25-26 Metro Amb Svc Inc Generic COI - All Lines

AID 1778575 · View on Simbli

Agenda Item

i. Renewal for RFP 23-544 for Ambulance Services (Not to exceed $550,000)

Summary: Triscilla Weaver, Ph.D., Chief of Access and Opportunity, Division of Access & Opportunity
Request: It is requested that the Board of Education approve the second of four one-year renewals for RFP 23-544 for ambulance services provided by Metro Ambulance Services Inc., doing business as American Medical Response, for an amount not to exceed $550,000.
Why: The DeKalb County School District continues to contract with Metro Ambulance Services, Inc., doing business as American Medical Response, to provide basic life support (BLS) ambulance services during athletic and district events. 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 events; as well as cross country, lacrosse, and soccer games.

The ambulance company will be required to be present throughout each event. The ambulance must be a basic life support vehicle equipped with all the necessary BLS equipment required by the State of Georgia Department of Public Health Rules and Regulations 511-9-2 for ground ambulance services.
Details: Emergency Medical Technicians (EMTs) play a vital role in responding to sports emergencies by providing immediate medical care to athletes who are injured or experience medical issues during events. EMTs are trained to quickly assess and stabilize individuals in critical condition, ensuring rapid intervention to reduce the severity of injuries and improve recovery outcomes. In sports, timely medical attention is crucial due to the nature of many injuries. EMTs can significantly impact the outcome by preventing complications and accelerating the recovery process.

American Medical Response has provided services for DCSD Athletics for the past seven years and has been the only company capable of handling the high volume of events required. American Medical Response will be required to have an ambulance present for the entire duration of each event. The ambulance dispatched to DCSD athletic and district events will be a Basic Life Support (BLS) unit, fully equipped with the necessary equipment as mandated by the Georgia Department of Public Health Rules and Regulations (511-9-2).
Financial impact: The total budget for these services is allocated from the cost code (100.2500.530200.00011.7090.9990.8010.092.0000) under the Athletics’ General Fund Budget in the amount not to exceed $550,000.
Contact: Triscilla Weaver, Ph.D., Chief of Access and Opportunity, Division of Access & Opportunity, 678-676-0485
Mrs. Myss Johnson-Jelks, Executive Director of Athletics, Division of Access & Opportunity, 678-676-1824
Effective: Upon Board Approval
Status: Approved by the Office of Legal Affairs
                                                                                                                                                                      DATE(MM/DD/YYYY)
                                     CERTIFICATE OF LIABILITY INSURANCE                                                                                                   03/25/2025

    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.




                                                                                                                                                                                                                                                                     Holder Identifier :
    IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If
    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                    (A/C. No.):
                                                                                                                                                             (800) 363-0105
Philadelphia PA Office
100 North 18th Street                                                                        E-MAIL
16th Floor                                                                                   ADDRESS:
Philadelphia PA 19103 USA
                                                                                                                  INSURER(S) AFFORDING COVERAGE                                NAIC #

INSURED                                                                                      INSURER A:         ACE American Insurance Company                             22667
Metro Ambulance Service, Inc.                                                                INSURER B:         ACE Fire Underwriters Insurance Co.                        20702
1380 Beverage Drive
Suite D                                                                                      INSURER C:         Indemnity Insurance Co of North America                    43575
Stone Mountain GA 30083-2133 USA                                                             INSURER D:         Underwriters At Lloyds London                              15792
                                                                                             INSURER E:         ACE Property & Casualty Insurance Co.                      20699
                                                                                             INSURER F:

COVERAGES                                        CERTIFICATE NUMBER: 570111624754                                               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                          XSLG48960455               03/31/2025 03/31/2026 EACH OCCURRENCE                                           $2,750,000
                                                                 SIR applies per policy terms & conditions        DAMAGE TO RENTED
                 CLAIMS-MADE    X   OCCUR                                                                                                                                      $100,000
                                                                                                                                     PREMISES (Ea occurrence)
                                                                                                                                     MED EXP (Any one person)                   $10,000
                                                                                                                                                                            $2,750,000




                                                                                                                                                                                                                                                                      570111624754
                                                                                                                                     PERSONAL & ADV INJURY

       GEN'L AGGREGATE LIMIT APPLIES PER:                                                                                            GENERAL AGGREGATE                      $5,000,000
                       PRO-
       X POLICY
                       JECT
                                     LOC                                                                                             PRODUCTS - COMP/OP AGG                 $2,750,000
           OTHER:                                                                                                                    SIR                                       $250,000
A      AUTOMOBILE LIABILITY                                      ISA H10817614                         03/31/2025 03/31/2026 COMBINED SINGLE LIMIT
                                                                                                                                                                           $10,000,000
                                                                                                                                     (Ea accident)




                                                                                                                                                                                                                                                                          Certificate No :
           ANY AUTO                                                                                                                  BODILY INJURY ( Per person)
       X
                                SCHEDULED                                                                                            BODILY INJURY (Per accident)
           OWNED
                                AUTOS
           AUTOS ONLY                                                                                                                PROPERTY DAMAGE
           HIRED AUTOS          NON-OWNED
                                AUTOS ONLY                                                                                           (Per accident)
           ONLY
       X   Comp Ded $2500   X   Coll Ded $2500

 E     X   UMBRELLA LIAB        X   OCCUR                        XCQG72514816005                       03/31/2025 03/31/2026 EACH OCCURRENCE                               $10,000,000
                                                                 Umb - Auto
           EXCESS LIAB              CLAIMS-MADE                                                                                      AGGREGATE                             $10,000,000
           DED      RETENTION
 C     WORKERS COMPENSATION AND                                  WLRC72631110                          03/31/2025 03/31/2026 X             PER STATUTE       OTH-
       EMPLOYERS' LIABILITY                                                                                                                                  ER
                                                  Y/N            AOS
       ANY PROPRIETOR / PARTNER / EXECUTIVE                                                                                          E.L. EACH ACCIDENT                     $1,000,000
 B     OFFICER/MEMBER EXCLUDED?
                                                   N N/A         SCFC72631158                          03/31/2025 03/31/2026
       (Mandatory in NH)                                         WI                                                                  E.L. DISEASE-EA EMPLOYEE               $1,000,000
       If yes, describe under
       DESCRIPTION OF OPERATIONS below                                                                                               E.L. DISEASE-POLICY LIMIT              $1,000,000




                                                                                                                                                                                          7777777707070700077761616045571110747714337325555307643015662435111073441755367121100716377742346663107663614022757302077364015121035130756526734011355507043157322055012076727242035772000777777707000707007
                                                                                                                                                                                          7777777707070700073525677115456000723111407032402007630400074337562075733663431364100752337770742201407022227352162011070332373421731100702222735207211007133236253173011077756163351765540777777707000707007
 D     E&O - Professional Liability                              CSHLC2501663               03/31/2025 03/31/2026 Per Occ/Agg                                              $15,000,000
       - Excess                                                  Ex Prof(Claim Made)/Ex GL                        SIR - Ex Prof                                            $10,000,000
                                                                 SIR applies per policy terms & conditions        SIR - Ex GL                                               $3,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Evidence of Coverage.




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.

           Metro Ambulance Service, Inc.                                              AUTHORIZED REPRESENTATIVE
           1380 Beverage Drive, Suite D
           Stone Mountain GA 30083-2133 USA




                                                                                                  ©1988-2015 ACORD CORPORATION. All rights reserved.
     ACORD 25 (2016/03)                                    The ACORD name and logo are registered marks of ACORD
                                                                             AGENCY CUSTOMER ID: 570000073826
                                                                                          LOC #:

                                     ADDITIONAL REMARKS SCHEDULE                                                                         Page _ of _
 AGENCY                                                                        NAMED INSURED
 Aon Risk Services Central, Inc.                                               Metro Ambulance Service, Inc.
 POLICY NUMBER
 See Certificate Number: 570111624754
 CARRIER                                                         NAIC CODE
 See Certificate Number: 570111624754                                          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


   ADDITIONAL POLICIES               If a policy below does not include limit information, refer to the corresponding policy on the ACORD
                                     certificate form for policy limits.

                                                                                        POLICY         POLICY
 INSR                                    ADDL SUBR          POLICY NUMBER              EFFECTIVE     EXPIRATION                 LIMITS
  LTR            TYPE OF INSURANCE       INSD WVD                                        DATE           DATE
                                                                                     (MM/DD/YYYY)   (MM/DD/YYYY)
        WORKERS COMPENSATION



   A                                      N/A        WCUC72631195              03/31/2025 03/31/2026
                                                     OH
                                                     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