§ 15-144. Certification application requirements.

(a)

No person, firm, corporation or partnership shall operate any of the services as described in section 15-143 unless a certificate of public convenience and necessity is first obtained from the board. Every application for a certificate under this division shall be in writing, signed or sworn by the applicant and shall be filed with the board. The application shall be on a form provided by the board and shall contain the following:

(1)

The name, age and address of the applicant and the length of time the applicant has resided in the county if the applicant is an individual; the business name of the partnership and the name, age and address of each partner and the length of time each partner has resided in the county if the applicant is a partnership; the names and residences of all officers, directors, and stockholders if the applicant is a corporation.

(2)

If the applicant is a corporation, the type and number of shares outstanding and the name and addresses of shareholders.

(3)

The date of incorporation or formation of the business association.

(4)

A description of all geographic areas of operation so as to preclude duplicate classifications of certificates for any geographic region.

(5)

The addresses of the applicant's present and proposed base station location, all substations, any office locations, and any and all fixed facilities.

(6)

The year, model, type, motor vehicle or FAA license number and mileage and/or engine hours and airframe hours, unit identification number, of every ambulance, rescue vehicle, aircraft or other type of transporting or responding vehicle used by the applicant.

(7)

A description of the applicant's communication system, including its assigned frequency, call number, mobiles, portables, range and hospital communications ability, and copies of Federal Communications Commission licenses that show FCC approval for using the assigned frequencies within the county. All communication systems must conform to the state department of general services, division of communications, state plan reference EMS communication systems as defined by state statute.

(8)

A proposed detailed budget, if public funds will be needed for operation. A budget is not required unless transportation services are intended.

(9)

Proof that the applicant possesses all required federal or state licenses and permits.

(10)

The name of the municipalities or counties, and a description of the geographical area that the applicant has previously been authorized to serve in the state and any area outside the state.

(11)

The names and addresses of at least three residents of the county as references.

(12)

A list of the fees currently charged and to be charged by applicant.

(13)

A sworn statement signed by the applicant or his/her authorized representative stating that all the information provided by the applicant in the application is true and correct.

(14)

A list of equipment and supplies which will be routinely carried on each vehicle.

(15)

An agreement of the applicant to file, in the event that the application should be granted and prior to its effectiveness, copies of policies of public liability, property damage and malpractice insurance as provided in this division or a surety bond conditioned for the payment and satisfaction of any final judgment, or proof of governmental self insurance as required by or provided for in this division and Chapter 401, Florida Statutes.

(16)

County occupational license when applicable. When applicable, compilation statement showing assets and liabilities prepared by a certified public accountant.

(17)

An agreement of the applicant to file, in the event that the application shall be granted and prior to effectiveness, a copy of standard operating procedures which shall include all general and/or specific instructions to personnel as to the exact nature of the duties, when applicable, under what conditions, to whom and how emergency care shall be reviewed and approved by the board prior to initiation of service.

(18)

Proof that the applicant has employed or contracted with a medical director qualified in the manner required by Section 401.265, Florida Statutes, as amended, and obligated to fulfill all requirements of that statute.

(19)

Any other information as may be reasonably required by the board.

(20)

An accompanying license fee in accordance with section 15-146.

(Ord. No. 93-45, § 4, 9-28-93)