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HomeMy WebLinkAboutAscension St Vincent Carmel/CFD/Training Services 4859-2187-1858, v. 1 AGREEMENT FOR EMERGENCY MEDICAL SUPERVISION AND TRAINING SERVICES THIS AGREEMENT FOR EMERGENCY MEDICAL SUPERVISION AND TRAINING SERVICES (“Agreement”) is entered into by and between ST. VINCENT CARMEL HOSPITAL, INC. D/B/A ASCENSION ST. VINCENT CARMEL, an Indiana not-for-profit corporation (“Hospital”), and CITY OF CARMEL FIRE DEPARTMENT (“Department”). W I T N E S S E T H: WHEREAS, Department is an Emergency Response Organization certified by the Indiana Emergency Medical Services Commission (“Commission”) to provide emergency medical services to the residents served by Department; WHEREAS, Hospital has the expertise and capability to provide medical direction and supervision for emergency medical services providers; WHEREAS, Department desires that Hospital provide medical direction and control for its emergency medical services activities, as required by the Commission; WHEREAS, Hospital is certified by the Commission as a training institution approved to administer emergency medical services training programs; WHEREAS, Department desires Hospital to provide emergency medical services training and supervision on behalf of the Department’s Associates in ambulances and/or first response units operated by Department; WHEREAS, Hospital desires to provide emergency medical services training to Associates of Department; and WHEREAS, Hospital and Department previously entered into an Agreement for Life Support Services (“Original Agreement”), effective August 1, 2006, and the parties now wish to terminate the Original Agreement and replace it with the terms of this Agreement, as set forth herein. NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows: I. DEFINITIONS Unless otherwise clearly required by the context of this Agreement, the terms set forth below shall have the following meanings. Other terms used herein shall have the meanings ascribed thereto in the Act, as defined below. 1.1 “Act” shall mean the Indiana Emergency Medical Services Act, as outlined in Title 16, Article 31, of the Indiana Code, and the regulations promulgated thereunder in Title 836 of the Indiana Administrative Code, Articles 1 through 4. 1.2 “Associates” shall mean those persons employed or otherwise engaged by Department seeking Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18 By Benjamin J Legge at 9:12 am, Jan 21, 2025 Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 certification by the Commission to provide various levels of emergency medical services. 1.2 “Life Support” shall mean basic life support, intermediate life support, and advanced life support as those terms are defined in the Act. 1.3 “Medical Director” shall mean a physician, appointed by Hospital and authorized in writing by Hospital’s medical staff, who shall act as the Medical Director for Hospital in its role as Supervising Hospital for Department. 1.4 “Policies of Hospital” shall mean and include the Bylaws and rules of the Hospital, the Bylaws and rules of Hospital’s medical staff as approved by Hospital’s Board of Directors, and other established policies, practices and procedures of Hospital. 1.5 “Preceptor or Primary Instructor” shall mean those individuals employed by Hospital who are qualified to act as Preceptors/Primary Instructor for Associates. 1.7 “Training” shall mean emergency medical services training programs administered by Hospital on behalf of Associates through Hospital’s Preceptor or Primary Instructor pursuant to the terms of this Agreement. 1.8 “Workforce Member” shall mean persons whose conduct, in the performance of work for the Hospital, is under the direct control of the Hospital, including, but not limited to, personnel, employees, volunteers, trainees, and other employees of Hospital, whether or not they are paid by the Hospital. II. HOSPITAL SERVICES 2.1 Certification of Hospital. Hospital shall remain certified by the Commission as a Supervising Hospital and a Training Institution throughout the term of this Agreement. 2.2 Services. Hospital agrees to provide medical supervision of life support services performed by Department’s Associates in accordance with the Act. 2.2-1 Continuing Education. Hospital shall provide continuing education and instruction opportunities from time to time. Hospital agrees to provide continuing education and instruction in accordance with applicable regulations promulgated by the Commission and any other requirements established by the Commission. Hospital may establish guidelines or requirements which exceed those established by the Commission if deemed advisable by the Hospital in the interests of quality patient care. Department agrees that it shall not employ nor permit an Emergency Medical Technician (“EMT”), A-EMT, or paramedic to perform life support services on Department’s behalf unless the individual has successfully achieved the objectives of continuing education as determined by Hospital. Department agrees to comply with any additional guidelines or requirements established by Hospital related to continuing education under this Agreement. 2.2-2 Audit and Review. Hospital shall provide audit and review services from time to time for the purpose of assessing the level of performance of Department’s EMT, A-EMT, and/or paramedics and the overall performance levels of Department in its rendering of life support services. Hospital shall provide Department with data relevant to the quality of care provided by its EMT, A-EMT, and/or paramedics and its general performance of life support services. Such audit and review services will include, but are not limited to: routine audits of patient care based on review of patient records; Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 observance of field operations; inspections of equipment and facilities; and critiques of radio communications. Hospital shall also audit and review medical procedures performed by Department’s clinical personnel in order to ensure an appropriate level of compliance with medical protocols, and an appropriate level of skill in the performance of medical techniques by those personnel. 2.2-3 Medical Control and Direction. (a) Protocols. Hospital shall develop standardized policies and procedures for medical control and the development of system protocol and/or standing orders to ensure the proper response to all medical emergency situations by emergency personnel. The protocols shall be signed by the Medical Director or his designee and said protocols are incorporated herein by reference thereto and made a part of this Agreement. A protocol may be terminated or modified by mutual agreement of the parties or unilaterally by Hospital upon written notice to Department, wherein said termination or modification by Hospital shall be effective upon Department’s receipt of the Hospital’s written notice. (b) Location of Protocols. Copies (written or electronic) of complete and current protocols are to be kept in all Department certified emergency medical vehicles, the applicable county dispatcher’s office and in the Hospital Emergency Department. A copy shall also be provided to the Indiana Emergency Medical Services Commission. Department shall be responsible for distributing a copy of the protocols to its EMT, A-EMT, and/or paramedics and shall also distribute a copy of every written termination or modification of a protocol to its EMT, A-EMT, and/or paramedics. Hospital shall post copies of all written protocols and copies of every written termination or revision of a protocol in Hospital’s Emergency Department and shall make them immediately available to Department and Commission upon request. (c) Physicians’ Orders. Communication of an order from a physician in the Hospital’s Emergency Department, or elsewhere in the Hospital if applicable, shall take precedence over all written protocols. (d) Performance Standards. Hospital may establish standards regarding overall performance of Department’s EMT, A-EMT, and/or paramedics which may exceed those established by the Commission as Hospital, in its discretion, deems advisable in the interest of quality patient care. Department agrees to comply with all such performance standards within ninety (90) days after written notice of such performance standards is provided to Department by Hospital. Said ninety (90) day notice requirement shall not apply if Hospital determines that the performance standards must be implemented in a shorter period of time or upon immediate notice for medical or patient care reasons. If such a determination is made by Hospital and is indicated in the written notice, Department agrees to implement the performance standards immediately upon receipt of said notice or as otherwise directed in said notice. 2.2-4 Emergency Medical Medications and Supplies. Medications and supplies required for the rendering of life support services may be supplied to Department by Hospital, upon approval from the Hospital and in accordance with Hospital policies and all applicable laws. Department shall reimburse Hospital for such medications and supplies pursuant to Section 5. 2.3 Emergency Medical Equipment. Hospital shall monitor the type and quality of emergency medical equipment used by Department in the provision of life support services. Hospital shall make recommendations to Department for the use of appropriate emergency medical equipment Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 2.4 Medical Director. Hospital shall provide a physician or physician designee, authorized in writing by Hospital’s medical staff, who shall act as the Medical Director for Hospital in its role as the supervising hospital for Department. The Medical Director shall at all times be immediately available to supervise the medical procedures performed by Department’s clinical personnel via the voice communication system identified in Section 2.8. The Medical Director, or his/her designee, shall be appointed by Hospital. 2.5 Certification Contingency. The provision of services as described in this Article II is contingent upon Department remaining certified by the Commission as an organization for the rendering of life support services. Hospital shall be under no obligation to provide the services described in this Agreement and shall not provide said services until Department provides Hospital with documented proof that it is currently certified by the Commission as an organization for the rendering of life support services. 2.6 Competency Review. Hospital shall review the competency of the clinical personnel of Department every two (2) years, and as needed to ensure competency. Hospital shall biennially send a letter to Department attesting to the competency of such personnel. 2.7 Reporting Changes. Hospital shall report in writing to Department any material changes to the parties’ relationship under this Agreement, including changes in key clinical Hospital personnel. Such reports shall be made within thirty (30) days of such material change. 2.8 Voice Communication System. Department shall provide means of voice communication to Hospital for medical control. The form of communication may be through the County E-911 Communications Center radio system; the Indiana Hospital Emergency Radio Network; cellular telephones as owned and operated by Department; or by standard telephone lines available for emergency crews to utilize. III. TRAINING SERVICES 3.1 Training Services. Hospital agrees to provide Training for Department in accordance with the requirements and standards for Basic, Advanced, and/or Paramedic emergency medical training set forth in the Act. Hospital and/or Department shall dismiss any Associate from the training program if the Associate is determined by Hospital to be unacceptable for reasons of health, performance, or any other cause which could interfere with Hospital’s operation or quality patient care. 3.2 Qualifications of Associates. Associates must meet and maintain during the term of this Agreement all requirements established by the Commission. Department is responsible for requiring its Associates to meet such Commission requirements and shall provide verification of such when requested by Hospital. IV. RESPONSIBILITIES OF DEPARTMENT 4.1 Regulatory and Hospital Standards. Department shall be solely responsible for maintaining compliance with all federal, state and local emergency medical service and life support laws and regulations with regard to its emergency medical units, its employees or independent contractors, its use of drugs, supplies, and equipment and its general operation as an EMT, A-EMT, and/or paramedic organization. Department agrees to comply with Occupational Health and Safety Administration (“OSHA”) requirements, including those applicable to bloodborne and airborne pathogens, during the Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 Field Internship Phase of the Educational Experience. Department further agrees to comply with all guidelines and standards established by Hospital for Training, continuing education and performance evaluation of Department personnel, employees or independent contractors. It is agreed that Hospital has no responsibility for verifying that Department and/or its personnel, employees or independent contractors satisfy all federal, state and local requirements as referenced above. As directed by Department personnel, Hospital personnel and Associates shall also comply with such OSHA requirements while aboard Department’s emergency medical units. 4.2 Primary Duty of EMT, A-EMT, and/or Paramedics to Contact Physician. Department understands and is responsible for informing its personnel, employees and independent contractors that protocols are not intended to encourage autonomous action by EMT, A-EMT’s, and/or paramedics. The purpose of such protocols is to equip the EMT, A-EMT’s, and/or paramedics with a grasp of what is expected of him/her in particular emergency situations to prevent the loss of valuable time. Department EMT, A-EMT’s, and/or paramedics shall establish radio or telephone contact with the Hospital’s Emergency Department before intervening with life support care, except for providing emergency first aid as allowed under the protocols established by Hospital. 4.3 Unsuccessful Attempts to Communicate. Unsuccessful attempts to establish radio communication with Hospital’s Emergency Department by the EMT, A-EMT, and/or paramedic neither absolves the EMT, A-EMT, and/or paramedic nor Department from responsibility to solicit direction from the Hospital Emergency Department Physicians, nor does it constitute authority for the EMT, A- EMT, and/or paramedic to perform any or all of the life support skills, except in those specific instances as allowed in the protocols. The EMT, A-EMT, and/or paramedic is responsible for continuing his attempt to contact the Hospital Emergency Department by radio, telephone or any other means that are available, both at the scene and while transporting the patient. 4.4 Duty to Implement Standards. Department is responsible for implementing and following all performance standards, protocols and requirements of Hospital and the Commission, as such pertain to the rendering of emergency medical services and life support services. 4.5 Confidential Information. Department shall instruct its personnel, employees and independent contractors on their responsibility for respecting the confidential and privileged nature of information which may come to their attention in regard to patient medical records and other Hospital information. 4.6 Criminal Background Checks/Health and Safety Screening. Department shall perform criminal background checks relative to Associates pursuant to this Agreement and ensure that all Associates are in compliance with Hospital health and safety screening requirements required by Hospital and provided to Department upon request. Department shall attest, upon request by Hospital and in the form of a letter provided upon placement of a given Associate in the Training program, that said Associate is in compliance with the screening requirements. Department shall permit Hospital to audit Department’s applicable records upon request to assure compliance with this Section. Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 V. REIMBURSEMENT The Department agrees to reimburse the Hospital for the costs of any medications or supplies provided pursuant to Section 2.2-4 of this Agreement. Reimbursement shall be calculated by adding the Hospital’s total cost for such medications and supplies. The Hospital shall submit an itemized invoice to the Department on a monthly basis. Payment of each invoice is due within thirty (30) days of receipt unless otherwise agreed in writing by the parties. VI. INSURANCE 6.1 Worker’s Compensation. Both parties agree to carry worker’s compensation insurance covering all of its employees and employer’s liability insurance in an amount not less than One Million Dollars ($1,000,000.00). Said worker’s compensation policy shall contain an endorsement waiving subrogation rights against the Hospital. 6.2 Comprehensive and Property Damage Liability. Both parties shall carry occurrence form, primary commercial general liability insurance in minimum amounts of One Million Dollars ($1,000,000.00) per occurrence, and Two Million Dollars ($2,000,000.00) general aggregate, and combined single limit on One Million Dollars ($1,000,000.00) bodily injury, One Million Dollars ($1,000,000.00) property damage and Two Million Dollars ($2,000,000.00) general aggregate. Such policies shall also include contractual liability protection insurance to satisfy both parties’ indemnification obligations set out in Article VIII below. 6.3 Professional Liability. Both parties shall carry medical malpractice insurance with those limits necessary to qualify themselves as providers under the Indiana Medical Malpractice Act (I.C. 34-18 et seq.), and shall remain providers thereunder throughout the term of this Agreement. 6.4 Proof of Coverage. Each party, upon request, shall provide the other with appropriate certificates evidencing the insurance coverages set out in this Article VI. VII. STATUS OF THE PARTIES In performing the services as contemplated hereunder, Hospital and Department agree that Department personnel are acting as independent contractors and not as the agents or employees of Hospital. No Associate in the program will be deemed to be an employee of Hospital nor will Hospital be liable for the payment of any wage, salary, or compensation of any kind for service provided by the Associates. Further, no Associate will be covered under Hospital’s Worker’s Compensation, Social Security, or Unemployment Compensation programs. VIII. INDEMNIFICATION 8.1 Department Indemnification. Department agrees that it will indemnify and hold harmless the Hospital, its officers, agents, employees, and personnel from any loss, cost, damage, expense, attorney’s fees, and liability by reason of bodily injury, property damage, or both of whatsoever nature or kind, arising out of or as a result of the sole negligent act or negligent failure to act of Department, its agents, employees, agents or personnel. 8.2 Hospital Indemnification. The Hospital agrees that it will indemnify and hold harmless Department, its officers, agents, employees, and personnel from any loss, cost, damage, expense, Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 attorney’s fees, and liability by reason of personal injury or property damage, or both of whatsoever nature or kind, arising out of or as a result of the sole negligent act or negligent failure to act of the Hospital, its employees, agents, or personnel. IX. TERM AND TERMINATION 9.1 Term. The initial term of this Agreement shall be for three (3) years commencing on the last date of signature. Thereafter, the Agreement is automatically renewable for successive one (1) year terms unless either party gives notice of termination at least sixty (60) days prior to the end of the then current term. 9.2 Termination. This Agreement may be terminated as follows: 9.2-1 Termination by Agreement. In the event Hospital and Department shall mutually agree in writing, this Agreement may be terminated on terms and date stipulated therein. 9.2-2 Early Termination. This Agreement may be terminated by either party with or without cause by delivering a written notice of termination to the other party at least thirty (30) days prior to such early termination. Such early termination shall not prejudice the rights of the currently enrolled Associates to complete the training program. 9.2-3 Termination of Individual EMT, A-EMT, and/or Paramedic. Department shall prohibitthe services of an EMT, A-EMT, and/or paramedic in the performance of life support skills, upon receipt of written notice from Hospital that such individual failed to exhibit satisfactory performance. Hospital shall not, however, have any affirmative duty or responsibility to notify Department to terminate a specific EMT, A-EMT, and/or paramedic or EMT, A-EMT, and/or paramedic unless Hospital has actual knowledge that said EMT, A-EMT, and/or paramedic or EMT, A-EMT, and/or paramedic is not performing life support skills in a satisfactory manner or that he consistently or repeatedly fails to perform EMT, A-EMT, and/or paramedic duties in accordance with the current protocols. X. ETHICAL AND RELIGIOUS DIRECTIVES The Parties acknowledge that Hospital conducts its operation in a manner consistent with the Ethical and Religious Directives for Catholic Health Care Services (“Directives”) as promulgated by the United States Conference of Catholic Bishops, Washington D.C., of the Roman Catholic Church or its successor. Nothing in this Agreement shall be construed to require the Hospital or its employees to violate the Directives. XI. REGULATORY AND CORPORATE COMPLIANCE 11.1 Regulatory Compliance. The parties agree that this Agreement is intended to comply with all applicable Hospital group purchasing contracts and state and federal laws, rules, regulations and accreditation standards, including, but not limited to, the Medicare and Medicaid Fraud and Abuse Statute and Regulations; Indiana regulations for supervising hospitals; the Robinson-Patman Price Discrimination Act; the Non-Profit Institutions Act; the Food and Drug Administration regulations; the Indiana Pharmacy Board statutes; the Joint Commission Accreditation Standards; and all regulations governing use of facilities financed with tax exempt bonds (“Laws”). If at any time, this Agreement is found to violate any applicable provision of these Laws, or if any party has a reasonable belief that this Agreement creates a material risk of violating any Laws, and after consultation with the other party, and Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 after thirty (30) days’ written notice to the other party, the parties shall renegotiate the portion of this Agreement that creates the violation or risk of violation of the Laws. If the parties fail to reach agreement, this Agreement shall automatically terminate thirty (30) days after said written notice. 11.2 Corporate Compliance. Hospital has in place a Corporate Compliance Program (the “Program”) which has as its goal to ensure that Hospital complies with federal, state and local laws and regulations. The Program focuses on risk management, the promotion of good corporate citizenship, including the commitment to uphold a high standard of ethical and legal business practices, and the prevention of misconduct. Department acknowledges Hospital’s commitment to the Program and agrees to conduct all business transactions which occur pursuant to this Agreement in accordance with the underlying philosophy of the Program adopted by Hospital. Department further agrees to disclose immediately any proposed or actual debarment, exclusion or other event that makes ineligible to participate in federal health care programs or federal procurement or non-procurement programs. 11.3 HIPAA Compliance. Hospital and Department agree that each party shall comply with all federal and state regulations, rules and orders, including but not limited to regulations promulgated under Section 264 of the Health Insurance Portability and Accountability Act (Public Law 104-91 - “HIPAA”). Hospital and Department agree that for purposes of HIPAA only, Associates shall be considered members of the Hospital’s Workforce, as that term is defined by HIPAA, and the Department agrees to require Associates to participate in any training required by Hospital for Workforce members so that Hospital may comply with HIPAA. For all other purposes the parties agree that each is acting as an independent contractor and not an agent or employee of the other. Furthermore, the parties shall promptly amend the Agreement to conform with any new or revised legislation, rules and regulations to which Hospital is subject now or in the future including, without limitation, the Standards for Privacy of Individually Identifiable Health Information or similar legislation (collectively, “Laws”) in order to ensure that Hospital is at all times in conformance with all Laws. If, within thirty (30) days of either party first providing notice to the other of the need to amend the Agreement to comply with Laws, the parties, acting in good faith, are (i) unable to mutually agree upon and make amendments or alterations to this Agreement to meet the requirements in question, or (ii) alternatively, the parties determine in good faith that amendments or alterations to the requirements are not feasible, then either party may terminate this Agreement upon thirty (30) days prior written notice. 11.4 Compliance with Anti-Kickback Statute. Each party shall comply with the Federal Health Care Programs’ Anti-Kickback Statute (42 U.S.C. § 1320a-7b) and any applicable regulations promulgated thereunder. The parties further recognize that this Agreement shall be subject to the amendments of the Anti-Kickback Statute or any of its applicable regulations. In the event any applicable provisions of the Anti-Kickback Statute or its regulations invalidate, or are otherwise inconsistent with the terms of this Agreement, or would cause one or both of the parties to be in violation of the law, the parties shall exercise their best efforts to accommodate the terms and intent of this Agreement to the greatest extent possible consistent with the requirements of the Anti-Kickback Statute and its applicable regulations. XII. GENERAL PROVISIONS 12.1 Amendments. This Agreement may be amended only by an instrument in writing signed by the parties hereto. 12.2 Assignment. Assignments of this Agreement or the rights or obligations hereunder shall be invalid without the specific written consent of the other party herein, except that this Agreement may be assigned by the Hospital without the written approval of Department to any successor entity operating Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 the facility now operated by Hospital or to a related or affiliated organization. 12.3 Confidentiality. Hospital and Department agree that the terms and conditions of this Agreement shall remain confidential. Neither Hospital nor Department shall distribute this Agreement or any part thereof or reveal any of the terms of this Agreement to parties other than their personnel, employees or agents. 12.4 Entire Agreement. By entering into this Agreement, Hospital and Department hereby mutually agree the Original Agreement shall terminate as of the Effective Date of this Agreement. This Agreement supersedes all previous contracts or agreements between the parties with respect to the same subject matter and constitutes the entire Agreement between the parties hereto. Neither Hospital nor Department shall be entitled to benefits other than those herein specifically enumerated. 12.5 Execution. This Agreement and any amendments thereto shall be executed in duplicate copies on behalf of the Hospital and Department by an official of each specifically authorized to perform such executions. Each duplicate copy shall be deemed an original, but both duplicate originals together constitute one and the same instrument. 12.6 Governing Law. This Agreement shall be construed and governed by the laws of the State of Indiana. 12.7 Notices. Notices or communications herein required or permitted shall be given to the respective parties by registered or certified mail (said notice being deemed given as of the date of mailing) or by hand delivery at the following addresses unless either party shall otherwise designate its new address by written notice: DEPARTMENT HOSPITAL Carmel Fire Department One Civic Square Carmel, Indiana 46032 Attn: Chief Ascension St. Vincent Carmel 13500 N. Meridian Street Carmel, Indiana 46032 Attn: President COPY TO: St. Vincent Contract Management 250 W. 96th Street, Suite 410 Indianapolis, Indiana 46260 12.8 Severability. In the event that any provision hereof is found invalid or unenforceable pursuant to judicial decree or decision, the remainder of this Agreement shall remain valid and enforceable according to its terms. 12.9 Waiver of Breach. The waiver by either party of a breach or violation of any provision of this Agreement shall not operate as nor be construed to be, a waiver of any subsequent breach hereof. IN WITNESS WHEREOF, the duly authorized officers and representatives of Hospital and Department have executed this Agreement on the dates written below. Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 4859-2187-1858, v. 1 ASCENSION ST. VINCENT CARMEL By:_________________________________ Name:______________________________ Title: _______________________________ Date:_______________________________ Approved and Adopted this day of , 20 . CITY OF CARMEL, INDIANA By and through its Board of Public Works and Safety BY: Laura Campbell, Presiding Officer Date: James Barlow, Member Date: Alan Potasnik, Member Date: ATTEST: Jacob Quinn, Clerk Date: Chad Dilley President, Ascension St. Vincent Carmel Docusign Envelope ID: 38B9729C-CBA9-4AD3-9088-A81A99EFAA18 1/13/2025 Docusign Envelope ID: 7F10CACC-9F71-4B89-843E-C84B89C4B580 5 2/6/2025 NOT PRESENT 2/6/2025 February 25 2/6/2025