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· Chado~te, N.C. 28218 <br /> Ambulance Se~c~ Business No: 376-9511 <br /> <br /> ~.~-- APPLICATION ~OR AMBULANCE FRANCHISE <br /> CABARRUS COUNTY <br /> <br /> (a) NON-EMERGENCY A~BULANCE SERVICE <br /> <br /> (b) Sarah V. Brooks,President <br /> CHAR-MECK AMBULANCE SERVICE,INC. <br /> Post Office Box 188~ <br /> Charlotte, North Carolina 28218-0895 <br /> <br /> (c) CHAR-NECK AMBULANCE SERVICE,INC. (articles enclosed) <br /> <br /> (d) History/Oescriptlon of Ambulance Service gcurrent call load chart' <br /> Service to be provided for patients for Cabarrus County. <br /> <br /> (e) State of NC. ambulance certification information <br /> <br /> (f) Current employee's either full or part-time EMT certificate <br /> copies <br /> <br /> (g) Administrative and operations base: <br /> 710 CflAR-MECK LANE <br /> Charlotte~NC. <br /> Cabarrus Location will be advised upon acceptance/granting <br /> of franchise. <br /> <br /> (h) Financial Statement for operations for CMAR-MECK for the <br /> year ending Oecember, 1989. <br /> <br /> (i) Certifloate of Insurance as stated presently 3/21/90 thru <br /> 3/21/91, upon acceptance/granting of franchise to reflect <br /> Cabarrus County as notified Certificate holder. <br /> <br /> January thru June,1990, call statistics by type as supplied <br /> by North Carolina 0ept. of Human Resources. <br /> <br /> S~bmitted by: CHAR MECK AMBULANCE SERViCE~INC. <br /> <br /> authorized by: <br /> ~Sarah W~ Brooks/President <br /> <br /> Db~,~c)~ N~ (704) S23.9¢30 <br /> 4. <br /> <br /> <br />