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<br /> <br />252-430-1503 <br />866-640-2028 <br /> <br /> <br /> <br /> <br />OSAGE AMBULANCE <br /> <br />2022 "TRAVOIS" TYPE II <br /> <br />ORDER FORM <br /> <br /> Dealer Name: <br /> <br />Southeastern Specialty Vehicles <br /> Salesperson: <br /> <br />Darren Hadley <br /> Customer Name: <br /> <br />Orange County Emergency Medical Services <br /> & Address <br /> <br />510 Meadowlands Drive <br /> <br />Hillsborough, NC 27278 <br /> <br /> <br /> <br /> Shipping Address: <br /> <br />911 Martin Creek Road <br /> <br />Henderson, NC 27537 <br /> <br /> <br /> <br /> <br /> <br /> Fleet Number: <br /> <br />BLS 1 & BLS 2 <br /> <br /> Contact Name: <br /> <br />Darren Hadley <br /> <br /> <br />Attachment B <br />DocuSign Envelope ID: 9B0A695D-8C3C-4D5E-AAFB-7F3A3936DFD4