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Dedicated Standby Contract

  1. GJFD logo
  2. Dedicated Standby Contract

    Event Information: 
    This coverage will be dedicated and crew will be in place 15 minutes prior to start time.

    The Grand Junction Fire Department will:
    Ensure compliance with all State, County, and local rules and regulations that govern ambulance services and/or coverage at special events.  Ensure personnel follow the protocols of the Mesa County Medical Director.  Apply the current fee schedule approved by the Grand Junction City Council.  Invoices will be calculated using the actual time provided, not estimated times.

  3. Day One
  4. Day Two
  5. Day Three
  6. Day Four
  7. Service Cost Estimate

    Advanced Life Support Ambulance (can transport): $178/hr

    Basic Life Support Ambulance (can transport): $168/hr

    Paramedic Staffed Squad— Advanced Life Support Person in EMS pickup (cannot transport): $89/hr

    EMT Staffed Squad— Basic Life Support Person in EMS pickup (cannot transport): $84/hr

  8. Medical Support Provided: First Ambulance
  9. Medical Support Provided: Second Ambulance
  10. Medical Support Provided: Third Ambulance
  11. Medical Support Provided: Fourth Ambulance
  12. Event Information
  13. Billing Information
  14. The event organizer agrees to pre-plan details of event coverage and encourage coordination between the on-site staff and the Grand Junction Fire Department:
  15. With a communication plan,
  16. Identification of staging Areas,
  17. Identification of ingress and egress routes,
  18. Coordination of Medical Treatment protocols,
  19. Planning in the event additional resources are needed.
  20. In addition, the event organizer agrees that:
  21. Payment for services provided is due within 30 days of the event.
  22. In the event of inclement weather, this event may be cancelled with notification to the appropriate Grand Junction Fire Department (GJFD) Communications Center at least two (2) hours prior to the start time without cost. 242- HELP (4357).
  23. Cancellations that occur within two hours of the event will be charged a minimum of two hours stand-by time at the agreed upon standby rate.
  24. By typing your name above you are electronically signing this document.

  25. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your contract will not be signed or initialed in the sense of a traditional paper document, 2) by signing or initialing in this alternate manner, you authorize your electronic signatures and initials to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide traditional signatures at a later date.

  26. Upon the completion of this form, a GJFD employee will call the Special Event Representative to confirm information and provide total cost estimate.
  27. Leave This Blank:

  28. This field is not part of the form submission.