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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 . Staffmg 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 dribul , provi drive an ambulance , ded 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 />