Applicants will follow the guidelines established by the county and use such forms as may be required by the county, which shall contain the following:
(A) A non-refundable fee of $1,200 shall accompany all original applications before consideration will be given to the application;
(B) The name and address of the applicant for franchise;
(C) The trade and all other names, if any, under which the applicant does business, together with a certified copy of the assumed name certificate filed with the Register of Deeds, or a copy of the Articles of Incorporation stating such name or names;
(D) A complete resume of the training and experience of the applicant in the transportation and care of patients;
(E) A full description of the type and level of service to be provided;
(F) A description of the physical location of the place or places from which the applicant intends to operate;
(G) The manner in which the public will be able to obtain services and how the non-emergency ambulances will be dispatched;
(H) Provide a current listing from the North Carolina Office of Emergency Medical Services (NCOEMS) continuum database of the personnel who will be providing the non-emergency transport operations in the county;
(I) A current listing of all ambulance apparatus that will be used by the applicant to provide ambulance transport services. This listing will include the make, model, agency ID number, vehicle identification number (VIN), and state permit number as maintained in the NCOEMS continuum database;
(J) A certificate of insurance in a form acceptable to the county, which documents that the applicant has complied with insurance coverage requirements, as follows:
(1) General liability insurance in the amount of at least $1,000,000 per occurrence, $2,000,000 umbrella coverage, for a combined total of $3,000,000, with a combined single limit with contractual coverage endorsements;
(2) Vehicle liability with insurance limits covering bodily injury, death, and property damage claims in the amount of at least $1,000,000 per occurrence, $2,000,000 umbrella, for combined coverage of $3,000,000, with combined single limits;
(3) Professional liability, errors and omissions insurance for all personnel in the minimum amount of $1,000,000 per occurrence, $3,000,000 combined coverage;
(4) Said certificate of insurance will be forwarded to the County Emergency Services Office 14 days prior to the agency going into business in the county from their insurance company referencing the dollar amounts listed above or greater;
(K) A fee schedule that outlines all charges and rates for services and loaded mileage; and
(L) Documentation of a training program that provides a minimum of 36 hours of annual continuing education and will also include:
(1) Blood-borne pathogens - infectious control training;
(2) Vehicle operations - driver training;
(3) HIPAA privacy and security training;
(4) Harassment and hostile work place; and
(5) Agency standard operational guidelines (SOG).
(Ord. passed 6-2-2014; Ord. passed 9-10-2018)