HomeMy WebLinkAboutORD-2009-177 - EMS - First Reading: Extension of the Ordinance Granting Emergency Services Franchise and Agreements to Orange EMS & Rescue Services, Inc. and Technical Rescue Services, Inc. 11-17-2009-4iO!~ P _ ~v0~ - I ~~ 7
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: December 7, 2009
Action Agenda
Item No. ~ -
SUBJECT: Second Reading: Extension of the Ordinance Granting Emergency Services
Franchise and Agreements to Orange EMS & Rescue Services, Inc. and
Technical Rescue Services, Inc.
DEPARTMENT: Emergency Services PUBLIC HEARING: (Y/N) No
County Attorney
ATTACHMENT(S):
EMS Services Franchise Agreements
(Previously Provided with the
November 17, 2009 Board Meeting
Agenda Materials)
INFORMATION CONTACT:
Frank Montes de Oca, Emergency
Services Director, 245-6100
Annette M. Moore, Staff Attorney,
245-2317
PURPOSE: To consider approving on second reading an extension to March 31, 2010 of the
EMS Franchise Agreements by ordinance for the two active rescue squads in the County:
Orange EMS & Rescue Squad, Inc. and Technical Rescue Services, Inc. d/b/a South Orange
Rescue Squad under the same terms and conditions as the franchise agreement adopted by
the Board on December 14, 2004.
BACKGROUND: At the November 17, 2009 meeting, the Board of Commissioners approved
on first reading a proposed extension until March 31, 2010 of the EMS Franchise Agreements
by ordinance of the two active rescue squads in the County: Orange EMS & Rescue Squad, Inc.
and Technical Rescue Services, Inc. d/b/a South Orange Rescue Squad under the same terms
and conditions as their current EMS franchise agreement. North Carolina law provides that "no
ordinance making a grant, renewal, extension, or amendment of any franchise may be finally
adopted until it has been passed at two regular meetings of the board of commissioners" and
that "no such grant, renewal, extension, or amendment may be made except by ordinance." 1
Staff is requesting that the Board provide final approval of the extension of the franchise
agreements until March 31, 2010.
The current Franchise Agreements, previously provided to the Board in the November 17, 2009
agenda package, were adopted at the Board's December 6 and 14, 2004 meeting after public
hearing on November 16, 2004. Both franchise agreements are set to expire on December 14,
2009. This extension to the current franchise agreement does not obligate the Board to grant
the current rescue squads with a franchise.
1 NCGS §153A-46
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Emergency Services, with the assistance of the County Attorney's Office, is recommending to
the Board updates to "An Ordinance Regulating Emergency Medical, First Responder and
Rescue Service and Granting of Franchise and Contracts to the Operators In the County of
Orange" (Franchise Ordinance). Prior to granting franchises, North Carolina law requires a
public hearing to help the Board determine if the franchise is "necessary to assure the provision
of adequate and continuing ambulance services and to preserve, protect, and promote the
public health, safety, and welfare." Once the Board makes this finding, it can permit the
franchise by ordinance. Between now and March 31, 2010, persons wishing to receive a
franchise will apply for a franchise and the Board will make a decision as to whether it will grant
the franchise.
An extension to the rescue squad's franchise agreements will allow the squads an opportunity
to review any changes to the Ordinance made by the Board and modify service delivery as
necessary prior to coming forward to the Board to ask for a franchise. Either franchisee could
come before the Board prior to March 31, 2010 with an application to be franchised; however,
the extension of the Franchise would be effective until March 31, 2010.
FINANCIAL IMPACT: None
RECOMMENDATION(S): The Manager recommends that the Board approve on second
reading the Ordinance extending the franchise until March 31, 2010, under the same terms and
conditions of the current Franchise Agreement by Ordinance of Orange EMS & Rescue Squad,
Inc. and Technical Rescue Services, Inc. adopted by the Board on December 14, 2004.
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: November 17, 2009
Action Agenda 5
Item No. '~- "
SUBJECT: First Reading: Extension of the Ordinance Granting Emergency Services
Franchise and Agreements to Orange EMS & Rescue Services, tnc. and
Technical Rescue Services, Inc.
DEPARTMENT: Emergency Services PUBLIC HEARING: (YIN) No
County Attorney
ATTACHMENT(S):
EMS Services Franchise Agreements
• Orange EMS & Rescue Squad,
Inc.
• Technical Rescue Services, Inc.
INFORMATION CONTACT:
Frank Montes de Oca, Emergency
Services, 245-6100
Annette M. Moore, Staff Attorney,
245- 2317
PURPOSE: To consider adopting on first reading the extension of the EMS Franchise
Agreements by Ordinance of the two active rescue squads in the County: Orange EMS &
Rescue Squad, tnc. and Technical Rescue Services, Inc. d/b/a South Orange Rescue Squad
under the same terms and conditions as the current EMS franchise agreements until March 31,
2010.
BACKGROUND: On December 6 and 14, 2004, the Board adopted by Ordinance ambulance
franchise agreements for Orange EMS and Rescue Services, Inc. and Technical Rescue
Services, Inc. The franchise agreements are set to expire on December 14, 2009. North
Carolina law established a public hearing notice/scheduling requirement related to the granting
of ambulance franchises. The purpose of the public hearing is to help the BOCC find if the
franchise is "necessary to assure the provision of adequate and continuing ambulance services
and to preserve, protect, and promote the public health, safety, and welfare." The Board held a
public hearing on November 16, 2004, and as a result granted the franchises to the two rescue
squads.
North Carolina law also provides that "no ordinance making a grant, renewal, extension, or
amendment of any franchise may be finally adopted until it has been passed at two regular
meetings of the board of commissioners" and that "no such grant, renewal, extension, or
amendment may be made except by ordinance." NCGS §153A-46
Emergency Services with the assistance of the County Attorney's Office is in the process of
' making updates to "An Ordinance Regulating Emergency Medical, First Responder and Rescue
Service and Granting of Franchise and Contracts to the Operators In the County of Orange"
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(the Franchise Ordinance) for the Board's consideration.. An extension to the rescue squad's
franchise agreements will allow the squads an opportunity to review any changes to the
Ordinance and make any modifications in service delivery as necessary prior to coming forward
to the Board to ask for a franchise. Either franchisee could come before the Board. prior to
March 31, 2010 with an application to be franchised; however, the extension of the Franchise
would be effective until March 31, 2010.
FINANCIAL IMPACT: None
RECOMMENDATIONS}: The Manager recommends that the Board approve on first reading
extending until March 31, 2010 the Franchise Agreement by Ordinance of Orange EMS &
Rescue Squad, Inc. and Technical Rescue Services, Inc.
STATE OF NORTH CAROLINA
ORANGE COUNTY
ORDINANCE 2004 -
EMS SERVICES FRANCHISE
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An Ordinance granting a non-exclusive Franchise ("hereafter
Franchise") to Technical Rescue Services, Inc., doing
business as South Orange Rescue Squad, a North Carolina
Non-Profit Corporation ~(°the Grantee°) to operate EMS
Services in Orange County, North Carolina.
WHEREAS, Orange County, ("the Grantor"), desires to
assure the availability of• EMS Services within the County;
WHEREAS, the Grantor has, following reasonable notice,
and after consideration, analysis and deliberation
conducted public proceedings, during which proceedings the
technical ability, financial condition, legal qualification
and general character of the Grantee were determined to be
acceptable to receive a Franchise to conduct its EMS
Services;
WHEREAS, the Grantor also has considered and analyzed
the qualifications of the Grantee and found the Grantee
meets applicable Orange County and North Carolina" State
standards related to the provision of EMS Services;
WHEREAS, the Grantor has determined that Grantee is
entitled to have a non-exclusive Franchise granted, that a
need exists. for the EMS Services contemplated herein to
improve the level of service available to .:residents of
Orange County, helping to assure the provision of adequate
and continuing service which preserves, protects, and
promotes the public health safety and welfare, and that
granting a Franchise to the Grantee is a cost effective and
reasonable manner of meeting the need;
WHEREAS, the Grantee desires to operate EMS Services
within the Grantor's jurisdiction; .
WHEREAS, the proposed EMS Services will fit. within the
existing services provided by the Orange County EMS system
so as not to-.adversely affect the level. of service or
operations of other Franchisees to render service; and
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WHERFA.S, the procedures of N.C. Gen. Stat. § 153A-250,
~ 153A-45, and § 153A-46 have been complied with.
NOW, THLREFORS, the parties agree as follows:
Section Z . Natute..aad. _Term:.of Grant
A. The Grantor hereby grants the Grantee a non-
exclusive Franchise to operate and maintain EMS
Services (be an EMS Services provider) in the
Franchise District upon the terms and conditions
set forth herein.
B. The Franchise granted herein is for a term of
five (5) years from the effective date of the
Franchise, which shall .be the date of acceptance
by' the Grantee of the Franchise terms end
conditions set forth herein.
Section 2. Abbreviations
As used in this Franchise, the following abbreviations
mean
EMS - Emergency'Medical Services
EMT - Emergency Medical Technician
EMT-P - EMT-Paramedic
Section 3. Definitions
The following words, terms.and phrases, when.us~d in this
Franchise, shall have the meanings ascribed to them in this
Section, except where the context clearly indicates a
different meaning:
Air Medical Ambulance means an aircraft specifically
designed and equipped to transport Patients by air as
defined by State Law. .
Ambulance means any privately or publicly owned motor
vehicle, aircraft or vessel that is specially designed,
constructed or'modified and equipped and is intended to be
used for and is maintained or operated for the
transportation on the streets or highways, waterways or
airways~of this .state of Persons who require Ground
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Ambulance, Air Medical Ambulance, Water Ambulance, or other
EMS Services authorized by this Franchise.
Ambulance Provider means an individual, firm, corporation
or association who engages or professes to engage~in the
business or service of transporting Patients or providing
other FMS Services.
Approved means approved by the North Carolina Medical Care
Commission pursuant to the latter's ru7:es~and regulations
promulgated under the authority of Law.
Convalescent Ambulance means an Ambulance used on a
scheduled basis solely to transport Patients having a known
non-emergency medical condition. Convalescent Ambulances
shall not be used~in place of any other category of
Ambulance as defined. herein.
County means the Grantor, Orange County, and its Board of
Commissioners or its designated representat"ive.
Emergency means something dangerous or serious which
happens suddenly or unexpectedly and involves a Victim or
other Patient who is or may be in need of immediate EMS
Services or medical treatment in order to prevent loss of
life or further aggravation or physiological or
psychological illness or injury.
Emergency Medical Technician (EMT) means an individual who
has completed a training program in emergency medical care
at least equal to the National Standard Training Program
for Emergency Medical.Techn~icians as defined by the United
States Department of Transportation and has been~certified~
as an emergency medical technician by the North Carolina
Office of Emergency Medical Service.
EMS Franchise Ordinance means "An [Orange County] Ordinance
Regulating Emergency Medical, First Responder, and Rescue
Service and Granting of Franchises and Contracts to the
Operators in the County of Orange."
LMS Noatransporting Service means providing EMS Services
using EMS Non-Transporting Vehicle.
EMS Noatransporting Vehicle means a motor vehicle dedicated
and equipped to provide. First Responder or Rescue Services
or to move medical equipment and EMS personnel functioning
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within the scope of practice of EMT-P to the scene of a
request for assistance. EMS Nontransporting Vehicles shall
not be used fox the transportation of Patients on the
streets, highways, waterways or airways of the County.
EMS Peer Revieter Committee means an Emergency Medical
Services Peer Review Committee as defined _by_Law~ _and _in _
Orange County is also known as the °Orange County EMS Audit
and Review Committee," which also has the powers and duties
of,•the °Emergency Medical Services Advisory Council" as
specified in the EMS Franchise Ordinance.
EMS System means this Franchise and the remaining aspects
of Orange County's coordinated arrangement of resources
(including personnel, equipment and facilities) organized
to respond•to medical emergencies, including without
limitation the Specialty Care Transport Program and
integrated with other health care providers and networks
.including, but not limited to, public health, community
health monitoring activities and special needs populations.
EMS Services means the combination of services to be
provided by Grantee pursuant to this Franchise as specified
in Section 4 of this Franchise.
EMS Services Vehicle (s) means Ambulance (s) or other
authorized vehicle(s) used by Grantee to provide EMS
Services.
First Responder means personnel trained in emergency
medical care that are dispatched to the scene of a medical
emergency for the primary purpose of providing emergency
medical assistance to a.Patient until an Ambulance or other
additional medical aid arrives.
Franchise means this instrument which is a permit issued by
the Grantor to Grantee for the operation of Grantee's EMS
Services and a contract by which both parties agree to.the
terms of the operation~of the EMS Services to be provided.
Franchise District means a specifically defined EMS
provider service area of the county established using
criteria that includes geographic size, road access, the
location of existing medical transportation services,
population and response time, as specified in Exhibit A
attached hereto and incorporated herein.
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Franchisees} means Persons or entities, other than the
Grantee, having been issued permits by the County for the
operation of Ambulance service, Rescue Squad, First
Responder unit or other related service within specified
service areas or districts in Orange County.
Ground Ambulance.means an Ambulance used to transport
Patients with traumatic or medical conditions or Patients
- for whom the need for emergency or non-emergency medical
care is anticipated either at the Patient location or
during transport. -
Law means all applicable laws and regulations including
without limitation Chapter 131E and 143E of the North
Carolina General Statutes and l0A N.C. Admin. Code 13P, as
amended, the Franchise Ordinance and other applicable
federal, State or local laws~and regulations.
Drivers license means any license or permit issued under or
granted by~North Carolina Law to operate a particular type
of motor vehicle that serves as an Ambulance or other EMS
Services Vehicle. -
Medical Crew Member means EMS personnel or other health
care professionals who are licensed or registered in North
Carolina and are affiliated with a Specialty Care Transport
Program.
Medical Director means the physician responsible for the
medical aspects of the management of the EMS System. The.
duties of the Medical Directox may be completed, through
written delegation as~provided for by Law:
Medical Oversight means the responsibility for the
management and accountability of the medical care aspects
of the EMS System. Medical Oversight includes physician
direction of the initial education and continuing education
of EMS personnel or medical crew members; development and
monitoring of both operational and treatment protocols;
evaluation of the medical care rendered by EMS personnel or
medical crew members; participation in system or program
evaluation; and directing, by two-way voice communications,
the medical care rendered by the EMS personnel or medical
crew members. -
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Model EMS System means an approved EMS System that chooses
to meet the criteria for and receives this designation by
the Office of Emergency Medical Services.
Office of Emergency Medical Services (OEMs) means a section
of the Division of Facility Services of the North Carolina
Department- of Health and Human Services: - ---- -
Operational Protocols means the official written
administrative policies and procedures of the Orange County
EMS System, as amended, that provide guidance for the day-
to-day operation of the EMS System.
Owaer means any Person or entity that owns an Ambulance or
other EMS Services Vehicle and provides EMS Services
covered by this Franchise.
Patient means an individual who is sick, injured, wounded
or otherwise incapacitated or helpless such that the need
for some medical assistance might be anticipated while
being transported to or from a medical facility.
Persoa means any individual, firm, partnership,
association, corporation, company, group of individuals
acting together for a common purpose, or organization of
any kind, including any governmental agency other than the
United States.
Physician means a medical or osteopathic doctor licensed by -
the North Carolina Medical Board to practice medicine in -
the North Carolina.
Practice Settings means the areas of practice for the
credentialed personnel that provide EMS Services pursuant
to this Franchise as provided for by Law at the location of
a physiological or-psychological illness or injury-
including transportation to an appropriate treatment
.facility if required; at public or community health -
facilities in conjunction with public and community health
initiatives, in hospitals and clinics; in residences,
facilities, or other locations as part of wellness or
injury prevention initiatives within the community and the
public health system; and/or•at mass gatherings or special
events.
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primax-y Ambulance Provider means the system of personnel,
EMS Transport System Vehicles and equipment normally
dispatched on a first call. response,
Reseue Service means the system of personnel, EMS System •
Vehicles clearly marked and identified to the public by
means of painted or adhesive lettering or emblems on the
exterior of the vehicles, and equipment required to respond
to situations where persons or victims are missing or
cannot escape an area through the normal exit or under
their own power, including without limitation Swiftwater
rescue, confined space rescue, .light and heavy vehicle
extraction, high/low angle rescue, collapse rescue and
trench rescue.
Secondary ABibulaace Provider means the system of personnel,
EMS System Vehicles and equipment meeting the same criteria.
as a Primary Ambulance Provider, but not normally
dispatched on a first call response.
Service means the same as "owner."
Specialty Care Transport Program means the Orange County
program designed and operated for the provision of
specialized medical care and transportation of critically
ill or injured Patients.
Specialty Care Transport Program Continuing $ducation
Coordinator means a Level I EMS Instructor within. the
Orange County~Specialty Care Transport Program who is
responsible for the coordi:nation~of EMS continuing
education programs for EMS personnel within the program.
System Continuing $ducatioa Coordinator means a Level I EMS
Instructor within the Orange County EMS System who is
responsible for the coordination of EMS continuing
education programs. .
Treatment Protocols means a written document authorized by
the medical directors of both the EMS System, including the'
Specialty Care Transport Program and the GEMS specifying
the diagnostic procedures, treatment procedures, medication
administration and Patient-care-related policies that shall
be completed by Grantee or its personnel or Medical Crew
Members based upon the assessment of a Patient.
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Victim means any Patient or potential Patient who is
entrapped, entangled, pinned, fallen, suspended or
otherwise in need of Rescue Service.
Water Ambulaace means a watercraft specifically designed
and equipped to serve as an EMS Services Vehicle to
transport Patients: ~. - -- ...
Section 4. General Responsibilities
(a) Grantee is authorized under this Franchise to operate
the following types of service(s), the combination of
which shall constitute Grantee's "EMS Services"for
the purposes of this Franchise:
® Rescue Service
® swiftwater rescue
® confined space rescue .
® high /low angle rescue
® Primary Ambulance Provider (Special Events
.Coverage Only)
(b) Grantee shall comply at all times with the -
requirements of the Orange County EMS Franchise
. .Ordinance, this Franchise and all applicable Law
relating to health, sanitation, safety, equipment,
Ambulance design or other EMS Services Vehicle design -
and.all legal requirements related to a Model EMS .
System and all other laws and ordinances.
(c) Grantee shall maintain in good standing its state and
local Drivers and Privilege license(s) to operate its
Ambulance or other.EMS Services as provided for by
Law.
Sectioa S. The Scope of Service
(a) Grantee shall operate its EMS Services, 24 hours per
each and every day of the calendar year, within the
Franchise District specified in Exhibit A, except when
a different or additional service area is provided for
herein.
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(b) Grantor may from time to time alter, and•at its sole
discretion, amend Exhibit A and the service area(s)'of
the County that constitute(s) the Franchise District.
(c) Grantee shall at all times during the term of the
Franchise provide the highest level of care to all
citizens within the service area of the Franchise
District.
Section 6. The EMS System Plan
Grantee shall comply with the Grantor's official written
EMS System plan for the management and deployment of EMS
Services Vehicles within the Franchise District and,
additionally, within other service areas pursuant to the
EMS System Mutual Aid Plan and any cooperative agreement to
continue services in service areas where Franchisees' EMS
System franchises have been suspended.
Section 7. Staffing and Performance Requirements
(a) Grantee shall comply with the scope of practice rules
promulgated by the North Carolina Medical Board
pursuant to Law regarding the medical skills and
medications that may be used by credentialed emergency
medical service personnel at each level of Patient
care.
(b) Grantee shall comply with standards for drivers and
attendants developed by the North Carolina Medical
Care Commission as~requirements for certification of
emergency medical technicians pursuant to Law and
rules and regulations promulgated by the Board of
Medical Examiners for advanced life support
• technicians, which are incorporated in this subsection
by reference.
(c) No staff of Grantee shall drive an Ambulance Vehicle,
attend a Patient in one, or permit one to be operated
when transporting a Patient within the County unless
the driver holds a currently valid North Carolina
Drivers license and a currently valid credential as an
EMT or EMT-P issued by the North Carolina Department
of Human Resources, Office of Emergency Medical
Services. Notwithstanding the foregoing, in an
exceptional circumstance when an EMT or EMT-P is not
available for the purpose of driving only, or when
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providing Non=Transporting Service, an approved
firefighter, First Responder, Rescue Service Provider
or law enforcement officer with a currently valid
North Carolina Drivers license may drive an Ambulance,
provided such driver does not attend a Patient or •
Victim or does not otherwise provide medical. services
to - a Patient or Victim: - - - - -- -- -
(d) Grantee shall comply with Grantor's official written
EMS System plan for the use of credentialed EMS
personnel for all of the authorized Practice Settings.
Any agreement between Grantee and a third party to
provide special events coverage is subject~to pre-
approved in writing by the Grantor, which approval
shall not be unreasonably withheld.
(e) Grantee's staff that operate EMS Services Vehicles
shall actively participate in any emergency vehicle
operation training provided by the Grantor.
(f) Grantee's staff shall comply with Grantor's official
written EMS System continuing education plan for EMS
personnel under the direction•of the Orange County
Continuing Education Coordinator. •
(g) Grantee's staff shall also participate in the clinical
and field internship educational components of
Grantor's continuing education plan.
(h) Grantee shall comply with all educational program
requirements for qualified credentialed EMS-personnel
as provided for by Law. -
(i) Grantee shall assign credentialed staff to assist, •
upon request, with any orientation provided by Grantor
to local area hospitals that routinely receive
Patients from Grantee.
Sectioa 8. Vehicle aad Squipmeat Requirements
(a) Grantee shall comply with all vehicle and equipment
standards as developed by the North Carolina Medical
Care Commission pursuant to Law, including without
limitation, those applicable to the EMS Services.
(b) Grantee shall maintain for each Ambulance and other
EMS Services Vehicle a permit as provided for by Law.'
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(c)~ Grantee shall comply with the state EMS
Nontransporting Vehicle. Permit Requirements.
(d) Grantee shall have available the following"minimum
number of Ambulances and other EMS Services Vehicles
in excellent working order to provide coverage to the
service area of the Franchise District 24 hours per
day. .
One (1) Type 2 Ambulance, Two (2) In-Service
Rescue Vehicles and other EMS Services Vehicles
and equipment as necessary to provide the high
quality of services provided far in this
Franchise.
(e) Grantee shall comply with the Grantor's operational
protocols for the management of equipment, supplies
and medications to assure that each Ambulance and
other EMS Services Vehicle contains the required
equipment and supplies on each response; for cleaning
and maintaining the equipment and vehicles; and to
assure that supplies and medications are not used
beyond the expiration date and stored in a temperature
controlled-atmosphere according to manufacturer's
specifications. .
(f)' Grantee shall comply with the Orange County's written
infection control policy including the cleansing and
disinfecting of Ambulances and other EMS Services
Vehicles and equipment that .are used to treat or
transport Patients...
{g) Grantor may, upon reasonable notice, inspect -all
equipment, Ambulances and other EMS Services Vehicles
used by Grantee . ~ '
'Section 9. Co~++nications Requirement
(a) Grantee shall equip each 'Ambulance and other EMS
Services Vehicle with the following:
I. .an operational two-way radio capable of
establishing good quality voice communications
from within the geographic confines of Orange
County to each hospital emergency department in
the County in which the service is based;
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II. two-way radio communications capabilities for
communications with all hospital emergency
departments to which transportation of Patients
is made-on a regular or routine basis anywhere
within the State of North Carolina; and
.III. an operational two-way"radio capable of
establishing communications from within the
geographic confines of the Orange County to the
Orange County Emergency Communications Center,
which~is the dispatching agency within the
County. ~ .
This subsection shall not apply to privately owned
vehicles of Grantee's staff.
(b) Grantee shall maintain current authorizations or
Federal Communication Commission licenses for all
frequencies and radio transmitters. operated by
Grantee. Grantee shall display at Grantee's
headquarters and make available for inspection per
Federal Communication Commission's rules and
regulations copies of all authorizations and licenses.
(c) Grantee's base of operations shall have at least one
open telephone 24 hours per each and every day of the
.calendar year. Grantee's telephone numbers shall be
'registered with Orange County~Emergency Communications
Center.
(d) Grantee's EMS Services shall be dispatched from the
Orange County Emergency Communications Center.
Sectioa 10. Data Collection aad Performaa.ce Report
(a) Grantee shall maintain the following records:
I. Record of dispatch which shall show the time the
.call was received, time dispatched, time arrived
on scene, time arrived at destination, time in
service and time returned to base.
II. Trip records stating all information required in
subsection I of this Section in addition to
information on a form authorized by Grantor. The
trip record shall be so designed as to provide
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the Patient with a copy containing all required
information.
III. Driver and attendant checklist and inspection
report listing contents and description of
operations for each vehicle, signed by the
• individual verifying vehicle operations and
equipment.
IV. A detailed record of complaints received from the
public, other enforcing agencies and services
regarding Franchise infractions.
V. Any other information Grantor deems reasonably •
necessary for a fair determination of the
capability of the applicant to provide Rescue
Service in Orange County in accordance with the
requirements of Law and the provisions of this
Franchise.
(B) Grantee shall establish and maintain a system to
record data that uses the Model data set and data
dictionary as specified in "North Carolina College of
Emergency Physicians: Standards for Medical Oversight
and Data Collection.
(C) Grantor may inspect Grantee's records any time in
order to ensure compliance with the Orange County
Franchise Ordinance and this Franchise.
Section 11. Medical. Oversight
(a) Grantee shall designate a representative of~Grantee to
attend and participate in regular meetings of .the
Orange County EMS Peer Review Committee.
(b) Grantee shall monitor and comply with any online .
medical direction for operating within EMT-P systems.
(c) Grantee shall comply with the Grantor's plan for
Medical Oversight and Written Treatment Protocols.
(d) Grantee shall comply with the Grantor's written plan
to address management of the EMS System including:
I. the triage of Patients to appropriate facilities
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II. transport. of Patients to facilities outside of
the system _
III. arrangements for transporting Patients to
appropriate facilities when diversion or bypass
plans are activated;
IV. a mechanism for reporting, monitoring•and
establishing standards-for system response times;
V. a disaster plan; and
VI. mass-gathering plan.
(e) Grantee shall comply with the Medical Director's
• written Guidance regarding decisions about the
equipment, medical supplies and medications that will
be carried on any Ambulance or other EMS Services
Vehicle.
(f} The Medical Director may suspend temporarily, pending
due process review by the EMS Peer Review Committee,
any of Grantee's EMS personnel from further
participation in. the EMS system when the Medical
Director determines that the activities or medical
care rendered by such personnel may. be detrimental to
.the care of the Patient, constitute unprofessional
behavior or result in non-compliance with
• credentialing requirements.
Sectioa 12. Rates and Adjustments
(a)~ Grantee shall submit a schedule of rates to the
Grantor for approval and shall not charge more nor
less than the authorized rates without specific
authorization from the Grantor.
(b) Grantee shall not attempt to collect rates on
emergency calls until the Patient has reached the
point of destination, has received medical attention
and is in a condition deemed by the physician fit to
consult with the service; but Grantee may attempt to
collect rates with family or guardian of the Patient
once the Patient is in the process of receiving
medical attention.
(c) On special events coverage and convalescent calls,
Grantee may attempt tb collect payment before the
Ambulance or other EMS Services Vehicle begins its
trip. •
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Section 13. Insurance
(a) Within (30) calendar days after the effective date of
the Franchise, the Grantee shall provide proof of the
required insurance. Grantee shall at all times during
the Franchise term maintain in force and effect
insurance coverage, issued by an insurance company
licensed to do business in North Carolina, covering
the following:
I. Every Ambulance or other EMS Services Vehicle
owned and/or operated by or for the Grantee
. providing for the following payment. of injury and
damages:
a. In the minimum sum of $1,000,000.00 for injury
to or death of .individuals in accidents
resulting from any cause for which the owner
of the vehicle would be liable on account o_f
liability imposed on him by Law, regardless of
whether the vehicle was being driven by the
owner or his agent; and
b. In the minimum sum of $1,000,000.00 for the
loss of or damage to the property of another,
including personal property, or under like
circumstances in sums as may be required by
the State of North Carolina or as authorized
by, the Grantor .
i. The insurance coverage minimum limits
required in subsections (a)I-a and (a)I-b of
this Section shall be evaluated annually by
the Orange County Office of Emergency
Management in consultation with the Orange
County Director of Central Services and-may
be revised by the Grantor as Grantor deems
appropriate, at Grantor's sole discretion.
In directing a change in insurance coverage,
the Orange County Office of Emergency
Management shall consider the risk needs
protected by this insurance coverage and the
availability in the marketplace of the
coverage amounts to be required.
15
•18
II. Grantee shall at all times during the Franchise
term maintain in force and effect insurance
coverage, issued by an insurance company licensed
to do business in North Carolina for Worker's
compensation coverage for all employees with
statutory limits in compliance with applicable
.. Law'. ..
(b) Insurance coverage necessary to comply with this
Section shall be approved by the Grantor, (such
approval shall not be unreasonably withheld) and
copies of such insurance policies (or certificates of
insurance) shall be • filed with the Grantor .
(c) The Grantor shall be named as an•additional insured as
its interests may appear. •
Section 14. Transfer of Ownership or Coatrol
(a) Prior approval of the Grantor shall be required where
ownership or control of more than ten percent of the
right of control of the Grantee is acquired by a
Person or group of Persons acting in concert, none of
whom own or control ten percent or more of such right
of control, singularly or collectively, at the date of
the Franchise. By its acceptance of the Franchise, the
Grantee specifically agrees that any such acquisition
occurring without prior approval .of the Grantor shall
constitute a violation of•the Franchise by the Grantee
and shall be cause for termination at the option of
the Grantor.
(b) Any change of ownership of Grantee without the
approval of the Grantor shall terminate the Franchise
and shall require a new application and a new
Franchise and conformance .with all the requirements of
the Orange County Franchise Ordinance, as amended, as
upon original franchising.
(c) Any change in the level•of service offered by a
Grantee's EMS Services unit without the approval of
the Grantor shall•terminate the Franchise and shall
require a new application and a new franchise and
conformance with all the requirements of the Orange
County Franchise Ordinance, as amended, as upon
original franchising. _ •
16
19
(d) Grantee may not sell, assign, mortgage or otherwise
transfer the Franchise without the approval of the
Grantor; and a finding of conformance with all
requirements of the Orange County Franchise Ordinance,
as amended, as upon original franchising.
Section 15. Miscellaneous Provisions
(a) Grantor may, upon reasonable notice, inspect the
' premises, vehicles, equipment and personnel of Grantee
to ensure compliance with this Franchise and perform
any other inspections that may be required.
(e) Grantee shall make available for inspection by the
State.of North Carolina, the Grantor, or their
designated representat~.ves, Grantee's EMS Services,
its equipment and the premises designated in the
application and all records relating to its '
maintenance and operation as such.
(b) Grantee shall cooperate with the Grantor to educate
the public concerning injury prevention and community
health. .
(c) Grantee's staff shall not wear or carry aboard any
Ambulance or other EMS Services Vehicle weapons as
defined by Law. The foregoing restriction shall .not be
construed to apply to equipment used by Grantee to
provide the EMS Services.
(f) Grantee shall post its Franchise Certificate, issued.
to it by'the Grantor, in a readily visible location at
the Grantee's base of operations for the EMS Services.
(g) Grantee shall not allow its Franchise Certificate to
be defaced, removed or obliterated.
(h) Grantee shall comply with all applicable Law and
Grantors policies and procedures related to'
confidentiality of medical information, including .
without limitation the Health Insurance Portability
and Accountability Act of 1996 (HIPAA).
Section 16. End-Term Provisions
(a) Grantee may terminate this Franchise with~60 days'
notice to the Grantor and the Grantor may revoke the
. . 2 p;
Franchise in the event of noncompliance with the
provisions of the Orange County Franchise Ordinance or
this Franchise. After a notice of service termination
is given, the provider may reapply for a franchise if
continued service is desired.
(b) Upon suspension, revocation-or termination of this
Franchise, Grantee•shall immediately cease all
operations authorized by the Franchise.
(c) Upon suspension, revocation or termination of a
Driver's license such Persons shall cease to drive an
•Ambulance or other EMS Services Vehicle. Upon
suspension, revocation~or termination of an
attendant's certificate, i.e., EMT or EMT-P
certificate, such Persons shall cease to attend
patients or otherwise provide medical care. Grantee
• shall not permit the foregoing Persons to drive an
Ambulance or other EMS Services Vehicle or provide
medical care in conjunction with the EMS Services.
(d) In the event that Grantee shall at any time during the
Franchise desire to sell any of the real and personal
property identified in Exhibit B (hereafter "Asset° or
"Assets") pursuant to a bona fide offer which it shall
have received, it shall offer to sell any such Asset
~. or Assets (hereafter "Asset or Assets for Sale") to
Grantor at the same price as that contained in such
bona fide offer. The offer to Grantor to sell an Asset
shall be in writing and shall include a copy of-the
bona. fide offer for the Asset received by the Grantee..
Grantor shall have 60 days from and after receipt
thereof•to decide whether or not to purchase the Asset
or Assets for Sale at such price. If Grantor shall
give notice of intent not to purchase or shall give no
notice within the time herein limited, Grantee may
accept such offer and proceed with the sale
thereunder. If Grantor notifies Grantee that it elects
to purchase the Asset or Assets for Sale at such
price, the parties shall enter into a contract of
purchase and sale forthwith. Such contract shall
provide, among other things,-for the conveyance of
good and marketable title by warranty deed. Upon
dissolution of-the Grantee pursuant to N.C. Gen. Stat.
§ 55A-14-1, et seq., the Assets shall be either: (a)
distributed to one or more appropriate receiving
successor Franchisee(s) that will carry on, in Orange
,a
21
County, the functions of ambulance, first responder,
rescue or other related emergency services meeting one
or more exempt purposes within the meaning of .
501 (c) (3) of :the Internal Revenue Code (or the
corresponding section of•any future federal tax code)
or (b) distributed to the Grantor for the foregoing
public purposes. This subsection 16 (d) of this EMS
Service Franchise survives the termination of the
Franchise . •
Section 17. Forum for Litigation
Any litigation between the Grantor and Grantee arising
under or regarding the Franchise shall occur, if in the
North Carolina courts, ia•Orange County Superior Court or
District Court having jurisdiction thereof, of it in the
federal courts, in the United States District Court for the
Middle District of North Carolina.
Section 18. Notice
Any notice provided for under the Franchise shall be
sufficient. if in writing and delivered Personally to the
following addressee or deposited in the United States Mail,
postage prepaid, certified mail, return 'receipt requested,
addressed as follows, or to such other address as the
receiving party hereafter shall specify in writing:
If to Grantor:
If to Grantee:
Orange County Emergency Management
PO Box 8181,
Hillsborough, NC 27278
Telephone Number: 919,-968-2050
Chief •
Technical Rescue Services, Inc.
Dba South Orange Rescue Squad
P.O. Box 128
Carrboro, NC 27278
Telephone Number: 919-619-2134
Section 19. Severability
If any Section, subsection, sentence, clause, phrase, or
other portion of this Franchise is, for any reason,
declared invalid, in whole or in part, by any court,
,~
~2
agency, commission, legislative body, or other authority of
competent jurisdiction, such portion shall be deemed a
separate, distinct and independent portion. Such
declaration shall not affect the validity of the remaining
portions hereof, which other portions shall continue in
full force and effect.
Section 20. Reservation of Rights
Notwithstanding any other provision of the Franchise,
Grantor and Grantee reserve all rights that they may
possess under the Law unless expressly waived herein.
Nothing herein shall constitute~a waiver of rights of
either party, provided, however, that both parties warrant
and represent that, as of the effective date of the
Franchise, they are not aware of any provision in the
Franchise that is contrary to applicable Law.
Section 21. Penalties and Remedies.
(a) A violation of any provision of the Orange County
Franchise Ordinance or other failure of the Grantee to
abide by any provision of this Franchise shall subject
the Grantee to a civil penalty of five hundred ($500)
dollars. If Grantee fails•to pay this penalty within
ten (10) days after being cited for a violation, the
Grantor may seek to recover the penalty by filing a
civil action in the nature of the debt.
(b) A violation of the •Franchise by the Grantee shall
constitute a misdemeanor, punishable as provided in
N.C. Gen. Stat: § I4-4.
(c) The Grantor may seek to enforce the Orange County
Franchise Ordinance or the Franchise through any
appropriate equitable action.
(d) Each day that a violation continues after the Grantee
has been notified of the violation shall constitute a
separate offense.
(e ). The Grantor may seek to enforce the Franchise by using
any one or any combination of the foregoing remedies.
20
23
Section 22. Non-Discrimination
The Grantee shall not discriminate in any manner on the
basis of factors prohibited by Law.
Passed on First Reading
Passed and Adopted
on Second Reading ~~ ~~ 2(X>
Y
IN WITNESS WHSRF.OF, the undersigned have caused this
agreement to be executed.
BY:
C erk
A]
B7
~~
. .'
24
Section 23. Acceptance by Grantee
This Franchise and all of its terms and provisions. shall be
accepted by Grantee in writing in the form hereinafter set
forth within thirty (30) days of the grant of this
Franchise by the Grantor and when accepted shall be filed
with Grantor's clerk who shall record the same in the Book
of Ordinances.
Such. written acceptance may be upon or at the end of a copy
of this Franchise Ordinance and it shall state and express
the acceptance of the said Franchise and its terms,
conditions and provisions; and Grantee shall agree in said
written acceptance to abide by, to observe and to perform
the same according to all of its terms and provisions,
subject to.~applicable state and federal law and shall
declare that statements and recitals contained on said
Franchise are correct and that it has made and does make
the agreements and statements set forth in this Franchise.
Acceptance herein referred to shall be in the following
form; •~ ~ .
-~ ~.
The undersigned, /~ ~¢-~1,r,~1 ~7~~-y in his/her
capacity as ~ of the
and on behalf of that company, does hereby accept and
approve the foregoing and attached Franchise and all of its
terms and conditions; and in consideration of the benefits
and privileges granted to it does hereby agree to abide by,
carry out, observe and perform all of the obligations and
things provided to be carried out and performed by it in
said Franchise approved by the Grantor Commissioners,
subject to applicable state and federal law
~, ~ .
This is the 3 ~ day of - 200.
22
25
STATE OF NORTHCAROLINA
COUNTY OF Orange
ut
On the 3 ~ day of 2 0 Q.~ before .me a
Notary Public in and f ,the Covnty and State aforesaid,
Personally appeared before
and on behalf of said Company, acknowledges the signix~g and
execution of the foregoing instrument. •
IN TESTIMONY WHEREOF I have hereunto subscribed my name
and a~fixed by notarial seal on the day and year above .
written. ~ , •,, /ji } ® .
Notary Pu1~J.ic
My commission expires: /D-/c3'0~
~3
~~ 26
• ~ ': : _
EXHIBIT A TO EMS SERVICES FRANCHISE "
FOR TECHNICAL RSSCIIE SERVICES, INC., DOING BIISINESS
AS SOIITH ORANGE RESCIIS SQIIAD, A NORTH CAROLINA NON-
PROFIT CORPORATION
FRANCHISE DISTRICT .__
GEOGRAPHIC SIZE: All of the County of Orange
24
27
EXHIBIT B TO EMS SERVICES FRANCHISE
FOR TSCHI~TICAL R$SCIIE SERVICES, INC., DOING BIISINESS
AS SOIITH ORANGE RESCtTE SQIIAD, A NORTH CAROLINA NON-
PROFIT CORPORATION
ASSETS
1. Real Estate and Improvements:
Lot and improvements located at the physical address of
202 East Roberson Street, Carrboro, NC, known within the
Orange County EMS System as "Station 2" and other real.
property and improvements owned by Grantee.
2.A11 ambulances, .rescue vehicles and equipment owned or
maintained by Grantee.
r'~"'- ,~
.28 fyj
a~` ` ~o
STATE OF NORTH CAROLINA
ORANGE CODNTY
ORD=NANCB 2004 -
EMS SERVICES FRANC$ISE
®ta ~ ~~t~
~~ ~~Cb`~
An Ordinance granting a non-exclusive Franchise ("hereafter
Franchise°) to Orange EMS & Rescue Squad,.2nc., a North
Carolina Non-Profit Corporation ("the Grantee") to operate
EMS Services in Orange County, North Carolina.
WHEREAS, Orange County, ("the Grantor"), desires to
assure the availability of EMS Services within the County;
WHEREAS, the Grantor has, following reasonable notice,
and after consideration, analysis and' deliberation
conducted public proceedings, during which proceedings the
technical ability, financial condition, legal qualification
and general character of the Grantee were determined to be
acceptable to receive a Franchise to conduct its EMS
Services;
WHEREAS, the Grantor also has considered and analyzed
the qualifications of the Grantee and found the Grantee
meets applicable Orange County and North Carolina State
standards related to the provision~of EMS Services; ~ .
WHEREAS, the Grantor has determined that Grantee is
entitled to have a non-eacclus'ive Franchise granted, that a
need exists for the 'EMS Services contemplated .herein to
improve the level of service available to residents of
Orange County, helping to assure the provision of adequate
and continuing service which preserves, protects, and
promotes the public health safety and welfare, and that
granting a Franchise to~the Grantee is a cost effective and
reasonable manner of meeting the need;
WHEREAS, the Grantee desires to operate EMS Services
within the Grantor's jurisdiction; .
WHEREAS, the proposed EMS Services will fit within the
existing services provided by the Orange~County EMS system
so as not to adversely affect the, level of service or
operations of other Franchisees to render service; and
S-f ~
1
29
WHERl3AS, the procedures of N.C. Gen. Stat. ~ 153A-250,
§ 153A-45, and § 153A-46 have been complied with.
NOW, THEREFORE, the parties agree as follows:
Section 1. 'Nature and Term of Grant
A. The Grantor hereby grants the Grantee a non=
exclusive Franchise .to operate and maintain EMS
Services (be an EMS Services provider) •in the
Franchise District upon the terms and.conclitions
set forth herein.
B. The Franchise granted herein is for a term of
five (5) years from the effective date of the.
Franchise, which' shall be the date of acceptance
'by the Grantee of the Franchise terms and
conditions set forth herein.
Section•.2. Abbreviations
As used in this Franchise, the following abbreviations
mean:
ENiS - Emergency Medical Services
EMT ~ - Emergency Medical Technician
EMT-P - EMT-Paramedic
Section 3. Definitions
The following words, terms and phrases, when used in this
Franchise, shall have. the meanings ascribed to them in this
Section, except where the context clearly indicates a
different meaning:
Air Medical Ambulance-means an aircraft specifically
designed-and equipped to•transport Patients by air as
defined by State Law.
Ambulance means any privately or. publicly owned motor• •
vehicle, aircraft or vessel that is specially designed,
constructed or modified and equipped and is intended to be
used for and is~maintained or operated for the
transportation on•the streets or highways, waterways or
airways of this state of Persons who require Ground
Ambulance, Air Medical Ambulance, Water Ambulance, or other
EMS Services authorized by this Franchise.
2
'~~ 30 ..
Ambulance Provider means an individual, firm, corporation
or association. who engages or professes to engage in the
business or service of transporting Patients or providing
other EMS Services.
Approved means approved by the North Carolina Medical Care
Commission pursuant to the latter's rules~and regulations
promulgated under the authority of Law. ~ '
Convalescent Ambulance means an Ambulance used on a
scheduled basis solely to transport Patients having a known
non-emergency medical condition. Convalescent Ambulances
shall not be used in place~of any other category of
Ambulance as defined herein.
County means the Grantor, Orange County, and its Board of
Commissioners or its designated representative.
Emergency means something dangerous or serious which
happens suddenly or unexpectedly and involves a Victim or
other Patient who is or may be in need of immediate EMS
Services or medical treatment in order to prevent loss of
life or further aggravation or physiological or
psychological illness or injury. ~ ~~
Smergeacy Medical Technician (EMT) means an individual who
has completed a training program in emergency medical care
at least equal to the National Standard Training Program
for Emergency Medical Technicians as defined by the United
States Department of Transportation and has been certified
as an emergency medical technician by the North Carolina
Office of Emergency Medical Service.
EMS Franchise Ordinance means "An [Orange County] Ordinance
Regulating Emergency Medical, First Responder, and Rescue
Service and Granting of Franchises and Contracts to the '
Operators in the County of Orange."
BM<S Noatraasportiag Service means providing EMS Services
using EMS Non-Transporting Vehicle.
EMS Noatraasporting Vehicle means a motor vehicle dedicated
and equipped to provide'First Responder or Rescue Services
or to move medical equipment and EMS personnel functioning
within the scope of practice of~EMT-P to the scene of a
request for assistance. EMS Nontransporting Vehicles shall
3
•~ ~ ~ ~ 31
not be used for the transportation of Patients on the
streets, highways, waterways or airways of the County.
EMS Peer Review Coa®.ittee means an Emergency Medical
Services Peer Review Committee as defined by Law, and in
Orange County is also known as the "Orange County EMS Audit
an~ Review Committee," which also has the powers and duties
of, the °Emergency Medical Services Advisory Council" as
specified in the EMS Franchise Ordinance. .
EMS System means this Franchise and the remaining aspects
of Orange County's coordinated arrangement of resources
(including personnel, equipment and facilities) organized
to respond to medical emergencies, including without
limitation the Specialty Care Transport Program and
integrated with other health care providers and networks
including, but not limited to, public health, community
health monitoring activities and special needs populations.
EMS Services means the combination of services to be
provided by Grantee pursuant to this Franchise as specified
in Section 4 of this Franchise.
EMS Services Vehicle(s) means Ambulance(s) or other
authorized vehicle(s) used by Grantee to provide EMS
Services.
First Responder means personnel trained in emergency
medical care that are dispatched to the scene of a medical
emergency for the primary purpose of providing emergency
medical assistance to a Patient until an Ambulance or other
additional medical aid arrives.
Franchise means this instrument which is a permit issued by
the Grantor to Grantee for~the operation of Grantee's EMS
Services and a contract by which both parties agree to the
terms of the operation of the EMS Services to be provided.
Franchise District means a specifically defined EMS
provider service area of the county established using
criteria that includes geographic size, road access, the
location of existing medical transportation services,
population and response time, as specified in Exhibit A
attached hereto and incorporated herein.
Franchisee(s) means Persons or entities, other than the
Grantee, having been issued permits by the County for the
4
' ~ 32
operation of Ambulance service, Rescue Squad, First,
Responder unit or other related service within specified
service areas or districts in Orange County.
Ground Ambulance means an Ambulance used to transport
Patients with traumatic or medical conditions or Patients
for whom the need•for emergency or non-emergency medical
care is anticipated either at the Patient location or
during transport.
Law means all applicable laws and regulations including
without limitation Chapter'131E and 143B of the North
Carolina General Statutes and l0A N.C. Admin. Code 13P, as
amended,' the Franchise- Ordinance and other applicable
federal, State 'or local laws and regulations.
Drivers license means any license or permit issued under or
granted by North Carolina Law to operate a particular type
of motor vehicle that serves as an Ambulance or .other EMS
Services Vehicle.
Medical Crew Member means EMS personnel or other health
care professionals who are licensed or registered in North
Carolina and are affiliated with a Specialty•Care Transport
Program.
Medical Director means the physician responsible for the
medical aspects of the management of the EMS System. The
` duties of the Medical Director may be completed, through
written delegation as provided for by Law.
Medical Oversight means the responsibility for the
management and accountability of the medical care aspects
of the EMS System. Medical Oversight includes physician
direction of the initial education and continuing education
of EMS personnel or medical crew members; development and
monitoring of both operational and treatment protocols;
evaluation of the medical .care rendered by EMS personnel or
medical crew members; participation Yn system or program
evaluation; and directing, by two-way voice communications,
the medical care rendered by the EMS personnel or medical
crew members. .
Model EM3 System means an approved EMS System that chooses
to meet the criteria for and receives this designation by
the Office of Emergency Medical Services.
5
_. ;. ~~ X33
Office of Emergency Medical Services (OEMs) means a section
of the Division of Facility Services of the North Carolina
Department of Health and Human"Services. .
Operational Protocols means the official written
administrative policies and procedures of the Orange County
EMS System, as amended, that provide guidance for the day-
to-day operation of the EMS System.
Owner means any Person or entity that owns an Ambulance or
other EMS Services Vehicle and provides EMS Services
covered by this Franchise.
Patient means an individual who is sick,, injured, wounded
or otherwise incapacitated or helpless such that the need
for some medical assistance might be anticipated while
being transported to or from a medical facility.
Person means any individual, firm, partnership,
association, corporation, company, group df individuals
acting together for a common purpose, or organization of
any kind, including any governmental agency other than the
United States.
Physician means a medical or osteopathic doctor licensed by
the North Carolina Medical Board to practice medicine in
the North Carolina.
Practice Settings means the areas of practice for'the
credentialed personnel that provide EMS Services pursuant
. to this Franchise as provided for by Law at the location of
a physiological or psychological illness or .injury
including transportation to an appropriate treatment
facility if required; at public or community health
facilities in conjunction with public and community health
initiatives, in hospitals and clinics; in residences,
facilities, or other locations as part of wellness or
injury prevention initiatives within the community and the
public health system; and./or at mass gatherings or special
events:
Primary Ambulance Provider means the"system of personnel,
EMS Transport System.Vehicles and equipment normally
dispatched on a first call response. "
Rescue Service means the system of personnel, EMS System
Vehicles clearly marked and identified to the public by
6
'•• 34 • .
means of painted or adhesive•lettering or emblems on the
exterior of~the vehicles, and equipment•required to respond
to situations where persons or victims are missing or
cannot escape an area through the normal exit or under
their own power, including without limitation •swiftwater
rescue, confined space rescue, light and heavy vehicle
extraction, high/low angle rescue, collapse rescue and
trench rescue.
Secondary Ambulance Provider means~the system of personnel,
EMS System Vehicles and equipment meeting the same criteria
as a Primary Ambulance Provider, but not normally
dispatched on a first call response. .
Service means the same as "owner."
Specialty Care Transport Program means the Orange County
program designed and operated for the provision of
specialized medical care and transportation of critically
ill or injured• Patients. •
Specialty Care Transport Program Continuing Education
Coordinator means a Level I EMS Instructor within the
Orange County Specialty Care Transport Program who is
responsible for the coordination of EMS continuing
education programs for EMS personnel within the program.
System Continuing Education Coordinator means a Level I EMS
Instructor within the Orange County EMS System who is
responsible for the coordination of EMS continuing
education programs. •
Treatment Protocols means a written document authorized by
the medical directors of both the EMS System, including the
Specialty Care Transport Program and the OEMS specifying
the diagnostic procedures, treatment procedures, medication
administration and Patient-care-related policies that shall
be completed by Grantee or its personnel or Medical Crew
Members based upon the assessment of a Patient.
Victim means any Patient or potential Patient who. is
entrapped, entangled, pinned, fallen, suspended or
otherwise in need of Rescue Service.
Water Ambulance means a watercraft specifically designed
and equipped to serve as an EMS Services Vehicle to
transport Patients. •
7
~• ~ 35
Section 4. Geaeral~Responsibilitfes
(a) Grantee is authorized under this Franchise to operate
the following types of service(s), the combination of
which shall constitute. Grantee's "EMS Services" for
the purposes of this Franchise:
® Rescue Service
® light and heavy vehicle extrication
® underwater (dive) rescue
® wilderness and land search
® Primary Ambulance Provider (Special Events
Coverage Only)
(b) Grantee shall comply at all times with the
requirements of the Orange County EMS Franchise
Ordinance, this Franchise and all applicable Law
relating to health, sanitation, safety, equipment,
Ambulance design or~other EMS Services Vehicle design
and all legal requirements related to a Model EMS
System and all other laws and ordinances,a
(c) Grantee shall maintain in good standing its state and
local Drivers and Privilege license(s) to operate its
Ambulance or other EMS Services as provided for by
Law.
Section 5. The Scope of Service
(a) Grantee shall operate its EMS Services,. 24 hours per
each and every day of the calendar year, within the
Franchise District specified in Exhibit A, except when
a different or additional service area is provided for
herein.
(b) Grantor may from time to time alter, and at its sole
discretion, amend Exhibit A and the service area(s) of
the County that constitute(s) the Franchise District.
(c) Grantee shall at all times during the term .of the
Franchise provide the highest level of care to all
citizens within the service area of•the Franchise
District.
8
• • ~ 3~6 _
Sectioa 6. The EMS System Plan.
Grantee shall comply with the Grantor's official written
EMS System plan for the management and deployment of EMS
Services Vehicles within the Franchise District and,
additionally, within other service areas pursuant to the
EMS System Mutual Aid Plan and any cooperative agreement to
continue services in service areas where Franchisees' EMS
System franchises have been suspended.
Section 7. Staffing aad Performance Requirements
(a) Grantee-shall comply with the .scope. of practice rules
promulgated by the North Carolina Medical Board
pursuant to Law regarding the medical skills and
medications that may be used by credentialed emergency
medical service personnel at each level of Patient
care. -
(b) Grantee shall comply with standards for drivers and
attendants developed by the North Carolina Medical
Care Commission as requirements for certification of
- •emergency medical technicians pursuant to Law and
rules and regulations promulgated by the Board of -
Medical Examiners for advanced life support ~~
technicians, which are incorporated in this subsection
by reference. - ~ -
(c) No staff of Grantee shall drive an Ambulance Vehicle,
attend a~Patient in one, or permit one to be operated
when transporting a Patient within the County unless
the driver holds a currently valid North~Carolina
Drivers license and a currently valid credential~as an
EMT or EMT-P issued by the North Carolina Department
of Human Resources, Office of Emergency Medical
Services. Notwithstanding the foregoing, in an
. exceptional circumstance when an EMT or EMT-P is not
available for the purpose of driving only, or when
providing Non-Transporting Service, an.approved
firefighter, First Responder, Rescue Service Provider
or law enforcement officer with a currently valid
North Carolina Drivers license may drive an Ambulance,
provided such driver does not attend a Patient or
Victim or does not otherwise provide medical services
to a Patient or Victim. ..
9
37
(d) Grantee shall comply with Grantor's official written
EMS System plan for the use of credentialed EMS
personnel for all of the authorized Practice Settings.
Any agreement between Grantee and a third party to
provide special events coverage is subject to pre-
approved in writing by the Grantor, which approval
shall not be unreasonably withheld.
(e) Grantee's staff that operate EMS Services Vehicles
shall actively participate in any emergency vehicle
operation training provided by the Grantor.
(f) Grantee's staff shall comply with Grantor's official
written EMS System continuing education plan for EMS
personnel under the direction of tfi.e Orange County
Continuing Education Coordinator.
(g) Grantee's staff shall also. participate in the clinical
and field internship educational components of
Grantor's continuing education plan.
(h) Grantee shall comply with all educational program
requirements for qualified credentialed EMS personnel
as provided for by Law.
(i) Grantee shall assign credentialed staff to assist,
upon request, with any orientation provided by Grantor
to local area hospitals that routinely receive
Patients from Grantee.
Section 8. Vehicle and Equipment Requirements
(a) Grantee shall comply with all vehicle and equipment
standards as developed by the North Carolina Medical
Care Commission pursuant to Law, including without
limitation, those applicable to the EMS Services.
(b) Grantee shall maintain for each Ambulance and other
EMS Services Vehicle a permit as provided for by Law.
(c) Grantee shall comply with the state~EMS
Nontransporting Vehicle Permit Requirements.
(d) Grantee shall have available the following minimum
number of Ambulances and other EMS Services Vehicles
in excellent working order to provide coverage to the
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service area of the Franchise District 24 hours per
day.
One (1) Type 1 Ambulance, Three (3) In-Service
Rescue Vehicles and other EMS Services Vehicles
and equipment as necessary to provide the high
quality of services provided for in this
Franchise.
(e) Grantee shall comply with the Grantor's operational
protocols for~the management of equipment, supplies
and medications to assure that each Ambulance and
other EMS Services Vehicle contains the required
equipment and supplies on each response; for cleaning
and maintaining. the equipment and vehicles; and to
assure that supplies and medications are not used
beyond the expiration date and stored in a temperature
controlled atmosphere according to manufacturer's
specifications.
(f) Grantee shall comply with the Orange County's written
_ infection control policy including the cleansing and
disinfecting of Ambulances and other EMS Services
Vehicles and equipment that are used to treat or
transport Patients.
(g) Grantor may, upon reasonable notice, inspect all
equipment, Ambulances and other EMS Services Vehicles
used by Grantee.
Section 9. Coa~unications Regv.iremeat
(a) Grantee shall equip each Ambulance and other .EMS
Services Vehicle with the following:
I. an operational two-way radio capable of
establishing. good quality voice communications
from within the geographic confines of Orange
County to each hospital emergency department in
the County in which the service is based;
II. two-way radio communications capabilities for
communications with all hospital emergency
departments to which transportation of Patients
is made on a regular or routine basis anywhere
within the State of North Carolina; and.
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III. an operational two-way radio capable of
establishing communications from within the
geographic confines of the Orange County to the
Orange County Emergency Communications Center,
which is the dispatching agency within the ,•
county. - •
This subsection shall not apply to privately owned
vehicles. of Grantee's staff.
(b) Grantee shall maintain current authorizations or
Federal Communication Commission licenses for all
frequencies and radio transmitters operated by
• Grantee.~Grantee shall display at Grantee's
headquarters and make available for inspection per
Federal Communication Commission's rules and
regulations copies of all authorizations and licenses.
(c) Grantee's base of operations shall have at least one
open telephone 24 hours per each and every day of the
calendar year. Grantee's telephone numbers shall be
registered with Orange County Emergency Communications
Center.
(d} Grantee's EMS Services. shall be dispatched from the
Orange County Emergency Communications Center.
Section 10. Data Collection and Performance Report
(a) Grantee shall maintain the following records:
I. Record of dispatch which shall show the time the
call was received, time. dispatched,~time arrived
on scene, time arrived at destination, time in
service and time returned to base..
II. Trip records stating all information required in
subsection~I of this Section in addition to
information on a form authorized by Grantor. The
trip record shall be so designed as to provide
the Patient with a copy containing all required
information. •
III. Driver. and attendant checklist and inspection
report listing contents. and description of
operations for each vehicle, signed by the
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individual verifying vehicle operations and
equipment.
IV. A detailed record of complaints received from the
public,~other enforcing agencies and services
regarding Franchise infractions. ~ ~~
V. Any other.information Grantor deems reasonably
necessary for a fair determination of the
capability of the applicant to provide Rescue
Service in Orange County in accordance with the
requirements of Law and the provisions of this
Franchise . •
(B) Grantee shall establish and maintain a system to
record data that uses the Model data set and data
dictionary as specified in "North Carolina College of
Emergency Physicians: Standards for Medical Oversight
and Data Collection.
(C) Grantor may inspect Grantee's records any time in
• order to ensure compliance with the Orange County
Franchise Ordinance and this Franchise.
Section 11. Medical Oversight
(a) Grantee shall designate a representative of Grantee to
attend and participate in regular meetings of the
Orange County EMS Peer Review Committee. .
(b)• Grantee shall monitor and comply with. any online
medical direction for operating within EMT-P systems.
(c) Grantee shall comply with the Grantor's plan for
Medical Oversight and Written Treatment Protocols.
(d) Grantee shall comply with the Grantor's written plan
to address management of the EMS System including:
• I. the triage of Patients to appropriate facilities
. II. transport of•Patients to facilities outside of
the system
III. arrangements for transporting Patients to
appropriate facilities when diversion or bypass
• plans are activated;
IV. a mechanism for reporting, monitoring and
establishing standards for system response times;
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V, a disaster plan; and
VI. mass-gathering plan.
(e) Grantee shall comply with the Medical Director's
written Guidance regarding decisions about the
equipment, medical supplies and medications that will
be carried on any Ambulance or other EMS Services
Vehicle.
(f) The Medical Director may suspend temporarily, pending
due process review by the EMS Peer Review Committee,
any of Grantee's EMS•personnel from further
participation in the EMS system when the Medical
Director determines that the activities or medical •
care rendered by such personnel may be detrimental to
the care of the Patient, constitute unprofessional
behavior or result in non-compliance with
credentialing requirements..
Section 12. Rates and Adjustments
(a) Grantee shall submit a schedule of rates to the
Grantor for approval and shall not charge more nor
less than the authorized rates without specific
authorization from the Grantor.
(b) Grantee shall not attempt to collect rates on
emergency calls until the Patient has reached the
point of destination, has received medical attention
and is in a condition deemed by the physician fit to
consult with the service; but Grantee may attempt to
collect rates with family or guardian of the Patient
once the Patient is in the process~of receiving
medical attention.
(c) .On special events coverage and convalescent calls,
Grantee may. attempt to collect payment before the
Ambulance or other EMS Services Vehicle begins its
trip.
Section 13. Insurance
(a) .Within (30) calendar days after the effective date of
the Franchise, the Grantee shall provide proof of the
required insurance. Grantee shall at all times during
the Franchise term maintain in force and effect
insurance coverage, issued by an insurance company
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~42
licensed to do business in North Carolina, covering
the following: .
I. Every Ambulance or other EMS Services Vehicle
owned and/or operated by or for the Grantee
providing for the following payment of injury and
damages: .
a. In the minimum sum of. $1,000,000.00 for injury
to or death of individuals in accidents
resulting from any cause for which the owner
"of the vehicle would be liable on account of
liability imposed on him by Law, regardless of
whether the vehicle was being driven by the
owner or his agent; and
b. In the minimum sum of $1,000,000.00 for the
loss of or damage to the property of another,
including personal property, or under like
circumstances in sums as may be required by
the State of North Carolina or~as authorized
by the Grantor. .
i. The insurance coverage minimum limits
required in subsections (a)I-a and (a)I-b of
this Section shall be evaluated annually by
the Orange County Office of Emergency
. Management in consultation with the Orange
County Director of Central Services and may
be revised by the Grantor as Grantor deems
appropriate, at Grantor's sole discretion.
In directing a change in insurance coverage,
the Orange County Office of Emergency
Management shall consider the risk needs
protected by this insurance coverage and the
availability in the marketplace of the
coverage amounts to be required.
II. Grantee shall at all times during the Franchise
term maintain in force and effect insurance
coverage, issued by an insurance company licensed
to do business in North Carolina for Worker's
compensation coverage for all employees with
statutory limits in compliance with applicable
Law. "
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(b) .Insurance coverage necessary to comply with this
Section shall be approved by the Grantor, (such
approval shall not be unreasonably withheld) and
copies of such insurance policies (or certificates of
insurance) shall be filed with the Grantor.
(c) The Grantor shall be named as an additional insured as
its interests may appear.
Section 14. Transfer of Ownership or Control
(a) Prior approval of the Grantor. shall be required where
ownership or control of more than ten percent of the
right of~control of the Grantee .is. acquired by a
Person or group of Persons acting in concert, none of
whom own or control ten percent or more of such right.
of control, singularly or collectively, at the date of
the Franchise. By its acceptance of the Franchise, the
Grantee specifically agrees that any such acquisition
occurring without prior approval of the Grantor shall
constitute a violation of the Franchise by the Grantee
and.shall be cause for termination at the option of
the Grantor.
{b) Any change of ownership of Grantee without the
approval of the Grantor shall terminate the Franchise
and shall require a new application and a new
Franchise and conformance with, all the requirements of
the Orange County Franchise Ordinance, as amended, as
upon original franchising.
(c) Any change in the level of service offered by a .
Grantee's EMS Services unit without the approval of
the Grantor shall terminate the_Frarichise and shall
require~a new application and a new franchise and
conformance with all the requirements of the Orange
County Franchise Ordinance, as amended, as upon
original franchising.
(d) Grantee may not sell, assign, mortgage or otherwise
transfer the Franchise without the approval of the
Grantor; and.a finding of conformance with all
requirements of the Orange County Franchise~Ordinance,
as amended, as upon original franchising.
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Section 15. Miscellaneous Provisions
(a) Grantor may, upon reasonable notice, inspect the
premises, vehicles, equipment and personnel of Grantee
to ensure compliance with this Franchise and perform
any other inspections that may be required.
(e) Grantee shall make available for inspection by the•
State of North Carolina, the Grantor, or•their
designated representatives, Grantee's EMS Services,
its equipment and the premises designated in the
application and all records relating to its
maintenance and operation as such. -
(b) Grantee shall cooperate with'the Grantor to educate
the public concerning injury prevention and community
health. -
(c) Grantee's staff shall not wear or carry aboard any
• Ambulance or other EMS Services Vehicle weapons as
defined by Law. The foregoing restriction shall not be
construed to apply to equipment used by Grantee to
provide the EMS Services.
(f) Grantee'shall-post its Franchise Certificate, issued
to it by the Grantor, in a readily visible location at
the Grantee's base of operations for the EMS-Services.
(g) Grantee shall not allow its Franchise Certificate to
be defaced, removed or obliterated. •
(h) Grantee shall comply with all applicable Law arid..
Grantors policies and procedures related to
confidentiality of medical information, including
without limitation the Health Insurance Portability
and Accountability Act of 1996 (HIPAA).
Sectioa 16. Ead-Term Provisions
(a) Grantee may terminate this Franchise with 60 days'
notice to the Grantor and the Grantor may revoke the
Franchise in the event of noncompliance with the
provisions of the Orange County Franchise Ordinance or
this Franchise. After a notice of service termination
is given, the provider may reapply for a franchise if
continued service is desired.
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45
(b) Upon suspension, revocation or termination of this
Franchise, Grantee shall immediately cease all
operations authorized by the Franchise.
(c) Upon suspension, revocation or termination of a
Driver's .license such Persons shall cease to drive an
Ambulance or other EMS Services Vehicle. Upon
suspension, .revocation or termination of an
attendant's certificate, i.e., EMT or EMT-P
certificate, such Persons shall cease to attend
patients or otherwise provide medical care. Grantee
shall not permit the foregoing Persons to drive an
Ambulance or other EMS Services Vehicle or provide
medical care in conjunction with the EMS Services..
(d) In the event that Grantee shall at. any time during the
Franchise desire to sell any of the real and personal
property identified in Exhibit B (hereafter "Asset" or
"Assets") pursuant to a bona fide offer which it. shall
have received, it shall offer to sell any such Asset_
or Assets. (hereafter "Asset or Assets for Sale") to
Grantor at the same price, as that contained in such
bona fide offer. The offer to Grantor to sell an Asset
shall be in writing and shall include a copy of the
bona fide offer for the Asset received by the~Grantee.
Grantor shall have 60 days from and after receipt
thereof to decide whether or not to purchase the Asset
or Assets for Sale at such price. If Grantor shall
give notice of intent not to purchase or shall give no
notice within the time herein limited, Grantee may
accept such offer and proceed with the sale.
thereunder. If Grantor notifies Grantee .that it elects
to purchase the Asset or Assets for Sale at such
price, the parties shall enter into a contract of
purchase and sale forthwith. Such contract shall
provide, among other things, for the conveyance of
good and marketable title by warranty deed. Upon
dissolution of the Grantee pursuant to N.C. Gen. Stat.
~ 55A-14-1, et seq., the Assets shall be either: (a)
distributed to one or more appropriate receiving
successor~Franchisee(s) that will carry on; in Orange
County, the functions of ambulance, first responde=,
rescue or other related emergency services meeting one
. or more exempt purposes within th_e.meaning of
501 (c) (3) of the Internal Revenue Code. (or the .
corresponding section of any future federal tax code)
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or (b) distributed to the Grantor for'the foregoing
public purposes. This subsection 16(d) of this EMS
Service Franchise survives the termination of the
Franchise.
Sectioa 17. Forum for Litigatioa
Any litigation between the Grantor and Grantee arising
under or regarding the Franchise shall occur, if in the
North Carolina courts, in Orange County Superior Court or
District Court having jurisdiction thereof, of~it in the
federal courts, in the United States District Court for the
Middle District of North Carolina.
Section 18. Notice
Any notice provided. for under the Franchise shall be
sufficient •if in writing and delivered'Personally to the
following addressee or deposited in the United States Mail,
postage prepaid, certified mail, return receipt requested,
addressed as follows, 'or to such other address as the
receiving party hereafter shall specify in writing:
If to. Grantor:
If ~to Grantee:
Orange County Emergency Management
PO BOX 8181,
Hillsborough, NC 27278
Telephone Number: 919-968-2050
Chief •
Orange EMS & Rescue Squad, Inc.
261 South Churton Street
Hillsborough, NC 27278
Telephone Number: 919-732-7440
Sectioa 19. Severability
If any Section, subsection, sentence, clause, phrase, or
other portion of .this Franchise is, for any reason,
declared invalid, in whole or in .part, by any court,
agency, commission, legislative body, or other authority of
competent jurisdiction, such portion shall be deemed a
separate, distinct and independent portion. Such
declaration shall not affect the validity of the remaining
portions hereof, which other portions shall continue in
full force and effect. _
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Sectioa 20.•Reservatioa of Rights
Notwithstanding ariy other provision of the Franchise;
Grantor and Grantee reserve all rights that they may
possess v.nder the Law unless expressly waived herein:
Nothing herein shall constitute a waiver of rights of
either party, provided, however, that both parties warrant
and represent that, as of the effective date of the
Franchise, they are not aware of any provision in the
Franchise that is contrary to applicable Law: .
Section 21. Peaalties~aad Remedies. ~ .
(a) A violation of any provision 'of the Orange County
Franchise Ordinance or other failure of the Grantee to
abide by any provision of this Franchise shall subject
the Grantee to a civil penalty of five hundred ($500)
dollars. If Grantee fails to pay this penalty within.
ten (10) days after being cited for a violation, ttie
Grantor may seek to recover the penalty by filing a
civil action in the nature of the debt.
(b) A violation of the Franchise by the Grantee shall
constitute a misdemeanor, punishable as provided in
N.C. Gen. Stat. ~ 14-4.
(c ) The Grantor may seek to enforce the Orange County
Franchise Ordinance or the Franchise through any
appropriate equitable action.
(d) Each day that a violation continues after the Grantee
has been notified. of the violation shall constitute a
separate offense.
(e) The Grantor may seek to enforce the Franchise by using
any one or any combination of the foregoing remedies.
Sectioa 22. Noa-Discriminatioa
The Grantee shall not discriminate in any manner on the
basis of factors prohibited by Law.
Passed on First Readiag ~~~Z~ ~ . ~y0 ~/
47
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Passed and Adopted (/
on Second Reading ,~i~ ~~~ ~d~ 7
IN i~rtITNES3 WHEREOF, the undersigned have caused this
agreement to be executed.
BY : ~ t/O~_ ; - -- - BS
• Clerk
APPROVED A3 TO F
BY
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Sectioa 23. Acceptance by Graatee
This Franchise and all of its terms and provisions shall be
accepted by Grantee in writing in the form hereinafter set
forth within thirty (30) days bf the grant of this
Franchise by the Grantor and when accepted shall be filed
with Grantor's clerk who shall record the same in the Book
of Ordinances. - -
Such written acceptance may be upon or at the end of a copy
of this Franchise Ordinance and it shall state and express
the acceptance of the said Franchise and its terms,
conditions and provisions; and Grantee shall agree in said
written acceptance to abide by,-to observe and to perform
the same according to all of its terms and provisions,
subject to applicable state and federal .law and shall
declare that statements and recitals contained on said
Franchise are correct and that it has made and doe's make
the agreements and statements set forth in this Franchise.
Acceptance herein referred to shall be in the following
form: - .
The undersigned, ,.~p~nn m~f Z~ - in his/her
ca acity as ~~ 5~~~ of the
~ctt~c.o ~rrtS ~- Q~SCv~. StZ.,,P~c,
and on behalf of that company, does hereby accept and
approve the foregoing and attached Franchise and all of its
terms and conditions; and in consideration of the benefits
and privileges granted to it does hereby agree to abide. by,
carry out, observe and perform all of the obligations and
things provided to be carried out and performed by it in
said Franchise approved by the Grantor Commissioners, -
subject to applicable state and federal law
This is the ~ day of eC¢Mb~(~ 2004.
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• STATE OF NORTHCAROLINA ) ••
• )
COUNTY OF~Orange )
On the ~~ ~ day of 1.JLC.P.~~ 2004 before me a
Notary Public in and for the County and State aforesaid,
Personally appeared before
A~leiztr ,
r
and on behalf of said Company,~acknowledges the signing and
execution of the foregoing instrument.-•
IN TESTIMONY WHEREOF I have hereunto subscribed my name
and affixed by notarial seal on the day and year above
wri!% f
Notary lic
My commission expires : G~G•~bP~ -3/, 009
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51
EXIiIBIT A TO SMS SERVICES FRANCHISE
FOR ORANGE SMS & RSSCIIS SQIIAD, INC.,
A NORTH CAROLINA NON-PROFIT CORPORATION
FRANCHISE DISTRICT'
GEOGRAPHIC SIZE: All of the County of Orange _
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~~ 52
EXHIBIT B TO SMS SSRVICSS FRANCHISE
FOR ORANGE SMS & R.ESCUS SQIIAD, INC.,
A NORTH CAROLINA NON-PROFIT CORPORATION
ASSETS
1. Real Estate and Improvements:
Lot and improvements located at the physical address of
261 South Churton Street in Hillsborough, NC, known
within the Orange County EMS System as "Station 1" and
other real property and improvements owned by Grantee.
1. All ambulances, rescue vehicles and equipment owned or
maintained by Grantee.
25