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APPENDIX A <br />CLIENT FEE SCHEDULE <br />Client has established the following fee schedule for emergency medical services transport: <br />Service Fee <br />Basic Life Support (BLS) $850.00 <br />Advanced Life Support (ALS) $1,000.00 <br />Advanced Life Support I (ALS) $1,200.00 <br />Loaded Mileage $16.00/mile <br />Non -Transport $300.00 <br />MILEAGE TRACKING OPTIONS DOCUMENTATION <br />Client will track and communicate mileage to Life Force which shall not exceed the loaded miles <br />from the Pickup point to Destination as follows: <br />(SELECT ONE) <br />x Odometer reading (Preferred documentation) <br />Mapquest <br />Client's Mileage Chart, a copy of which is attached <br />MAYFIELD VILLAGE <br />CUSTOMER NAME: <br />2/20/23 <br />CDATE: <br />