RULE 228.00.14-001 - Uniform Fire Department Insurance Reimbursement Billing Form (2014)

RULE 228.00.14-001. Uniform Fire Department Insurance Reimbursement Billing Form (2014)

Rules

Purpose: The purpose of the Uniform Fire Department Insurance Billing Reimbursement Form is to provide a form and give general guidance for a fire department that is making a claim for reimbursement for services and resources utilized while responding to a fire, or accident involving personal property.

Scope: This document applies to all volunteer and municipal fire departments, within the State of Arkansas, that wish to file a claim for reimbursement from the owner of personal property involved in a fire or accident.

This document does not apply to fire departments that operate licensed transport ambulance services as outlined by the Arkansas State Board of Health, Section of Emergency Medical Services Rules and Regulations for Emergency Medical Services; or to fire departments operating under existing ordinances or intergovernmental cooperation agreements.

Authority: Act 1345 of 2013

Municipal Fire Departments

1. The fire or accident must have occurred beyond the corporate limits of the fire department's city or town.

2. The fire department must make reasonable effort to obtain reimbursement from the property owner for ninety (90) days.

3. Equipment rates shall be based on the FEMA Schedule of Equipment rates in effect January 1, 2013

4. Expendable resources rates will be based on 100% of current market value. All claims filed for expendable resources must be accompanied by receipts.

5. Pay rates approved by the municipality, at the time of the incident, shall be used to calculate reimbursement for personnel costs.

6. Claims shall be supported by a completed and attached Uniform Fire Department Insurance Reimbursement Billing Form.

7. Each apparatus responded may not be billed for dual purpose (i.e., Engine W/ rescue may be billed for either, not both).

Volunteer Fire Departments

1. The fire department must make reasonable effort to obtain reimbursement from the property owner for ninety (90) days.

2. Equipment rates shall be based on the FEMA Schedule of Equipment rates (January 1, 2013)

3. Expendable resources rates will be based on 100% of current market value. All claims filed for expendable resources must be accompanied by receipts.

4. Claims shall be supported by a completed and attached Uniform Fire Department Insurance Reimbursement Billing Form.

5. Claimed amount per incident shall not exceed $1000.00 USD if it only involves personal property of nonmembers.

6. Each apparatus responded may not be billed for dual purpose (i.e., Engine W/ rescue may be billed for either, not both).

Fire Department Information

FEMA's SCHEDULE OF EQUIPMENT RATES

Commonly Used Fire Service Equipment

This list is reproduced from FEMA's Schedule of Equipment Rates.

The entire Schedule of Equipment Rates is available online at http://www.fema.gov/schedule-equipment-rates

Rates for equipment not listed will be furnished by FEMA upon request by contacting Pat Hanger, FEMA Region VI, 1-940-898 -5167, or patricia.hanger@fema.dhs.gov

Cost Code

Equipment

Specification

Capacity/Size

HP

Notes

Unit

Rate

8070

Automobile*

     

to 130

Transporting People

mile

$0.50

8130

Boat, Row*

        

Heavy Duty

hour

$0.85

8131

Boat, Runabout*

Size

13'x5'

to 50

Outboard

hour

$14.00

8132

Boat, Tender*

Size

14'x7'

to 100

Inboard w/360° drive.

hour

$26.00

8310

Generator*

Prime Output

5.5 kW

to 10

  

hour

$3.25

8311

Generator*

Prime Output

16 kW

to 25

  

hour

$8.00

8690

Truck, Fire

Pump Capacity

1000 gpm

     

hour

$70.00

8691

Truck, Fire

Pump Capacity

1250 gpm

     

hour

$80.00

8692

Truck, Fire

Pump Capacity

1500 gpm

     

hour

$85.00

8693

Truck, Fire

Pump Capacity

2000 gpm

     

hour

$90.00

8694

Truck, Fire Ladder

Ladder Length

75 ft

     

hour

$125.00

8695

Truck, Fire Ladder

Ladder Length

150 ft

     

hour

$150.00

8800

Truck, Pickup*

        

Transporting People

mile

$0.50

8801

Truck, Pickup*

  

1/2 ton

     

hour

$14.00

8802

Truck, Pickup*

  

1 ton

     

hour

$20.00

8780

Truck, Water

Tank Capacity

2500 gal

to 175

Include pump and rear spray system

hour

$31.00

8781

Truck, Water

Tank Capacity

4000 gal

to 250

Include pump and rear spray system

hour

$42.00

*Only department owned equipment can be billed

The following reimbursement rates are approved by FEMA.

FEMA's FIRE MANAGEMENT ASSISTANCE GRANT (FMAG)

Cost Code

Cost Code Description

Unit

Unit Price

  

Truck, Fire, Tender, 5000 gpm

hr

$ 125.00

  

Truck, Fire, Tender, 2500 gpm

hr

$ 95.00

  

Truck, Fire, Tender, 1000 gpm

hr

$ 70.00

  

Truck, Fire, Wildland, 150 gpm

hr

$ 45.00

  

Truck, Fire, Wildland, 50 gpm

hr

$ 42.50

  

Truck, Fire, Wildland, 30 gpm

hr

$ 36.50

  

Truck, Fire, Pumper, Type I, 1000 gpm

hr

$ 70.00

  

Truck, Fire, Pumper, Type II, 500 gpm

hr

$ 62.50

  

Truck, Fire, Pumper, Type III, 120 gpm

hr

$ 44.00

  

Truck, Fire, Structure, 1000 gpm

hr

$ 70.00

  

Truck, Fire, Structure, 250 gpm

hr

$ 46.50

Brush Trucks - use the pump gpm rating to determine the rate to use instead of truck size.

Rescue/Extrication Trucks - if it has a pump, use the pump gpm rating to determine the rate to use. If no pump, use the truck size (tonnage) to determine the rate to use.

(6/24/2015)

The following state regulations pages link to this page.