§ 28-29. Application for ambulance franchise.

Application for a franchise to operate ambulances in Halifax County shall be made by the ambulance provider upon such forms as may be prepared or prescribed by the county and shall contain:

(1)

The name and address of the ambulance provider and owner of the ambulance(s) and the location where the ambulances will be housed and the taxing jurisdiction of the ambulances.

(2)

The trade or other fictitious names, if any, under which the applicant does business, along with a certified copy of an assumed name certificate stating such name or articles of incorporation stating such name.

(3)

A resume of the training and experience of the applicant in the transportation and care of patients.

(4)

A full description of the type and level of service to be provided including the location(s) of operation(s).

(5)

A description of the applicant's capability to provide 24-hour coverage, seven days per week for the district governed by the franchise applied for an accurate estimate of the minimum and maximum times for a response to calls within such district.

(6)

An audited financial statement of the applicant as the same pertains to the operations in Halifax County, said financial statement to be in such form and in such detail as may be required by the county.

(7)

Copy of IRS Tax Exempt status letter (i.e. 501(c)(3), if any.

(8)

Federal Employer Identification Number (FEIN).

(9)

Emergency Medical Services Provider Certification.

(10)

Any additional information the county shall deem necessary for a determination of the capability of the applicant to provide ambulance services in Halifax County.

(Ord. of 5-5-97(1), § IV; Ord. of 10-24-00(1), § IV; Ord. of 6-6-2011, § IV(4.1))