New Ambulance Service Provider Licensing / Permit Application Process

Please read and complete the following application carefully. Make sure all information is accurate to prevent a delay in verification and processing. Before an application is approved an inspection of the office and ambulance(s) is required. It is the Ambulance Service Provider responsibility to contact the Delaware State Fire Prevention Commission designated representative to schedule an inspection. Please be sure when the ambulance is scheduled for inspection, it has all required equipment on it and all equipment is in normal working condition (as the manufacture intended). (Re-Inspection Fees will apply)

After all documentation is received and the inspections are completed, the designated representative will forward the application packet to the Delaware State Fire Commission for final review. Once a decision is made you will be notified within 5 days. Non-Emergency Ambulance Service Providers once you are notified you will need to schedule an appointment to have the Ambulance Permit Stickers placed on your ambulance(s). An Ambulance Service Permit, when issued is, valid until December 31st of the year issued.

The following is an explanation of the items required for the company’s application:

1. Application complete and accurate.
2. Certificate of Liability Insurance showing the Delaware State Fire Prevention Commission as a certificate holder and the insurance coverage as stated in the Ambulance Service Regulations.
   • The Primary, Secondary or Non-Emergency Ambulance Service Provider must provide proof of liability insurance in the amount of $1 Million blanket liability coverage and proof of automobile liability insurance in theamount of $1 Million individual, $3 Million aggregate per occurrence.
3. Ambulance List completed and accurate with vehicle information.
4. Employee/Member List completed and accurate with required information.
5. Copy of the company’s QA/QI Process for Glucometers.
6. Infection Control Compliance according to Title 16, Chapter 10A.
7. HIPAA Compliance according to Title 16, Chapter 12 (secured location for patient information)

Non-Emergency Ambulance Service Providers must submit items 1 through 7 along with the items below:

• Copy of Delaware Business License.
• Copy of a current Drivers License for each person listed as the owner of the company and the Director of Operations.
• Copy of the Contract for Non-Emergency Ambulance Service.
• Pay application fee (s). of $175.00
• Pay associated fee (s): License and unit permits.
• Must have a physical office in the state of Delaware in a non-residential zone that has a full-time staff for day-to-day operations.