Affirmation_and_Disclosure_Form.pdfAffirmation_and_Disclosure_Form.pdf

This is an Affirmation and Disclosure Form related to an ambulance services contract opportunity issued by the Ohio Department of Rehabilitation and Correction (ODRC). The contract, designated DRC270054, seeks a vendor to provide emergency and non-emergency medical transportation for inmates across ODRC institutions. The contractor must ensure emergency medical transportation is provided within a response time of fifteen minutes or less from initial dispatch call to unit arrival at the location. The scope of services includes all emergency and non-emergency trips to local hospitals and to The Ohio State University Medical Center or Corrections Medical Center, with all associated disposables and both basic life support (BLS) and advanced life support (ALS) services included.

The pricing structure requires the contractor to submit separate pricing for BLS and ALS services for both local hospital transports and transports to The Ohio State University Medical Center or Corrections Medical Center. If the contractor cannot meet the fifteen-minute response time requirement, the contractor must document the call, arrange for another ambulance service to respond, and reimburse the institution for the service cost while also compensating the third-party ambulance service that performed the transport. The contractor bears full financial responsibility for any service gaps or delays, ensuring continuity of emergency medical services regardless of whether the primary contractor can respond.