Quotation Estimate Paramedic in United States Chicago –Free Word Template Download with AI
1200 W. Madison Street, Suite 450, Chicago, IL 60607, United States
Phone: (312) 555-0198 | Email: [email protected]
IL EMS License No. 2024-CH-78451 | NPI: 1740289365
Quotation EstimateQuotation Details
Quotation No.: QTE-2025-CH-03847
Date Issued: June 12, 2025
Valid Until: July 12, 2025
Service Location: United States Chicago, Illinois
Prepared For
Client: Lakeview Community Health Center
Address: 2845 N. Clark Street, Chicago, IL 60657
Contact: Dr. Margaret Ellison, Director
Email: [email protected]
This Quotation Estimate is issued by Midwest Emergency Medical Services, LLC for the provision of certified Paramedic services within the United States Chicago metropolitan area. The Paramedic personnel engaged under this agreement will hold current Illinois Department of Public Health (IDPH) Paramedic licenses, Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and National Registry of Emergency Medical Technicians (NREMT) certifications. All Paramedic staff will operate in compliance with the Illinois Emergency Medical Services Act (410 ILCS 65) and the Chicago Department of Public Health regulations governing emergency medical response in the United States Chicago jurisdiction.
| Item No. | Description | Duration / Qty | Unit Rate (USD) | Subtotal (USD) |
|---|---|---|---|---|
| 01 | Paramedic On-Site Coverage – Community Health Fair (2 Paramedics per shift, 8-hour shifts, 3 consecutive days) | 6 shifts | $1,850.00 | $11,100.00 |
| 02 | Paramedic Ambulance Transport – Non-Emergent Patient Transfers within United States Chicago city limits (includes 1 Paramedic + 1 EMT) | 12 trips | $425.00 | $5,100.00 |
| 03 | Paramedic Critical Care Transport – Inter-facility transfer from Chicago to regional tertiary care center (includes 2 Paramedics, ventilator, cardiac monitor) | 4 trips | $1,200.00 | $4,800.00 |
| 04 | Paramedic Training & Education – On-site ACLS refresher workshop for nursing staff (delivered by senior Paramedic instructor) | 2 sessions (4 hrs each) | $950.00 | $1,900.00 |
| 05 | Paramedic Equipment & Consumables – IV kits, oxygen cylinders, AED pads, trauma dressings, and PPE for all Paramedic personnel during the engagement period | 1 lot | $2,340.00 | $2,340.00 |
| 06 | Paramedic Dispatch & Coordination Fee – 24/7 radio and digital dispatch monitoring for United States Chicago service area | 30 days | $185.00/day | $5,550.00 |
| 07 | Paramedic Liability & Professional Indemnity Insurance – Coverage for all Paramedic personnel operating in United States Chicago | 30 days | $1,100.00 | $1,100.00 |
| 08 | Administrative & Reporting – Incident reports, patient care documentation, and compliance filing with Chicago EMS Authority | 1 lot | $750.00 | $750.00 |
| TOTAL ESTIMATED COST (Before Applicable Taxes) | $32,640.00 | |||
| Illinois State Sales Tax (10.25%) | $3,345.60 | |||
| GRAND TOTAL (USD) | $35,985.60 | |||
- This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiration date, all rates for Paramedic services are subject to revision based on current market conditions in the United States Chicago emergency medical sector.
- Payment terms: 50% deposit due upon acceptance of this Quotation Estimate; remaining 50% due within fifteen (15) business days following completion of all Paramedic services rendered.
- All Paramedic personnel assigned to this contract will be employees of Midwest Emergency Medical Services, LLC and will not be considered agents or employees of the client. The client assumes no liability for the actions of our Paramedic staff beyond the scope of the agreed-upon services.
- Any additional Paramedic services requested beyond the scope outlined in this Quotation Estimate will be billed at the standard United States Chicago hourly rate of $225.00 per Paramedic per hour, subject to a minimum two-hour engagement.
- Force Majeure: Neither party shall be liable for delays or failures in performance of Paramedic services caused by acts of God, severe weather events affecting United States Chicago, government-mandated shutdowns, or public health emergencies declared by the Chicago Department of Public Health.
- This Quotation Estimate does not constitute a binding contract until a formal Service Agreement is executed by both parties. All terms herein are subject to the final Service Agreement.
- All Paramedic patient care documentation will be maintained in accordance with HIPAA regulations and Illinois medical records retention laws. Records will be stored at our United States Chicago facility for a minimum of seven (7) years.
- Disputes arising from this Quotation Estimate or the resulting Paramedic service engagement shall be resolved through mediation in Cook County, Illinois, before any litigation is pursued.
By signing below, the client acknowledges receipt of this Quotation Estimate for Paramedic services in United States Chicago and agrees to the terms and conditions outlined above. This signature authorizes Midwest Emergency Medical Services, LLC to schedule and deploy Paramedic personnel as described.
For: Midwest Emergency Medical Services, LLC
Name: Robert J. Callahan, Operations Director
Date: ______________________
For: Lakeview Community Health Center
Name: Dr. Margaret Ellison, Director
Date: ______________________
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