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Applications for First Responder Services for Caldwell, Cedar Grove, Eno, Mebane, New Hope, North Chatham, Orange Grove and White Cross fire departments in accordance with the provisions of the EMS Francise Regulating Ordinance
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Applications for First Responder Services for Caldwell, Cedar Grove, Eno, Mebane, New Hope, North Chatham, Orange Grove and White Cross fire departments in accordance with the provisions of the EMS Francise Regulating Ordinance
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Last modified
3/2/2016 8:54:33 AM
Creation date
2/10/2015 9:30:03 AM
Metadata
Fields
Template:
BOCC
Date
3/15/1994
Meeting Type
Work Session
Document Type
Others
Agenda Item
VIII-A
Document Relationships
Agenda - 03-15-1994 - VIII-A
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Path:
\Board of County Commissioners\BOCC Agendas\1990's\1994\Agenda - 03-15-94 Regular Mtg.
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A <br /> . 5 <br /> APPLICATION <br /> FOR <br /> AMBULANCE RESCUE OR MEDICAL FIRST RESPONDER FRANCHISE <br /> ORANGE COUNTY, NORTH CAROLINA <br /> Date of Application: March 1 , 1994 <br /> I . APPLICANT: <br /> A. Name of Applicant: Eno Fire Department, <br /> B. Address :Street: 5019 US 70 <br /> City/State: Durham, N. C . Zip 27705 <br /> C . Telephone No . at Base of Operations : 919-383-5967, <br /> D . Name of Owner/Contact Person: Johnny Riley, <br /> E . Address :Street: 6313 Mt . Herman Church Road <br /> City/State: Durham, N. C . Zi p 27705 <br /> F . Telephone No . : 919-383-277 . <br /> G. *Trade Name: NIA <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 /> [X] First Responder [ ] D-Level [ ] Extrication <br /> [ ] Emergency Med Techn. [ ] I-Level [ ] High/Low Angle <br /> [ ] Convalescent Transport [ ] P-Level [ ] Confined Space <br /> [ ] Trench <br /> [ ] Water <br /> H. ATTACHMENTS REOUIRED: <br /> 1 . 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 /> ti <br />
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