Orange County NC Website
Browse       Search
3 <br /> APPLICATION <br /> FOR <br /> AMBULANCE RESCUE OR MEDICAL FIRST RESPONDER FRANCHISE <br /> ORANGE COUNTY, NORTH CAROLINA <br /> Date of Application: December 12, 1993 <br /> I. APPLICANT: <br /> A. Name of Applicant: Orange County Rescue Squad <br /> B. Address:Street: 261 South Churton Street <br /> City/State: Hillsborough, N. C. Zip 27278 <br /> C. Telephone No. at Base of Operations: (919) 732-8984 <br /> D. Name of Owner/Contact Person: Douglas W. Noell, Chief <br /> E. Address:Street: 102 Dublin Road <br /> City/State: Chapel Hill, N. C. Zip 27516 <br /> F. Telephone No. : 929-4407-Home 967-8211-Work <br /> G. *Trade Name: Orange County Rescue Squad <br /> H. Category of Franchise Applied For (A separate <br /> application must be completed for each category of <br /> service applied for) : <br /> BLS: ALS: RESCUE SERVICES <br /> First Responder D-Level Extrication <br /> Emergency Med Techn. I-Level High/Low Angle <br /> Convalescent Transport [y] P-Level Confined Space <br /> Trench <br /> Water <br /> H. ATTACHMENTS REQUIRED: <br /> I. Certified copy of Articles of Incorporation Charter <br /> or *Assumed Name Certificate. <br /> 2. Resume' of training and experience of the applicant <br /> in rescue and transportation and care of patients. <br /> 3. A financial statement as it pertains to operations <br /> in Orange County. <br /> 4. A copy of Organization's By-Laws (if applicable) . <br /> 5. A copy of Organization's Standard Operating <br /> Procedures. <br /> 6. A current roster of members to include name, <br /> address, and social security number. <br />