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12 <br /> b. Grantor may from time to time alter, and at its sole discretion, amend <br /> Exhibit A and the service area of the County that constitute (s) the <br /> Franchise District. <br /> C. Grantor shall at all times during the terms of the Franchise provide the <br /> highest level of care to all residents within the service area of the <br /> Franchise District. <br /> Section 6. The Orange County Emergency Services System("ESS") Plan <br /> a. Grantee shall comply with the Grantor's official written ESS System Plan <br /> for the management and deployment of EMS Services Vehicles within the <br /> Franchise District and, additionally, within other service areas pursuant to <br /> the EMS System Mutual Aid Plan and any cooperative agreement to <br /> continue services in service areas where Franchisees' EMS System <br /> franchises has been suspended. <br /> b. Grantee shall keep at its place a business at all times the most current copy <br /> of the ESS System Plan. <br /> Section 7. Staffing and Performance Requirements <br /> a. Grantee shall comply with the scope of practice rules promulgated by the <br /> North Carolina Medical Board pursuant to law regarding the medical skills <br /> and medication that may be used by credentialed emergency medical <br /> services personnel at each level of patient care. <br /> b. Grantee shall comply with standard for drivers and attendants developed <br /> by the North Carolina Medical Care Commission as requirements for <br /> certification of emergency medical technicians pursuant to law, rules and <br /> regulations promulgated by the Board of Medical Examiners for advanced <br /> life support technicians, which is incorporated in this subsection by <br /> reference. <br /> C. No staff of Grantee shall drive an ambulance vehicle, attend a patient, or <br /> permit an ambulance to be operated when transporting a patient within the <br /> County unless the driver holds a currently valid North Carolina Drivers <br /> license and currently valid credentials as an EMT, EMT-I or EMT-P <br /> issued by the North Carolina Department of Health and Human Services, <br /> Office of Emergency Medical Services. Notwithstanding the foregoing, in <br /> an exceptional circumstance when an EMT, EMT-I, or EMT-P is not <br /> available, for the purpose of driving only or when providing Non- <br /> Transport Service an approved firefighter, First or Medical Responder, <br /> Rescue Services Provider or law enforcement officer with a currently valid <br /> North Carolina drivers license may drive an ambulance, provided such <br /> North State Investment Group, LLC d/b/a North State Medical Transport <br /> EMS Franchise Agreement <br /> Page 8 of 23 Rev <br />