the offeror and shall not be reimbursed by DCSD.
There is no guarantee of any offeror receiving an award as a result of submitting a response to this
RFP.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 16
G. INSURANCE
The DCSD Risk Manager sets insurance and indemnification requirements for each Solicitation.
Certificate of Insurance / Accord Form is required with solicitation submittal. Provision of
Certificate of Insurance is a mandatory requirement. Proposals submitted with certificates of
insurance will be considered conditionally responsive to the insurance and indemnification
requirement. Final award of this RFP will be contingent upon receipt within six (6) business days of
request for insurance documentation complete with the following requirements and fully acceptable
to the DCSD Risk Manager. No work will commence / no purchases will be made without the written
statement of approval of insurance coverage from the DCSD Risk Manager. In the event the
awarded offeror cannot produce insurance coverage acceptable to the Risk Manager within the
time provided, DCSD reserves the right to award this solicitation to the first runner-up.
(1) The successful Offeror shall procure and maintain throughout the term of this agreement a
policy or policies of insurance providing coverage as set forth below that shall protect the offeror
and the Indemnitees (as defined in Part II, Section I of this RFP) from any claims for bodily injury,
property damage, or personal injury which may arise out of offeror’s operations under this
agreement. The foregoing policies shall be obtained from insurance companies approved to do
business in the State of Georgia and companies acceptable to DCSD. Offeror shall procure the
insurance policy(ies) at the offeror’s own expense and shall furnish to DCSD a certificate of
insurance containing the following:
(a) Name and address of authorized agent;
(b) Name and address of insured;
(c) Name of insurance company;
(d) Description of coverage in standard terminology;
(e) Policy period;
(f) Policy Number;
(g) Limits of liability;
(h) Name and address of certificate holder;
(i) Acknowledgment to the DCSD of notice of expiration or cancellation;
(j) Signature of authorized agent;
(k) Telephone number of authorized agent; and
(l) Details of policy exclusions applicable to this agreement in comments section of insurance
certificate.
All certificates evidencing primary and excess layers shall be renewed and kept current and up to
date on an annual basis.
(2) Offeror is required to maintain the following insurance coverage during the term of this
agreement:
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 17
(a) Workers Compensation Insurance in the amounts of the statutory limits established by the
General Assembly of the State of Georgia. Offeror shall have the ability to self-insure its required
workers compensation coverage if offeror is an approved self-insurer in the State of Georgia.
(b) Comprehensive General Liability Policy, or equivalent coverage, to include products and
completed operations liability and contractual liability. The Comprehensive General Liability Policy
shall have dollar limits sufficient to insure that there is no gap in coverage between this policy and
any excess or Commercial Umbrella Policy described below.
(c) Comprehensive Auto Policy to include but not be limited to liability coverage on any owned,
non-owned and hired vehicle used by offeror or offeror’s personnel in the performance of
this agreement. The Comprehensive Automobile Policy shall have dollar limits sufficient
to insure that there is no gap in coverage between this policy and the excess or
Commercial Umbrella Policy required under this agreement.
(d) Commercial Umbrella or Excess Liability Policy, which must provide the same or broader
coverage than those provided for in the above Comprehensive General Liability and Business Auto
Policies. Policy limits for the Commercial Umbrella or Excess Liability Policy shall have an annual
aggregate limit not less than $2,000,000.
(e) Under all coverage and certificates required hereunder, policies shall or be endorsed to
include the following terms and conditions:
(i) All policies and coverage shall be on an “occurrence” not “claims made” basis.
(ii) The foregoing policies shall contain a provision that coverage afforded under the policies
will not be canceled, or not renewed, allowed to lapse for any reason until at least sixty
(60) days prior written notice has been given to DCSD.
(iii) Shall waive all right of subrogation against Indemnitees (as defined in Part II, Section
I of this RFP) for losses arising out of this agreement.
(iv) A severability of interest or cross liability clause or endorsement applies to commercial
general liability and excess liability policies.
(v) Certificates of Insurance showing such coverage to be in force shall be filed with
DCSD prior to commencement or continuation of any work under this agreement.
(vi) All such coverage shall remain in full force and effect during the term and any renewal
thereof.
(f) Under coverage and certificates required under Sections 2(a), 2(b), (c), and (d) above,
policies shall be endorsed to include the following terms and conditions:
(i) Minimum limits of $1,000,000 per occurrence $2,000,000 in the annual aggregate.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 18
Primary limits of coverage in the amount of $1,000,000 per occurrence must be with insurers
approved to conduct business in the State of Georgia. Excess or umbrella liability insurance
may be placed with any insurer submitted by offeror, including captive or self-insured programs,
with the prior written approval of DCSD.
(ii) Contractual liability coverage, specifically referencing this agreement and its
Indemnity, applies to liability assumed by the named insured.
(iii) Shall include Indemnitees as additional insured.
(iv) Shall waive all right of subrogation against Indemnitees (as defined in Part II, Section
I of this RFP) for losses arising out of this agreement.
(v) A severability of interest or cross liability clause or endorsement applies to commercial
general liability and excess liability policies.
(vi) Shall be primary and not excess to any other coverage provided by or available to the
Indemnitees (as defined in Part II, Section H of this RFP).
(g) Offeror shall require any and all subofferors performing work under this agreement to carry
insurance of the types and with limits of liability as offeror shall deem appropriate and adequate for
the work being performed. However, the obligations of the offeror to the Indemnitees assumed in
Sections of Indemnification, and Insurance shall not be reduced or diminished by the standards set
for the subofferors. Further, offeror agrees that their obligations to indemnify and insure the
Indemnitees shall pertain to all losses arising out of the subofferor’s acts or negligence in the same
manner and to the same extent as if committed by the offeror. Offeror shall obtain and make
available for inspection by DCSD, current certificates of insurance evidencing insurance coverage
by such subofferors.
H. INDEMNIFICATION
The successful offeror shall indemnify, defend, and hold harmless the DeKalb County School Board,
the DeKalb County School District, DCSD, and their officials, officers, employees, agents, volunteers,
and assigns (all of whom may collectively be referred to as "Indemnitees" throughout this RFP), from
any and all claims, demands, suits, actions, legal or administrative proceedings, losses, liabilities, costs,
interest, and damages of every kind and description, including any attorneys’ fees and/or litigation and
investigative expenses, for bodily injury, personal injury, (including but not limited to offeror’s
employees), or loss or destruction of property (including loss of use, damage or destruction of DCSD
owned property) to the extent that any such claim or suit was caused by, arose out of, or contributed
to, in whole or in part, by reason of any act, omission, professional error, fault, mistake, or negligence
whether active, passive or imputed, of the offeror its employees, agents, representatives, or their
employees, agents, or representatives in connection with or incidental to offeror’s performance of the
agreed-upon services regardless of whether such liability, claim, damage, loss, cost or expense is
caused in part by an Indemnitee.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 19
The successful offeror shall also indemnify, defend, and hold harmless the Indemnitees from any and
all costs, expenses, claims, demands, rights, liabilities and causes of action inuring to offeror from
events over which the Indemnitees exercise no control, such as Acts of God, strikes or government
restrictions.
Offeror's obligation to indemnify any Indemnitee shall survive the completion, expiration, or termination
of offeror’s agreed-upon services for any reason.
I. ILLEGAL IMMIGRATION REFORM AND ENFORCEMENT ACT OF 2011 (MANDATORY
REQUIREMENT)
The Illegal Immigration Reform and Enforcement Act of 2011 applies to and is a requirement for all
DeKalb County School District solicitations for physical performance of services (i.e. public works
contracts).
Offerors must complete and/or have their subcontractors complete the following forms:
1. Immigration and Security Certification
2. Offeror E-Verify Affidavit
3. Contractor Affidavit (Contractor Only)
4. Subcontractor Affidavit (Subcontractor Only); and
5. Sub-Subcontractor Affidavit (Sub-Subcontractor Only)
The Immigration and Security Certification, the Offeror E-Verify Affidavit, the Contractor Affidavit, the
Subcontractor Affidavit and the Sub-Subcontractor Affidavit are found on pages 39-44 of this solicitation
document. The Immigration and Security Certification, the Offeror E-Verify Affidavit, the Contractor
Affidavit, Subcontractor Affidavit and the Sub-Subcontractor Affidavit must be completed, notarized and
submitted with your proposal.
I acknowledge the Illegal Immigration Reform and Enforcement Act of 2011 requirements for service
providers and confirm by my signature below that the Immigration and Security Certification, the
Contractor Affidavit, the Subcontractor Affidavit and the Sub-Subcontractor Affidavit are each
completed, notarized and made a part of this solicitation response package. I also acknowledge that
all items or services furnished to DCSD must comply with applicable federal and state immigration laws,
and regulation.
X
______Please check here if the Illegal Immigration and Reform Act of 2011 does not apply to your
solicitation, because it is one for items, commodities, or products. If this does not apply to any portion
of the solicitation, then the Offeror is not required to complete the Contractor Affidavit, the Subcontractor
Affidavit and the Sub-Subcontractor Affidavit found on pages 42-44. Please be advised that pages
39-41 must still be completed.Metro Ambulance Services, Inc
DBA American Medical Response
Signature of Engaging Official: __________________________________________ 11/29/2022
Date: _____________
(Company Name / Certifying Official Signature)
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 20
J. INTERVIEWS
DCSD reserves the right to require offerors to participate in one or more interviews with DCSD board
members and/or staff. Offerors must be prepared to discuss the salient points of their proposal within
two (2) normal working days of being asked to participate in interviews. There are to be no
presentations, individually or collectively, without such invitation.
Offerors who are invited to one or more interviews will be required to provide a one (1) hour virtual
presentation/demonstration of requested services.
K. CONTRACT TERMS
In the event DCSD determines that outsourcing these services are in its best interest, with the approval
of the DeKalb County Board of Education, the successful offeror will be notified in writing. A contract
confirming firm fixed price and other terms shall be signed by the parties. Services are to begin on or
about the Winter of 2022. The initial contract duration shall be approximately one year from the date
of execution. The contract may/may not contain up to four (4) one (1) year renewal
options contingent upon DCSD’s offer of such renewal, the successful offeror’s acceptance and the
approval of the DeKalb County Board of Education to extend the contract. The contract is subject to
the approval of the DeKalb County Board of Education and to fiscal year funding limitations. The
contract price must be held firm for the entire term of the contract. DCSD reserves the right to terminate
any resulting contract for convenience. In the event of contract termination by DCSD, the DCSD will
be responsible only for those services and deliverables that have been received and accepted. Any
cancellation for convenience by DCSD shall be effective three (3) business days after receipt of the
Notice of Cancellation for convenience from DCSD by the offeror. Non-performance of contract terms
shall give sufficient cause for DCSD to cancel the contract. Non-performance shall be construed to
include, but is not limited to, failure of the offeror to deliver equipment or perform services in the time
specified or in the manner required.
A contract is attached which includes all of the terms and conditions that the offeror must affirm and
comply. Refer to Attachment J, Standard Form Agreement for Non-Capital Professional
Services. Please review DCSD’s attached contract terms and conditions prior to submitting a response
to this RFP. Offerors should plan on the contract terms and conditions attached to this RFP being
included in any award as a result of this RFP. Therefore, all costs associated with complying with these
requirements should be included in any pricing quoted by the offeror.
By submitting a proposal, offeror acknowledges its acceptance of the RFP specifications and the
contract terms and conditions without change except as otherwise expressly stated in the submitted
proposal. If an offeror takes exception to a contract term or provision, the offeror must state the reason
for the exception and state the specific contract language it proposes to include in place of the
provision. Any exceptions to the contract must be submitted as an attachment to the offeror’s
response. Proposed exceptions must not conflict with or attempt to preempt mandatory requirements
specified in the RFP.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 21
L. PERMITS AND APPLICABLE LAWS
Offerors shall at their own expense obtain all necessary permits, certifications, and licenses and shall
comply with all applicable local, state, and federal laws, ordinances, rules, and regulations necessary
to the full execution of the requirements stated herein. If Offeror holds a professional certification which
is licensed by the state of Georgia, Offeror shall submit a copy of their valid professional
license. Offerors shall maintain all such permits, licenses, certifications, and compliances in a current
status throughout the course of the contract. Offerors shall submit copies of permits, licenses, and
certifications evidencing proof of the aforementioned immediately upon request of DCSD. Offerors
shall be in compliance with registration with the Georgia Secretary of State’s office as applicable.
M. INFRINGEMENT
Offeror shall fully indemnify Indemnitees against any claims of infringement of any patent, copyright,
trade secret, trademark, or other intellectual property rights related to the offeror’s response to this RFP
or services performed upon contract award. Offeror’s obligation to indemnify any Indemnitee shall
survive the completion, expiration, or termination of offeror’s agreed-upon services for any reason.
N. OWNERSHIP RIGHTS
DCSD shall retain ownership rights to the contents of all documents, supporting literature, and data
submitted by offerors to this RFP.
O. NON-COLLUSION
Offerors shall fully certify that they, as individuals or as officials of a business entity, have not entered
into any agreement, participated in collusion, or otherwise taken any action in restraint of free and
competitive responses to this RFP. Further, offerors guarantee that their response is not made in
conjunction with or on behalf of another party and that they have not been directly or indirectly induced
in any manner or taken any action to result in a restriction of trade or in an unfair advantage. Offeror
must sign below acknowledging the above statement.
Metro Ambulance Services, Inc DBA
American Medical Response
Signature of Engaging Official: ___________________________________________ Date: _11/29/2022_
(Company Name / Certifying Official Signature)
P. CONFLICT OF INTEREST
Offeror shall use its best efforts to disclose with their proposal the name of any officer, director, or agent
who also is a DCSD employee, agent, representative, contractor, immediate family member (spouse,
child, sibling, or parent or the spouse of a child, sibling or parent) or DeKalb County Board of Education
member. Offerors shall also disclose the name of any DCSD employee, agent, representative,
contractor, immediate family member or board member who owns, directly or indirectly, an interest in
five percent or more in the Offeror’s company or any of its branches. In the event the Offeror was aware
of a conflict of interest prior to the award of the contract and did not disclose the conflict DCSD may, at
its discretion, terminate the contract for default. The Offeror further agrees that, if after award, a conflict
of interest is discovered, an immediate and full disclosure in writing must be made to the DCSD
Purchasing Department which must include a description of the action which the Offeror has taken or
proposes to take to avoid or mitigate such conflicts. If a conflict of interest is determined to exist, DCSD
may, at its discretion, cancel the contract. Offerors shall certify that their response to this RFP is
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 22
impartial, at arms-length, and free of any conflict of interest at this time, unfair advantage, or personal
benefit to any DCSD official.
Offeror must sign below acknowledging the above statement.
Metro Ambulance Services, Inc DBA
Signature of Engaging Official:American Medical Response
___________________________________________ 11/29/2022
Date: _____________
(Company Name / Certifying Official Signature)
Q. FINANCIAL STABILITY
1. Offerors shall provide a copy of their company’s financial statements for the previous two (2)
years – for example 2020 and 2021.
2. Indicate here if your company is publicly traded or not publicly traded:
My company is publicly traded. _____/
My company is not publicly traded. __X__/
3. If your company is a publicly traded company, provide a copy of your company’s annual report for
the previous two (2) years – for example 2020 and 2021.
4. List all civil and criminal proceedings your company has been the subject of, or named a party in,
and provide the outcome of those proceedings. This list should include any lawsuits, administrative
actions or litigation to which your company is currently a party or has been a party. Please explain
the basis for all claims, your response to those claims and state whether a settlement was reached
or a judgment entered.
5. State whether your company, or any affiliate currently or previously associated with your company,
has ever filed a petition in bankruptcy, taken any actions with respect to insolvency, reorganization,
receivership, moratoriums or assignment for the benefit of creditors, or otherwise sought relief from
creditors.
6. State whether your company was the subject of any order, judgment or decree not subsequently
reversed, suspended or vacated by any court permanently enjoining your company from engaging
in any type of business practice.
R. NO OBLIGATION/NO CONTRACT GUARANTEED
This RFP does not commit DCSD to contract with any offeror to this RFP. There is no guarantee of any
offeror receiving an award or contract as a result of submitting a response to this RFP.
Offeror must sign below acknowledging the above statement.
Metro Ambulance Services, Inc DBA
American Medical Response
Signature of Engaging Official:_____________________________ 11/29/2022
Date: _____________
(Company Name / Certifying Official Signature)
S. CONFIDENTIALITY AND NON-DISCLOSURE (MANDATORY REQUIREMENT)
Information made available to offerors by DCSD shall be used only for purposes related to responding
to this RFP and shall not be used for any other purpose without the express written permission of
DCSD.
Offerors to this RFP unequivocally agree to assume responsibility for protecting and safeguarding the
confidentiality of DCSD records that are not public information. Such information may include, but is
not limited to student and human resource file content.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 23
PART III
SCOPE OF WORK AND REQUIREMENTS
The DeKalb County School District (DCSD) is seeking professional services from highly qualified and
capable ambulance service providers for services during athletic events and graduation events. Basic
life support equipment and services shall be as required by the State of Georgia Department of Public
Health Rules and Regulations 511-9-2 Emergency Medical Services for ground ambulance services.
Rules and Regulations of the State of Georgia Department 511 Rules of Georgia Department of Public
Health are attached as Appendix I to this RFP.
The ambulance company will be required to be present throughout each entire event.
DCSD reserves the right to make multiple awards.
A. PURPOSE
DCSD desires to contract with a minimum of three (3) qualified ambulance companies to provide basic
life support (BLS) ambulance services during athletic events and graduation events for the DeKalb
County School District.
The ambulance company will be required to be present throughout each entire event; and ambulance
shall be a basic life support ambulance with all the necessary and required basic life support equipment
required by the State of Georgia Department of Public Health Rules and Regulations 511-9-2
Emergency Medical Services for ground ambulance services.
B. SCOPE OF SERVICES
DCSD needs ambulance service for the Athletic Fall and Spring Sporting seasons. Ambulance services
will be required for all high school varsity, junior varsity, and middle school football games; varsity,
junior varsity and middle school track and field; cross country, lacrosse, soccer games and high school
graduations. Refer to Attachment A, Estimated Number of Games and Graduations (page 32).
All events will be held in DeKalb County School District venues, as noted in Attachment B, List of
Venues - Athletic Events and Graduation Events page 33).
C. SPECIFICATIONS
1. The ambulance company will be required to be present throughout each entire event; and
ambulance shall be a basic life support ambulance with all the necessary and required basic
life support equipment required by the State of Georgia Department of Public Health Rules
and Regulations 511-9-2 Emergency Medical Services for ground ambulance services.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 24
2. Ambulance company must be licensed in accordance with Rule 511-9-2-.07 of the
Department 511 Rules of Georgia Department of Public Health for ground ambulance
services.
3. Provide ambulance and two (2) certified EMTs at all high school varsity, junior varsity, and
middle school football games; varsity, junior varsity and middle school track and field; cross
country, lacrosse, soccer games and high school graduations.
4. Ambulance and crew will be required to be at the site 15 minutes before event time and stay
15 minutes after the end of the event.
5. Both crew members shall be licensed and or certified according to State of Georgia
Department of Public Health Rules 511-9-2-.12 Emergency Medical Services Personnel
guidelines.
6. Medical personnel will wear appropriate uniform with name badge clearly identifying medical
response personnel.
7. EMTs will remain at the stadium field and with the vehicle at all times, except when
responding to an emergency relating to the services required by this contract.
8. EMTs must respond to any and all emergencies occurring at said event when requested to
do so by school administrators, coach, team physician, school trainer or stadium security.
9. Ambulance must be in position at the stadium upon start of the game. Upon arrival and prior
to departure, the driver shall report to the DeKalb County Stadium Manager.
10. Ambulance shall be a Basic Life Support (BLS) ambulance with all the necessary and
required basic life support equipment required by the Department 511 Rules of Georgia for
ground ambulance services.
11. Ambulance will carry appropriate splinting and hemorrhage control equipment including
pertinent supplies.
12. Ambulance will have appropriate communication devices including handheld portable radio
or cellular phones.
13. Coverage will be guaranteed so that at all events continuous coverage will be provided on
site with no break in service.
14. In the event an emergency takes place requiring transportation from the field, another on-
duty ambulance will be dispatched immediately. This process will ensure continuous medical
care and stand by service.
15. Payment for transporting anyone to the emergency room will be the responsibility of the
DCSD. The ambulance company must agree to accept payment from DCSD.
16. Prior to leaving, EMTs must check with each head coach on the field or the School Resource
Officer (SRO) assigned to the stadium, following the event to ascertain if there are any
injuries requiring attention. If so, appropriate procedures will be taken by the EMTs.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 25
D. COMPANY PROFILE
Offerors to this Request for Proposal are required to demonstrate, and include with their submissions
to this RFP, a full and complete company profile, to include, but not be limited to: the date of
establishment, mission statement, type and confirmation of company’s legal entity form, company’s
organizational structure/chart, principals’ names and titles, company size in relation to industry, number
of employees, company history, financial position, and all relevant current and past experience on
similar projects in comparable K-12 school districts and references for those projects. The offeror
should also include the educational background for staff that will be assigned to this project, including
the company’s overall experience in providing the requested services within this solicitation.
E. BACKGROUND CHECK
A criminal background check must be performed on all contractors, consultants, subcontractors,
volunteers and vendors (hereinafter jointly referred to as "Individuals") who provide services on DCSD
premises, supervise services on DCSD premises, or has contact with students. These Individuals shall
undergo the same criminal background check, within the last 365 days, as required by DCSD
employees. Such background checks will be performed by DCSD at the expense of the Individual at a
cost of $45.00 per individual. Additionally, any charges against the Individual, may be deemed
unacceptable in DCSD’s sole discretion regardless of whether dismissed, expunged, sealed, removed
from the record, treated as a “first offender” or dead docketed. Upon receipt and evaluation of DCSD’s
background check results, DCSD may demand that the Individual have no contact with DCSD students
or parents, or provide services to DCSD premises. Any failure of the contractor to obtain a criminal
records background check through DCSD, as stated herein, may result in termination of any resulting
contract between contractor and DCSD.
F. REFERENCES (MANDATORY REQUIREMENT)
Offeror must provide the names and contact phone numbers of at least three (3) current clients,
preferably clients comparable to DCSD, for whom the offeror is providing or has provided services as
defined within the scope of work. Refer to Attachment F – Offeror’s Reference Form, (page 34).
References will be contacted.
G. BROCHURES, CATALOGS, MANUALS, WEBSITES, LITERATURE
In addition to the formal response to this RFP, all offerors are encouraged to submit brochures,
catalogs, manuals, website materials, industry literature, DVD’s and any other marketing and
informational media which will support and enhance their submission value.
H. ADDED VALUE
Offerors are encouraged to describe in detail all added value or additional services or benefits available
and offered at no cost to DCSD in their RFP responses. Attach and label as “ADDED VALUE.”
I. AUTHORIZATION TO SELL
Offerors responding to this RFP must provide a Certificate of Authorization that authorizes offeror to
sell the manufacturer’s equipment, if applicable.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 26
J. EVALUATION CRITERIA
DCSD advertises this RFP as an opportunity for interested and qualified firms specializing in providing
services to submit responses consistent with the scope of work stated herein. Offerors to this RFP are
encouraged to submit their most comprehensive, innovative and creative proposals for DCSD.
DCSD may, at its sole discretion, select or reject all or portions of the service(s) proposed from
responsive and responsible offerors. As a part of the evaluation process, DCSD may find it necessary
to evaluate the addition or deletion of components of an offeror’s proposal in order to make equivalent
comparisons to other proposals. DCSD will select the offeror whose proposal DCSD determines best
meets the needs of DCSD, based on the requirements and evaluation criteria set forth herein.
The determination of the successful proposal will be based upon information supplied by the offeror in
the RFP response and upon other information that will be obtained by DCSD as it deems necessary.
Proposal conformance to RFP instructions, terms, conditions, and requirements is critical to offeror
responsiveness.
The lowest-cost proposal submitted may not necessarily be determined to be the most responsive
and responsible proposal when all factors have been considered. However, the quoted price is an
important factor in the determination of the selected proposal.
All responsive offerors will be carefully reviewed and evaluated for responsibility, capacity, business
strength, qualifications, expertise, demonstrated experience in Bus AC Retrofits for large urban public
school districts and highest and best value to DCSD with consideration to quality, approach,
timeliness, dedicated personnel, and added value (if any). Proposal conformance to RFP instructions,
terms, conditions, and requirements is critical to offeror responsiveness.
An Evaluation Committee will evaluate the proposals using the following criteria:
Relative Weight Evaluation Criteria
30% References
30% Credentials (are EMT’s certified?)
20% Project Cost
20% Availability (can the ambulance service company cover all
events?)
100% Total
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 27
K. PAYMENTS
Offerors must provide a firm fixed price for the entire project. By submitting a response to this Request
for Professional Services, the successful offeror agrees that if the offeror does not complete the project
on a mutually agreed terms, at DCSD’s sole election, DCSD may terminate any remaining obligation
for performance under the agreement or contract; at DCSD’s sole election, any agreement or contract
will be terminated without recourse. DCSD, at its sole option, will have the right to seek a new offeror
to perform the required services.
L. TRANSITION PLAN
Transition on Commencement of Contract
The awarded offeror shall assume full services in accordance with the award of the RFP. The awarded
offeror shall coordinate and cooperate with DCSD’s existing provider(s) to ensure a smooth and orderly
transition with uninterrupted services.
Transition and Continuity of Service upon Expiration of Contract. Continuity of services is
necessary to DCSD. The awarded offeror agrees to this philosophy and upon expiration of contract,
agrees to:
• Exercise best efforts and cooperation for an orderly and efficient transition to another provider or to
DCSD.
• Negotiate a plan in good faith with successor to determine the nature and extent of the phase-in,
phase-out services required. The plan shall specify a date for services described in the plan and
shall be subject to approval by DCSD. The existing service providers shall provide sufficient
experienced personnel during the phase-in and phase-out periods to ensure that the imperious
services in the contract are maintained at the required level of need and proficiency.
• All DCSD property (including but not limited to, students and DCSD records, parts, equipment,
facilities, keys and materials) shall be returned to DCSD upon expiration of contract.
• Offeror shall include in their response any DCSD or any subsequent contractor requirements, if
offeror is awarded this contract and does not retain this contract upon its expiration.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 28
M. REQUIRED CONTENT / DOCUMENT CHECKLIST
IMPORTANT NOTICE: Failure to provide the information and/or documentation required in
this solicitation may cause the submission to be declared non-responsive and rejected.
Refer to Part I, Section G, Page 11, for additional information on the format and submission of proposals.
Offerors are required to submit one (1) original, one (1) duplicate copy and one (1) electronic copy (flash
drive) of the proposal of their response. Responses must be submitted on 8 ½” x 11” single-sided stock.
All RFP submissions must include the following items and attachments.
The Request for Proposals document, RFP 23-544 Ambulance Services, MUST BE the first
document in the submission; this document consists of 66 pages and is located at
https://dekalbschoolsga.ionwave.net/Login.aspx1
Table of Contents for your submission
• Addenda – Each individual Addendum must be printed, signed and inserted immediately
following the Table of Contents (Mandatory Requirement)
• Certificate of Insurance (Mandatory Requirement)
• Company Financial Statements and Company Annual Reports
• Attachment C – Ambulance Service Questionnaire (Mandatory Requirement)
• Attachment D – Cost Proposal Form (Mandatory)
• Attachment E – Critical Paragraphs (Mandatory Requirement)
• Attachment F – Offeror’s Client Reference Form (Mandatory Requirement)
• Attachment G - Statement of Confidentiality and Non-Disclosure (Mandatory Requirement)
• Attachment H – Suspension and Debarment Certification (Mandatory Requirement)
• Attachment I – Immigration & Security Certification (Mandatory Requirement)
• Attachment K – Signature Page (Mandatory Requirement)
• Company Profile
• Brochures, Catalogs, Manuals, Websites, Literature, DVDs and other marketing media
• Project Scope of Work
• Added Value
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 29
Attachment A
RFP 23-544
Ambulance Services
ESTIMATED NUMBER OF GAMES AND GRADUATIONS
Estimated Estimated Total
Event Number of Events Hours Schedule
Varsity Football Games 200 300 Played on Thursday & Friday
evening at five (5) separate
venues.
Junior Varsity Football 130 120 Played on Monday evening at five
Games (5) separate venues
Middle School Football Played on Saturday mornings at
Games 115 125 five (5) separate venues
Varsity, Junior Varsity, Meets are held on Tuesday,
and Middle School Wednesday, Thursday afternoons
Track 7 140 and Saturday mornings. Middle
School at three (3) separate
venues. Varsity and Junior
Varsity at one (1) venue.
Soccer Games 300 1800 Played on Monday – Thursday
afternoon at five (5) separate
venues.
Lacrosse Games 100 300 Played on Monday – Thursday
afternoons at five (5) separate
venues.
High School Graduations are held on Monday
Graduations 20 25 – Friday at one (1) venue.
Estimated Totals 872 2680
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
RFP 23-544 AMBULANCE SERVICES PAGE 30
ATTACHMENT B
RFP 23-544
Ambulance Services
List of Venues
Athletic Events and Graduation Events
Adams Stadium
2415 North Druid Hills Road
Atlanta, Georgia 30329
Avondale Stadium
1192 Clarendon Road
Avondale Estates, Georgia 30002
James R. Hallford Stadium
3789 Memorial College Avenue
Clarkston, Georgia 30021
North DeKalb Stadium
3688 Chamblee-Dunwoody Road
Chamblee, Georgia 30341
William “Buck” Godfrey Stadium
2817 Clifton Springs Road
Decatur, Georgia 30034
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
ADDENDA
1701 MOUNTAIN INDUSTRIAL BOULEVARD, STONE MOUNTAIN, GA 30083
https://dekalbschoolsga.ionwave.net/Login.aspx
November 16, 2022
TO: ALL OFFERORS UNDER RFP 23-544, AMBULANCE SERVICES
FROM: Procurement Department, DeKalb County School District
ADDENDUM NO. 1
RFP 23-544, Ambulance Services, is hereby amended as follows:
1. Part III, Scope of Work and Requirements, Paragraph C.3, Specifications. Add the
following sentence:
In the event of the need to transport, one (1) certified EMT and one (1) Paramedic must be
provided.
2. All other conditions remain in full force and effect.
3. If a response has been submitted and anything in this Addendum causes the offeror to
change the item offered or to increase or decrease the bid price, the new price and/or
change(s) will be inserted below.
______________________________________________________________________
4. All offerors under RFP 23-544, Ambulance Services, are kindly requested to acknowledge
receipt of this Addendum by signing the page below and returning with your proposal.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
Addendum No. 1 - RFP 23-544, Ambulance Services
1
RFP 23-544 AMBULANCE SERVICES PAGE 1
QUESTIONS & ANSWERS
RFP 23-544 Ambulance Services
Today’s Date: November 16, 2022
RESPONSES MUST BE RECEIVED IN THE PURCHASING DEPARTMENT:
- PROPOSAL DEADLINE TIME - Before 2:00 PM, Tuesday, November 29, 2022
- VIRTUAL PUBLIC ACKNOWLEDGEMENT - At 2:00 PM, Tuesday, November 29, 2022
RESPONSES TO BE ACKNOWLEDGED: Beginning 3:00 PM EST, Tuesday, November 29, 2022
Via Microsoft Teams
DeKalb County School District
Purchasing Department
1701 Mountain Industrial Boulevard
Stone Mountain, GA 30083
Question #1: The RFP calls for 2EMT’s. In order to transport you would need one Paramedic.
Answer #1: Refer to Addendum No. 1.
Question #2: Are the forms online? Or where do we get them?
Answer #2: The RFP (with forms) is online at https://dekalbschoolsga.ionwave.net/Login.aspx. The RFP is also available on
The Georgia Procurement Registry.
Question #3: Can we bid part of this or do we have to bid it all?
Answer #3: DCSD accepts all responses.
Metro Ambulance Services, Inc DBA
American Medical Response 2
Chris Valentin | Regional Director of Operations
DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 03/31/2022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If
Holder Identifier :
SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this
certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME:
Aon Risk Services Central, Inc. PHONE FAX
(A/C. No. Ext):
(866) 283-7122 (800) 363-0105
Philadelphia PA Office (A/C. No.):
100 North 18th Street E-MAIL
15th Floor ADDRESS:
Philadelphia PA 19103
USA INSURER(S) AFFORDING COVERAGE NAIC #
INSURED INSURER A: ACE American Insurance Company 22667
American Medical Response INSURER B: Indemnity Insurance Co of North America 43575
6363 Fiddlers Green
14th Floor INSURER C: ACE Fire Underwriters Insurance Co. 20702
Greenwood Village CO 80111 USA INSURER D: Lloyd's Syndicate No. 2623 AA1128623
INSURER E: Great American Insurance Company of NY 22136
INSURER F:
COVERAGES CERTIFICATE NUMBER: 570086743329 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
A X COMMERCIAL GENERAL LIABILITY XSLG72486377 03/31/2022 03/31/2023 EACH OCCURRENCE $2,750,000
SIR applies per policy terms & conditions DAMAGE TO RENTED
X CLAIMS-MADE X OCCUR $100,000
PREMISES (Ea occurrence)
MED EXP (Any one person)
PERSONAL & ADV INJURY $2,750,000
570086743329
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000
PRO-
X POLICY LOC PRODUCTS - COMP/OP AGG $2,750,000
JECT
OTHER: SIR/Deductible $250,000
A AUTOMOBILE LIABILITY ISAH25562434 03/31/2022 03/31/2023 COMBINED SINGLE LIMIT
$10,000,000
(Ea accident)
BODILY INJURY ( Per person)
Certificate No :
X ANY AUTO
SCHEDULED BODILY INJURY (Per accident)
X OWNED
AUTOS
AUTOS ONLY PROPERTY DAMAGE
HIRED AUTOS NON-OWNED
(Per accident)
ONLY AUTOS ONLY
E
UMBRELLA LIAB X OCCUR EXC4051353 03/31/2022 03/31/2023 EACH OCCURRENCE $10,000,000
X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000
DED RETENTION
B WORKERS COMPENSATION AND WLRC68929280 03/31/2022 03/31/2023 X PER STATUTE OTH
EMPLOYERS' LIABILITY -
A Y/N WLRC68920243 03/31/2022 03/31/2023
ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT $1,000,000
C
OFFICER/MEMBER EXCLUDED?
N N/A SCFC68920322 03/31/2022 03/31/2023
(Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000
D E&O-PL-XS W1B173220701 03/31/2022 03/31/2023 Per Claim $10,000,000
7777777707070700077761616045571110766524236026555107773136543725022072660457147211220761717332255122307607351123760003072441146433257110706310662320155207226330241071322076727242035772000777777707000707007
7777777707070700073525677115456000722105413572006007661114570623136074222377060230150742732265206651107033732317033104070233372420721000702333734217210007133236353162001077756163351765540777777707000707007
Professional Liability SIR $3,000,000
SIR applies per policy terms & conditions
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Evidence of insurance.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
POLICY PROVISIONS.
American Medical Response Inc. AUTHORIZED REPRESENTATIVE
6363 S. Fiddlers Green Circle
14th Floor
Greenwood Village CO 80111 USA
©1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
3
AGENCY CUSTOMER ID: 570000073826
LOC #:
ADDITIONAL REMARKS SCHEDULE Page _ of _
AGENCY NAMED INSURED
Aon Risk Services Central, Inc. American Medical Response
POLICY NUMBER
See Certificate Number: 570086743329
CARRIER NAIC CODE
See Certificate Number: 570086743329 EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER
INSURER
INSURER
INSURER
If a policy below does not include limit information, refer to the corresponding policy on the ACORD
ADDITIONAL POLICIES
certificate form for policy limits.
POLICY POLICY
INSR ADDL SUBR POLICY NUMBER LIMITS
EFFECTIVE EXPIRATION
LTR TYPE OF INSURANCE INSD WVD DATE DATE
(MM/DD/YYYY) (MM/DD/YYYY)
WORKERS COMPENSATION
A N/A WCUC6892036A 03/31/2022 03/31/2023
OH-SIR
SIR applies per policy terms & conditions
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
4
KPMG LLP
Suite 800
1225 17th Street
Denver, CO 80202-5598
Independent Auditors’ Report
Board of Directors
AMR HoldCo Inc.:
Opinion
AL
We have audited the consolidated financial statements of AMR HoldCo Inc. and its subsidiaries (the Company),
which comprise the consolidated balance sheets as of December 31, 2021 and 2020, and the related
consolidated statements of operations, changes in equity, and cash flows for the each of the years in the three-
year period ended December 31, 2021, and the related notes to the consolidated financial statements.
In our opinion, the accompanying consolidated financial statements present fairly, in all material respects, the
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financial position of the Company as of December 31, 2021 and 2020, and the results of its operations and its
cash flows for each of the the years in the three-year period ended December 31, 2021 in accordance with U.S.
generally accepted accounting principles.
Basis for Opinion
EN
We conducted our audits in accordance with auditing standards generally accepted in the United States of
America (GAAS). Our responsibilities under those standards are further described in the Auditors’
Responsibilities for the Audit of the Consolidated Financial Statements section of our report. We are required to
be independent of the Company and to meet our other ethical responsibilities, in accordance with the relevant
ethical requirements relating to our audits. We believe that the audit evidence we have obtained is sufficient
and appropriate to provide a basis for our audit opinion.
D
Responsibilities of Management for the Consolidated Financial Statements
Management is responsible for the preparation and fair presentation of the consolidated financial statements in
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accordance with U.S. generally accepted accounting principles, and for the design, implementation, and
maintenance of internal control relevant to the preparation and fair presentation of consolidated financial
statements that are free from material misstatement, whether due to fraud or error.
In preparing the consolidated financial statements, management is required to evaluate whether there are
N
conditions or events, considered in the aggregate, that raise substantial doubt about the Company’s ability to
continue as a going concern for one year after the date that the consolidated financial statements are issued.
O
Auditors’ Responsibilities for the Audit of the Consolidated Financial Statements
Our objectives are to obtain reasonable assurance about whether the consolidated financial statements as a
whole are free from material misstatement, whether due to fraud or error, and to issue an auditors’ report that
includes our opinion. Reasonable assurance is a high level of assurance but is not absolute assurance and
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therefore is not a guarantee that an audit conducted in accordance with GAAS will always detect a material
misstatement when it exists. The risk of not detecting a material misstatement resulting from fraud is higher
than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions,
misrepresentations, or the override of internal control. Misstatements are considered material if there is a
substantial likelihood that, individually or in the aggregate, they would influence the judgment made by a
reasonable user based on the consolidated financial statements.
KPMG LLP, a Delaware limited liability partnership and a member firm of
the KPMG global organization of independent member firms affiliated with
KPMG International Limited, a private English company limited by guarantee.
In performing an audit in accordance with GAAS, we:
● Exercise professional judgment and maintain professional skepticism throughout the audit.
● Identify and assess the risks of material misstatement of the consolidated financial statements, whether
due to fraud or error, and design and perform audit procedures responsive to those risks. Such
procedures include examining, on a test basis, evidence regarding the amounts and disclosures in the
consolidated financial statements.
● Obtain an understanding of internal control relevant to the audit in order to design audit procedures that
are appropriate in the circumstances, but not for the purpose of expressing an opinion on the
effectiveness of the Company’s internal control. Accordingly, no such opinion is expressed.
AL
● Evaluate the appropriateness of accounting policies used and the reasonableness of significant
accounting estimates made by management, as well as evaluate the overall presentation of the
consolidated financial statements.
● Conclude whether, in our judgment, there are conditions or events, considered in the aggregate, that
raise substantial doubt about the Company’s ability to continue as a going concern for a reasonable
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period of time.
We are required to communicate with those charged with governance regarding, among other matters, the
planned scope and timing of the audit, significant audit findings, and certain internal control related matters that
we identified during the audit.
EN
Denver, Colorado
April 29, 2022
D
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2
AMR HOLDCO INC.
(a wholly-owned subsidiary of Global Medical Response, Inc.)
CONSOLIDATED BALANCE SHEETS
(in thousands)
December 31, December 31,
2021 2020
ASSETS
Current assets:
Cash and cash equivalents $ 379,886 $ 122,616
Insurance collateral 231,903 200,159
Accounts receivable, net 574,332 444,910
Supplies inventory 56,661 62,839
AL
Prepaid expenses 37,414 34,814
Other current assets 49,317 38,498
Total current assets 1,329,513 903,836
Property and equipment, net 302,370 329,244
Operating right-of-use assets 178,729 168,055
Finance right-of-use assets 4,123 5,584
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Intangible assets, net 980,967 973,439
Goodwill 839,975 813,892
Other assets 38,548 22,908
Total assets $ 3,674,225 $ 3,216,958
LIABILITIES AND EQUITY
Current liabilities:
EN
Accounts payable $ 44,125 $ 38,494
Accrued wages, benefits and taxes 165,524 171,248
Other accrued liabilities 232,845 183,758
Current portion of lease obligations and long-term debt 43,743 37,533
Total current liabilities 486,237 431,033
Operating lease obligations 147,848 142,345
D
Finance lease obligations and long-term debt 4,670 7,574
Deferred income taxes 123,091 103,348
Insurance reserves 194,829 159,293
Other long-term liabilities 16,346 17,914
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Total liabilities 973,021 861,507
Commitments and contingencies
Equity:
Investment by Parent 2,364,331 2,126,188
N
Accumulated other comprehensive income (loss) 1,304 2,817
Retained earnings 335,569 226,446
Total equity 2,701,204 2,355,451
Total liabilities and equity $ 3,674,225 $ 3,216,958
O
The accompanying Notes to Consolidated Financial Statements are an integral part of these statements.
C
3
AMR HOLDCO INC.
(a wholly-owned subsidiary of Global Medical Response, Inc.)
CONSOLIDATED STATEMENTS OF OPERATIONS
(in thousands)
Year Ended December 31,
2021 2020 2019
Net revenue 3,161,096 2,829,600 2,686,552
Operating expenses:
Employee wages, benefits and taxes 1,709,480 1,632,403 1,556,574
Maintenance, fuel and other direct expenses 183,786 160,547 163,320
Insurance expense 110,390 121,470 92,983
AL
Other operating expenses 891,718 657,344 526,390
Governmental grants (70,814) (34,358) —
Acquisition, integration and other charges 30,387 31,534 47,420
Depreciation and amortization 154,873 158,513 160,022
Total operating expenses 3,009,820 2,727,453 2,546,709
Operating income (loss) 151,276 102,147 139,843
Interest income (expense), net 2,696 3,426 676
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Equity in earnings of unconsolidated affiliates (17) 282 478
Other income (loss), net 716 692 1,685
Net income (loss) before income taxes 154,671 106,547 142,682
Income tax (benefit) expense 45,548 34,134 32,147
Net income (loss)
Other comprehensive income (loss):
EN $ 109,123 $ 72,413 $ 110,535
Unrealized holding gains (losses) on investments (4,698) 3,383 3,417
Defined benefit pension plan net gain (loss) 2,840 (7,062) (2,442)
Deferred income tax benefit (expense), net 345 973 (337)
Total other comprehensive income (loss), net of income tax (1,513) (2,706) 638
Comprehensive income (loss) $ 107,610 $ 69,707 $ 111,173
D
The accompanying Notes to Consolidated Financial Statements are an integral part of these statements.
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4
AMR HOLDCO INC.
(a wholly-owned subsidiary of Global Medical Response, Inc.)
CONSOLIDATED STATEMENTS OF CHANGES IN EQUITY
(in thousands)
Accumulated Retained
Investment Other Earnings
by Parent/ Comprehensive (Accumulated
Prior Parent Income (Loss) Deficit) Total
Balance at January 1, 2019 $ 2,497,175 $ 4,084 $ 44,299 $ 2,545,558
Cumulative-effect adjustment upon application of
accounting change — 801 (801) —
Net working capital distributed to Parent (180,850) — — (180,850)
Acquisitions funded by Parent 21,237 — — 21,237
AL
Net income (loss) — — 110,535 110,535
Other comprehensive income (loss), net of tax expense of
$0.3 million — 638 — 638
Balance at December 31, 2019 $ 2,337,562 $ 5,523 $ 154,033 $ 2,497,118
Net working capital distributed to Parent (228,374) — — (228,374)
Acquisitions funded by Parent 17,000 — — 17,000
Net income (loss) — — 72,413 72,413
TI
Other comprehensive income (loss), net of tax benefit of
$1.0 million — (2,706) — (2,706)
Balance at December 31, 2020 $ 2,126,188 $ 2,817 $ 226,446 $ 2,355,451
Net working capital contributed by Parent 164,320 — — 164,320
Acquisitions funded by Parent
Net income (loss)
EN 73,823
—
—
—
—
109,123
73,823
109,123
Other comprehensive income (loss), net of tax benefit of
$0.3 million — (1,513) — (1,513)
Balance at December 31, 2021 $ 2,364,331 $ 1,304 $ 335,569 $ 2,701,204
The accompanying Notes to Consolidated Financial Statements are an integral part of these statements.
D
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5
AMR HOLDCO INC.
(a wholly-owned subsidiary of Global Medical Response, Inc.)
CONSOLIDATED STATEMENTS OF CASH FLOWS
(in thousands)
Year Ended December 31,
2021 2020 2019
Cash flows from operating activities:
Net income (loss) $ 109,123 $ 72,413 $ 110,535
Adjustments to reconcile net income (loss) to net cash provided by operating
activities:
Depreciation and amortization 154,873 158,513 160,022
Loss on disposal of property and equipment 1,470 3,807 1,780
Unrealized loss (gain) on marketable equity securities (5,078) (3,596) (2,602)
Other, net (5,603) 1,695 1,037
AL
Equity in earnings of unconsolidated affiliates (17) (282) (478)
Deferred income taxes 20,079 35,451 31,614
Change in operating assets/liabilities, net of acquisitions:
Accounts receivable, net (128,609) 3,818 (65,662)
Accounts payable 5,631 11,693 4,163
Accrued wages, benefits and taxes (6,427) 51,348 12,482
Accrued liabilities 40,013 4,254 (10,192)
Other assets and liabilities, net 29,133 (8,217) 22,904
TI
Net cash provided by operating activities 214,588 330,897 265,603
Cash flows from investing activities:
Purchases of property and equipment (93,904) (104,683) (100,338)
Proceeds from the sale of property and equipment 936 2,484 554
Acquisition of businesses, net of cash and restricted cash acquired (73,823) (17,000) (21,237)
Net change in investments held as insurance collateral 1,581 642 1,109
Purchases of marketable securities
Sales and maturities of marketable securities
EN (72,227)
42,152
(93,025)
67,239
(156,513)
106,499
Other investing activities, net (3,529) 296 43
Net cash used in investing activities (198,814) (144,047) (169,883)
Cash flows from financing activities:
Net working capital and other transfers contributed by (distributed to) Parent 242,478 (211,374) (159,613)
Payments on finance lease obligations and long-term debt (3,715) (3,800) (282)
Proceeds from issuance of long-term debt — 2,487 —
Net cash provided by (used in) financing activities 238,763 (212,687) (159,895)
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Effect of exchange rate changes on cash, cash equivalents, restricted
cash and restricted cash equivalents 5,603 (1,477) (1,060)
Net increase (decrease) in cash, cash equivalents, restricted cash and restricted
cash equivalents 260,140 (27,314) (65,235)
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Cash and cash equivalents, beginning of period (including restricted cash and
restricted cash equivalents of $56.8 million, $12.7 million, and $34.4 million,
respectively) 179,460 206,774 272,009
Cash and cash equivalents, end of period (including restricted cash and
restricted cash equivalents of $59.7 million, $56.8 million, and $12.7 million,
respectively) $ 439,600 $ 179,460 $ 206,774
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Supplemental disclosure of cash flow information
Cash paid during the period for
Income taxes, net of refunds received $ 2,204 $ (2,577) $ (544)
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The accompanying Notes to Consolidated Financial Statements are an integral part of these statements.
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Notes to Consolidated Financial Statements
1. Description of Business
AMR HoldCo Inc., along with its subsidiaries (collectively, “AMR” or the “Company”) operates in 38 states and the
District of Columbia, including monetary assets of an investment held in Trinidad and Tobago, providing a full range of
healthcare transportation services, including emergency (“911”), non-emergency, managed transportation, fire protection
services, fixed-wing ambulance and disaster response. In addition, AMR operates 911 call and response services for large
and small communities all across the United States, offers contracted medical staffing, and provides telephone triage,
transportation dispatch and demand management services.
Prior to March 14, 2018, the Company was a wholly-owned subsidiary of Envision Healthcare Corporation (“EVHC” or
“Prior Parent”). On March 14, 2018, Global Medical Response, Inc. (“GMR” or “Parent”) completed the acquisition of all
outstanding equity interests of AMR (the “Acquisition”). Since March 14, 2018, the Company has been a wholly-owned
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subsidiary of GMR.
2. Summary of Accounting Policies
Consolidation
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The consolidated financial statements of the Company include all of its wholly-owned subsidiaries. All significant
intercompany transactions and balances have been eliminated in consolidation.
Investment by Parent
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Investment by Parent, in the consolidated financial statements represents the Company’s cumulative investment from the
Parent for the accumulation of the following to the extent that they are not cash settled:
• Investments in AMR
• Net cash transfers to and from AMR
• Overhead cost allocations, if any
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• Transactions between the Parent and AMR
• Net cash transactions due to the Parent’s centralized cash management.
Use of Estimates
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The preparation of financial statements requires management to make estimates and assumptions relating to the reporting
of results of operations, financial condition and related disclosure of contingent assets and liabilities at the date of the
financial statements including, but not limited to, estimates and assumptions for revenue, accounts receivable, insurance-
related reserves and acquired or pushed-down intangible assets. Actual results may differ from those estimates under
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different assumptions or conditions.
Cash and Cash Equivalents
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Cash and cash equivalents are comprised principally of demand deposits at banks and highly liquid short-term investments
with a maturity generally three months or less at acquisition, and are recorded at cost, which approximates market value.
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Supplies Inventory
Parts and supplies inventory is valued at cost, determined on a first in, first out basis. Durable medical supplies are
capitalized as inventory and expensed as used.
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Notes to Consolidated Financial Statements – Continued
Restricted Cash
At December 31, 2021 and 2020, the Company held restricted cash and cash equivalents of $59.7 million and $56.8
million, respectively, classified within “Insurance collateral” in the accompanying consolidated balance sheets. The cash
was restricted for the purpose of satisfying the obligations of the Company’s wholly-owned captive insurance subsidiary.
CARES Act
In March 2020, in response to the COVID-19 pandemic, the Coronavirus Aid, Relief, and Economic Security Act
(“CARES Act”) was signed into law. The CARES Act provides numerous tax provisions and other stimulus measures,
including temporary changes regarding prior and future utilization of net operating losses, temporary changes to the prior
and future limitations on interest deductions, temporary delay of certain payment requirements for the employer portion
of social security taxes, technical corrections from prior tax legislation for tax depreciation of certain qualified
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improvement property, and the creation of certain payroll tax credits associated with the retention of employees. The
CARES Act also includes a number of benefits that are applicable to the Company and other healthcare providers
including, but not limited to, the appropriation of funding to health care providers for related expenses or lost revenues
that are attributable to the COVID-19 pandemic.
The Company received approximately $70.8 million and $34.4 million for the years ended December 31, 2021 and 2020,
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respectively, from the provider relief funds. The fund payments are grants, not loans, however providers are restricted
and the funds must be used only for grant approved purposes. Upon receiving and having satisfied the terms and
conditions associated with the initial tranche distribution of funds, the Company accounted for these as restricted
contributions and recognized income in the consolidated statements of operations. Net cash provided by operating
activities includes these grants received in the respective periods.
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The Company’s assessment of whether the terms and conditions for amounts received have been met considers all
frequently asked questions and other interpretive guidance currently issued by the U.S. Department of Health and Human
Services (“HHS”). After consideration of the guidance provided, the Company believes the governmental grants
recognized are appropriately recorded as of December 31, 2021 and 2020.
Recent Accounting Pronouncements
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From time to time, new accounting pronouncements are issued by the Financial Account Standards Board (“FASB”) or
other standards setting bodies that the Company adopts as of the specified effective date. Unless otherwise discussed, the
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impact of any other recently issued standards that are not yet effective are either not applicable to the Company at this
time or will not have a material impact on the Company’s consolidated financial statements upon adoption.
In November 2019, the FASB issued ASU No. 2019-10, “Financial Instrument – Credit Losses (Topic 326), Derivatives
and Hedging (Topic 915), and Leases (Topic 842),” which among other changes in accounting and disclosure
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requirements, provides guidance on how an entity should measure credit losses on financial instruments. The ASU is
effective for private entities for fiscal years beginning after December 15, 2022. We currently expect the adoption of
ASU 2016-13 will have an immaterial impact on our consolidated financial statements and related disclosures.
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In March 2020, the FASB issued ASU No. 2020-04, “Reference Rate Reform (Topic 848): Facilitation of the Effects of
Reference Rate Reform on Financial Reporting.” The ASU provides optional transition guidance, for a limited time, to
companies that have contracts, hedging relationships or other transactions that reference the London Inter-bank Offered
Rate (“LIBOR”) or another reference rate which is expected to be discontinued because of reference rate reform. The
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amendments provide option expedients and exceptions for applying GAAP to contracts, hedging relationships, or other
transactions if certain criteria are met. The amendments in this update are effective as of March 12, 2020 through
December 31, 2022. The amendments in this update may be applied as of any date from the beginning of an interim
period that includes or is subsequent to March 12, 2020, or prospectively from a date within an interim period that
includes or is subsequent to March 12, 2020, up to the date that the financial statements are available to be issued. All
8
Notes to Consolidated Financial Statements – Continued
other amendments should be applied on a prospective basis. The Company is in the process of evaluating the effect that
the adoption of this standard will have on its consolidated financial statements, but does not expect it will have a material
effect.
3. Revenue Recognition and Accounts Receivable
Revenue Recognition
The majority of our revenue is generated from fee for service patient revenue, which is derived principally through
contracts originating from ground medical transport services provided to patients of healthcare facilities and communities
served. Each transport constitutes a single performance obligation and, in most instances occur at readily determinable
transaction prices. As a practical expedient, the Company adopted a portfolio approach to sources of patient revenue,
applied by payor type. At this level, each portfolio shares the characteristics conducive to ensuring that the results do not
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materially differ from the new standard if it were to be applied to each individual patient contract related to each transport.
Accordingly, there was not a change in the Company’s method to recognize revenue. Subsequent changes in the customer’s
ability to pay, are recorded as bad debt within other operating expenses.
Estimating revenue is a complex process, largely due to the volume of transactions, the number and complexity of contracts
with payors, the limited availability, at times, of certain patient and payor information at the time services are provided,
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and the length of time it takes for collections to fully mature. Patients are billed for services provided, and the Company
receives payments for these services from patients or their third-party payors. Payments for services provided are generally
less than billed charges. The Company recognizes fee for service revenue, net of contractual adjustments and discounts
for uninsured patients, at the time transport services are provided. In the period services are provided, the Company
estimates gross charges based on: billed services plus an estimate for unbilled services based on pending case data
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collected, estimates of contractual allowances (explicit price concessions) based on contracted rates and historical or actual
cash collections (net of recoveries), when available, and estimates of the discount (implicit price concession) for uninsured
patients based on historical cash collections (net of recoveries) from uninsured patients. For third-party payors, the specific
benefits provided for under each patients’ healthcare plan, mandated payment rates under the Medicare and Medicaid
programs, as applicable, and historical cash collections are utilized. These expected collections are based on fees and
negotiated payment rates in the case of third-party payors, the specific benefits provided for under each patient’s healthcare
plans, mandated payment rates in the case of Medicare and Medicaid programs, and historical cash collections (net of
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recoveries) in combination with expected collections from third party payors. In addition, the Company records net revenue
from uninsured patients at an estimated realizable value based on historical cash collections (net of recoveries). The price
concession includes an estimate of uncollectible balances due from uninsured patients, uncollectible co-pay and deductible
balances due from insured patients and special charges, if any, for uncollectible balances due from managed care,
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commercial and governmental payors.
The relationship between gross charges and the transaction price recognized is significantly influenced by payor mix, as
collections on gross charges may vary significantly depending on whether and with whom the patients the Company
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provides services to in the period are insured and the Company’s contractual relationships with those payors. Payor mix
is subject to change as additional patient and payor information is obtained after the period services are provided. The
Company periodically assesses the estimates of unbilled revenue, contractual adjustments (explicit price concessions) and
discounts (implicit price concessions) for uninsured patients and payor mix for a period of at least one year following the
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date of service by analyzing actual results, including cash collections, against estimates. Changes in these estimates are
charged or credited to the consolidated statement of operations in the period that the assessment is made. Significant
changes in payor mix, contractual arrangements with payors, specialty mix, acuity, business office operations, general
economic conditions and health care coverage provided by federal or state governments or private insurers may have a
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significant impact on estimates and significantly affect the results of operations and cash flows. Concentration of credit
risk with respect to other payors is limited due to the large number of such payors.
The Company’s billing and accounting systems provide historical trends of cash collections and contractual write-offs,
accounts receivable agings and established fee adjustments from third-party payors. These estimates are recorded and
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Notes to Consolidated Financial Statements – Continued
monitored monthly as revenues are recognized. The principal exposure for uncollectible fee for service visits is from self-
pay patients and, to a lesser extent, for co-payments and deductibles from patients with insurance.
Other revenue primarily represents income earned from fire protection service contracts, standby, special event,
community subsidies and income earned from our contract with the Federal Emergency Management Agency (“FEMA”)
for disaster relief efforts and other federal and state agencies to coordinate emergency medical services responses.
Revenue is recognized for these services when our performance obligation is satisfied, which is generally when services
are rendered and in an amount that reflects the consideration to which we expect to be entitled. At contract inception, we
assess the services specified and identify a performance obligation for each distinct contracted service. These other
sources of revenue contracts general consist of fixed-price or variable consideration. Revenue for fixed-price contracts is
typically recognized at the time of billing, unless evidence suggests that the revenue is earned or the Company’s
obligations are fulfilled in a different pattern. In these instances, revenues are deferred and recognized ratably over the
life of the contract. Payment is generally received upfront and revenues are deferred and recognized over the life of the
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contractual service period. Revenue for variable consideration contracts is typically recognized as the services are
performed at the contractually billable rate.
Net revenue for the years ended December 31, 2021, 2020 and 2019, consisted of the following (in thousands):
Year Ended December 31,
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2021 2020 2019
Medicare $ 773,128 25 % $ 766,688 27 % $ 839,445 31 %
Medicaid 315,036 10 % 308,939 11 % 310,035 12 %
Commercial insurance and managed care (excluding Medicare
and Medicaid managed care)
Self-pay
EN 865,338
123,700
27 %
4%
768,014
103,773
27 %
4%
898,071
116,688
33 %
4%
Net transport revenue 2,077,202 66 % 1,947,414 69 % 2,164,239 80 %
Complementary revenue 1,083,894 34 % 882,186 31 % 522,313 20 %
Net revenue $ 3,161,096 100 % $ 2,829,600 100 % $ 2,686,552 100 %
Net transport revenue includes fee for service patient revenue. Complementary revenue primarily includes income
earned from our membership program, community subsidies, fire protection service contracts, standby, special event,
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coordinated care services, and income earned from our contract with FEMA and other federal and state agencies to
coordinate emergency medical services responses.
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Accounts Receivable
The Company manages accounts receivable by regularly reviewing its accounts and contracts and by providing
appropriate adjustments to the estimate of the transaction price. Some of the factors considered by management in
determining the adjustments are the historical trends of cash collections, contractual and uninsured write-offs, accounts
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receivable agings, established fee schedules, contracts with payors, changes in payor mix and procedure statistics. Actual
collections of accounts receivable in subsequent periods may require changes in the estimated transaction price.
The Company tests its analysis by comparing cash collections to net fee for service revenues and monitoring self-pay
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utilization. In addition, when actual collection percentages differ from expected results, on a contract by contract basis,
supplemental detailed reviews of the outstanding accounts receivable balances may be performed by the Company’s
billing operations to determine whether there are facts and circumstances existing that may cause a different conclusion
as to the estimate of the collectability of that contract’s accounts receivable from the estimate resulting from using the
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historical collection experience. Changes in these estimates, if any, are charged or credited to the consolidated statements
of operations in the period of change. Material changes in estimates may result from unforeseen write-offs of patient or
third-party accounts receivable, unsuccessful disputes with managed care payors, adverse macro-economic conditions
which limit patients’ ability to meet their financial obligations, or broad changes to government regulations that
adversely impact reimbursement rates for services provided by the Company. Significant changes in payor mix, changes
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Notes to Consolidated Financial Statements – Continued
in contractual arrangements with payors, business office operations, general economic conditions and health care
coverage provided by federal or state governments or private insurers may have a significant impact on the Company’s
estimates and significantly affect its results of operations and cash flows. Consideration of credit risk is limited by the
diversity and number of facilities, patients, payors and by the geographic dispersion of the Company’s operations.
4. Acquisitions
The Company accounts for its business combinations under the requirements of the acquisition method of accounting and
under the premise that an acquirer be identified for each business combination. The acquirer is the entity that obtains
control of one or more businesses in the business combination and the acquisition date is the date the acquirer achieves
control. The assets acquired and liabilities assumed at the acquisition date are recognized at their fair values as of that date,
and the direct costs incurred in connection with the business combination are recorded and expensed separately from the
business combination. Acquisitions in which the Company is able to exert significant influence but does not have control
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are accounted for using the equity method.
Acquired assets and assumed liabilities include, but are not limited to, accounts receivable, fixed assets, intangible assets,
deferred income taxes and insurance liabilities. The valuations are based on comparable market transactions, discounted
cash flow analyses, actuarial analyses or other appropriate valuation techniques to determine the fair value of the assets
acquired or liabilities assumed.
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During the years ended December 31, 2021 and 2020, the Company paid $77.4 million and $17.0 million, in cash, in total
aggregate purchase consideration for acquisitions. The Company acquired each of these companies in order to achieve
certain operational and strategic benefits.
EN
The acquisitions completed during the years ended December 31, 2021 and 2020 consist of the following:
Acquired Operation Location Date Acquired
Hunter Ambulance, Inc. New York September 2021
Ojai Ambulance, Inc. California May 2021
Arizona Ambulance of Douglas, Inc. Arizona May 2021
Capstone Fire Management, Inc. California March 2021
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ABC Ambulance, LLC Arizona June 2020
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Notes to Consolidated Financial Statements – Continued
The Capstone Fire Management, Inc. acquisition is subject to an earn-out provision estimated at $0.4 million that the
Company expects to pay over a three year period. The Hunter Ambulance, Inc. acquisition is subject to contingent
consideration of $2.5 million expected to be paid by the end of 2025.
The acquisition date fair value of the total consideration transferred and acquisition date fair value of each major class of
assets and liabilities for acquisitions completed during 2021 and 2020 are as follows (in thousands):
2021 2020
Accounts receivable, net 813 —
Spare parts, medical supplies and fuel — 118
Prepaid expenses 314 —
Property and equipment 6,918 1,132
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Finance right-of-use assets 1,045 —
Customer relationship intangible asset 38,809 11,500
Goodwill 32,485 4,298
Other assets 179 —
Accrued wages, benefits and taxes (703) (48)
Other accrued liabilities (1,387) —
Finance lease obligations (1,045) —
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$ 77,428 $ 17,000
The goodwill recorded for acquisitions completed during the years ended December 31, 2021 and 2020 is expected to be
fully deductible.
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The accounting for acquisitions completed during 2021 is currently preliminary. The Company continues to obtain
information relative to the fair values of the assets acquired and liabilities assumed in the transactions, which could result
in material changes to the amounts allocated above. The Company expects to finalize the purchase price allocations for
these acquisitions as soon as practicable. The purchase price allocation for acquisitions completed during 2020 is
considered final.
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5. Fair Value Measurements
The fair value of a financial instrument is the amount at which the instrument could be exchanged in an orderly transaction
between market participants to sell the asset or transfer the liability. The inputs used by the Company to measure fair value
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are classified into the following hierarchy:
Level 1: Quoted prices in active markets for identical assets or liabilities as of the reporting date. The Company does
not adjust the quoted price for these assets or liabilities, which include marketable securities held in connection with
the Company’s captive insurance program.
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Level 2—Pricing inputs are other than quoted prices in active markets, which are either directly or indirectly
observable as of the reporting date, and fair value is determined through the use of models or other valuation
methodologies.
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Level 3—Pricing inputs are unobservable as of the reporting date and reflect the Company’s own assumptions about
the fair value of the asset or liability. Balances in this category include the Company’s estimate, using a combination
of internal and external fair value analyses, of contingent consideration for acquisitions described in Note 4.
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The Company has adopted the provisions of ASU No. 2016-01 and ASU No. 2018-03 effective for the 2019 annual
reporting period, which required changes in the fair value of equity investment securities to be recognized in net income.
In prior periods, the changes in the fair value of equity investment securities were recognized through accumulated other
comprehensive income. Upon adoption, the Company recognized a cumulative effect adjustment of approximately $0.8
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Notes to Consolidated Financial Statements – Continued
million to retained earnings and accumulated other comprehensive income related to the unrealized loss on corporate
equity securities and has recognized the change in fair value on these equity securities as a component of other income
(expense), net in the consolidated statements of operations.
The following table summarizes the valuation of the Company’s financial instruments by the above fair value hierarchy
levels as of December 31, 2021 and 2020 (in thousands):
December 31, 2021
Description Level 1 Level 2 Level 3 Total
Assets:
Available-for-sale securities $ 118,711 $ 8,505 $ — $ 127,216
Marketable equity securities 44,973 — — 44,973
Liabilities:
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Contingent consideration — — 2,979 2,979
December 31, 2020
Description Level 1 Level 2 Level 3 Total
Assets:
Available-for-sale securities $ 115,938 $ — $ — $ 115,938
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Marketable equity securities 27,377 — — 27,377
Insurance Collateral
Insurance collateral is comprised of investments in U.S. Treasuries and marketable equity and debt securities held by the
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Company’s wholly-owned captive insurance subsidiary that support the Company’s insurance programs and reserves, as
well as cash deposits with third parties. Certain of these investments, if sold or otherwise liquidated or if they decline
significantly in value, would have to be replaced by other suitable financial assurances and are, therefore, considered
restricted. All debt securities are designated as available-for-sale and reported at fair value with the temporary unrealized
gains and losses reported as a separate component of accumulated other comprehensive income (loss), net of deferred
income tax. Declines in the fair value of debt securities which are determined to be other-than-temporary are recognized
in the statements of operations, thus establishing a new cost basis for such investment. All equity securities are carried at
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fair value with changes in fair value reported as a component of other income (loss), net in the consolidated statements
of operations. Investment income earned on these investments is reported as a component of other income, net in the
accompanying statements of operations. Realized gains and losses are determined based on an average cost basis.
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Investments are generally classified within Level 1 or Level 2 of the fair value hierarchy because they are valued using
quoted market prices, broker or dealer quotations, or alternative pricing sources with reasonable levels of price
transparency.
Insurance collateral consisted of the following as of December 31, 2021 and 2020 (in thousands):
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December 31
2021 2020
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Available-for-sale securities:
Corporate and municipal bonds $ 118,711 $ 109,919
Preferred or fixed rate cap securities 8,505 6,019
Total available-for-sale securities 127,216 115,938
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Marketable equity securities 44,973 27,377
Cash deposits and other 59,714 56,844
Insurance Collateral $ 231,903 $ 200,159
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Notes to Consolidated Financial Statements – Continued
Amortized cost basis and aggregate fair value of the Company's marketable securities as of December 31, 2021 and 2020
were as follows (in thousands):
December 31, 2021
Gross Gross
Cost Unrealized Unrealized Fair
Basis Gains Losses Value
Description:
Corporate and municipal bonds $ 116,987 $ 2,444 $ (720) $ 118,711
Preferred or fixed rate cap securities 8,445 123 (63) 8,505
Total available-for-sale securities 125,432 2,567 (783) 127,216
Marketable equity securities 34,497 10,913 (437) 44,973
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Total securities $ 159,929 $ 13,480 $ (1,220) $ 172,189
December 31, 2020
Gross Gross
Cost Unrealized Unrealized Fair
Basis Gains Losses Value
Description:
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Corporate and municipal bonds $ 103,727 $ 6,201 $ (9) $ 109,919
Preferred or fixed rate cap securities 5,728 291 — 6,019
Total available-for-sale securities 109,455 6,492 (9) 115,938
Marketable equity securities 21,979 5,505 (107) 27,377
Total securities
EN $ 131,434 $ 11,997 $ (116) $ 143,315
As of December 31, 2021, available-for-sale securities included U.S Treasuries, corporate bonds and fixed income
securities of $5.7 million with contractual maturities within one year, $61.3 million with contractual maturities extending
longer than one year through five years and $60.3 million with contractual maturities extending longer than five years.
Actual maturities may differ from contractual maturities as a result of the Company's ability to sell these securities prior
to maturity.
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The Company evaluates the investment securities available-for-sale on a quarterly basis to determine whether declines in
the fair value of these securities are other-than-temporary. The evaluation consists of reviewing the fair value of the
security compared to the carrying amount, the historical volatility of the price of each security, and any industry and
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company specific factors related to each security. There were no available-for-sale investment securities that were other-
than-temporarily impaired as of December 31, 2021 and 2020.
The Company is not aware of any specific factors indicating that the underlying issuers of the corporate bonds/fixed
income securities would not be able to pay interest as it becomes due or repay the principal amount at maturity.
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Therefore, the Company believes that the changes in the estimated fair values of these debt securities are related to
temporary market fluctuations and the Company does not intend to dispose of these investments. Additionally, the
Company is not aware of any specific factors which indicate the unrealized losses on the investments in corporate equity
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securities are due to anything other than temporary market fluctuations.
The Company realized net gains (loss) on the sales and maturities of available-for-sale securities of $1.2 million, ($1.2)
million, and $0.1 million for the years ended December 31, 2021, 2020, and 2019, respectively.
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Notes to Consolidated Financial Statements – Continued
6. Property and Equipment, net
Property and equipment is recorded at cost, except for property and equipment acquired through business acquisitions,
which is initially recorded at fair value. Depreciation of property, plant and equipment is provided substantially on a
straight line basis over their estimated useful lives, which are as follows:
Buildings 20 to 40 years
Leasehold improvements Shorter of 5 years or life of lease
Vehicles 7 to 12 years
Computer hardware 3 years
Other 3 to 15 years
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Maintenance and repairs that do not extend the useful life of the property are charged to expense as incurred. Gains and
losses from dispositions of property and equipment are recorded in the period incurred. Property and equipment, net,
consisted of the following (in thousands):
December 31, December 31,
2021 2020
Land $ 2,807 $ 2,737
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Building and building improvements 7,807 7,776
Leasehold improvements 25,748 23,925
Medical equipment and other 191,266 165,501
Vehicles 294,456 267,416
Computer hardware and software 160,681 138,043
Construction in process
EN 8,719 21,007
Property and equipment 691,484 626,405
Less: Accumulated depreciation (389,114) (297,161)
Property and equipment, net $ 302,370 $ 329,244
Depreciation expense was $119.4 million, $120.6 million, and $123.5 million for the years ended December 31, 2021,
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2020 and 2019, respectively.
7. Lease Commitments
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Right of use assets and lease liabilities are recorded for the majority of our operating leases. We enter into operating and
finance leases for vehicles, equipment and real estate, among other things. Lease terms are generally between one to 20
years, some of which include renewal options, and some of which include options to terminate the leases within one
year. Variable lease payments were $8.1 million and $6.7 million for the years ended December 31, 2021 and 2020,
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respectively. Variable expenses include common area maintenance, utilities, and other items as periodically billed by
property management or the related lessor. Our lease agreements do not contain any material residual value guarantees
or material restrictive covenants.
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We determine if an arrangement is a lease and classify that lease as either an operating or finance lease at inception.
Operating leases are included in operating right-of-use assets, current portion of lease obligations and operating lease
obligations on our consolidated balance sheets. Finance leases are included in finance right-of-use assets, current portion
of lease obligations and finance lease obligations on our consolidated balance sheets. As permitted under the standard,
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leases with an initial term of 12 months or less are not recorded on the balance sheet and we recognize lease expense for
these leases on a straight-line basis over the lease term in our consolidated statements of operations.
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Notes to Consolidated Financial Statements – Continued
Right of use (“ROU”) assets represent our right to use an underlying asset for the lease term and lease liabilities
represent the present value of our obligation to make lease payments arising from the lease. Operating lease ROU assets
and liabilities are recognized at commencement date based on the present value of lease payments over the lease term.
When our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information
available at commencement date in determining the present value of lease payments. The operating lease ROU asset also
includes the impact of prepaid or deferred lease payments. The length of our lease term may include options to extend or
terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for operating lease
payments is recognized on a straight-line basis over the lease term.
The components of lease expense were as follows (in thousands):
Year Ended December 31,
2021 2020
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Operating lease cost $ 56,049 $ 54,698
Short-term lease cost(1) 392 444
Finance lease cost:
Amortization of right-of-use assets 2,112 1,535
Interest on lease liabilities 435 438
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Total finance lease cost 2,547 1,973
Total lease costs $ 58,988 $ 57,115
________________________________________
(1) Leases that have terms of 12 months or less.
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Supplemental cash flow information related to leases was as follows (in thousands):
Year Ended December 31,
2021 2020
Cash paid for amounts included in the measurement of lease
liabilities:
Operating cash flows from operating leases $ 54,435 $ 52,120
Operating cash flows from finance leases $ 435 $ 438
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Finance cash flows from finance leases $ (2,888) $ (3,028)
Right-of-use assets obtained in exchange for lease obligations:
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Operating leases $ 22,114 $ 9,248
Finance leases $ 10 $ 3,785
Right-of-use assets recognized at January 1, 2020, upon adoption
of ASU No. 2016-02 $ 169,113
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Notes to Consolidated Financial Statements – Continued
Supplemental balance sheet information related to leases was as follows (in thousands):
December 31, 2021December 31, 2020
Operating Leases:
Operating right-of-use assets $ 178,729 $ 168,055
Current portion of lease obligations $ 40,456 $ 34,487
Operating lease obligations 147,848 142,345
Total operating lease liabilities $ 188,304 $ 176,832
Finance Leases:
Finance right-of-use assets $ 7,760 $ 6,998
Accumulated amortization (3,637) (1,414)
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Finance right-of-use assets, net $ 4,123 $ 5,584
Current portion of lease obligations $ 2,393 $ 2,170
Finance lease obligations 2,343 4,401
Total finance lease liabilities $ 4,736 $ 6,571
Weighted Average Remaining Lease Term (in years):
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Operating leases 5.89 6.36
Finance leases 2.07 2.99
Weighted Average Discount Rate:
Operating leases
Finance leases
EN 6.69%
7.19%
7.16%
7.31%
Future commitments as of December 31, 2021 for lease liabilities related to premises, equipment and other recurring
commitments are as follows (in thousands):
Maturities of Lease Liabilities
D
Year Ending December 31, Operating Leases Finance Leases Total
2022 $ 51,441 $ 2,641 $ 54,082
2023 42,792 1,898 44,690
2024 36,219 543 36,762
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2025 30,113 — 30,113
2026 20,808 — 20,808
Thereafter 48,026 — 48,026
Total lease payments $ 229,399 $ 5,082 $ 234,481
Less: Amount representing interest (41,095) (346) (41,441)
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Total 188,304 4,736 193,040
Less: Short-term lease obligation payments (40,456) (2,393) (42,849)
Total long-term lease obligations $ 147,848 $ 2,343 $ 150,191
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8. Goodwill and Intangible Assets, net
The Company’s intangible assets include goodwill and other intangibles, which include the fair value of both the customer
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relationships and trade names. The Company’s indefinite-lived intangibles include goodwill, trade names and licenses.
Goodwill represents the excess of purchase price over the fair value of net assets acquired. The Company evaluates
indefinite-lived intangible assets, including goodwill, for impairment at least on an annual basis and more frequently if
certain indicators are encountered. Goodwill is tested at the reporting unit level, defined as an operating segment or one
level below an operating segment (referred to as a component), with the fair value of the reporting unit being compared to
17
Notes to Consolidated Financial Statements – Continued
its carrying amount. The Company consists of one reporting unit. If the fair value of a reporting unit exceeds its carrying
amount, the goodwill associated with the reporting unit is not considered to be impaired.
The Company completed its annual impairment test as of October 1, 2021, using a qualitative assessment and determined
that its indefinite-lived intangibles were not impaired. The Company’s finite-lived intangibles include its customer
relationships and testing for impairment is performed whenever events or circumstances indicate that the carrying amount
may not be recoverable. The Company’s policy is to recognize an impairment change when the carrying amount is not
recoverable and such amount exceeds fair value. During the years ended December 31, 2021, 2020 and 2019, there were
no events or circumstances that indicated a potential impairment in the Company’s finite-lived intangibles.
The following table presents changes in the carrying amount of goodwill during the years ended December 31, 2021 and
2020 (in thousands):
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Year Ended Year Ended
December 31, December 31,
2021 2020
Balance at beginning of period $ 813,892 $ 803,347
Measurement period adjustments (6,402) (153)
New acquisitions 32,485 10,698
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Balance at end of period $ 839,975 $ 813,892
Intangible assets consist primarily of customer relationships, non-amortizing trade names and certain non-amortizable
licenses. The table below illustrates the useful lives of each class of intangible assets and the remaining weighted average
amortization period.
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Weighted Average
Amortizable Intangibles Assets Estimated Useful Life Amortization Period
Customer relationships 20 years 16 years
The Company’s intangible assets, net, as of December 31, 2021 and 2020 are as follows (in thousands):
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December 31, 2021 December 31, 2020
Gross Net Gross Net
Carrying Accumulated Carrying Carrying Accumulated Carrying
Amount Amortization Amount Amount Amortization Amount
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Amortizable intangible assets:
Customer relationships $ 775,041 $ (138,474) $ 636,567 $ 729,832 $ (100,793) $ 629,039
Total amortizing intangible assets 775,041 (138,474) 636,567 729,832 (100,793) 629,039
Non-amortizable intangible assets
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Licenses 18,400 — 18,400 18,400 — 18,400
Trade names 326,000 — 326,000 326,000 — 326,000
Total non-amortizing intangible assets 344,400 — 344,400 344,400 — 344,400
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Total intangibles, net $ 1,119,441 $ (138,474) $ 980,967 $ 1,074,232 $ (100,793) $ 973,439
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18
Notes to Consolidated Financial Statements – Continued
The following table shows the expected amortization of long-lived intangible assets for each of the years ending
December 31 (in thousands):
2022 $ 38,760
2023 38,760
2024 38,760
2025 38,760
2026 38,760
Thereafter 442,767
$ 636,567
Amortization expense was $37.7 million, $36.7 million and $36.4 million for the years ended December 31, 2021, 2020
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and 2019, respectively.
9. Other Accrued Liabilities
Accrued liabilities were as follows as of December 31, 2021 and 2020 (in thousands):
December 31, December 31,
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2021 2020
Insurance reserves $ 81,395 $ 71,035
Deferred revenue 29,317 27,915
Patient refunds 21,977 18,282
Accrued legal fees and settlements 3,891 2,807
Other
EN 96,265 63,719
Total other accrued liabilities $ 232,845 $ 183,758
10. Income Taxes
The components of income tax expense (benefit) were as follows (in thousands):
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Year Ended December 31,
2021 2020 2019
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Current:
Federal $ 17,820 $ 1,091 $ (1,727)
State 7,649 6,449 2,293
Total current 25,469 7,540 566
Deferred:
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Federal 12,925 22,403 26,816
State 7,154 4,191 4,765
Total deferred 20,079 26,594 31,581
Total tax expense (benefit):
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Federal 30,745 23,494 25,089
State 14,803 10,640 7,058
Income tax expense (benefit) $ 45,548 $ 34,134 $ 32,147
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Notes to Consolidated Financial Statements – Continued
A reconciliation of the provision for income taxes at the federal statutory rate of 21% compared to the effective tax rate is
as follows (in thousands):
Year Ended December 31,
2021 2020 2019
Income tax expense (benefit) at the statutory rate $ 32,481 $ 22,375 $ 29,963
Increase (decrease) in income taxes resulting from:
State taxes, net of federal 11,315 9,372 4,813
Political expenses 133 241 114
Valuation allowance 1,840 848 3,170
Unrecognized tax benefits 624 1,541 (3,857)
Tax credits (2,715) (2,694) (2,413)
Other 1,870 2,451 357
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Income tax expense (benefit) $ 45,548 $ 34,134 $ 32,147
Deferred income taxes reflect the impact of temporary differences between the reported amounts of assets and liabilities
for financial reporting purposes and such amounts as measured by tax laws and regulations. The deferred tax assets and
liabilities represent the future tax return consequences of those differences, which will either be taxable or deductible when
the assets and liabilities are recovered or settled.
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Significant components of the Company’s deferred taxes were as follows at December 31, 2021 and 2020 (in thousands):
December 31, December 31,
2021 2020
Deferred tax assets:
EN
Accounts receivable $ 8,135 $ 4,990
Accrued liabilities 21,853 23,855
Lease Obligations 47,538 44,941
Operating loss and credit carryforwards 11,752 11,652
Insurance and other long-term liabilities 12,703 11,816
Deferred tax assets 101,981 97,254
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Valuation allowances (10,664) (8,783)
Total deferred tax assets 91,317 88,471
Deferred tax liabilities:
Intangible assets (82,020) (58,839)
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Property and equipment (54,820) (57,600)
Right-of-use assets (44,962) (42,593)
Attribute reduction (32,606) (32,787)
Total deferred tax liabilities (214,408) (191,819)
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Net deferred income taxes $ (123,091) $ (103,348)
On March 27, 2020, the CARES Act was enacted. It includes temporary changes to existing U.S. corporate income tax
laws that impact the Company, most notably the ability to offset 100% of taxable income with net operating loss
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carryforwards.
As of December 31, 2021, the Company has federal net operating loss carryforwards of $28.3 million with an indefinite
carryforward period. The Company has state and local net operating loss carryforwards of $106.7 million, of which $41.9
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million may expire in the years 2029-2041. A valuation allowance is established when it is more likely than not that all,
or a portion, of net deferred tax assets will not be realized. Based on review of available evidence, the Company has
determined that it is more likely than not that certain deferred tax assets may not be realized. The increase in valuation
allowance of $1.8 million is primarily attributable to net operating loss carryforwards.
20
Notes to Consolidated Financial Statements – Continued
The Company operates in multiple taxing jurisdictions and in the normal course of business is examined by federal and
state tax authorities. The Company considers many factors and uses judgment in estimating and assessing the impact of
uncertain tax positions. Final audit results may vary from the Company’s estimates. In nearly all jurisdictions, the tax years
prior to 2017 are no longer subject to examination.
A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (in thousands):
Year Ended Year Ended
December 31, December 31,
2021 2020
Balance at beginning of period $ 1,598 $ —
Additions for tax positions for current year 385 327
Additions for tax positions of prior years 234 1,271
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Reductions for tax positions of prior years (10) —
Reductions for tax positions due to lapse of statute of limitations — —
Balance at end of period $ 2,207 $ 1,598
As of December 31, 2021, the Company has $2.2 million of unrecognized tax benefits of which $2.1 million would
affect the effective tax rate, if recognized. The Company does not expect the total amount of unrecognized tax benefits
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to significantly change within the next twelve months.
The Company recognized $0.1 million and zero, within income tax expense in the consolidated statements of operations
related to interest and penalties for the years ended December 31, 2021 and 2020, respectively. The Company
recognized a $0.5 million reduction of the interest and penalties previously recognized during the year ended December
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31, 2019. There are $0.1 million and no amounts of interest and penalty obligations recognized within other long-term
liabilities in the consolidated balance sheets as of December 31, 2021 and 2020, respectively.
11. Insurance
Insurance reserves are established for automobile, workers compensation, general liability and professional liability claims
utilizing policies with both fully insured and self-insured components. This includes the use of a wholly-owned off-shore
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captive insurance program, GMR Insurance Services, Ltd. (“GMRIS”). In those instances where the Company has obtained
third party insurance coverage, the Company normally retains liability for the first $1 to $3 million of the loss. Insurance
reserves cover known claims and incidents within the level of Company retention that may result in the assertion of
additional claims, as well as claims from unknown incidents that may be asserted arising from activities through
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December 31, 2021.
The Company establishes reserves for claims based upon an assessment of claims reported and claims incurred but not
reported. The reserves are established based on consultation with third party independent actuaries using actuarial
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principles and assumptions that consider a number of factors, including historical claim payment patterns (including legal
costs) and changes in case reserves and the assumed rate of inflation in health care costs and property damage repairs.
Provisions for insurance expense included in the statement of operations include annual provisions determined in
consultation with third-party actuaries and premiums paid to third party insurers.
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21
Notes to Consolidated Financial Statements – Continued
The table below summarizes the non-health and welfare insurance reserves included in the accompanying balance sheets
(in thousands):
December 31, 2021 December 31, 2020
Accrued Insurance Total Accrued Insurance Total
Liabilities Reserves Liabilities Liabilities Reserves Liabilities
Automobile $ 30,343 $ 70,715 $ 101,058 $ 26,772 $ 58,401 $ 85,173
Workers’ compensation 32,198 87,451 119,649 29,677 63,338 93,015
General/ Professional liability 18,854 36,663 55,517 14,586 37,554 52,140
$ 81,395 $ 194,829 $ 276,224 $ 71,035 $ 159,293 $ 230,328
12. Other Comprehensive Income (Loss)
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The following table presents the tax effect on each component of “Other comprehensive income (loss)” for the years
ended December 31, 2021 and 2020 (in thousands):
For the year ended For the year ended
December 31, 2021 December 31, 2020
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Tax Tax
Before Benefit Before Benefit
Tax (Expense Net of Tax Tax (Expense Net of Tax
Amount ) Amount Amount ) Amount
Unrealized holding gains (losses) on investments $ (4,698) $ 1,042 $ (3,656) $ 3,383 $ (752) $ 2,631
Defined benefit pension plan net gains (loss) 2,840 (697) 2,143 (7,062) 1,725 (5,337)
Other comprehensive income (loss)
EN $ (1,858) $ 345 $ (1,513) $ (3,679) $ 973 $ (2,706)
The “Accumulated other comprehensive income (loss)” is detailed in the following table, net of tax (in thousands):
Unrealized holding Defined benefit
gains (losses) on pension plan net
Accumulated Other Comprehensive Income (Loss) investments gains (loss) Total
D
Balance at December 31, 2018 $ (870) $ 4,954 $ 4,084
Reclassification adjustment for losses on marketable equity
securities 801 — 801
Other comprehensive income (loss) before reclassification 2,391 (2,465) (74)
FI
Amounts reclassified from accumulated other comprehensive
income (loss) 93 619 712
Balance at December 31, 2019 $ 2,415 $ 3,108 $ 5,523
Other comprehensive income (loss) before reclassification 2,432 (5,337) (2,905)
Amounts reclassified from accumulated other comprehensive
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income (loss) 199 — 199
Balance at December 31, 2020 $ 5,046 $ (2,229) $ 2,817
Other comprehensive income (loss) before reclassification (5,806) 2,143 (3,663)
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Amounts reclassified from accumulated other comprehensive
income (loss) 2,150 — 2,150
Balance at December 31, 2020 $ 1,390 $ (86) $ 1,304
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22
Notes to Consolidated Financial Statements – Continued
13. Retirement Plans and Employee Benefits
Rural/ Metro Pension Plan
As part of the Company’s acquisition of Rural/ Metro on October 28, 2015, the Company acquired a defined benefit
pension plan (the “Pension Plan”) that covers eligible employees of one of Rural/ Metro’s subsidiaries, primarily those
covered by collective bargaining arrangements. Eligibility is achieved upon the completion of one year of service.
Participants become fully vested in their accrued benefit after the completion of five years of service.
The Pension Plan was amended on April 8, 2016 (the “curtailment date”), whereby the Pension Plan became frozen for all
participants as of June 30, 2016. As part of the freezing of the Pension Plan, no new benefits accrue, no hours of service
earned after the freeze date will count in determining a participant’s credited service, and no earnings earned after the
freeze date are counted in determining a participant’s average annual earnings. In November 2019, the plan offered lump
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sum settlements to certain participants, resulting in the settlement of approximately $10.9 million of accumulated benefit
obligations and a $0.6 million realized gain was recorded for the year ended December 31, 2019, presented within the
“Other income (loss)” caption on the consolidated statements of operations. Benefits expense under this plan was
approximately $0.3 million, $0.3 million and $0.5 million for the years ended December 31, 2021, 2020 and 2019,
respectively. The net accrued benefits liability under this plan totaled $14.0 million and $16.6 million at December 31,
2021 and 2020, respectively, presented within the “Other long-term liabilities” caption on the consolidated balance sheets.
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The Company’s general funding policy is to make annual contributions to the Pension Plan as required by the Employee
Retirement Income Security Act. No contributions were made during 2021 or 2020.
EN
Other Postemployment Benefits
The Company participates in a 401(k) plan maintained by the Parent, for its employees and employees of certain
subsidiaries who meet the eligibility requirements set forth in the plan. Employees may contribute a maximum of 80% of
their gross pay each year up to the annual limit established by the Internal Revenue Service ($19,500 for 2021 and 2020).
The Company’s match is 50% of contributions up to 8% of eligible compensation.
The Company’s contributions to the plan were $28.5 million, $24.8 million and $21.7 million for the years ended
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December 31, 2021 2020 and 2019, respectively. Contributions are included in salaries and benefits in the accompanying
consolidated statement of operations.
FI
Collective Bargaining Agreements
Approximately 36% of AMR employees are represented by 71 active collective bargaining agreements. There are seven
operational locations representing approximately 1,000 employees currently in the process of negotiations. In 2022, 21
collective bargaining agreements, representing approximately 5,800 employees will be subject to negotiation. While the
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Company believes it maintains a good working relationship with its employees, the Company has experienced some
union work actions. The Company does not expect these actions to have a material adverse effect on its ability to provide
service to its patients and communities.
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14. Commitments and Contingencies
Lease Commitments
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As discussed in Note 7, the Company leases various facilities and equipment under operating lease agreements. On January
1, 2020, the Company adopted ASU No. 2016-02. Upon adoption, we recognized right of use assets and lease liabilities
for the majority of our operating leases. Prior to the adoption of ASU No. 2016-02, the Company recorded certain other
assets, including leasehold improvements and vehicles, under capital leases. Capital-leased assets were capitalized using
23
Notes to Consolidated Financial Statements – Continued
implicit interest rates at the inception of the lease and were amortized over the lesser of the contractual lease term or the
useful life of the leased asset. Capital leases were collateralized by the underlying assets.
Rent expense for operating leases totaled $60.3 million for the year ended December 31, 2019. Rent expense is included
in the “Other operating expenses” caption on the consolidated statements of operations.
Principal payments for capital lease obligations totaled $0.2 million for the year ended December 31, 2019.
Interest payments related to capital lease obligations totaled $0.5 million for the year ended December 31, 2019. These
interest payments are included in the “Interest expense, net” caption on the consolidated statements of operations.
Refer to Note 7 for further information on the impact on the adoption ASU No. 2016-02 on the Company’s consolidated
financial statements for the years ended December 31, 2021 and 2020.
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Guarantee of Parent Company Debt and Letters of Credit
Parent company debt of $5.4 billion is partially guaranteed by the assets and working capital, respectively, of AMR on a
full and unconditional and joint and several basis, with limited exceptions considered customary for such guarantees,
including the release of the guarantee upon the sale of AMR’s assets.
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Parent company secured letters of credit outstanding on behalf of AMR as of December 31, 2021 were $141.9 million.
Customary letter of credit fees comprise the majority of interest expense reported in the consolidated statements of
operations.
Other Legal Matters
EN
In March 2017, Rural Metro of Florida received a Civil Investigative Demand from the U.S. Attorney Office for the Middle
District of Florida (DOJ) requesting documentary materials and written interrogatories related to the Rural Metro of
Florida’s provision of services to a number of Medicare beneficiaries. The government contended that it had certain civil
claims against Rural Metro of Florida arising from the submission of claims for basic life support, non-emergency services,
which the government contended lacked medical necessity or were improperly documented. This matter was settled in
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February 2021 for $0.7 million.
The Company is involved in other litigation arising in the ordinary course of business. Management believes the outcome
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of these legal proceedings will not have a material adverse impact on its financial condition, results of operations or
liquidity.
15. COVID-19
N
The continued spread of COVID-19 in the areas in which we operate could adversely affect our business. The transport
and treatment of highly contagious COVID patients in our aircraft or ground ambulance units or the exposure of our
employees during the normal course of their personal and professional lives may result in a temporary shutdown of
portions of operations, the diversion of patients, quarantine of staff, or staffing shortages. There may also be disruptions
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or delays in production and delivery of materials and products in the supply chain. The current corona virus outbreak, or
any actions governmental authorities take in connection with COVID-19 may result in a decrease in demand for our
services and could adversely impact our business. The potential impact of the outbreak with respect to our markets or
our business is difficult to predict.
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16. Subsequent Events
The Company has evaluated new information and events through April 29, 2022, which is the date these consolidated
financial statements were available to be issued, to determine the need to either update these consolidated financial
24
Notes to Consolidated Financial Statements – Continued
statements or to provide additional disclosures about those events. No additional disclosures were deemed necessary by
the Company.
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EN
D
FI
N
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25
RFP 23-544 AMBULANCE SERVICES PAGE 31
ATTACHMENT C
RFP 23-544
Ambulance Services
Ambulance Service Questionnaire
1. Will the Proposer be able to provide Basic Life Support (BLS) level of ambulance service at
five (5) separate stadium venues, for varsity football games? (Thursday and Friday evening)
x
Yes_____ 875
No_____
Company will be able to provide BLS and ALS level of services for
Explain: ___________________________________________________________
all five (5) venues for varsity football games (Thursday and Friday evenings).
___________________________________________________________________
2. Will the Proposer be able to provide BLS level of ambulance service at five (5) separate
stadium venues, for junior varsity football games? (Monday evening)
x
Yes_____
175,000
No_____
Company will be able to provide BLS and ALS level of services at
Explain: ___________________________________________________________
five (5) separate venues for junior varisty football games (Monday evenings).
__________________________________________________________________
3. Will the Proposer be able to provide BLS level of ambulance service at five (5) separate
stadium venues, for middle school football games? (Saturday morning)
x
Yes_____ 875
No_____
Company will be able to provide BLS and ALS level of services at five (5) separate
Explain: ___________________________________________________________
venues for Middle School football games (Tuesday-Thursday afternoons & Saturday mornings).
__________________________________________________________________
4. Will the Proposer be able to provide BLS level of ambulance service at three (3) stadium venues,
for middle school track and one (1) stadium venue for varsity and junior varsity track meets?
(Tuesday – Thursday afternoons and Saturday morning)
x
Yes_____
113,750
No_____
Company will be able to provide BLS and ALS services at (3) venues for Middle School Track
Explain: ___________________________________________________________
one (1) venue for Varsity and Junior Varsity Track meets (Tuesday-Thursday, and Saturday mornings).
__________________________________________________________________
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
30
RFP 23-544 AMBULANCE SERVICES PAGE 32
5. Will the Proposer be able to provide BLS level of ambulance service at five (5) separate
stadium venues, for soccer games? (Monday – Thursday afternoons)
Yes_____x 875
No_____
Company will be able to provide BLS and ALS level of services
Explain: ___________________________________________________________
at five (5) separate venues for soccer games (Monday-Thursday afternoons).
__________________________________________________________________
6. Will the Proposer be able to provide BLS level of ambulance service at five (5) separate
stadium venues, for lacrosse games? (Monday – Thursday afternoons)
Yes_____x 100,625
No_____
Company will be able to provide BLS and ALS level of services at five (5)
Explain: ___________________________________________________________
seperate venues for Lacrosse games (Monday - Thursday afternoons).
__________________________________________________________________
7. Will the Proposer be able to provide BLS level of ambulance service at five (5) separate stadium
venues, for lacrosse games? (Monday – Thursday afternoons)
Yes_____x 875
No_____
Company will be able to provide BLS and ALS level of services at five (5)
Explain: ___________________________________________________________
separate venues for Lacrosse games (Monday - Thursday afternoons)
__________________________________________________________________
8. Will the Proposer be able to provide BLS level of ambulance service at one (1) stadium venues,
for high school graduations? (Monday – Friday)
Yes_____x 6,125
No_____
Company will be able to provide BLS and ALS level of services
Explain: ___________________________________________________________
at one (1) venue for High School Graduations (Monday - Friday)
__________________________________________________________________
9. Will the Proposer be able to submit copies of Emergency Medical Technician (EMT)
certification/licenses for all personnel that would be assigned to provide these services for
DeKalb County School District.
Yes_____x 875
No_____
Company will be able to submit all certifications & licenses for personnel
Explain: ___________________________________________________________
that would be assigned to all DeKalb County School District events/venues.
__________________________________________________________________
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
31
RFP 23-544 AMBULANCE SERVICES PAGE 33
10. Are the proposed vehicles to be used for this contract equipped with the following?
X
Yes_____ No______ 2 Certified EMTs
X
Yes_____ No______ Car seat
X
Yes_____ No______ IV Pumps
X
Yes_____ No______ AED/Defibrillator
X
Yes_____ No______ Vent - Adult; Pedi, and Infant
X
Yes_____ No______ Cardiac Monitor
X
Yes_____ No______ O2 Tanks
X
Yes_____ No______ Pulse Oximeter
X
Yes_____ No______ Suction
X
Yes_____ No______ V/S Monitor
X
Yes_____ No______ Airway Equipment
X
Yes_____ No______ Emergency Meds
X
Yes_____ No______ Hemorrhage Equipment
X
Yes_____ No______ Splinting Equipment
X
Yes_____ No______ Traction Splinting Equipment
X
Yes_____ No______ Proper C-Spine Immobilization Equipment
X
Yes_____ No______ Proper Face Mask Removal Equipment
X
Yes_____ No______ Linens
The BLS units are fully equipped with all items listed above. ALS units are also fully equipped with all items listed
above; however, the ALS units are staffed by two (2) paramedics and has additional advance level equipment such
as cardiac drugs, advance airway adjuncts, and the ability to perform additional advance life support interventions.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
32
RFP 23-544 AMBULANCE SERVICES PAGE 34
ATTACHMENT D
RFP 23-544
Ambulance Services
Cost Proposal Form
Estimated
Estimated Total Vendor Per Event
Number of
Event Hours Cost Total Cost
Games/Events
(b) Column (a) x (c)
(a) (c)
Varsity Football Games 200 300
875
$_____________ 175,000
$_____________
Junior Varsity Football 130 120
875
$_____________ 113,750
$_____________
Games
Middle School Football
Games 115 125 875
$_____________ 100,625
$_____________
Varsity, Junior Varsity, 7 140
875
$_____________ 6,125
$_____________
and Middle School Track
Soccer Games 300 1800
875
$_____________ 262,500
$_____________
Lacrosse Games
875
$_____________ 87,500
$_____________
100 300
High School Graduations
1925
$_____________ 38,500
$_____________
20 25
784,000
$_____________
TOTAL COST
Metro Ambulance Services, Inc
DBA American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
33
RFP 23-544 AMBULANCE SERVICES PAGE 35
ATTACHMENT E
RFP 23-544
Ambulance Services
Critical Paragraphs
Offerors must put their initials in the space provided in front of each critical paragraph and
sign below. Initials signify that the information has been read and the offeror agrees to comply
to the requirement, stipulations, terms and conditions. Attach and label “Critical Paragraph.”
1) ____ This RFP does not commit DCSD to any offeror to this RFP. DCSD is not liable for any costs
incurred by an offeror in responding to this RFP. There is no guarantee of any offeror receiving
an award or contract as a result of submitting a response to this RFP.
2) ____ Any news release or publicity pertaining to any phase of this RFP will be the responsibility of
DCSD and must be cleared through the DCSD’S Department of Communications and
Community Relations.
3) ____ It is the responsibility of offerors to make themselves aware of and to comply with any addenda,
questions and answers posted to the DCSD website in relation to this RFP. All addenda must
be printed, signed by the certifying official and included in the RFP submittals. Failure to do so
will cause the offeror to be deemed non-responsive to the requirements of this RFP.
4) ____ Offerors to the RFP agree to fully indemnify DCSD as stated in the RFP, Part II, H, page 18.
5) ____ Offerors certify that they have not engaged in collusion and guarantee that their response is not
made in conjunction with or on behalf of another party and that they have not been directly or
indirectly induced or acted in any manner to result in restriction of trade or unfair advantage.
6) ____ The DCSD reserves the right to reject any and/or all responses submitted and to waive any
technicalities or minor irregularities in responses received. DCSD reserves the right to award
any resulting contract in the manner that is in the best interest of and most advantageous DCSD.
7) ____ Offeror understands that this solicitation requires Board of Education Approval.
Metro Ambulance Services, Inc
DBA American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
34
RFP 23-544 AMBULANCE SERVICES PAGE 36
ATTACHMENT F
RFP 23-544
Ambulance Services
OFFEROR’S CLIENT REFERENCES
(Please copy this form and use one form per reference.)
Attach and label “Offeror’s Client References.”
Rugby ATL
_______________________________
Company Name Providing Reference
598 W Atlanta Street SE, Marietta, GA 30060
_______________________________
Address City/State/Zip
Mark Carney
_______________________________
Name of Contact Person
707-999-8828
_______________________________
Telephone Number of Contact Person
mcarney@rugbyatl.rugby
_______________________________
Email Address of Contact Person
2022-Current
_______________________________
Date/Duration of Service Relationship
Describe in Detail Services Provided (use additional sheets if necessary):
Provide Paramedic / EMT (ALS&BLS)
(1) Year contract, set to expire on 5/01/2023
Time Period of Project or Contact _______________________________________________
Important! This is a vital part of your RFP submission. DCSD will verify client
references. It is advisable that you inform your reference contact person that you have
listed them for reference.
__________________________________________________________________________________________
__________________________________________________________________________________________
Metro Ambulance Services, Inc
DBA American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
35
RFP 23-544 AMBULANCE SERVICES PAGE 36
ATTACHMENT F
RFP 23-544
Ambulance Services
OFFEROR’S CLIENT REFERENCES
(Please copy this form and use one form per reference.)
Attach and label “Offeror’s Client References.”
DEKALB FIRE RESCUE DEPARTMENT
_______________________________
Company Name Providing Reference
1950 W. Exchange Place, Tucker, GA 30084
_______________________________
Address City/State/Zip
Darnell D. Fullum, Fire Chief
_______________________________
Name of Contact Person
(678) 406-7731
_______________________________
Telephone Number of Contact Person
Ddfullum@dekalbcountyga.gov
_______________________________
Email Address of Contact Person
5 years
_______________________________
Date/Duration of Service Relationship
Describe in Detail Services Provided (use additional sheets if necessary):
911 Emergency Medical Services transport provider for DeKalb County
01/01/2020 - 12/31/2024
Time Period of Project or Contact _______________________________________________
Important! This is a vital part of your RFP submission. DCSD will verify client
references. It is advisable that you inform your reference contact person that you have
listed them for reference.
__________________________________________________________________________________________
__________________________________________________________________________________________
Metro Ambulance Services, Inc
DBA American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
36
RFP 23-544 AMBULANCE SERVICES PAGE 36
ATTACHMENT F
RFP 23-544
Ambulance Services
OFFEROR’S CLIENT REFERENCES
(Please copy this form and use one form per reference.)
Attach and label “Offeror’s Client References.”
Troup County School System (Football Coverage)
_______________________________
Company Name Providing Reference
100 North Davis Road – Building C LaGrange, GA 30241
_______________________
Address City/State/Zip
Steven D. Heaton, District Athletic Director
_______________________________
Name of Contact Person
(706) 812-7900
_______________________________
Telephone Number of Contact Person
Heatonsd@troup.org
_______________________________
Email Address of Contact Person
10 years
_______________________________
Date/Duration of Service Relationship
Describe in Detail Services Provided (use additional sheets if necessary):
Provided EMS services for football games at sporting venue
Annual Contract (July – July)
Time Period of Project or Contact _______________________________________________
Important! This is a vital part of your RFP submission. DCSD will verify client
references. It is advisable that you inform your reference contact person that you have
listed them for reference.
__________________________________________________________________________________________
__________________________________________________________________________________________
Metro Ambulance Services, Inc
DBA American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
37
RFP 23-544 AMBULANCE SERVICES PAGE 37
ATTACHMENT G
RFP 23-544
Ambulance Services
Statement of Confidentiality and Non-Disclosure
Any non-public information made available to the offeror by DCSD in relation to this RFP shall be used
only for those purposes outlined in the RFP document and shall not be used in any other way without
the written permission of the DCSD.
If the offeror is uncertain about the proposed use of information provided in relation to this RFP, the
offeror shall consult with the DCSD RFP contact person as identified in the RFP document for
clarification.
The offeror agrees to assume full responsibility for protecting the confidentiality of DCSD records that
are not public information. Such information may include, but is not limited to student and employee
data and other written and oral information of a personal and/or confidential nature, which shall be
safeguarded by the offeror to ensure that it is not improperly disclosed.
Metro Ambulance Services, Inc DBA American Medical Response (AMR)
__________________________________
Offeror Company Name
Chris Valentin, Regional Director
__________________________________
Company Representative
11/29/2022
__________________________________
Date
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
38
RFP 23-544 AMBULANCE SERVICES PAGE 38
Attachment H
RFP 23-544
Ambulance Services
SUSPENSION AND DEBARMENT CERTIFICATION
By submitting this RFP, the offeror certifies that the proposing company and/or its principals have not been
suspended, excluded, disqualified, debarred, proposed for debarment, declared ineligible or voluntarily excluded
from participation in any transaction by any federal or state department or agency and that the offeror complies
with all applicable orders, rules and regulations related thereto.
Further, by submitting this RFP, the offeror certifies that all lower tier participating individuals and/or company(s)
and all respective principals of lower tier participants have not been suspended, excluded, disqualified, debarred,
proposed for debarment, declared ineligible or voluntarily excluded from participation in any transaction by any
federal or state department or agency and that the offeror complies with all applicable orders, rules and
regulations related thereto.
The certification placed herein is a material representation of fact upon which reliance will be placed as RFP
submissions are evaluated and any transaction is entered into. If it is later determined that the prospective
offeror has knowingly rendered an erroneous certification, the DCSD may pursue all available remedies,
including but not limited to suspension and/or debarment.
The prospective offeror shall provide immediate written notice to the DCSD Purchasing Department if at any
time the prospective offeror learns that its certification was erroneous when submitted or has become erroneous
by reason of changed circumstances.
The prospective offeror agrees by submitting this form that, should the proposed transaction be entered into, the
prospective offeror shall not knowingly enter into any lower tier transaction with a person or entity that is
debarred, suspended, declared ineligible, or voluntarily excluded from participation in this transaction.
By signing and submitting this form, the offeror is providing the certification set out above.
Metro Ambulance Services, Inc DBA
American Medical Response (AMR) 11/29/2022
Signature of Engaging Official: _________________________________________ Date: _____________
(Offeror Company Name/Certifying Official Signature)
Chris Valentin, Regional Director of Operations
Further, the DCSD’s Purchasing Department will check the SAMS website at http://sams.gov to determine if
the offeror is listed.
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
SUPPLIER NAME/ CERTIFYING OFFICIAL SIGNATURE
39
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41
42
43
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RFP 23-544 AMBULANCE SERVICES PAGE 64
ATTACHMENT K
RFP 23-544
Ambulance Services
SIGNATURE PAGE
I certify that I have read this RFP document in its entirety and agree to conform to and comply with the
terms, conditions and requirements of this RFP. I also certify that I am a duly appointed official of the
offering company with the authority to authorize and engage this RFP submittal. Further, I certify that
the contents of the response to this RFP are true, accurate and complete.
Christopher Valentin
Metro Ambulance Services, Inc. dba
American Medical Response (AMR)
______________________________ Regional Director of Operations
_______________________________
Printed Name/Engaging Authorized Position/Title
Company Official
Metro Ambulance Services, Inc. dba
American Medical Response (AMR)
_______________________________
Offeror’s Company Name
Metro Ambulance Services, Inc
DBA American Medical Response
_______________________________ chris.valentin@gmr.net
________________________________
Signature/Engaging Authorized E-mail address
Company Official
909-841-2354
________________________________
Telephone Number
11/29/2022
______________________________
Date
Metro Ambulance Services, Inc DBA
American Medical Response
______________________________________________
COMPANY NAME/ CERTIFYING OFFICIAL SIGNATURE
46
DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 �
...,MR.
1. AMR COMPANY PROFILE
Date of establishment, mission statement, type and confirmation of company's legal entity form, company's
organizational structure/chart, principals' names and titles, company size in relation to industry, number of
employees, company history, financial position, and all relevant current and past experience on similar projects in
comparable K-12 school districts and references for those projects. The offerer should also include the educational
background for staff that will be assigned to this project, including the company's overall experience in providing
the requested services within this solicitation..
AMR HISTORY
As part of the Global Medical Response (GMR) nationwide family of companies, we have pioneered the
delivery of healthcare to patients through new technologies, homegrown initiatives, and support from
regional and industry national experts. AMR has unmatched experience in providing high quality,
performance-based ambulance services to communities and contracts similar to this RFP. With 39,000
national employees and a fleet of 8,100 vehicles, GMR cares for millions of patients a year in thousands
of communities nationwide.
8,100 375 132 158
Ground �-I) Rotor-Wing Fire
Vehicles Aircraft Vehicles
12.1 million
39 ' 000
Clinicians and Support Personnel
4, Q Q Q
patients treated last year
Communities
379
We performed a
critical intervention Air Base Locations
10
every
65 Communication Centers
minutes.
48 Fire Stations
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � ,MR.
...
Today, we provide emergency/911 Advanced Life Support ("ALS") and/or Basic Life Support ("BLS")
ambulance transport services for more than 4000 communities across the United States GMR
Overview (https://global-medical-response.wistia.com/medias/gdpi0cm0ax). Currently, more than 50
of our clients have populations of 200,000 or more. This support structure gives us a stable financial
backing as well as a vast network of national resources, including a close integration with community
hospitals and physicians.
Company Name Metro Ambulance Services, Inc. dba American Medical Response (AMR)
Address 1380 Beverage Dr. Suite D, Stone Mountain, Georgia 30083
Contact Name Christopher Valentin, Regional Director of Operations
Email chris.valentin@gmr.net
Phone Number 909-841-2354
Business Size Corporation I Large Business
Date of Establishment 8/20/1968
Company Size AMR 28,000+ I Metro Ambulance Services, Inc. GA 473
Chart - Please see page 47 for the AMR organization chart.
Principals' Names And Titles:
Edward B. Van Horne President and Chief Operating Officer
Michael E. Preissler Executive Vice President, Chief Financial Officer and
Chief Administrative Officer
Thomas A.A. Cook Executive Vice President, General Counsel, and Secretary
Jennifer Mardosz Senior Vice President and Chief Compliance Officer
Lisa Jacoba Senior Vice President and Chief Human Resources Officer
Sean Tuley Senior Vice President and Chief Information Officer
Eric J. Thomas Senior Vice President of Revenue Management
Ed Racht Senior Vice President and Chief Medical Officer
Karl Metcalf Vice President - Tax
Scott Andreasen Assistant Secretary
Company Size In Relation To Industry - Large
Number of Employees - AMR 28,000+ I Metro Ambulance Services, Inc. GA 473
Financial Position - AMR is a corporation and has been in business for 30 years. Collectively, AMR is
the ground ambulance service solution for the Global Medical Response (GMR) family of companies, a
privately held corporation with annual revenues over $4 billion, $530 million available on our line of
credit and more than $200 million in cash and cash equivalents on-hand.
Experience on similar projects in comparable K-12 school districts - Please see the experience listed
on page 53.
References - Please see the references provided in Attachment F.
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � ,MR.
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Wilmond Meadows Chief Meadows is trained as a certified paramedic and has
over 30 years of experience with the Atlanta Fire Department. The Deputy Chief
of Support Services is responsible for several logistical functions across the
department including the Fleet maintenance and repair of all departmental
vehicles, equipment, and facilities. The division manages budgetary processes and
procures all equipment, materials and supplies for the department.
/I: ....I ��.,-�-
Deputy Chief of Training and Professional Services manages AMR Dekalb
,, County EMS Training which provides training and professional development for
caregivers and all incumbent EMS personnel. This Operations supports
Deployment, Fleet Services, Continue Education and Workforce Deployment,
Human Resources, Internal Affairs, Recruiting and Pre-Billing and the Compliance Standards providing
important support functions for the department. Wilmond holds the following certifications: GA State
Paramedic with National Registry, ACLS, PALS, CPR. Primary Role/Duties: Deputy Chief of Support
Services in charge of fleet/equipment maintenance and repair.
Tedd Winneberger AMR Operations Manage (North Fulton), is a seasoned
Paramedic with over 30 years of experience. Throughout his career, he has
worked in multiple EMS systems. He started his career in ALS in 1989, working for
West Jersey Health Systems in Southern New Jersey. In this role, he provided ALS
coverage for both Atlantic and Cape May Counties, spending most of his time in
Atlantic City. In 1993, he was hired by Sussex County Emergency Medical Services
(SCEMS), a high performance and progressive system in southern Delaware.
During his tenure at SCEMS, he was promoted through the ranks from Paramedic I
to Paramedic Ill. As a Paramedic Ill, along with his duties as a medic, he was also
an assistant shift supervisor. He also served the departments as a Public
Information Officer (PIO) and as a Special Operations Coordinator. In the PIO role, he was responsible
for all official department communications. His special operations duties included oversite of the
department's Special Operations Team. During this time, Tedd was also active at the state level serving
on many committees to include the State Protocol Committee. While at SCEMS, Tedd joined FEMA as
part of the National Disaster Medical System (NDMS). He then went to FEMA full time as a Logistics
Chief responsible for medical logistics during and after the 2005 hurricane season. Tedd started his
time at AMR as the Special Programs Operations Supervisor for the AMR Capital Region. In this role,
Tedd was responsible for the management of the Critical Care Transport teams assigned to multiple
hospital systems, transporting the highest acuity patents. Tedd is currently serving as the Operations
Manager for the North Fulton Operation in Roswell. He is a national registered paramedic in addition to
Maryland, Florida and D.C., holds 17 various Life Support, Hazmat and Firefighter related certifications
and has 600+ hours of training regarding Special Operations, Hazmat Response, Incident Management,
Operations Planning and Emergency Response. Primary Role/Duties: Tedd will handle oversite of all
EMS Operations in the North Fulton Market.
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � ,MR.
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Matt Peczka, is AMR's Clinical and Education Manager. He has 20 years of EMS
experience. Matt graduated with honors from Springfield College with a bachelor's
degree in EMS Management, and obtained both his EMT and Paramedic
certifications while completing his degree. During his 20 years in EMS, Matt has
worked in a variety of EMS settings including private EMS, fire-based EMS, and
pediatric critical care. Matt became a Georgia EMS Instructor in 2012 and has
taught in both private EMS training programs as well as the Technical College
System of Georgia. He came back to AMR in 2014 and quickly assumed the role of
Clinical Manager in the Georgia Operations. Matt currently serves as a Regional
Manager of Clinical Practices in GMR's Southeast Region where he supports both
the American Medical Response footprint in Georgia and Florida as well as the Georgia bases of Air
Evac Lifeteam. He is also an instructor in Collaborative High-Reliability and Just Culture and leads a
team of internal instructors representing all of GMR's solutions. Matt has a passion for creating reliable
and resilient systems, aggressively advocating for high quality evidence-based clinical care, and
developing up-and-coming leaders within GMR. Primary Role/Duties: Matt will manage clinical
education.
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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AMR Organization Chart
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � ,MR.
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AMERICAN MEDICAL RESPONSE EVENT MEDICAL SERVICES
AMR is more than a healthcare provider. AMR is the nation's most experienced provider of event
medical standby services and first aid. AMR has several long-standing relationships with convention
centers, large-scale venues and stadiums, sports facilities, and festivals to provide event medical
standby services, both nationally and throughout the State of Georgia. We pride ourselves on the
partnerships we have built in becoming an industry leader of ambulance and event medical standby
services throughout the nation.
AMR supports some of the nation's prominent racetracks and speedways, along with being the national
EMS provider for NASCAR and the official sponsor for the INDYCAR safety team. In 2019, AMR became
the official EMS Safety Team Provider for IMSA Racing providing a dual paramedic safety team.
AMR can provide DCSD students, staff, guests, spectators, and officials with industry-best practices
and a suite of customized solutions. Over the years, AMR has evolved as an industry leading
transportation provider, remaining responsive, reliable, and respected in all we do.
Across the country, AMR provides high-quality medical transportation to countless events at various
venues under GMR's service footprint. As a result, we have developed solid protocols and robust
relationships with our community partners for years, aiding in times of disaster and providing education
and support.
••
••••••
• ••••••••••
••••••••••••••
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 �
... ,MR.
AMR believes in making a difference by caring for people in need. From our core services to our
customer philosophy to our corporate structure, we create and embrace good things for the customers
and communities we serve.
Since our inception, AMR has provided a menu of medical transportation solutions including, but not
limited to, Advance Life Support ("ALS"), Basic Life Support ("BLS"), Critical Care Transport ("CCT"),
pediatric support and bariatric services. We also provide emergency response and dispatch services,
non-emergency transport services, air ambulance services, event medical services, managed
transportation services, and disaster management services among our robust suite of options.
Our dedication to patient outcomes is reflected throughout our organization thanks to a culture built
on quality and integrity. We have become the industry leader by serving others. By attracting the
brightest, most qualified personnel, supported by extensive national resources and comprehensive
programs, AMR offers an unequaled partnership in the delivery of a high standard of medical
transportation.
LOCAL DEDICATION
Our history and roots run deep in the
State of Georgia. For decades, AMR.
through its predecessor companies
has proudly served numerous
emergency and non-emergency
systems throughout the state,
demonstrating an unwavering
commitment to enhancing patient
satisfaction for those we serve.
Please see the map of the GMR
county service areas in the state of
Georgia here.
... GMR County Service Areas
� GMR Ground Operations
� GMR Rotor Wing Bases
Metro Ambulance Services, Inc DBA
American Medical Response (AMR) 54
Qualified Partner
Qualified Personnel
55
56
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � ,MR.
...
We use the LIFEPAK 15 in many of our operations because it
includes unique clinical capabilities, such as non-invasive monitoring
for Sp02, carbon monoxide and methemoglobin to detect chemical
exposures.
With this device, not only can DCSD easily acquire a pre-medication
12-lead electrocardiogram ("ECG"), we can also rely on the device to
continuously monitor all 12 leads in the background while we treat
the patient. This lets crews monitor multiple parameters while
allowing defibrillating and pacing, making it easier for them to
manage technology and critical situations at the same time.
LICENSING
AMR medical personnel are all fully licensed and certified by the state of Georgia as Emergency Medical
Technicians, either Basic or Intermediate and Paramedics.
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � ,MR.
...
2.REFERENCES
AMR has several local partnerships with venues for various public events. We have worked to
streamline emergency and non-emergency transportation, thanks to our well-established relationships
with local medical facilities. Please see the following references for three of our current operations and
programs. The partners are also listed on Attachment F - Offeror's Client Reference Form.
DEKALB FIRE RESCUE DEPARTMENT
Contact I Title Darnell D. Fullum, Fire Chief
Address 1950 W. Exchange Place, Tucker, GA 30084
Phone (678) 406-7731
Email Ddfullum@dekalbcountyga.gov
Description of Services 911 Emergency Medical Services transport provider for DeKalb County
Contract Period 01/01/2020 - 12/31/2024
RUGBY ATL
Contact / Title Mark Carney
Address 598 W Atlanta Street SE, Marietta, GA 30060
Phone (707) 999-8828
Email mcarney@rugbyatl.rugby
Description of Services Provide Paramedic / EMT (ALS and BLS)
Contract Period 05/01/2022 - 05/01/2023
TROUP COUNTY SCHOOL SYSTEM (FOOTBALL COVERAGE)
Contact / Title Steven D. Heaton, District Athletic Director
Address 100 North Davis Road - Building C LaGrange, GA 30241
Phone (706) 812-7900
Email Heatonsd@troup.org
Description of Services Provided EMS services for football games at sporting venue
Contract Period 10 years
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � ,MR.
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3-BROCHURES, CATALOGS, MANUALS,
WEBSITES, LITERATURE
Metro Ambulance Services, Inc DBA
American Medical Response (AMR) 60
DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 �
... ,MR.
NATIONAL STRENGTH, LOCAL COMMITMENT
With more than 28,000 national employees
and 8,600 ground emergency vehicles,
American Medical Response (AMR)
provides services to millions of patients
a year in thousands of communities
nationwide. This nationwide structure
gives our local operations a stable financial
backing, as well as a vast network of
resources that allow us to integrate with
the communities we serve and leverage
economies of scale to provide cost
effective, high-quality pre-hospital care.
We work collaboratively with our community partners, building relationships based on mutual
trust and a shared commitment to getting patients the medical treatment they need, when
they need it. Our goal of providing care to the world at a moment's notice begins locally: one
community and one patient at a time. This patient-centered-care delivery model ensures that
we provide the right level of care at exactly the right time and in the most appropriate setting,
for any given patient.
THE INDUSTRY LEADER IN EMS
AMR is the ground emergency medical services arm of the Global Medical Response (GMR)
family of solutions. GMR is the industry-leading ground, air, specialty and residential fire
services and pre-hospital innovation company. With nearly 39,000 employees, GMR delivers
compassionate, quality medical care, primarily in the areas of emergency and patient
relocation services, in the United States and around the world.
AMR SERVICES OVERVIEW*
We continuously earn the privilege to care for our patients. It is at the forefront of everything we do.
■ 911 operations ■ Bariatric transport
■ lnterfacility transport ■ Wheelchair van services
■ Basic life support (BLS) ■ Scheduled transport
■ Advanced life support (ALS) ■ Event medical/special events
■ Specialty care/critical care transport ■ Patient billing and management
·services vary by locaaon
GROUND AND AIR COVERAGE
Through GMR, we also have access to the nation's leading air medical operations. From coast to
coast and internationally with rotor-wing and fixed-wing aircraft, we can expand our service area
to reach patients in need and transport them to facilities with the level of care that matches their
requirements. This is especially important in more rural areas that have less access to medical
resources, such as Level 1 Trauma Centers.
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � lf'iMR.
THE AMR DIFFERENCE*
We are dedicated to being good stewards of the communities we serve. We are accountable for
what we do and take pride in how we do it.
■ Conduct more than 12.1 million critical, emergent and non-emergent patient encounters each year
■ Partner with more than 5,000 healthcare facilities from coast to coast
■ Approximately 230 performance-based 911 contracts nationally, 50 covering communities
with populations exceeding 200,000
■ Largest ambulance fleet in the nation with more than 8,600 meticulously maintained vehicles
■ Industry-leading vehicle maintenance programs
■ 65 communication centers nationwide, 25 of which are Accredited Centers of Excellence by
the International Academies of Emergency Dispatch (IAED)
■ A patient database of more than 33 million current patient records
■ Prime contractor with the Federal Emergency Management Agency (FEMA), providing
ground ambulance, air ambulance, paratransit services and non-ambulance EMS personnel
to supplement the federal and military response to a disaster, act of terrorism or any other
public health emergency
■ Training communities in bystander, compression-only CPR and in stemming blood loss during
World Save a Life Challenge
•As of 03 2022
INNOVATION DRIVES EVOLUTION
The global COVID-19 pandemic underscored the fact that the healthcare industry must
continuously evolve. AMR taps into the innovative solutions of GMR, allowing us to provide
our partners with the latest advancements in healthcare technology. GMR is driven to develop
solutions that inspire progress. These include:
Transportation Management Platform: Enables the scheduling of any level of medical
transport at the click of a button with our Online Ordering tool
Nurse Navigation Line: Provides quick, accurate patient triage to determine the right
locus of care
Transfer Center: Offers a hospital throughput solution to coordinate, manage and
schedule medical transports
Managed Transport: Provides Non-Emergency Medical Transport (NEMT) through
customized local programs
Hospital at Home: Provides all in-home clinical services to high-acuity patients at the
direction of virtual clinicians, partnering with hospitals in the Centers for Medicare
and Medicaid Services (CMS) Hospital at Home program
B
Concierge Model: Resolves common patient movement challenges by providing a
predetermined scheduling window to distribute discharges over several hours, allowing
hospitals to reduce or eliminate the need for a subsidized ambulance service
Metro Ambulance Services, Inc DBA
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DeKalb County School District (DCSD). Ambulance Services
Request for Proposal (RFP) 23-544 � ,MR.
...
Please see the following video for a demonstration of our extensive event medical experience as a GMR
company 2020 GMR Ev ent Medical Video.mp4
Metro Ambulance Services, Inc DBA
American Medical Response (AMR)
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