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03 " <br /> 2 <br /> IV. List each ambulance and rescue vehicle owned and operated by the <br /> applicant (see attached) . <br /> V. Submit a financial statement indicating the net worth of the <br /> owner of applicant over and above all debts , judgments , claims <br /> and demands whatso ever. <br /> VI . List the title of all actions and unsatisfied judgments of record <br /> including the amount of judgments against such owner. <br /> VII . Submit the court record, if any, of applicant. If applicant is <br /> a corporation, partnership, association or other organization, <br /> the court record of any of the officers , directors and supervising <br /> employees thereof, including the general manager or director. <br /> VIII . List liens , mortgages , or other encumbrances on such ambulances <br /> --the amount and character thereof. <br /> IX. Describe the Insurance coverage of the applicant, giving the <br /> name and address of insuror and the depth of such coverage . <br /> X. Type of Ambulance Service Proposed: <br /> Emergency Transportation <br /> L Convalescent and Nonemergency Transportation <br /> L:=7 Rescue <br /> Other (Specify) <br />