Specifications include, but are not limited to: Contractor shall provide all management, personnel, facilities, equipment, materials, fuel and supplies necessary to operate emergency ambulance services at the 9-1-1 Advanced Life Support (ALS) level for twenty-four (24) hours per day, seven (7) days per week within the unincorporated areas of San Diego County inclusive of Ocotillo Wells, the Anza-Borrego State Park and surrounding desert communities and provide mutual aid to adjacent areas as needed. Additionally, Contractor shall provide billing services, interface with fire department first responders and provide community education services. Contractor shall participate in service area quality assurance activities and regional quality improvement processes.