How do I submit the Ambulance Service Special License Application?

Mail the completed application, required attachments, and $411.20 fee to City of Vancouver Business Licensing, or drop them off at City Hall's first-floor customer service.

What attachments are required?

The application lists a certificate of liability insurance and supporting compliance documents, plus a schedule of rates for the application period.

When is a renewal application due?

To renew for the next license year, submit the application, attachments, and fee to the City by December 1 of the current license year.

Vancouver, WA · Clark County

No notary required

Ambulance Service Special License Application

Ambulance service operators use this application to request a special license to provide ambulance service in Vancouver.

What this form is

The application requests a Vancouver ambulance service special license and asks for applicant, business, owner, contact, and service information. Applicants must submit a certificate of liability insurance with supporting documents and a schedule of rates. The form includes attestations about ambulance and attendant credentials and a declaration by the authorized signatory. An issued license expires December 31 of the service license year; renewal materials are due by December 1.

Who needs it

Ambulance service operators seeking or renewing a Vancouver special license complete and submit this application with its required attachments and fee.

How to submit it

Submit the completed application, attachments, and $411.20 fee by mail to City of Vancouver Business Licensing, PO Box 8995, Vancouver, WA 98668-8995, or drop them off at City Hall, first-floor customer service, 415 W 6th St, Vancouver, WA 98660.

About notarization

This document is signed and dated without a notary; the signer declares under penalty of perjury that the application information and attestations are accurate and complete.

How to submit this form

1
Download The Application
Download the Ambulance Service Special License Application PDF.
2
Complete The Application
Provide the requested applicant, business, owner, contact, and ambulance service information, then sign and date the form.
3
Gather Required Attachments
Include a certificate of liability insurance with supporting documents and a schedule of rates.
4
Submit To The City
Send or drop off the completed application, attachments, and $411.20 fee at one of the listed City of Vancouver locations.

Frequently asked questions

Do I need a notary for the Ambulance Service Special License Application?: No. The form is signed and dated without a notary, though the signer declares under penalty of perjury that the information and attestations are accurate and complete.
How do I submit the Ambulance Service Special License Application?: Mail the completed application, required attachments, and $411.20 fee to City of Vancouver Business Licensing, or drop them off at City Hall's first-floor customer service.
What attachments are required?: The application lists a certificate of liability insurance and supporting compliance documents, plus a schedule of rates for the application period.
When is a renewal application due?: To renew for the next license year, submit the application, attachments, and fee to the City by December 1 of the current license year.

Need something notarized?

This Ambulance Service Special License Application doesn’t need a notary — but if you have another Vancouver form that does, a commissioned online notary can help.