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5. Financial statement pertaining to (proposed) operations in Orange County.. <br /> 6. M/ <br /> A list of radio frequencies the applicant is authorized to operate on, and a copy of the . <br /> FCC license(s) in the name of the person providing the service. <br /> 7. I/. A description of the applicant's capability to provide twenty-four hour coverage, seven <br /> days per week for the district covered by the franchise applied for. <br /> 8. ICI pe An accurate estimate of the minimum and maximum times for a response to calls <br /> within the district covered by the franchise applied. <br /> 9. A written plan detailing how the applicant will furnish credentialed personnel and a <br /> current ster of all credentialed personnel with a list of their credentials. <br /> 10. A copy of the applicant's written standard operating procedures including but not <br /> limited to the management of equipment, supplies, and medications. <br /> 11.riV Copy of organization by-laws (if applicable). <br /> 12. LJ Roster of all members and employees, including name, address, and NCDL number. <br /> 13. V List all vehicles owned and operated by applicant. <br /> 14. W17- <br /> Proposed fee schedule for service in Orange County. <br /> CERTIFICATIONS <br /> *Provide initials in each certification blank to indicate agreement to each statement <br /> I certi on behalf of the named franchise applicant the following: <br /> �� 1. That the information contained within and any attachments provided is true and correct and <br /> �a to the best of my knowledge; <br /> R2. That the franchise applicant is compliance with North Carolina General Statutes 131E, Article <br /> 7; <br /> A � 3. That the applicant shall provide notices to Orange County Emergency Services of any <br /> changes to the information provided in this Application within five (5) days of any changes <br /> and/or any relinquishment of the franchise; <br /> ii___4. That I am the duly authorized agent of the Board and have been authorized to submit t his <br /> application and certification to the Orange County; and <br /> /gf,15. That any information found to be false or misleading may be grounds for termination of the <br /> ,if g Y g <br /> franchise and the franchise agreement. <br /> Authorizing Name/Title: 6'rl i�G1 a9J tee d o s I O f treU'f r <br /> Authorizing Signature: det.� /4/ , Date: //2`-A <br />