File Ref. #198
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MIAMI BEACH FIRE DEPARTMENT 2c\()(1 ..
Fire Chief's'Offi'dID
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To:
Lawrence A. Levy
City Manager
Date: May 12, 2000
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Subject: APPROVAL OF E.M.S. RATE INCREASE
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Attached for your information is the Miami-Dade County approval of the City of Miami Beach1D.creased
EMS rate schedule. The new transportation fees were implemented effective May 1,2000.
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OFFICE OF AMBULANCE REGULATION
COORDINATION
140 WEST FLAGLER STREET
SUITE 903
MIAMI, FLORIDA 33130-1561
Consumer Services Department
Tel: (305) 375-4222 Ext. 7854 . Fax: (305) 375-4120 . TOO: (305) 375-4177 · E-mail: consumer@co.miami-dade.f1.us
Apri127,2000
Floyd Jordan, Fire Chief
City of Miami Beach Fire Rescue Department
2300 Pinetree Drive
Miami Beach, Florida 33139
Dear Chief Jordan:
We are pleased to provide the enclosed certified copy of the April 11, 2000 public hearing agenda
item wherein the Board of County Commissioners passed and adopted Resolution No. R-308-00
approving an emergency medical services rate schedule increase and establishing a charge for
mileage for the City of Miami Beach Fire Rescue Department.
If you should have any questions concerning this issue, or if we can be of assistance in another
matter, please do not hesitate to contact us.
../
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ve Gunn
Ambulance Regulation Coordinator
Enclosures
c: Sheila Rushton, Director, Consumer Services Department
Cathy Grimes Peel, Assistant Director, Consumer Services Department
Edward Del Favero, EMS Division Chief, City of Miami Beach Fire Rescue Department
MIAM'-
MIAMI-DADE COUNTY, FLORIDA _."
CICertcopy
I:~EMORANDUM
Agenaa Item No. 4(K)
TO:
DATE:
April 11, 2000
Honorable Chairperson and Members
Board of County Commissioners
SUBJECT: City of Miami Beach
Fire Rescue Department's Transport
Rate Increase Request
FROM:
RECOMMENDA TION
It is recommended that the Board approve a request by the City of Miami Beach to increase the
Miami Beach Fire Rescue Department's emergency medical services transport rate schedule, and
to establish a charge for mileage.
BACKGROUND
Chapter 4, Article I of the Code, relating to air and ground ambulances, including emergency
medical transport vehicles, requires all owners and operators to file with the County Manager a
schedule of the rates which will be charged for the transportation of persons in these units. All
rates require approval by the Board, after a public hearing.
The City of Miami Beach Fire Rescue Department has submitted a request to increase their
Advanced Life Support (ALS) and Basic Life Support (BLS) base transport and oxygen
administration rates, and to establish a charge for mileage. The proposed rates were approved by
Mayor Kasdin and the City Commission on January 12,2000 by Resolution No. 2000-23445.
The proposed adjustments are necessary due to increased operational expenses for both medical
supplies and vehicle maintenance, and to become consistent with the current rates, as approved
by the Board, for the Miami-Dade Fire Rescue Department and the City of Miami Department of
Fire Rescue. The proposed schedule of rates per patient, per intervention is as follows:
Advanced Life Support (ALS) Base Transport Rate
$290.00
Current Rate Proposed Rate
$310.00
Basic Life Support (BLS) Base Transport Rate
Mileage, per mile or fraction thereof
Oxygen
LV./I.O. Solutions
Cardiac Monitoring
Intubation
Spinal Immobilization
175.00
N/A
25.00
25.00
25.00
25.00
25.00
Attachments
/
310.00
7.50
30.00
25.00
25.00
25.00
25.00
'" MEMORANDUM
TO:
HOllo ChaiIperson and Members
Board of County Commissioners
DATE:
SUBJECT:
April 11, 2000 .
Agenda Item No. 4(K)
FROM:
p/ c::? ~
Robert A Ginsburg
County Attorney
Please note any items checked.
"4-Day Rule" (Applicable ifraised)
6 weeks required between first reading and public hearing
Decreases revenues or increases expenditures without balancing
budget
Budget required
Statement of fiscal impact required
Statement of private business sector impact required
Bid waiver requiring County Manager's written
reconunendation
Ordinance creating a new board requires a detailed County
Manager's report for public hearing
"Sunset" provision required
Legislative findings necessary
'......
2-
.'
Approved
.veto
Override
Mayor
Agenda Item No. 4 (K)
4-11-00
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RESOLUTION NO.
R-30a-oo
RESOLUTION APPROVING A REQUEST TO INCREASE
THE CITY OF MIAMI BEACH FIRE RESCUE
DEPARTMENT'S AUTHORIZED EMERGENCY MEDICAL
SER VICES RATE SCHEDULE AND TO EST ABLISH A
,
CBARGE FOR MILEAGE
WHEREAS, this Board desires to accomplish the purpose outlined in the accompanying
memorandum, a copy of which is incorporated herein by reference;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMTSSfnNFRS OF ~!AM!-DADE COlT~TY, FLORIDA, t~a:
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accordance with Chapter 4, Article I of the Code, approves an increase in the City of Miami
Beach Fire Rescue Department1s authorized emergency medical services rate schedule, and to
establish a charge for mileage.
The foregoing resolution was offered by Commissioner Dermis C.Moss
who moved its adoption. The motion was seconded by Commissioner Dorrin D. Rolle
and upon being put to a vote, the vote was as follows:
3
Dr. Miriam Alonso
Dr. Barbara M. Carey-Shuler
Betty T. Ferguson
Natacha Seijas Millan
Dennis C. Moss
Dorrin D. Rolle
Agenda !Cern No. 4 (K)
Page No.2
Bruno A. Barreiro
Miguel Diaz de la Portilla
Gwen Margolis
Jimmy L. Morales
Pedro Reboredo
Katy Sorenson
aye
aye
aye
aye
absent
aye
aye
Javier D. Souto
aye
absent
aye
aye
absent
absent
The Chairperson thereupon declared the resolution duly passed and adopted this 11 th day
of April, 2000. This resolution shall become effective ten (10) days after the date of its adoption
unless vetoed by the Mayor, and if vetoed, shall become effective only upon an override by this
Board.
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Approved by the County Attorney-.
as to form and legal sufficiency. v K ~
MIAMI-DADE COUNTY, FLORIDA
BY ITS BOARD OF
COUNTY COMMISSIONERS
HAR VEY RUVIN, CLERK
By:
10\ Y SUL.LIV AN
Deputy Clerk
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CITY OF MIAMI BEACH
1700 Convention Center Drive, Miami Beach, Flotida 33139
htlp:\\d.miaml-be:ach.f1.us
Office of lhg City Manager
Telephone (305) 673.7010
Facsimile (305) 673-7782
February 10, 2000
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Mr. Merrett R. Sticrheim
Miami-Dade County Manager
111 N.W. 111 Street, Suite 2910
Miami, Florida 3312&
Rc: City of Miami Beach Request for Rescue Transportation Fee Rate Increase
Dear Mr. Stierheim:
On January 12, 2000, the City of Miami Beach adopted by Resolution an increase in its rescue
transportation fee for basic and advanced life support, established a charge for lllileage and an
mcrease in the charge for oxygen. A copy of the approved City of Miami Beach Commissioll
Memorandum and Resolution is enclosed for your review.
1 am requestmg that t111S Issue be addressed tor approval by the {vliarm-IJade l..-ulHlly
Cummission as soon as possible. Should you have any 4uestions regarding tillS request. please
contact me and I will assure that respouses are provided.
Sincerely,
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Lawrence A. Levy ~
City Manager
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CITY OF MIAMI BEACH
CITY HALL 1700 CON\IENTION CENTER DRIVE UIAMI BEACH. R.ORIDA 3J13G
hltp:\\d.mlaml-bolel1.f1.UI
COMMISSION MEMORANDUM NO. ~
FROM:
Mayor Neisen O. Kasdin and
Members of tbe City Commission
Luwrence A. Le~
City Manager
DATE: January 12,2000
TO:
SUBJECf: A RESOLUTION OF THE MAYOR AND CITY COMMISSION OF THE
CITY OF MIAMI BEACH, FLORIDA, AMENDING RESOLUTION NO.
95-21653 INCREASING THE PRESENT FIRE RESCUE TRANSPORT
FEE FROM S175 FOR BASIC LIFE SUPPORT, AND S290 FOR
ADVANCED LIFE SUPPORT, TO $310 FIRE BASIC LIFE SUPPORT,
AND 5310 FOR ADVANCED LIFE SUPPPORT, AND ESTABLISHING A
MILEAGE CHARGE OF $7.50 PER MILE, AND INCREASING THE
CHARGE FOR MEDICAL OXYGEN FROM S25 TO $30 PER
INTERVENTION.
ADMINISTRATION RF.COMMENDA TION~
Adopt the Resolution.
ANAL YSIS:
The Fire Department presently proVldes medical transportation tor persons requiring Basic Life
Support (BLS) or Advanced LIfe Support (AL..<';) at a rate of $175 per BLS and $290 for ALS
transport. (Established by Resolution No. 92-20593 on September 16, 1992, amended July 26,
1995, Resolution No. 95-21653).
Since the establishment of the first transportation fee, the Fire Department has experienced
increased budgetary costs in providing BLS and ALS transport service, both for medical supplies
and increased vehicle maintenance costs.
An internal city audit of our Transport Billing Service, (Advanced Data Processing) confirmed
that ADP was meeting or exceeding the tenus of their contract (see attaclunent). in order to
increase revenue, the audit report suggested that the City increase transport fees to equal Miami
Dade and Cily of Miami Fire Departments. The proposed increases in tr8I1Sport rates will be
consistent with the rate structure of both Miami and Miami-Dade County Fire Departments. (See
attached ehart indicating Rescue Transpol1 tee sLrUclures for other Fire Departments in South
Florida).
AGENDA ITEM C. I ~
DATE /-(2-0D
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The proposed rate increase for expendable medical supplies and transport mileage charge will
provide needed revenue to the Fire Department to offset increased budgetary costs. A
comparison of the fees charged by the City of Miami Bea.c.h and other local governmental entities
is attached. for your review. If the proposed fee increase is approved for Miami Beach, the fees
will be comparable with other entities. The annual budget for the Rescue Division is $7,599,884.
Revenue from Rescue Transports is $1,200,000. The revenue increase due to fee adjusunents
is projected to be approximately $370,000 during FY 99/2000.
Medicare will pay 80% of the cap for Miami Beach. Currently. that cap is $175.00 for BLS and
$203.62 for ALS Transports. The other 20% is paid by secondary insurance or out of pocket.
The cap for Miami and Miami-Dade County is $292.95. This year the City of Miami Beach
received the maximum allowable increase of 15%. We will continue pursuing annual increases
until we reach the maximum cap of$292.95.
A majority of private insurance companies will pay 100% of what is usual and customary of the
transportation fcc, plus additional charges as listed below, minus applicable deductions.
Automobile insurance polices pay 100% provided the policy has P.I.P. coverage. HM.D swill
pay 100% of the amoWlt billed. Revenue received from rescue transportation fees consists of
4~ y~ % from private insurance, 31 % from M~ciir.Rr(':, 111/, % from Medicaid and 7% out of
pocket.
No mdividual will be denied Fire Rescue transport services due to an mabil1ty to pay for such
services. The proposed increases are as follows.
CMB
CMB
.1Jroposed
l)rcseot
Advanced Lile Suppor1
Basic Life Support
Mileage Charge / PER Mile
Oxygen
Cardiac Mouitoring
LV. /1.0.
Intubation
SpinallmmoblJization
$175.00
$290.00
o
$25.00
$25.00
$25.00
$25.00
$25.00
S3 J U.OU
$310.00
$ 7.50
.$ 3U.00
$ 25.00
$ 25.00
.$ 15.00
$ 25.00
It is recommended that Resolution No. 95-21653, Schedule of Fire Rescue Transport Fees for
Fire Department be amended.
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RESOLUTION NO.
2000-23445
A RESOLUTION OF TIlE MAYOR AND CITY COMMISSION OF THE
CITY OF MIAMI BEACH, FLORIDA, AMENDING RESOLUTION NO. 92-
20593 INCREASING THE rRESENT FIRE RESCUE TRANSPORT FF~
FROM S175 I'.OR DASIC LIFE SUPPORT, AND $290 FOR ADVANCED
LIFE SUPPORT, TO 5310 FOR BASIC LIFE SUPPORT, AND S310 FOR
AnV ANCED LIFE SUPPORT; ESTABLISHING A MILEAGE CHARGE OF
$7.50 PER MILE; AND INCREASING THE CHARGE FOR MEDICAL
OXYGEN FROM S25 TO 530 PER INTERVENTION.
WHEREAS, it is necessary to raise the established Fire Rescue Transport Fees for Basic
Life Support and Advanced. Life Support. due to increased operation expenses and to become
uniform with Miami-Dade County Rescue Services; and
WHEREAS, the present rates for said services are Sl75 for Basic Life Support and $290 for
Advanced Life Support Transports; and
WHEREAS, a fee for transport mileage ofS7.50 per mile transported shall be established;
and
WHEREAS, the increased fees for said services and increased charges for expendable
medical supplies shall be as [allows:
Advo.nced Life Support
Basic Life Suppon
Mileage Charge / PER Mile
Oxygen
$) 10.00
$310.00
$ 7.50
$ 30.00
and,
WHEREAS, notwithstanding the above tees, no individuals shall be deprived of Fire Rescue
Transport Services due to the inability to pay for such services.
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BE IT DULY RESOLVED BY MA VOR AND CITY COMMISSION OF THE
CITY OF MIAMI BEACH, FLORIDA, that the present l~ire Rescue Transport Fees be
increased from $ 175 for Basic Life Support., and $290 for Advanced Life Support, to $310
for Basic Life Support, and $310 for Advanced Life Suppo~ establishing a mileage charge
of S7.50 per mile; and increasing the charge for medical oxygen from $25 to $30 per
intervention.
PASSED AND ADOPTED this 12th day of January ,2000
ATTEST:
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CITY CLERK
~~
MAYOR
LL\MTIB~F.0<9
C\f1rC:~"Lll;\ComjMcmo 8. Rs;so. Fcc lncccr.sc
APPROVED AS 10
FORM & lANGUAGE
& FOR EXECUTION
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CrrY OF MIAMI BEACH
INTERNAL AUDIT REPORT
,.
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DATE: July 9, 1999
TO: Sergio RodrlguGz, City Manager
VIA: Mayra Diaz Buttacavoli, Assistant CIty Manager
FROM:.' James J. Sutter, IntGrna/ Auditor
SUBJECT: FIre Rescue Fees
PERIOD: October 1, 1997 through May 31, 1999
TN r RODUCTION
The Fire Rescue DIvision of the Flee Dcpan:mem is responsible for providmg emergency medical
transport servi.c.c: in acxordan.ce with Resolution 92-20593. This resolution provides that the City
clurge $150 for Basic Life Support (BLS) and.$250 for Advance LIfe Support (ALS) for eacb
transport. On July 26. 1995. clw City Cnmmic:sjon p~ and adopted an increase in the rescue
fees to S175 for (BLS) and S190 for (~. The Metro ~ Coun1y Commission subsequently
approved this increase and became effective an November 7, 1995.
City Commission Memo No. 359-94 of May 18, 1994 awarded a one yw- c:ontract to Adva.nce
Dam Processing, lm:., to provUk emergency ml'1'li~ transport billing and collection services for
the City, with an option for two additional ye3l'S at the City Manager's discretion. Th.c: tv.'o years
ended on September 30, 1997 and ADP hAs been operating without a cmttracr for the past 21
momhs. The Fire Rescue Division pro~ the Contraaor (ADP) with a daily lisr of the munber
of U'aDsports, along wim the transporce.d individua.ls' c.a.mes and addresses for billing purposes.
The COntractor is also responsible for follow~. collection and reporting acrlviLies.
Revenues collecred for FlScal Year 97/98 were SI,209.145. For the eight moneb. period ending
~y 31.1999. revenues anlOllD! to $157.104.
Page 1 of 4 Pages
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INTERNAL AUDIT REPORT
FIRE RESCUE FEE BEVENUE
Julv 9. 1999
"
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OVERALL OPINION AND SUMMARY OF FINDINGS
The Com:raa expired on September 30, 1991 aDd there has been no communication by the City
to the Comra.ctOr on whether me City iml"'oos (0 exercise iC3 option to renew me agrt".t!rDent or have
a Dew RFP sent oDt for lhe service. It is le('-omm~ed ~ the City immediately act accordingly
to either renew or rebid this agreemcm.
All ~ forms and invoicd tested were properly authorized, accounted. for and fees charged
were COrTect and in compIClnl'.e with the City Resol11tion. All collections Were correctly and timely
deposited ill the lockbox. ADP correctly bills for ~ 7% of prior momhs collections. Follow up
efforts to collect WIpaid 3.IDDWlIS were reasonable before they were written-off. The Finance
departm.e:nr reconciles on a monthly basis, the l0ckb0x to the Fmancial Management System. No
exception were noted.
Overpaymcm made by iDsurancc companies or ia.dividuab were correctly and timely returned and
record:d in the fin::mrial Managemem System.
The minimllm reimbursement allowed by Medlcarc and Medicaid is much Jower for the City of
Miami Beach, as compared to the minimnm rciInbmsernem to Miami Dade Coumy aDd other near
by mnnidpalitic:s. In aMidon, rhe City's fees for such service are lower tlum other near by
municipalities .
SCOPE
1. Confirm that the City i3 timely providlng ADP with the names. addresses and amowus for
billing for each person transponed by a rescue vehicle, and Chat these documentS are
picked up by an authorized repr~t:ive of ADP once a week, and that ADP i.oiti21es
bUllng within five: days of receipts of these: documcnu.
2. Confirm that the City FIre Rescue Division is reconciling the number of billings provided
to ADP with the oumber ADP a.auaJJy bUb.
3. Confirm tbat ADP is taking timely aDd 8pptOplWe follow-up action on delinquencies and.
is mailing additional invoices [0 coUca amoum due.
4. Confirm that ADP is adhering [0 the loc.kbox agreement and all collections for services
Page 2 of 4 Pages
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INTERNAL AUOfT REPORT
FIRE fi~CUE FEE RFVENUE
~.
,
JuJv 9 1999
billed by ADP are deposited into the approved bank lockbox.
5. Confum that ADP bas properly ca1culau:d and the Cicy correctly paid the monthly
collection fee of 7 %.
6. Confirm that daily COlJectiODS were corrca1y timely recorded in the City's Financial
Management System.
"
7. Confirm that collections are reconcilc:d monthly with" the City's Financial Management
System.
FINDINGS. RECOMMENDATIONS, AND MANAGEMENT RESPONSES
1. FiDdiDf
The agreement with ADP to provide emergency medical ttansport billing and collection
services for the Cicy, expired 00 ~ 30. 1997. The Coattaaor has been operating
since without an ~~ Both the rue Departmcul and the Finance department, are
very pleased with ADP's performance and the cooperation lhey receive from the
Conrractor.
Recommendarion
The FIre Dc:partmcm should renew the Comraa with ADP as soon as poosible or send out
new ~r for proposals tor these services.
Man~vemenr R~n'le:
Chief Jordan has indica1Cd that the Fire Depanment is already working on renewing the
contract with ADP, with the Procuremcm Depactmem.
2. Flndin2'
Internal Audlt reviewed the billing and collecrlon process aDd noted the evCQ though an
increase has been received from Medicaid since the last audit it is still much lower than
near by municipalities.
It was also determine tha1 tbe Cicy of Miami Bcac:h charges less Ulan Miami Dade County
and otber near by municipalities for the ~ and BLS. Currently Miami Dade County is
charging .$310 for ALS and BLS. The City of Miami is incrcasing..lheir fee to the $310
level. We arc aIITeOIly charging $175 for (BlS) and $290 for (ALS). Miami Dade
County as well as the City of Miami charge 57_SO per mile for additionaJ revenues.
Page 3 of 4 Pages
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FIRE RESCUE FEE REVENUE
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July 9. 1999
whereby the City does not charge for m.ileage wbich may result is ~ome additional revenue.
Recommendation
The Fire PepartmeDt should (".1lnnlC( the Medicare F-ducation and Outteach [0 negotiate an '
increase in the fees paid by Medicare. AIJo, the Fire Depan.mem may want to propose
increasing ALS and BI..S fees to the City Commission for approval. fa be competitive with
other municipalities.
"
Manap"ement R~n.~
The Fire DepartIIleIlt has inrlil'~tl"(j that 1bey have spoken (0 Medicare Education and
OuU'eaCh to discuss increasing the fees paid by Medicare. However, Medicare informed
the Fire Department that siDc:e the City recenI1y got an increase in the fees, they must wait
a year before reapplying.
The Fire. Depanmau has indicated that they will be gOing in froot of Commission for
approval on the incrcase of ALS aDd BLS fees.
CIo5in~ Conference
A closing conference was held on Friday, JUDe 9, 1999 in the Internal Audit depanmenL
Attendees were Aoyd Jord2n P'.tre Ollef; Ed DelFavero. EMS Chief; lames Sutter, Internal
Auditor; and Laura Fran.co-Rubin.es. Senior Auditor. FinAing!i: and managemcm's responses
included above were discussed at the closing meeting.
JJS:l.F;!f
(Audit Pcrlormed by Laura Franco, SOllor Auditor)
(fircresc. wpd) 98/99
cc: Floyd Jordan. Fire Chief
Ed Delfavero, EMS DiviJion Chief
Bill Gonz.alez, Financial Analyst m
Page 4 of 4 Pages
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FAX NO.
305 372 6082
OF F I CE OF AL I NA T. HUDAK
MUNICIPALITIES
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MIAMI-DADE COUNTY, FLORIDA
PUBLIC NOTICE
THE BOARD OF COUNTY COMMISSIONERS of Miami-Dade County, Florida will meet on
Tuesday, the 11 th of April, 2000 at approximately 9:30 a.m., in the County Commission
Chambers, Second Floor, Stephen P. Clark Center, III N. W. First Street, Miami, Florida to
consider the request by the City of Miami Beach Fire Rescue Department to increase their
emergency medical services rate schedule.
A person who decides to appeal any decision made by the Board of County Commissioners with respect to any
matter considered at its hearing. will need a record of the proceedings. Such person may need to ensure that a
verbatim record of the proceedings is made including the testimony and evidence upon which the appeal is to be
based.
HAR VEY RUVIN, CLERK
KA Y SULLIVAN, DEPUTY CLERK
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S'.l'ATE OF FLORIDA
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SS:
COUNTY OF MIAMI-DADE
I, HARVEY RUVIN, Clerk of the Circuit Court in and for Miami-Dade County,
Florida and Ex-Officio Clerk of the Board of County Commissioners 0 f Said County,
Do Hereby Certify that the above and foregoing is a true and correct copy of
Resolution No. R-308-00
adopted by said board of County Commissioners
at its meeting held on APRIL 11
2000
IN WITNESS WHEREOF, I have hereunto set my hand and official seal on
this 27th day of
APRIL
, A.D. 2000
HARVEY RUVIN, Clerk
Board of County Commissioners
Dade County, Florida
By
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SEAL
Board of County Commissioners
Miami-Dade County, Florida