index swa-1 certificates of necessity · arizona department of health services state of arizona...

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INDEX SWA-1 Certificates of Necessity Certificate No. 86: SW General, Inc. dba Southwest Ambulance Certificate No. 66: Southwest Ambulance of Casa Grande, Inc. dba Southwest Ambulance and Rescue of Arizona Certificate No. 109: Rural/Metro Corporation (Maricopa) dba Rural/Metro Ambulance Service dba Arizona Medical Transport dba AMT Certificate No. 71: Professional Medical Transport, Inc. dba PMT Ambulance Certificate No. 46: Comtrans Ambulance Service, Inc. dba Comtrans Ambulance Service dba Promed Transport dba American Comtrans Certificate No. 58: R/M Arizona Holdings, Inc. dba Canyon State Ambulance dba Payson Medical Transport dba Lifestar EMS Certificate No. 75: Emergency Medical Transport, Inc., dba American Ambulance SWA-2 Letter dated September 6, 2012 to Ithan Yanofsky from Marcus Montoya re: ABC Ambulance

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INDEX

SWA-1 Certificates of Necessity

Certificate No. 86: SW General, Inc. dba Southwest Ambulance

Certificate No. 66: Southwest Ambulance of Casa Grande, Inc. dba Southwest Ambulance and Rescue of Arizona

Certificate No. 109: Rural/Metro Corporation (Maricopa) dba Rural/Metro Ambulance Service dba Arizona Medical Transport dba AMT

Certificate No. 71: Professional Medical Transport, Inc. dba PMT Ambulance

Certificate No. 46: Comtrans Ambulance Service, Inc. dba Comtrans Ambulance Service dba Promed Transport dba American Comtrans

Certificate No. 58: R/M Arizona Holdings, Inc. dba Canyon State Ambulance dba Payson Medical Transport dba Lifestar EMS

Certificate No. 75: Emergency Medical Transport, Inc., dba American Ambulance

SWA-2 Letter dated September 6, 2012 to Ithan Yanofsky from Marcus Montoya re: ABC Ambulance

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. -86 - as

County of Maricopa DOCKET NO. EMS 3642

THE ARIZONA DEPARTMENT OF HEALTH SERVICES has found, under the authority of A.R.S. § 36-2232 dm and Pursuant to Department of Health Services rules, that public necessity requires the operation of

SW GENERAL, INC. dba SOUTHWEST AMBULANCE

as a ground ALS and BLS ambulance service in the State of Arizona for the transportation of individuals who are sick, injured, wounded or otherwise incapacitated or helpless within the following set -vice area, with the following central operations station and response limes:

1. Service Area: Service Area for unlimited ambulance service:

a. Cities of Phoenic, Mesa, Tempe, Scottsdale, Paradise Valley, Glendale, Peoria, Chandler, Sun City,

Gilbert, Apache Junction, El Mirage, Surprise, Youngtown and the Town of Guadalupe.

b. Mesa, Southeast County area and Gilbert to be encompassed by the fobowing specific

geographical boundaries; beginning at the southwest corner of Mesa at the intersection of the Western

Canal and Price Road, proceed north along Price Road to a point 9/10ths of one mile north of First

Street (Tempe). Proceed in a northeasterly direction following the southern boundary of the Salt River

Indian Reservation and the Southern Canal to a point intersecting with Bush Highway. Then, proceed

due South along the Bush Highway to a point where the imaginary intersection of Indian School Road

(Tonto National Forest boundary) and Bush Highway intersect, then proceed east and south along the

southern boundary of the Tonto National Forest and the western and southern boundary of the Usery

Mountain Park to a point where McLellan and the Maricopa County/Final County line intersect Then,

due south along the Maricopa County/Final County line to a point that intersects with the imaginary

intersection of the Maricopa/Pinal County line and Hunt Highway. Then, northwesterly along the Hunt

Highway to the intersection of Hunt Highway and the Maricopa/Pinal County line. Then, west on the

Now, therefore, by virtue of the authority vested in the Arizona Department of Health Services, under the constitution and laws of the State of Arizona, does hereby grant this

RENEWAL

CERTIFICATE OF NECESSITY authorizing the operation of the aforesaid ambulance service for a period ending May 31,2014 unless for cause sooner amended, suspended, revoked or terminated subject to the decisions and orders, and rules of the Department

PROVIDED, that this certificate shall not be assigned nor transferred unless authorized by the Arizona Department of Health Services.

BY THE ORDER OF THE ARIZONA DEPARTMENT OF HEALTH

SERVICES, IN WITNESS WHEREOF, I WILL HUMBLE the Director of the Arizona Department of Health Services, have hereunto set my hand and caused the official seal of the Arizona Department of Health Services to be affixed at Phoenix, Arizona on /4e,L; 2.0 1/

DIRECTOR

SWA-1

43;

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. -

County of Maricopa DOCKET NO. EMS 3642

Hunt Highway alignment to Gilbert Road Then, north on Gilbert Road to its intersection with

Galveston Street. Then, due west along the Galveston Street alignment to Cooper Road Then, north

along the western boundary of the Town of Gilbert municipal boundaries to the intersection of Country

Club Drive (Arizona Avenue) and Western Canal. Then, due west to the intersection of Western Canal

and Price Road or point of origin.

c. The Apache Junction Fire District boundary as of August 10, 1993.

L Florence Junction: Beginning at a point two miles south of Baseline Road on the Maricopa/Pinal

County border line; then, proceed due east approximately nine miles along the southern boundary of the

Apache Junction Fire District boundary; then, proceed due north three miles along the Apache Junction

Fire District boundary; then, proceed due east nine miles along the Tonto National Forest boundary;

then, due south six miles along the Tonto National Forest boundary; then on a line due west for four

miles; then, due south three miles to Florence Junction; than on a line southwest for approximately

seven miles to Combs Road; then, proceed due west nine miles along an extension of Combs Road to the

Maricopa/Pinal County border line; then proceed due north nine miles along the Maricopa/Pinal

County border line to the point of origin.

e. Beginning at a point where the Maricopa County border and a northern extension of 9r

Avenue intersect (GPS: N 33 0 54' 16.57"W 112° 15' 30.68'); proceed in a westerly direction along

the Maricopa County border to a point (GPS: N 33° 55' 20.20" W112° 25' 58.98"); proceed south

to mile post 11 on State Route 74 (GPS: N 33 0 49' 54.32" W 112° 26' 43.36'9; proceed southeast to

mile post 138 on US Highway 60 (GPS: N 33° 41' 02.49" W 112° 24' 30.73"); proceed in a westerly

direction to a point (GPS: N 33° 44'22.01" W 112° 39' 18.55"); proceed south to a point (GPS: N

33° 43' 25.59" W112° 39' 19.31"); proceed west to a point (GPS: N33° 43' 25.26" W112° 40'

(19.13"); proceed south to a point (GPS: N 33° 42'39.31" W 112' 40' 07.01'); proceed east to a

(GPS: 33° 42' 39.74" W 112° 36' 28.70"); proceed south to a point (GPS: N 33' 39' 11.83" 112° 36 28.51"); proceed west to a point (GP.S.: A 33 39' 11.42" 11' 172" 37' 31.39"); proceed

south to a point (GAS": .‘' 33 SM . /S. 99" II . 112' 37' 30. 7.9 .): proceed Ii•evt to a point (GPS: 3s • 33.88"); proceed south to a point

CERTIFICATE OF NECESSITY

(CONTINUATION PAGE ONE )

1-IXPIRES .May 31,2014

,

EXPIRES May 31, 2014

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. - 86 -

County of Maricopa DOCKET NO. EMS 3642

(GPS: N 33° 37' 25.81" W 112° 38' 33.27'); proceed west to a point (GPS: N 33° 37' 26.20" W 112°

40' 07.40"); proceed south to a point (GPS: N 33° 33' 57.35" W 112° 40' 06.77"); proceed east along

an extension of Olive Avenue to a point where Olive Avenue and 91 Avenue intersect (GPS: N 33°

33'54.81" W 112° 15' 20.45"); proceed north along 91" Avenue to a point where an extension of 91"

Avenue and the Maricopa County border intersect, the point of origin. Excluding the Fire District of

Sun City West Fire boundaries as of February IS, 2005 for 9-1-1 emergency calls.

2. The rest of Maricopa County upon request for prescheduled, inter-facility and convalescent

transports.

3. Legal Address: 708 West Baseline Road, Mesa, Arizona 85210.

4. Response Times:

a. Within any of the cities granted in which the applicant has located a central operations or sub-

operations station, for response within that city (specifically to include the City of Phoenix):

I) Ten (10) minutes on ninety (90) percent of all emergency transports.

2) Fifteen (15) minutes on ninety-five (95) percent of all emergency transports.

3) Twenty (20) minutes on one hundred (100) percent of all emergency transports.

b. Otherwise:

I) Ten (10) minutes on eighty (80) percent of all emergency transports.

2) Fifteen (15) minutes on ninety (90) percent of all emergency transports.

3) Twenty (20) minutes on one hundred (100) percent of all emergency transports.

c. Applies only to the service area granted in sub-paragraph "1.d."

1) Fificea f I 5) n,inule.s on eighty (80) percent of all emergency tran.sportv.

7.,cen6 - 7t11: (25) mittotc ,, on ninety 00) percent ol allentergem.T /Tan:port:.

(Pt) inmates on one numirea 1011) percent of all emergency transporty.

CERTIFICATE OF NECESSITY

(CONTINUATION PAGE TWO 1

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA

CERTIFICATE NO. - 66 -

County of Maricopa I ss

DOCKET NO. EMS 3559

THE ARIZONA DEPARTMENT OF HEALTH SERVICES has found, under the authority of A.R.S. § 36-2232 et q and Pursuant to Department of Health Services rules, that public necessity requires the operation of

SOUTHWEST AMBULANCE OF CASA GRANDE, INC. dba SOUTHWEST AMBULANCE AND RESCUE OF ARIZONA

as a ground ALS and BLS ambulance service in the State of Arizona for the transportation of individuals who are sick, injured, wounded or otherwise incapacitated or helpless within the following service area, with the following central operations station and response times:

1. Service Area:

West Valley areas of Goodyear, Litchfield Park, Tolleson and Avondale, otherwise Olive Avenue on the

North, the Estrella Mountains on the South, 91st Avenue on the East and Wintersburg Road (Palo Verde)

on the West.

2. Central Operating Station: 222 East Main, Mesa, Arizona 85201.

3. Response Times:

a. Ten (10) minutes on eighty (80) percent of all ambulance calls made.

b. Fifteen (15) minutes on ninety (90) percent of all ambulance calls made.

c. Twenty (20) minutes on one hundred (100) percent of all ambulance calls made.

Now, therefore, by virtue of the authority vested in the Arizona Department of Health Services, under the constitution and laws of the State of Arizona, does hereby grant this

RENEWAL

CERTIFICATE OF NECESSITY authorizing the operation of the aforesaid ambulance service for a period ending September 30, 2013 unless for cause sooner amended, suspended, revoked or terminated subject to the decisions and orders, and rules of the Department.

PROVIDED, that this certificate shall not be assigned nor transferred unless authorized by the Arizona Department of Health Services.

BY THE ORDER OF THE ARIZONA DEPARTMENT OF HEALTH

SERVICES, IN WITNESS WHEREOF, I WILL HUMBLE the Director of the Arizona Department of Health Services, have hereunto set my hand and caused the official seal of the Arizona Department of Health

Services to be affixed at Phoenix, Arizona on 71771 „2, ;070

/ DIRECTOR

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. - 109 -

Is

County of Maricopa DOCKET NO. EMS 3588

111E ARIZONA DEPARTMENT OF HEALTH SERVICES has found, under the authorits of A.R.S. § 36 - 2232

issl and Pursuant to Department of Health Services rules, that public necessity requires the operation of

RURAL/METRO CORPORATION (MARICOPA) dha RURAL/METRO AMBULANCE SERVICE

dba ARIZONA MEDICAL TRANSPORT dba AMT

a Eround ALS and BLS Ambulance sem ice in the State of Arunna for the transportation of indiriiduak who are sick, injured.

V. minded or otherwise incapacitated or helplma within the follow mg .cm ice area, with the following central operations station and response times:

1. Service Area:

From a point where Yavapai County line and an extension of 163rd Avenue would meet, east along the

county line to the Tonto National Forest. Then, south approximately 9 2 miles to the corner of the Tonto

National Forest boundary. Then, east approximately 27 miles to the southwest corner of the Mazatzal

Wilderness Area. Then, southeast to mile post 210 on 1 lighway 87. Then, south to the entrance to Lost

Dutchman State Park Then east to the southwest boundary of the Superstition Wilderness Area, then

following the southwestern boundary of the Superstition Wilderness Area to an imaginary intersection with

a northward extension of Barkley Road. Then, due south on Barkley Road to an intersection with US.

Highway 60. Then, due west on an imaginary line to Baseline Road where it intersects with the Maricopa

County/Pinal County line. Then, due south along the Maricopa County/Pinal County line, following an

imaginary extension of the Maricopa County/Pin::! County line, to a point that intersects with Hunt

Highway ,. Then, westerly and slightly north to the intersection of Hunt Highway and the Maricopa

County/Pinal County line. Then, west on the Hunt high way alignment to Gilbert Road. Then, due north to

the intersection of Gilbert Road and Galveston Street. (continued next page)

sow, therefore. by virtue of the authority s estcd in the Arizona Department of Health Sers ices. under the constitution and laws

of the State of ,Arizona. does hereby grant this

RENEWAL

CERTIFICATE OF NECESSITY

authorizing the operation of the aforesaid ambulance sers me for *period ending November 30, 2013 unless

for cause 10011CI amended. suspended. resoked or terminated subject to the decisions and orders, and rules of the Department.

PROVIDED, that this certificate shall not be assigned nor transferred unless authorized by the Arizona Department of Health Services.

In THE ORDER OF THE ARIZONA DEPARTMENT OF HEALTH

SERVICES, IN WITNESS WHEREOF, I WILL HUMBLE the Director of the Arizona Department of Health Services. base hereunto set my hand and caused the official seal of the Arizona Department of Health Services to

he aimed at phoenix, Ar..na o•

DIRECTOR

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. -109 -

County of Maricopa DOCKET NO. EMS 3588

Then, due west along the Galveston Street alignment to Cooper Road Then, due north along the western

boundary of the Town of Gilbert municipal boundaries to the intersection of Country Club Drive (Arizona

Avenue) and Western Canal. Then, due west to intersection of Western Canal and Price Road. Then, along the current southern city limits of Tempe and South Mountain Park to the Gila River Indian Reservation.

Then, northwest along the Gila River Indian Reservation to Estrella Mountain Park. Then, south along the

Estrella Mountain Park border inclusive of the park boundaries to 163rd Avenue north to the Yavapai County line or point of origin. Service area excludes any portion of the City of Chandler.

2. Central Operating Station: Scottsdale, Arizona (8401 East Indian School)

3. Sub-Operations Stations:

Carefree, Arizona (7174 Sleepy Hollow, Bldg. E).

Fountain Hills, Arizona (16426 Palisades Blvd.). Glendale, Arizona (5220 West Luke).

Mesa, Arizona (Mesa Lutheran Hospital; 10310 East Apache Trail; 334 North Bush Highway). Phoenix, Arizona (5302 North 7th Street). Scottsdale, Arizona (7110 East McDonald Drive).

Sun City, Arizona (13203 North 103rd Avenue and 18700 North 107th Avenue).

Sun City West, Arizona (19001 Camino del Sol and 20622 Stardust Boulevard). Queen Creek, Arizona (22407 South Ellsworth Road).

4. Response Times:

a. Within any of the cities granted in which the Applicant has located a central operations or sub-

operations station, for response within that city (specifically to include the City of Phoenix): 1) Ten (10) minutes on ninety (90) percent of all emergency transports. 2) Fifteen (15) minutes on ninety-five (95) percent of all emergency transports. 3) Twenty (20) minutes on one hundred (100) percent of all emergency transports.

b. Otherwise: 1) jien tin) minutes on fifty OA percent of oil emergency transports.

2) I wenty (20) minutes on seventy ( 'tit percent 01(1/I emergency transports.

!him . ($a) Mill iiieN on 44.01('-five 185) percent emergency transports.

4) Sixty (611) minutes on one hundred (loo percent a/all emergency transports.

CERTIFICATE OF NECESSITY

(CONTINUATION PAGE ONE )

ISSUED

Ulf

EXPIRES Vovemher 30, 2013

T,)R

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. -71 - ss

County of Nlariropa DOCKET NO. EMS 3704

THE ARIZA1NA DEPARTMENT OF HEALTH SERVICES has found, under the authority of A.R.S. 36-2232 et m and Pursuant to Department of Health Services rules, that public necessity requires the operation of

PROFESSIONAL MEDICAL TRANSPORT, INC. dba PMT AMBULANCE

as ground ALS and BLS a m bulsince service in the State of .Arizosia for the transportation of individuals who are !Lick injured. %flooded or otherwise incapacitated or helpless %%ohm thr following SCIFVICf 2rez, tiith the following central operations siarion and response times:

1. Service Area:

a. Cities of Phoenix, Tempe, Mesa, Scottsdale, Chandler, Paradise Valley, Glendale. Peoria, Gilbert, Sun

Lakes, ihwatukee and the Town of Guadalupe.

b. Beginning at the Southwest corner of Mesa at the intersection of the Western Canal and Price Road,

proceed North along Price Road to a point 9/111ths of one mile North of First Street (Tempe). Proceed in

a Northeasterly direction following the Southern boundary of the Salt River Indian Reservation and the

Southern Canal to a point intersecting with the Bush Highway. Then proceed due South along the Bush

Highway to a point where the imaginary intersection of Indian School Road (Tonto National Forest

boundary) and Bush Highway intersect. Then proceed East and South along the Southern boundary of

the lanto National Forest and the Western and Southern boundary of the Usery Mountain Park to a

point where McLellan and the Maricopa CounWPinal County line intersect. Then, due South along the

Maricopa Countv/Pinal County line to the point that intersects with Guadalupe Road. Then due West

along Guadalupe Road to intersect with Power Road. Then, due South to the intersection of Power

Road and Ray Road. Then, due West along Ray Road to intersect with Cooper Road Then North along

the Western boundary of the Town of Gilbert municipal boundaries to the intersection of Country Club

Drive (Arizona Avenue) and Western Canal. Then, due West to the intersection of Western Canal and

Price Road or Point of Origin.

•mrs therefore. by virtue of the authority bested in the Arizona Department of Health Services, under the constitution sad laws A the Stale of Arizona, does hereby grant this

TRANSFER

CERTIFICATE OF NECESSITY Authorizing the operation of the aforesaid ambulance sersice for a period ending October 31, 2012 males.% for cause sooner amended. suspended, res eked or terminated subject to the decisions and orders, and rules of the Department-

PROVIDED, that this certificate shall not be assigned nor transferred unless authorized by the Arizona Department of Ileahh Services.

BY THE ORDER OF THE ARIZONA DEPARTMENT OF iii:ALTH

SERVICES, IN WITNESS WHEREOF. I WILL HUMBLE the

Director of the Arizona Department of Health Services, have hereunto net

my hand and caused the official seal of the Arizona Department of Health

Services to be affixed at Phoenix. Arizona on

/...70

I ls..d I el—• IRECI UR

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. - 71 -

County of Maricopa DOCKET NO. EMS 3704

2. Central Operations Station: Tempe, Arizona (2495 South Industrial Park) (Administration and Communications).

3. Response Times: a. Within any of the cities granted in which the Applicant has located a central operations or sub-

operations station for responses within that city (speccally to include the City of Phoenix): (1) Ten (10) minutes on ninety (90) percent of all emergency transports. (2) Fifteen (15) minutes on ninety-five (95) percent of all emergency transports. (3) Twenty (20) minutes on one hundred (100) percent of all emergency transports.

b. Otherwise: (1) Ten (10) minutes on eighty (80) percent of all emergency transports.

(2) Fifteen (15) minutes on ninety (90) percent of all emergency transports.

(3) Twenty (20) minutes on one hundred (100) percent of all emergency transports.

CERTIFICATE OF NECESSITY

(CONTINUATION PAGE ONE )

ISSI D 1, )

EXPIRES October 31, 2012 Dii(n TOR

1)4(ECTOR

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. - 46 - I ss

County of Maricopa DOCKET NO. EMS 3706

THE ARIZONA DEPARTMENT OF HEALTH SERVICES has found, under the authority of A.R.S. § 36-2232 et m. and Pursuant to Department of Health Services rules, that public necessity requires the operation of

COMTRANS AMBULANCE SERVICE, INC. dba COMTRANS AMBULANCE SERVICE

dba PROMED TRANSPORT dba AMERICAN COMTRANS

as a ground ALS and BLS ambulance service in the State of Arizona for the transportation of individuals who are sick, injured, wounded or otherwise incapacitated or helpless within the following service area, with the following central operations station and response times:

1. Service Area: All of Maricopa County.

2. Central Operations Station: Phoenix, Arizona (2617 N. 24 m Street).

3. Response Times:

a. Ten (10) minutes on ninety (90) percent of all ambulance calls.

b. Fifteen (15) minutes on ninety-five (95) percent of all ambulance calls.

c. Twenty (20) minutes on ninety-seven (97) percent of all ambulance calls.

d Twenty-five (25) minutes on one hundred (100) percent of all ambulance calls.

NOTE: Ambulance service is limited to behavioral health situations such as drugs, alcohol and mental

health related crises.

Now, therefore, by virtue of the authority vested in the Arizona Department of Health Services, under the constitution and laws of the State of Arizona, does hereby grant this

TRANSFER

CERTIFICATE OF NECESSITY authorizing the operation of the aforesaid ambulance service for a period ending April 30, 2013 unless for cause sooner amended, suspended, revoked or terminated subject to the decisions and orders, and rules of the Department.

PROVIDED, that this certificate shall not be assigned nor transferred unless authorized by the Arizona Department of Health Services.

BY THE ORDER OF THE ARIZONA DEPARTMENT OF HEALTH

SERVICES, IN WITNESS WHEREOF, I WILL HUMBLE the Director of the Arizona Department of Health Services, have hereunto set my hand and caused the official seal of the Arizona Department of Health Services to be affixed at Phoenix, Arizona on -1:0-3(1..044.4-7 3, 20 ( 1-..

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. - 58 - ) as

County of Maricopa DOCKET NO. EMS 3707

THE ARIZONA DEPARTMENT OF HEALTH SERVICES has found, under the authority of A.R.S. § 36-2232 et sm. and Pursuant to Department of Health Services rules, that public necessity requires the operation of

R/M ARIZONA HOLDINGS, INC. dba CANYON STATE AMBULANCE

dba PAYSON MEDICAL TRANSPORT dba LIFESTAR EMS

as a Eround ALS and BLS ambulance service in the State of Arizona for the transportation of individuals who are sick, injured, wounded or otherwise incapacitated or helpless within the following service area, with the following central operations station and response times:

1. Service Area:

Beginning on State Highway 87 at Milepost 300, following a straight line East by Southeast to Milepost 280

on State Highway 260, then following a straight line Southwest to the community of Young, then following a

straight line South to State Highway 288 and Forest Service Road 203 (Cherry Creek Road), then

Southwesterly to State Route 188 milepost 232, then Northwest to the Burnt Corral Campgrounds on

Highway 88, then Northwest to milepost 210 on Highway 87, then West three miles to Otero Creek, then

following a straight line North by Northwest to the point where the Zane Grey Highway (otherwise known as

Hwy. 260) intersects the Yavapai Coconino County line, then following a straight line East by Northeast to

State Highway 87 at milepost 300.

2. Central Operating Station: Payson, Arizona (1014 South Westerly Street).

Now, therefore, by virtue of the authority vested in the Arizona Department of Health Services, under the constitution and laws of the State of Arizona, does hereby grant this

TRANSFER

CERTIFICATE OF NECESSITY authorizing the operation of the aforesaid ambulance service for a period ending May 31, 2013 unless for cause sooner amended, suspended, revoked or terminated subject to the decisions and orders, and rules of the Department.

PROVIDED, that this certificate shall not be assigned nor transferred unless authorized by the Arizona Department of Health Services.

BY THE ORDER OF THE ARIZONA DEPARTMENT OF HEALTH

SERVICES, IN WITNESS WHEREOF, I WILL HUMBLE the Director of the Arizona Department of Health Services, have hereunto set my hand and caused the official seal of the Arizona Department of Health

Services to be affixed at Phoenix, Arizona on ;, 3 1417

-e-----71144"--

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA CERTIFICATE NO. - 58 } ss

County of Maricopa DOCKET NO. EMS 3707

3. Response Times:

a. 75% (seventy-five percent) of all calls within 10 (ten) minutes.

b. 85% (eighty-five percent) of all calls within 20 (twenty) minutes.

c. 95% (ninety-five percent) of all calls within 30 (thirty) minutes.

d 100% (one hundred percent) of all calls within 105 (one hundred five) minutes.

CERTIFICATE OF NECESSITY

(CONTINUATION PAGE ONE )

ISS 'ED

EXPIRES \Lv 31, 2013

DIRECTOR

/

ARIZONA DEPARTMENT OF HEALTH SERVICES

STATE OF ARIZONA

CERTIFICATE NO. - 75 -

County of Maricopa ) ss

DOCKET NO. EMS 3705

THE ARIZONA DEPARTMENT OF HEALTH SERVICES has found„ under the authority of A.R.S. § 36-2232 et q and Pursuant to Department of Health Services rules, that public necessity requires the operation of

EMERGENCY MEDICAL TRANSPORT, INC., dba AMERICAN AMBULANCE

as a ground BLS ambulance service in the State of Arizona for the transportation of individuals who are sick, injured, wounded or otherwise incapacitated or helpless within the following service area, with the following central operations station and response times:

1. Service Area: Cities of Phoenix, Mesa, Tempe, Gilbert, Queen Creek, Sun Lakes and Ahwatukee.

2. Central Operating Station: Phoenix, Arizona (1401 East Washington Street).

3. Response Times: Not applicable.

4. The authority granted under this certYicate is restricted to interfacility preschedtded transport ofpatients,

which includes transporting a person within its certificated area from home to a health care institution,

between health care institution to home, and from home-to-home

Now, therefore, by virtue of the authority vested in the Arizona Department of Health Services, under the constitution and laws of the State of Arizona, does hereby grant this

TRANSFER

CERTIFICATE OF NECESSITY authorizing the operation of the aforesaid ambulance service for a period ending August 31, 2014 unless for cause sooner amended, suspended, revoked or terminated subject to the decisions and orders, and rules of the Department.

PROVIDED, that this certificate shall not be assigned nor transferred unless authorized by the Arizona Department of Health Services.

BY THE ORDER OF THE ARIZONA DEPARTMENT OF HEALTH

SERVICES, IN WITNESS WHEREOF, I WILL HUMBLE the

Director of the Arizona Department of Health Services, have hereunto set my hand and caused the official seal of the Arizona Department of Health

-fiLau.A.7 3, 2-0 1 Services to be affixed at Phoenix, Arizona on

Vrie„..Th

jDdCTOR

BlueCross BlueShield of Arizona

An Independent Licensee of the Blue Cross and Blue Shield Association

September 6, 2012

lthan Yanofsky Deputy Bureau Chief Bureau of Emergency Medical Services & Trauma System 150 North 18th Avenue, Suite 540 Phoenix, Arizona 85007

Re: ABC Ambulance

Dear Mr. Yanofsky:

The purpose of this letter is to clarify my letter to you dated August 16, 2012, regarding ABC Ambulance. Please be advised the August 16 letter was neither intended to provide an opinion or conclusion related to need for, nor have I participated in the development of a needs assessment of, ambulance services to be provided by ABC Ambulance within the relevant service area.

Please let me know if you have any questions.

M rcus Montoya Vice President Provider Network Management

Cc: Norka I. Carrasquillo

SWA-2 Post Office Box 13466 • Phoenix, AZ 85002-3466

2444 West Las Paimaritas Drive • Phoenix, AZ 85021-4883 • (602) 864-4400 • www.szblue.com