Medical Support Trailer (MST)SAMPLE.pdf

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Agreement Number: _____________________

MEDICAL SUPPORT TRAILER (MST)

INTRODUCTION

This intent of this agreement is to provide an overview of the role, duties, and equipment pertinent to the Medical Support Trailer (MST) resource. Medical Support Tent may be acceptable, if requested and documented by the incident.

The purpose of the MST is to provide medical assessments and treatment to incident personnel on expanded incidents requiring a large amount of medical support for managing illnesses and injuries. They may also provide care for incident emergencies and infectious disease control.

GENERAL REQUIREMENTS.

The Emergency Equipment Rental Agreement (EERA) for is for Local, Regional, and Nationwide basis. The Contractor is responsible for all personnel licenses, licensed equipment, materials, supplies, transportation, lodging, qualified medical personnel, and supervision and management of those personnel, necessary to meet or exceed the Agreement specifications. The resources may be used on fire suppression, all-hazard incidents, and prescribed fire project work to include but not limited to: prescribed burn unit preparation, ignition, holding, and contingency. The Medical Unit Leader (MEDL), Incident Commander, or the responsible Government Representative is authorized to administer the technical aspects of this agreement.

Nurse Practitioners, Physician, Physician Assistants, Paramedics, Registered Nurses, and EMT's assigned to the MST for an incident shall function within the policy of the assigned state’s regulatory bodies such as state Board of Nursing, State Board of Medicine, State Office of Emergency Medical Services Authority (EMSA),etc. They shall utilize the scope of practice for which they are trained and certified to perform in concordance with the policies and procedures established by the state of operations; local EMS Agency

(LEMSA).

- The MST is a staged medical unit (most common a Trailer, seldomly a Tent) to be placed in camp while assigned to a wildland fire or other emergency incident. The MST will report directly to the MEDL under Logistics (LOGS) within the Incident Command System (ICS).

STAFFING AND EQUIPMENT MINIMUM REQUIREMENTS.

a) MST roles and minimum staffing requirements are listed below. MST personnel shall possess documentation validating their licensure and/or certification to function as a medical care provider in their assigned role.

b) All personnel shall have license and medical certification in good standing within the State of Licensure. Any necessary licenses/reciprocity for state of incident must be obtained. All MSTs require medical oversight by a licensed physician and must be in compliance with State regulations for medical oversight. Oversight shall include QI/QA processes.

c) All resources arriving from outside of incident ordering state shall contact the appropriate State Medical Authority to receive authorization to operate in that jurisdiction.

d) If an ALS ambulance is co-located with the MST, the ALS equipment list referenced below and in Exhibit M may be waived to defer to the ALS ambulance.

e) Advanced Life Support (ALS) equipment must meet the minimum requirements of the scope of care available in the MST.

Examples of medical supplies required would be appropriate cardiac and respiratory therapies.

f) The Contractor shall report to incident fully self-sufficient to include a generator, fuel for generator for at least 48hrs, and water for the trailer (as needed), fully stocked medical supplies, qualified medical personnel, ALS Kit, etc. to meet incident needs. The incident may provide the Contractor fuel for their generator (if the resource is available and at the discretion of incident).

g) The incident may provide Potable Water, if the resource is available at the incident and at the discretion of Incident Management Team (IMT).

- Gray Water and Black Water removal is the responsibility of the Contractor. No gray water disposal or sewer pumping services will be paid for by the Government for the resources/equipment that fall under this agreement.

The capabilities of a Medical Support Trailer or Tent will vary with location—proximity to pharmacy for over-the-counter medications and prescriptions is one factor, proximity and capability of any local clinics, urgent care or emergency departments is another factor. Please order accordingly.

See the charts below for various requirements.

SAMPLE

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MEDICAL SUPPORT TRAILER (MST)

Optional are highlighted in this color.

MST Type 1 2 3

Level Of Care

Independent Practitioner with

Prescription Capability

ALS Capable, Limited Medications with

Telehealth

Basic Care and Over the Counter Medications

Number/Type of Staff with Unit

(1) Registered Nurse, PA or NP and (1) Paramedic (1) Paramedic (1) EMT (2) EMTs

*Physician and EMT acceptable

*(2) Paramedics acceptable

*Paramedic and EMT acceptable

**Ability to Provide Care to Personnel on Incident 1500 or above 500 - 1500 0 - 500

Distance to Local Pharmacy or Hospital Greater than 1 hour 30 min to 1 hour Less than 30 min

Minimum Level of Care/Training NP/PA ALS Medical ALS Medical BLS Medical

Number of Beds / ALS Pt. Capacity 2 2 1 (No ALS Capability)

Specialized Equipment ALS Equipment Cardiac

Monitor ALS Equipment Cardiac Monitor BLS Equipment AED

ALS Equipment per supplemental Exhibit M

NOTE: If an ALS Ambulance is co-located with the MST, the ALS equipment list may be waived at the MEDL discretion to defer to the ALS Ambulance.

Pt. Isolation Capabilities Yes Yes No

Hours of Operation and Availability 18-24hr Incident Dependent

18-24hr Incident Dependent 18hr

POC Testing (limited) Urine Dip, Glucose, iStat Varies Optional No

Come Fully Stocked Yes Yes Yes 24hr Online Medical Control Yes Yes Yes

Full Telehealth Yes Limited No CA-16 Signature Capability

Delayed permitted if using scan and secure email.

Yes Optional No

Special care skills such as suturing minor lacerations (no layered closure, no face, no joints)

(Optional)

Optional Optional No

*The number/types of MST’s needed for Incident may fluctuate based on incident needs and complexity changes.

**Ability to Provide Care to Personnel on Incident for “Typing” is not solely based on the # of personnel on incident. The incident Typing is based on the incident Level of Care Needed to support. Example: 200 incident personnel, but incident is located 6 hours from a nearest town or city, this would be a Type 1 based on the distance from available resources (i.e., hospital, pharmacy, etc.).

Documentation: Capable of documenting all patient care and able to share documentation with MEDL or equivalent designee on incident. Record of issues shall be completed and shared with MEDL or designee.

CA-16 signatures shall comply with the U.S. Department of Labor (DOL). DOL's definition of physician - "The term “physician” includes doctors of medicine (MD), surgeons, podiatrists, dentists, clinical psychologists, optometrists, chiropractors and osteopathic practitioners within the scope of their practice as defined by State law."

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MEDICAL SUPPORT TRAILER (MST)

Minimum Equipment List (MEL). When ordered, the Medical Support Trailer (MST), or Tent, will come with all equipment and qualifications defined in the Minimum Equipment List (MEL).

Please note variations of types and brands of over-the-counter medications and quality may vary depending on changes in availability. The list below is used as a guide depicting necessary inventory to achieve incident goals.

Optional are highlighted in this color.

General Medical Assessment UOM Minimum Quantity Level of Care - 1 2 3 Stethoscope, BP Cuff, Pulse Oximeter 1 EA 1 1 1 Glucometer and All Needed Supplies Kit 1 1 1 PPE (Gloves, Gowns, Masks, Eye Protection) Enough for Patients to be Served** 1 EA ** ** **

N-95 1 EA 50 25 10

Patient Blankets (Optional) 1 EA 10 5 1 Urinals 1 EA 10 5 1 Bedpans 1 EA 5 1 1 Cardiac Monitor 1 EA 1 1 AED Tongue Depressors 1 EA 100 30 25 Anti-Bacterial Soap Per Provider 5 5 2 Triage Tags 1 EA 50 25 25 Secure Document Storage Capability System 1 1 1

ALS Equipment per Supplemental Exhibit M If an ALS Ambulance is co-located with the MST, the ALS equipment list may be waived at the MEDL discretion to defer to the ALS Ambulance.

Allergy UOM Minimum Quantity

Diphenhydramine (e.g., Benadryl® or Generic) 1PP 200 150 100 Diphenhydramine Cream 1 Tube 20 20 10 Loratadine (e.g. Claritin® or Generic) 1 PP 100 60 30 Famotidine (e.g., Pepcid® or Generic) 1 PP 50 25 10 Fexofenadine (e.g., Allegra® or Generic) 1 PP 50 25 10 Cetirizine (e.g., Zyrtec®) 1 PP 50 25 10

Cold and Flu UOM Minimum Quantity

Cold and Cough relief medications 2 PP 500 300 150 Cough Drops 1 PP 3000 2000 750 Cough Syrup - 10ml 1 PKT 20 10 10 DayQuil® (or Generic) 2 PP 50 25 25 Emergen-C® 1 PKT 100 60 30 Mucinex® (or Generic) 1 PP 50 25 10

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Cold and Flu UOM Minimum Quantity

NyQuil® (or Generic) 2 PP 20 10 10 Phenylephrine (Generic or equivalent) 2 PP 200 150 75 Sore Throat Lozenges 1 PP 20 20 20 Multi Symptom Flu Medications (E.g., Theraflu® or Equiv.) 1 PKT 10 10 5 Nasal Saline 1 BTL 40 25 10 Nasal Decongestant Spray 1 BTL 25 15 10 Zinc Lozenges (e.g., Zicam® or Equiv.) 1 PP 50 25 25

GI Medications UOM Minimum Quantity

Calcium Carbonate (e.g., Tums® or Generic) 2 PP 200 150 75 Antacid/ Anti-Diarrheal Bismuth (e.g., Pepto Bismal®) 2 PP 50 25 10 H2 Blocker (Omeprazole, i.e.) 1 PP 50 25 10 Anti-Diarrheal (e.g., Imodium® or Generic) 1 PP 100 60 30 Gas Relief (e.g., Gas-X®) - Box of 10 1 PP 10 5 5 Stool Softener 1 PP 200 100 30 Ondansetron (Zofran®) 4mg 1 PP 50 25 0 Emesis Bags 1 PP 50 25 10

Oral UOM Minimum Quantity

Abbreva® - .07 oz 1 Tube 5 5 5 Carmex® (Optional) 1 EA 5 5 5 Dent - Temp, Kits 1 EA 5 3 2 Dental Analgesic (e.g., Oragel®) 1 PKT 20 10 5

Eyes UOM Minimum Quantity

Eye Drops - (Refresh/ Lubricating) .01oz - Pack of 5 1 EA 100 60 30 Eye Drops - (Refresh/ Allergy) - .5oz 1 EA 10 5 2 Eye Wash - 1 oz 1 BTL 100 60 30 Eye Wash - 4 oz 1 BTL 10 5 2

Ears UOM Minimum Quantity

Wax Removal Solution (DeBrox® or Equiv.) 1 BTL 10 5 1 Ear Anesthetic Topical (Auralgan® or Equiv.) 1 BTL 5 2 1

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Body Care UOM Minimum Quantity

Aloe Gel - 8 oz 1 EA 10 5 2 Baby Wipes - Packs of 10 1 EA 200 150 75 Anti-Chaffing (e.g., Body Glide® ) - 1.5 oz 1 EA 50 25 10 Body Lotion - 4 oz 1 BTL 10 5 5 Lip Balm (e.g., Chapstick®) - SPF 1 EA 2000 1200 500 Gold Bond Powder® - Gold 4 oz 100 75 40 Gold Bond Powder® - Green 6 oz 100 75 40 Hand Lotion - 1 oz 1 Tube 50 30 20 Hydrocortisone Cream - 1/32 oz 1 PKT 100 75 30 Nasal Saline Spray - 1.5 oz 1 BTL 100 60 30 Cotton Swabs (e.g., Q-Tips®) - Packs of 10 (Optional) 1 EA 50 25 10 Tissues - Packs of 10 1 EA 50 20 10 Toothbrushes 1 EA 5 5 5 Vitamin A+D Cream - .5g 1 PKT 20 10 5 Zinc Oxide - 2 oz 1 Tube 10 5 2 Oral Hydration Solution --NWCG Guide Compliant 1 PKT 500 200 100 Sunscreen 30 SPF or Higher 1 oz 100 40 25

Poison Oak / Ivy UOM Minimum Quantity

Calagel® - 6 oz 1 BTL 200 150 75 Poison Oak Bar Soap - 2 or 4 oz 1 EA 50 25 10 Pre Contact Wipes 1 PKT 100 60 30 Post Contact Wipes 1 PKT 100 60 5 Tecnu Extreme®, Marie's® or Zanfel® 1 - 4 oz (or Equiv.) 1 BTL/Tube 100 50 10

Feminine Hygiene UOM Minimum Quantity

AZO® 12 PP 1 1 1

AZO Test Strips--Bottle 1 EA 1 1 1 Miconazole Nitrate 1 EA 3 1 1 Tampons 1 EA 100 75 30 Pads 1 EA 100 75 30 Pregnancy Test 1 EA 5 2 1

Minor Injury & Wound Care UOM Minimum Quantity

Triple Antibiotic/ Bacitracin® Ointment 1 PKT 500 350 200 Elastic Bandage (Ace Wrap®) - 2" 1 EA 35 25 10 Elastic Bandage (Ace Wrap®) - 3" 1 EA 10 10 5 Elastic Bandage (Ace Wrap®) - 4" 1 EA 10 10 5 Alcohol Prep Pads 1 PKT 100 100 50

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Minor Injury & Wound Care UOM Minimum Quantity

Antiseptic Wound Wipes (Optional) 1 PKT 50 50 25 Anti-Inflammatory Cream (e.g., Aspercreme®) - 2.7-3 oz 1 Tube 10 5 3 Athletic Tape - 1" 1 EA 100 60 30 Athletic Tape - 2" 1 EA 50 30 10 Band-Aids - 1x3" Strip 1 EA 500 300 100 Band-Aids - 2x3" Patch 1 EA 50 30 10 Band-Aids - Knuckle 1 EA 200 150 75 Band-Aids - Fingertip 1 EA 100 60 30 Band-Aids - Blister 1 EA 100 60 30 Bio Freeze® - 3 mil (Optional) 1 PKT 100 50 25 Burn Gel (Optional) 1 PKT 10 5 3 Coban® - 1" 1 EA 10 10 5 Coban® - 2" 1 EA 50 25 10 Coban® - 3" 1 EA 50 25 10 Cold Packs - Small 1 EA 25 15 5 Gauze Squares - 2x2 (Sterile) 1 EA 200 150 75 Gauze Pads - 2x2 Non-Sterile 1 EA 200 150 100 Gauze Squares - 4x4 (Sterile) 1 EA 100 50 25 Gauze Squares - 4 x 4 Non-Sterile 1 EA 200 100 50 Rolled Gauze (e.g., Kerlix®) - 2" 1 EA 100 50 30 Rolled Gauze (e.g., Kerlix®) - 3-4" 1 EA 100 50 30 Hot Packs 1 EA 5 5 5 Muscle Gel - 3.5 gm 1 PKT 50 30 10 Muscle Pain Patch (e.g., Salonpas®) 1 Patch 20 15 5 New Skin® or Equivalent 1 BTL 5 5 5 Splinter Out 1 PCG 10 5 5 Tweezers 1 EA 25 10 5 Magnifier 1 EA 1 1 0 Scalpel (Optional) 1 EA 20 10 0 Transparent Film Dressing (Optional) 1 EA 100 50 25 Wound Irrigation Supplies (Basin/Syringe/Scrub Brush) for EA PT 50 25 10 Wound Irrigation Solution (Optional) 500 ml 16 10 5

Insect UOM Minimum Quantity

Bug Spray FR - 2 oz 1 BTL 50 25 10 Bug Wipes FR 1 PKT 50 25 10 Sting Relief Swabs / Ampules 1 EA 20 25 10 Sting Relief Wipes 1 PKT 50 25 10

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Foot Care UOM Minimum Quantity

Antifungal Cream (Tolnaftate) - .5 oz 1 Tube 20 15 10 Antifungal Spray - 4 oz 1 EA 10 5 2 Antifungal Powder (Tolnaftate) - 1.5 oz 1 EA 75 50 30 Gold Bond® Powder - Blue - 5 oz 1 EA 50 50 30 Hypafix® Tape (or Equivalent) - 1 ft 1 FT 25 20 10 Flannel Adhesive Pads, Various Sizes (e.g., Moleskin®) 1 PAD 400 300 150 Second Skin® - Moist pads 1 EA 1000 750 300

Lower GI UOM Minimum Quantity

Fleet® Enema 1 BTL 2 1 0 Laxative (e.g., Ex-Lax® )- Box of 8 1 BX 2 1 1 Magnesium Citrate - 10 oz 1 EA 2 1 0 Fiber Supplement(e.g., Metamucil®) 1 PKT 5 3 2 Non-Stimulating Laxative (e.g., MiraLAX®) 1 PKT 3 2 1 Hemorrhoid cream (e.g., Preparation H® - 1 oz) 1 Tube 10 5 2 Stool Softener 1 PP 200 100 30

Antibiotics Requires Independent Prescriber or Telehealth UOM Minimum Quantity

Cephalexin 1 capsule 90 *Medical Direction

*Medical Direction

Amoxicillin Clavulanate 2 capsule 90 *Medical Direction

*Medical Direction

Doxycycline 3 capsule 90 Medical *Direction

*Medical Direction

*Others as per Medical Direction

Pain Relief UOM Minimum Quantity Level of Care - 1 2 3 Acetaminophen (Tylenol®) 500 mg 1 tab 1000 700 500 Ibuprofen (Advil, Motrin ®) 200 mg 1 tab 1000 700 500 Naprosyn (Aleve ®, Naproxen ®) 220mg 1 tab 500 200 100 Aspirin 324 mg 1 tab 200 100 50

IV Fluids (with Start Kits, Tubing, etc.) UOM Minimum Quantity

Normal Saline 0.9% 1 L 20 10 0 Lactated Ringers 1 L 10 5 0

Medications--Advanced Life Support UOM Minimum Quantity

ALL ACLS Meds per Medical Direction & Scope of Practice* Albuterol Inhaler, 17 gm, with Spacer 1 EA 10 8 5

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Medications--Advanced Life Support UOM Minimum Quantity

Albuterol Sulfate Solution, 2.5 mg/3 ml 1 EA 30 10 5 Naloxone Hydrochloride, 2 mg per ml 1 EA 25 10 5

Medications--Prescription UOM Minimum Quantity

As per Medical Direction Steroid Injectable (Dexamethasone e.g.)

Steroid Oral (Prednisolone, Dexamethasone e.g.)

Albuterol Inhaler 1 EA 20 10 3 Anti-Emetic

Miscellaneous UOM Minimum Quantity

Ziplock® or Equivalent Snack Bags (Optional) 1 EA 500 300 100 Ziplock® or Equivalent Sandwich Bags 1 EA 500 300 100 Ziplock® or Equivalent Gallon Bags (Optional) 1 EA 100 50 10 Fingernail Clippers 1 EA 5 3 2 Hand Sanitizer--Individual Size 1 EA 30 20 10 Glucose Tubes 1 oz 1 EA 10 5 5

(End of MEL)

DOCUMENTATION.

• Medical Support Trailer (MST) will be responsible to turn in the following daily tracking data.

o Patient Care Reports (PCR) – CA State Title 22 does not require a PCR to be filed with any Incident

Management Teams (State or Federal). At the request of the MEDL information such as Name, DOB, Employer and Chief Complaint may be relayed to the team for record keeping.

o Patient Contacts will be documented on 214 unit log and turned in to the Medical unit for tracking purposes.

o Daily dispensary statistics and trends tracking.

o Daily injury log.

o Shift tickets for approving signature and any other financial documents required by incident or contractual obligations.

Individual additional items which are billable through the contract must be listed on shift ticket as a separate line item. Provide a description and dollar amount associated with each.

Shift ticket shall be approved with signature through MEDL.

STATE LICENSING/CERTIFICATION/APPROVAL CONTRACTUAL REQUIREMENTS

Personnel will arrive at incident with an Incident Qualification Card Identifying NWCG qualifications. Personnel are required to have Incident Qualification Cards (IQS). All contracted incident EMTs and Paramedics are required to carry proof of current state license with them at all times. Each EMT and Paramedic must carry a written copy of their home EMS units off‐line medical control documentation (standing orders and protocols) under which they operate under their own medical direction.

• Contractors are to ensure their resource can legally provide care at the location(s) of any resource order accepted.

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• If the resource is found NOT to be qualified, the resource may be given time by the incident to remedy the issue.

• If the resource cannot become compliant within the time specified by the incident, they shall be demobilized and will not receive pay including mobilization for travel compensation.

This agreement does not circumvent or supersede state/local laws, regulations, and/or policies to provide emergency medical services within any given state. ALL medical personnel must adhere to local and state laws, regulations, and policies within the state they are being ordered to, and working in, when providing medical care. It is the responsibility of each Contractor to ensure their company is properly licensed/certified/approved to work within a state, not the Government’s, prior to accepting an order for incident in that state. If a Contractor is found to be non-compliant with their agreement, that could be considered grounds for termination of the agreement. If the noncompliance also violates state law, the state may prosecute.

It is the responsibility of the contractor, through the Medical Unit Leader (MEDL) or their designee, to notify the local EMS jurisdictions of their incident assignment. It is the responsibility of the licensed EMS Provider, upon arrival to the incident, to make arrangements for Patient Care Integration Agreements with the local EMS Jurisdiction.

The Government/incident reserves the right to verify training at any time for all operators hired under this agreement.

NON-CONSUMABLE/CONSUMABLE MEDICAL SUPPLIES.

Medical equipment kits must be consistent with their Medical Direction and protocols, and at a minimum, meet the stocking inventory listed below for the appropriate EMS license level. Contractor agrees to furnish a packing list of non-consumable equipment and supplies which include but will not be limited to heart monitoring, heart defibrillator, oxygen, and intravenous fluid administration capabilities, and an inventory of Consumable Medical Supplies to the Medical Unit Leader or their designee for approval upon arrival at an incident. Agency may choose to purchase additional consumable supplies that are not listed and require the medical unit to dispense these items as necessary.

While at the incident the contractor will keep a daily log of medical supplies used for reimbursement purposes (when reimbursement is requested by the Contractor to the MEDL/Incident) at the end of incident. All replacement items must be verified in writing by the Medical Unit Leader or their designee. Contractor will need to submit a claim with supporting documentation in order to receive reimbursement for supplies used on incident. Claim settlement quantities will based on beginning inventory submitted to the Medical Unit Leader or designee upon arrival to the incident, and claim payments will be based on current market prices for the inventory used on this incident. Only items approved by the MEDL will be considered for claim purpose; items not on the original inventory list will not be accepted for claim purpose.

The Government may, at its option, elect to furnish supplies when necessary to keep the resource operating. Supplies furnished to the contractor by the Government will need to be returned to the incident upon demobilization of the resource. If the Government provided supplies are not returned to the Government at the time of demobilization, the Government will determine the actual cost of the Government furnished supplies and those costs will be deducted from the payment to the Contractor.

Equipment (medical kit(s) and vehicle(s) shall be maintained in good repair by the Contractor.

INCIDENT PRE‐USE INSPECTION:

All resources furnished under this agreement shall be in acceptable condition. The Government reserves the right to reject resources that are not in safe and operable condition. Prior to incident use or anytime the resource is under hire, the Government will perform inspections. If the resource does not pass inspection at the incident or designated inspection station, it is considered noncompliant. The Contractor may be given 24 hours or time frame designated by Government representatives to bring the resource into compliance. If the resource does not pass inspection, no payment will be made for travel to the incident or point of inspection or return to the point of hire, or for the time that the resource was not available.

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MISCELLANEOUS SUPPLIES, CHARGES AND CREDITS.

The Government may, at its option, elect to furnish supplies when necessary to keep the resource operating. Supplies furnished to the contractor by the Government shall be returned to the incident upon demobilization of the resource. If the Government provided supplies are not used on the incident or returned to the Government at the time of demobilization, the Government will determine the actual cost of the Government furnished supplies and those costs will be deducted from the payment to the Contractor. Licenses, Fees and Permits. Contractors are responsible for all licenses, fees and permits needed to perform work under this agreement.

ORDERING RESOURCES.

The incident may use this existing EERA to fill additional orders that have been negotiated on this Agreement for the pricing is shown on the Schedule (page 2). The incident may continue to add and fill additional resources against this Agreement, as deemed reasonable by the MEDL or IMT, to meet the medical operational needs of the incident. So long as the Contractor can a) meet the resource needs requested by the incident and b) can accept the additional orders. The Contractor should ensure they receive a new or updated resource order from Incident/Dispatch for accurate invoicing and payment.

Optional Pay Item resources for additional medical personnel under hire require their own resource orders to ensure accurate payment. Optional Items include the following that may be placed against this agreement (Only at the written request of the MEDL):

o ADDITIONAL NURSE - ALS PERSONNEL AT REQUEST OF MEDL, ADV PROTOCALS FOR

POSION OAK

o ADDITIONAL EMTP - PERSONNEL AT REQUEST OF MEDL, ADV PROTOCOLS o ADDITIONAL EMTB - PERSONNEL AT REQEST OF MEDL, BLS

PAYMENT

a) Daily Rates. MST daily rates include any mob/demob mileage for the Contractor to include from point of hire to the incident (round trip). Refer to the General Clauses To Emergency Equipment Rental Agreement Form OF-294 for additional information.

o Mileage is paid and included in the Daily Rate for the resource is to and from (mobilization/demobilization) incident based on location; Contractor point of hire is as shown in Block 4 or Block 6 on the EERA. If discrepancies are noted, the Government and the Contractor shall agree prior to payment.

o MST daily rates listed on this agreement also include the following:

MST CONFIGURATION DETAILS: MD OVERSIGHT/DIRECTION/PROTOCOLS

QUALIFIED STAFFED MEDICAL PERSONNEL

STOCKED W/FIRST AID SUPPLIES & OTC MEDS 0600 TO 2200 LOCAL TIME

ALS & BLS CAPABILITIES 24 HOURS (Based on the MST Type ordered)

b) The host agency for each incident is responsible for payments. The payment office will be designated in Block 9 on the Emergency Equipment - Use Invoice, Form OF-286. Refer to the General Clauses To Emergency Equipment Rental Agreement Form OF-294, Payment Office Information for additional information.

c) The time under hire shall start at the time the resource begins traveling to the incident after being ordered by the Government, and end at the estimated time of arrival back to the point of hire after being released.

Factor 4: Price:

Factor 4: Price:

Factor 4: Price:

Factor 4: Price: