HomeMy WebLinkAbout2005-308 Agrmt - PSR Physician Svcs Dr Rostykus
Agreement for Provision of Services
of EMT Supervising Physician
This Amendment to the 2003-2004 Agreement for Provision of Services of EMT
Supervising Physician is made on the date last written below by and between PSR Physician
Services, an Oregon limited liability company ("Physician") and Ashland Fire & Rescue
("Agency„).
The following items are amended to read as follows:
2.0 Term
The term of this Agreement shall be one (1) year, commencing July 1, 2005 and ending
June 30, 2006. Either party may terminate this Agreement at any time for any reason upon
sixty (60) days advance written notice to the other.
5.0 Compensation
Agency shall pay Physician $3,237.31 per year as compensation for the services
performed under this Agreement. Payment shall be made no later than the 30th of September
of the term of this Agreement, unless other arrangements have been mutually agreed to.
Ashland Fire & Rescue
By Date P-l I6 / J`-
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Title .4,6wlA,, Svcs ~ilz6eynap-~
PSR Physician Services, an Oregon Limited Liability Company
By Date -7 l o~ f l LO S
-La-)16 1~~* -
Paul S. Rostykus, MD ,/Member
2005-2006 Agreement for Provision of Services of EMT Supervising Physician
• PSR Physician Services, LLC
436 Grandview Drive
Ashland, OR 97520
541482-2823 sherpa@mind.net
July 31, 2005
Ashland Fire & Rescue
455 Siskiyou Blvd.
Ashland, OR 97520
Keith Woodley,
Enclosed are two copies of the Agreement for Provision of Services of EMT Supervising
Physician for Ashland F:;i o & ocS:Ue cOthe 200v-vv2nn~t'S r•.
.c ~ . forth e i ~ h iii agreement i5 an., addt]C~en
idtiril iii
the agreement for 2003-2004, with changes to two sections: Term and Compensation. Please
review this addendum, sign and return one copy to me.
The total fee for Supervising Physician services by Paul S. Rostykus, MD, MPH for Ashland Fire
& Rescue for the year July 1, 2005 through June 30, 2006 is $3,237.31 due now.
As you may be aware, I am re-evaluating my ability to provide EMS Supervising Physician
services to the EMS agencies of Jackson County. My priority is and will continue to be high
quality, standardized county-wide EMS supervision to the 911 dispatched agencies, such as
yours. One of my proposed changes is to enlist additional physician involvement in this process
which I think will enhance the great EMS system we have.
Please contact me if you have any questions.
Thank you.
Sincerely,
Paul S. Rostykus, MD, MPH
Supervising Physician
Jackson County EMS
14
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W
. CITY OF
-AS H LA N D oa TE_ _o NUMBER
J
waft 20 E MAIN ST. 8/15/2005 06216
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 006381 SHIP To: Ashland Fire Department
PSR PHYSICIAN SERVICES, LLC, DR. PAUL ROSI (541) 482-2770
436 GRANDVIEW DR 455 SISKIYOU BLVD
ASHLAND, OR 97520 ASHLAND, OR 97520
FOB Point: Req. No.:
Terms: Net 30 days Dept.: FIRE & RESCUE
Req. Del. Date: Contact: Greg Case
Special Inst: Confirming? NO
Quantity Unit L pescription nit Price Ext. Price
Supervising Physician Services 3,237.31 I
by,Paul S. Rostykus,,MD, FY 2006
11 July 1,
2005 to June 30, 2006
Agreement 2003-2004
Amendment'
Term: July 1, 2005 to June 30, 2006
Compensation: $3,237.31
I
I
i
,t
SUBTOTAL 3,237.31
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 3,237.31
ASHLAND, OR 97520
":::Account Number Project Number.:" Amount Account Number Project Nu, r 'Amount
E 110.07.13.00.60415 3,237.31
Authorized Signature VENDOR COPY