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Home My WebLink About1999-0601 Ambulance License Council Communication Ashland Fire & Rescue Ambulance License Renewal Application June 1, 1999 Submitted by: Approved by: Keith E. Woodley, Fire Chief o~.~ (.~ Mike Freeman, City Administrator ! I' ~'"' Paul Nolte, City Attorney ~ Title: Ambulance License Renewal Application Synopsis: Ashland Municipal Code (AMC) Chapter 6.40.110 requires ambulance service providers operating within the City of Ashland to apply annually for an ambulance operator's license. Recommendation: Staff recommends approval of the request by Ashland Fire & Rescue for renewal of their ambulance operator's license. Background Information: AMC Chapter 6.40.110 requires ambulance service providers operating within the City limits to apply annually for an operator's license. The issued license shall be valid from the date of issuance to the next following thirtieth day of June, commencing on the first day of July by ordinance. AMC Chapter 6.40.100 sets forth license requirements, all of which have been met by the applicant. Applicant's Name: ASHLAND FIRE & RESCUE Trade Name, if any: . . Address: 455 SlSKIYOU BLVD. ASHLAND, OREGON 97520 T.elephone number: (54.1) 482-2770 . . . Ambulance descriptions: Manufacturer VIN # License # 1. 1992 FORD LIFELINE LIFELINE 1FDKE EXEMPT 2. 1996 FORD LIFELINE 3OM7P HAO59 45 3. 1992 WHEELED COACH ....... LIFELINE 1FDKE EXEMPT 2. 1985 BRAUN 30F8TH A48282 WHEELED 1FDJS3 EXEMPT COACH 4M4NH A34394 BRAUN 1FDJE3 EXEMPT 0L8FHA 49888 Addresses and descriptions of the premises at and from which it is proposed to.maintain and operate such ambulances: . . 1.455 SISKIYO.U BLVD. ASHLAND, OREGON 97520 . 2. 1860 HIGHWAY 66 ASHLAND, OREGON 97520 ~ Attach information showing that every proposed driver, attendant, and driver- attendant is qualified as required in Ashland Municipal Code Chapter 6.40 and as required by the laws of the state of Oregon. PAGE 1-APPLICATION (p:flreMambulan.app) r~ Enclose with the application, the initial license fee of $300 plus $100 per ~/(~ ambulance. ~3 Enclose a performance bond in the amount of $500,000. ~ \~ ~Enclose an insurance policy meeting the requirements of AMC ~.40.110.7. Attach additional pages as necessary. Explain any box not checked. Submit your application and required enclosures to Barbara Chdstensen, City Recorder, City Hall, 20 East Main Street, Ashland, Oregon 97520. I certify that each ambulance listed above is adequate and safe for the purposes for which it is to be used and that it is equipped as required by Ashland Municipal Code Chapter 6.40 and the laws of the state of Oregon. Pdnt name: Title: '-~ t u/,l ,,o~J Date: PAGE 2-APPLICATION (p:.r~ambu~a..app) CERT. # 112485 B/~(~ili~'"~' ~30/1999 ANDERS, ~,t:~, ~:~'~'~' · ' '~' ?~t~'' '~, , ~/- ~,~ 23 Wilson R_~!~:]'.~;,~.-~, c. rd has com~' ,~, ~'. ~,-.~~.,¢~t ~o~ ~vel i~ted. STATE OF OREGON- DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENC¥:aE'~iCAL~ECHNIClAN ,¥-" .<:"--'":'~"-',., ~1 ' ~..v ~..~,, ~ - -/-..: '.' . ,'; :.-: -.. ., CERT. # ~0z4S P~mCi:~.~~ o6aoa~ BU~S, ~Y; W'- x~::.::...,.. 530 N ~u~clSt~:'=~. ~:~; ' ~,~:.?' .- Ashland, OR :97520 ;. ~: '.' ,.,,..:.. , , The individual nam~d'a~ve and described on the reverse of this card has compieted the ~ui(e~nts set lo~h in ORS 823.010 ~. and is ce~ified as ~ Eme~en~ Medical Technician al the level indicated. ~/~ H~rd ~. Jr. Eli~r Hall. MPH Ohiet. E~roe~ M~i~l ~es Administrator. Or~ Hea,h ~si~ J STATE OF OREGON - DEPARTMENT OF HUMAN RESOURGES J OREGON H~LTH DIVISION J EMEnBENCY MEo~cALXECHmC~AN . ~ -~, . 06~011~ CASE, G~G~I':': [ Ashland, OR' I The individual nam~'a~:v~ a~ de~b~d On tho reverse of this ~ card has completed ~e r~uirements set lo~h in ORS 823.010 ~. and is ceflified aS"an Eme~gen~ Medi~l Technician at the [ level indicate. Eli~ ~1, MPH Chief, E~ M~I ~s ~nistrat~, Or~ Heath ~s~ I I Il I!' I -- -- -- F -~T~TTE-~F~GZN '--O-~pA'~T'~'E~ ~'~ HUMAN RESOURCES OREGON HEALTH DIVISION I I I EXP~ 06/3011999 No_ 25361 STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDEN'[IRC~..TION HT: 6' 4~:]~+:~.'~,~i'' ~?~ark Brown · · .. ;: :.Y .¥;,-~ .~ · WT, 200,:. :,,.EYES.:BIue ~ .:. , ~: :!.'( . , :::..:' Signature of Cei'tlf~te Holder This certificate is the property el the Oregon Health Division and must be surrendered by the holder on demar~l. STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION EMT-P::,CERT.~ #:113788 ~"' ~'"~:' '"~ ;~ ' ;?'i' ;~ ' ':'`~ ~':' ' HT: 5' 9" =:%~.:~::: HAIR: Dark Brown o /3on iq o_ 255 This certificate is the property el lhe Oregon Health Division and must be surrendered by the holder on demand. EMERGENCY MEDICAL TECHNICIAN ION HT: 5' Holder r1999 ATTA PHO HEF ATTACH PHOTO HERE 26123 EMERGENC'~ CHNICIAN I , Genii Po~~L~ /: I1~!1 I ~. ,.~,~~~~ ;~.~n the reveme of this - -'- I card nas ~mp~~~?~?~w ~. ~. and Is cemift~.~s~:~~ ~ical T~hniclan at t~ ~nls~t~. Chlet. E~ M~I ATTACH PHOTO HERE No_ 23451 T~s cerlfficete/s the pmpe~ of lhe Oregon Health t:)N~n and must be sunenderedbytheho~derondemand. m ~,v m v HERE -[ STATE OF OREGON- DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENCY'i~li~iCAi:'TECHNIClA, Ashland, OR~9~0 "~; ~", ~'' ~?' ~": ~ indi~uaf~a~ve~:~ de{~d on the reverse of this card has ~mpr~'~ ~re~nts set fO~h in ORS 823.010 ~. a~ is ce~ifi~.as ~.E~en~ M~ical Technician at the level indicted. ' Eli~ ~1, MPH Chef, E~ M~I ~s ~ministrator, Or~ Heath ~s~ ~~REGoNTD~~ 0F HUMAN RESOURCES OREGON H~LTH DIVISION EMERGENC~ECHNIClAN The indMdua~'na~d~~~~d ~'n the reverse of ~is ~ has ~mpi~te~e ~. a~ ~ ~ifi~.a~'~~e~ M~di~l Technician at t~ level i~i~t~. E~ ~, MPH Ch~, E~ ~1 STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN . IDEI~ ~:;~TION WI': 175~ IR~ Blonde Signature c~:~ ate Holder ATTACH PHOTO HERE No_ 26105 This certificate is the property of the Oregon Health D/vision and must be surrendered by the holder on demand. STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN HT: 5' 9 WT: ATTACH PHOTO HERE Signature o~cedificate Holder EXPIRF_ 06/30/1999 NO 26058 This certif~cete is the properly of the Oregon Health Division and must be -- [ STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENCY MEDICAL TECHNICIAN 100386 ,B,A.~IC EXPIRF~ 06/30/1999 ~3~ N min"- Ashland, OR. :07520 The individual named, above and described on the reverse of this card has completed the requirements set forth in ORS 823.010 et EEl. and is certified as an Emergency Medical Technician at the ~level indicated. ~.~¢~. ~ Howard '~l~k.~d, Jr. Elinor Hall, IdPH Chief, Emergency Medical Sen~ces Administrato~, Oregon Health Div~sk:m SLATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION W~leT:~on~ - . HT: 5 6 ~ .'~:?~::~ ~: ~ite ~: 2~: :??/~E~: H~el Signature M,,..~.': .rllrmate Holder EXPIRES 06/30/1999 ATTACI- PHOTC HERE NO 25149 This ce~ficate is the property of the Oregon Health Division and must be surrendered by the holder on demand. m m m N m m m m m m m m m m STATE OF OREGON - DEPARTMENT OP HUMAN RESOURCES OREGON HEALTH D~VNS~ON EMERGENCY gEflCAL ~¢HNICIAN ,~/,.'~ ~-~ ..,~.,~. ,,.: ~ ',,. CERT. ~ 118~I . r~IC;f~~ ~BO/I~ .. : '.X:.~-?~?/,' · . The individual named.a~Ve'~ de~d on the reverse of this card has ~mpjete~t~ r~e~n~ ~t fo~h in ORS 823.010 ~ ~. and is ceAifi~ aS:~~e~ M~i~l Technician at the level i~i~ted. :':-::/.~ ~ ~.:.~.>' ~ / ~ / ~f, E~r~ M~I ~s ~nlstrator, ~ Hea~ ~s~n STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN ~ AI-rACI- IDENTIFICATION ~:.' PHOTC ~ ',~~"'~"~ HERE HT: 6' l,~~~ Brown WT:;IS5.I~_.;~-~EYES?B'rO~n cSig'~i~re of Ot~rtJrK~te H-H'-oi'~r EXPIRES 06/30/1999 N i 25551 This certif'v, ate is the properly of the ore~ Health Division and must be surrendered by the heifer on demand. ! - STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENCY MED*iCAL TECHNICIAN CERT. # 121237 P~DIC-,EX~[RE~ 06/3011999 FREIHEIT, MATTHEW E PO Box 535 '; ;i' ~//:"~ · Ashland, OR": 9752Q, The individual named'aboTM and described on the reverse of this card has completed the ~equi~'ements set forth in ORS 823.010 et f~fl. and is certified as an Emergency Medical Technician at the level indicated. Elinor Hall. MPH Chief, Emergency Medical Services Administrator, Oregon Health Divtsio~ I I STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION EMT-P :!:CERT?:#:1~I237" '~.:~. ;'. .. · ~ ~'r:'~....~:~- . Signature of ~te HoiSt EXPI 06/30/1 9 Ne 24 ~is ~nir~te ~ ~ ~ ~ ~ ~ Hea~h ~s~ a~ must su~ by ~ ~r ~ ~. ATTACH PHOTO HERE STATE OF OREGON-DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENCY MEI:JicAL(~ECHNIClAN ~ERT. # 126163 P~~ ':EXP~:06/30/1999 , . , . , . ~, ~ ,... ,,%..., ~., / : . ~e mdmdual.oame~e'~d~d on the reveme of thts ~rd has ~p~i~ed~-''"~"~ ' '<~.rs.~t ~hh in ORS S23.010 ~ ~. and is ~ifi~ a¢~".~m~oe~ M~dical Technician at the -- level ~nd~ted. ~ ~ ..*' ~, / / ~ G~ ~, NRE~-P Eli~ ~a, MPH ~. ~ M~I ~s ~tmt~, ~ Hea~ ~i~ STATE OF oREGoN- DEPARTMENT OF "MAN RESOURCES OREGON HEALTH DI~ EMERGENCY' ~.:Xt~;T. ECHNIClAN ,;;' ...:;':'::::;' ....... -,..k) '~':. ~IF..RT. # 124336 p~lC.,.~~.:,06/301t999 1313 Mill P6nd?¥*~ ~' ..~::~' !/-; '::?, =d h~ ~,pl~.a'~~'.~,a~!o,, ,n ORS ~23.0t 0 et ~1. and is certif~d~..a~An"*;~t~ rgpr*- *~'ncy~M~J',cal Technician at th.e STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN . IDEATION ~ HTw~:5' g'n~l~~ ~ht Brown N 9 ~ ~te ~ ~ ~ ~ ~ ~ H~ D~ a~ must ~~ by ~ ~r ~ ~. ATTACH PHOTO HERE 30280 STATE OF ~REGON " EMERGENCY MI t,L TECHNICIAN )N HT: 6' Brown WI': No 30634 -- [--" "~T~TE'"'~; OREGON' DEPARTMENT OF HUMAN RESOURCES 1 I OREGON HEALTH DIVISION I I EMERGENCY MEDICAL TECHNICIAN HANSTEIN,-DAVID C ~'': ........ '" I 1516Larkspur :;: :.',/, .. ,..: I-i] I Medford, OP. 97501 · ~ The individual named above a.nd described.on the reverse of this I card has completed the requirements set forth in ORS 823.010 et ,~J;i. and is certified as an Emergency Medical Technician at the I level indicated. "' '" (..~~.. I ElinorHaft, MPH - ' ! Chief. Emergency Medical Sera'ices Administrator, O~egon Health Division STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION ~T: 6 2 ,.;;: :.~¢~ ~: Dark Brown Signature of.~te Ho~r /30/1999 N9 25 ~s ~r~te ~ ~ ~ ~ ~ ~ Hea~h ~ su~e~r~ by ~ ~er ~ ~. ATTACH PHOTO HERE STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENCY I~-~:L:'TECH NICIAN I~JERT. # 113607 .P~DIO;LEx;PIRES 06/30/1999 455 Siski~6U BNd,.".. Ashland, OR,!~7520 The Individual' na~ed al~v'e~i'.r~l. 'described On the reverse of this card has compli~ted'th~ r~e~l, bfr'e~n6nts set todh in ORS 823.010 et · ~1. and is certir~:l aS:an. Eme~ericy Medical Technician at the level Indicated. Elinor Hell. MPH Chief, Emeqleacy Medical Senates Admlnistrat(x, Oregon Health OREGON HEALTH DIVISION EMERGENCY MEDICAL TECHNICIAN I CmtT. ~ ~0~72 BnSlC F.,~IRES 06/30/1.9 ~ON~, OREC, ORY R 455 Siskiy:ou Boulevard Ashland, OR 97520 The individual named above and described on the reverse of this card has completed the requirements set lorth in ORS 823.010 et rd~. and is certified as an Emergency Medical Technician at the level indicated. Chief. Emergency Medical Services Administrator, Oregon Health Division OREGON HEALTH DIVISION EMERGENCY MEDICAL TECHNICIAN · . ,:.¢?: :, CERT. # 1.18250 BASXC :;E,X~IRF~'.06/30/I~I~) ROBBINS,'R, OBB L. '. PO Bo 3315. .... Ashland, OR :'97520 ~ i~i~dual 0a~da~v~.~'~M,~n ~e revere of this ~ h~ ~m~et~'t~ ~, and is ~difi~ as''~ ,E~~M~I T~ni~n at th~ I ~~,Jr. a~ ~, MPH ~f, E~ M~ ~s ~t~, Ig t' ' STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION ATTACH PHOTO HERE Signature ~ .C~,:..~tirmate Holder EXPIRES 06/30/1999 N o 25509 This ~te is Ihe lxoPe~ of the Oregon Health Divfslon and must be ATTAC PHOT, HER[ STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION GregorY` JOnes :.'. - HT: 6' 0" HA~: Dark Brown WT: 180 EYES: Hazel Signature of Certificate Holder 06/30/1999 N_° 2532 This certificate is the propen'y of the Oregon Health Divfsion and must be surrendered by the holder on demand. STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION HT: 5' ~.~~~: D~k Brown ~;~~ ~E~:;~IU~ ~'~ '.::~c~.~" Sig~ture ~te Hol~r al-i'aOh PHOTO HERE 25471 This cer~ate is the pmpeay of the On~on Health ~ and must be HT: 6' Brown 24884 STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENC¥~CHNIClAN . s,uJ~..., ~:~~.~~'.~c~\\ 170 Bric ' ' " ' ~' : "- Taint, 0 ,. : 0 c~d .~ co~~.~ ~ J-" '~T~TE"~-'~EG"~'N- DEPARTMENT OF HUMAN RESOURCES · o.~o..~.~ o,v,s,o. '. ~ ~ ~~ t~.in ORS ~3.~10 ~ ~. ~ ~ ~ ~1 T~nl~an at ~ level i~t~. -~ ~ ~ M~ STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN HT: 6' Brown WI': ATTACH PHOTO HERE ~~~ 25232 STATE OF OREGON' EMERGENCY MEDICAL TECHNICIAN )N HT: 5' Bwwn WT ATTACH PHOTO HERE ! Holder oe3on~ N o 25540 · J-" -~ATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES J OREGON HEALTH DIVISION J I I EMERGENCY MEdiCAL TECHNICIAN I_~ I ,,.. I~ I CERT. # 12319"/ P~IC .EXP~ 06/30/1999 SHEPHERD,DAVID G "- -. J~ J 921 Chestnut Ave. ' J Medfoid, OR 97501 .. Jj~ . J The individual named above and described on the reverse of this J J card has completed the requirements set forth in ORS 823.010 et sea. and is certified as an Emergency Medical Technician at the J J level indicated. ~ _. J I Howard ~, Jr. Elinor Hall, MPH I iChief, Emergency Medical Sendces Administrator, Ch'egon Health Division J STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN J card has completed'th& ~equire'm~nts S&t forth in ORS 823.010 et sea. and is certified as"hn' Eme~'g6~cY Medical Technician at the · . -~. ,~ ;~ :, I levellnd,cated. ''.. '-' '-'>' ~/ . (.~// J H~ard ~. Jc Elinor Hall. MP" jChiel, Emergency Medical Sendces Administrator, Oregon Health Division r STATE OF OREGON-D~-~RT'~'E~ OF HUMAN RESOURCES J OREGON HEALTH DIVISION i E M ERG E~ CY~i~-'(~A:I: ~jEcliNIcIAN J The individu~i na~ed~a~ a'~d ~e~d.on ~e reverse of this IDEN:r/FICATION ~:~. ': , :< Z~,'< . .? "..':~4'..' ~g~t~e o~.~te H~lder ~m~ o~/~o/~.~ N ~ 25994 ~s ~di~te ~ ~ ~ ~ ~ ~ Heath D~ a~ must ~ s~e~r~ by ~ ~r ~ ~. ATTACH PHOTO HERE ----~G~-o~~ EMERGENCY MEDICAL TECHNICIAN ATTACH IDE~e~ATION .a'- -jl~.. HERE HT:0 ~~~ark Brown Sig~ture ~ ~'~te Holder EXPI~ 06130/1999 N 9 25433 This ~dir~te ~ ~ p~ of me Or~ Hea~h DMs~ a~ must ~ surre~r~ by ~ ~r ~ de~. STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES I OREGON HEALTH DIVISION I EMERGENCY MEDICAL TECHNICIAN I ICERT.#123787 PARAIVIEDIC EXP~ 06/30/1999 Ii] STEPHENS, ROBERT W 10290 Butte Falls Hwy ~ Eagle Point, OR 97524 I The individual named above and described on the reverse of this card has completed the requirements set lorth in ORS 823.010 et sea. and is certified as an Emergency Medical Technician at the H0wa~level indicated. ~~ ~ Elinor Hall, MPH Chief. Emergency Medical Services Administrator. Oregon Health Division STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENCY MEDICAL TECHNICIAN IERT.# 124824 PARAMEDIC EXPIRES 06/30/1999 STRUHS. JUSTIN D 1575 Canary Ct NE Salem, OR 97301 I I I I I I I t OREGON HEALTH DIVISION i EMERGENCY MEDICAL TECHNICIAN I . CERT. # 118911 PARAMEDIC STOY, JOHN T 955 Grandview Dr. Ashland, OR 97520 The individual named above and described on the reverse of this card has completed the requirements set forth in ORS 823.010 et sea. and is certified as an Emergency Medical Technician at the Gregg V~. I~ander. NREMT-P Elinor Hall. MPH Chief. Emergency Medical Services Administrator. Oregon Health Division EXPIRES 06/30/1999 The individual named above end described on the reverse of this card has completed the requirements set forth in ORS 823.010 et ,~,.q. and is certified as an Emergency Medical Technician at the H~~level indicated. ~..~,~ ~ Elinor Hall, MPH Chief. Emergency Medical Services Administrator. Oregon Health Division STATE OF OREGON - DEPARTMENT OF HUMAN RESOURCES OREGON HEALTH DIVISION EMERGENCY MEDICAL TECHNICIAN CERT. # 116422 BASIC EXPIRF, S 06/30/1999 WHITE, DANIEL R 945 N. Mountain Ashland, OR 97520 The individual named above and described on the reverse of this card has completed the requirements set lorth in ORS 823.010 et S.Qg. and is certified as an Emergency Medical Technician at the ~level indicated. ~..~,~ ~ ~ Elinor Hall. MPH Chief, Emergency Medical Services Administratn~ c~ ..... u .... . r,: ....... I! SIAl I:: Ut' UHI::~a~JN EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION EMT-P CERT. # 123787 Robert Stephens HT: 6' 0" HAIR: Light Brown WT: 219 EYES: Brown Signature of Certifmate Holder EXPIRES 06/30/1999 N ~_ ATTACt PHOTO HERE STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION EMT-P CERT. # 124824 Justin Struhs HT: 6' 0' HAIR: Dark Brown WT: 225 EYES: Brown j~ Sionature of Certificate Holder XPIRES 06/30/1999 N°_ 29351 This certif~7.ate is the properly of the OregOn Health O~viSion and must be surrendered by the holder on demand EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION EMT-P CERT. # 118911 John Stoy HT: 6' 1' HAIR: Dark Brown WT: 195 EYES: Blue ATTACF PHOTO HERE Signature of Certificate Holder EXPIRES 06/30/1999 N o_ 25031 This certir~ate is the property of the Oregon Health Division and must be surrendered by the holder on demand. STATE OF OREGON EMERGENCY MEDICAL TECHNICIAN IDENTIFICATION EMT-B CERT. # 116422 Daniel White HT: 6' 2" HAIR: Dark Brown WT: 185 EYES: Blue ATTACH PHOTO HERE Signature of Certificate Holder EXPIRES 06/30/1999 N o_ 2 6 0 3 8 This certificafo is fhe orooertv of tho ~r,,~,,,~ u .... . '",: ........ 2606' This certificate is the propen~ of the Oregon Health Division and must be surrendered by the holder on demand. Covered Entity' City of Ashland Agent: Direct This is to certify that coverage is provided to the designated entity as noted below. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the terms, exclusions and conditions of such coverage are not amended by this certificate. EFFECTIVE EXPIRATION HMIT OF TYPE OF COVERAGE DATE DATE LIABILITY ['~ 07/01/98 06/30/00 $ 1,000,000 Comprehensive Liability Combined (Including Owned and Nonowned Auto) Single Limit Replacement ~] Auto Physical Damage Value on Deductible: 07/01/98 06/30/99 Specified Collision $ 500.00 Vehicles Comprehensive $ ~. nan_ nn ~ Property Per Filed Deductible: Values Property $ ~ o. ooo. nn Mobile Equipment $ 10,000. O0 07/01/98 06/30/99 $ 5o,ooo Crime Earthquake & Flood $10,000,000 Deductible Earthquake 5 % of Value; $50,000 Minimum Flood $50,000 Statutory [-~ Workers' Compensation $2,000,000 ~-] Employer's Liability Certificate Holder Should any of thc above described coverage be canceled befor~ the expiration date thereof, City/County Insurance Services will endeavor to provide 30 days written notice to the certificate holder named herein, but failure to provide such notice shah impose no obligation or liability of any kind upon CIS, its agents, or representatives. Issue Date · · Subject: City of Ashland City Recorder's Office Barbara Christensen, City Recorder (541) 488-5307 (phone) City Hall 20 E. Main St. Ashland, Oregon 97520 (541) 488-5311 (fax) May 5, 1999 MEMO TO: Mike Freeman, City Administrator FROM: i~~arbara Christensen, City Recorder Emergency Medical Services- Ambulance License Review Attached you will find Chapter 6.40 which outlines the procedure for reviewing and approving an application for Ambulance Operator License, and an application from the Fire Department for Ambulance Operator License. In accordance with our ordinance this application is done on an annual basis and is valid from the date of issuance to the next following thirtieth day of June. An application for renewal of an annual license must be submitted to the city at least thirty days prior to its expiration date. I am submitting this application now to you for review and placement on a future agenda for council approval. Please return original application to me after presenting to council.