As someone pointed out earlier, these must be EASV's. Registered ems agencies are authorized to put easv's on the road as long as they comply with the regulations. According to the NYS Department of Health, Procedure for obtaining EASV authorization cards: Only agencies certified as ambulance services by the Department of Health may apply for authorization of personally owned EASVs. 1. Prior to issuance of authorization as an EASV the Chief Executive, or their designee, shall complete a copy of the Affirmation of Compliance (DOH - 1881) that indicates each vehicle is in compliance with 10 NYCRR part 800 and have it notarized. 2. Any time a vehicle is added to the list of authorized vehicles an Affirmation of Compliance must be completed and notarized for the added vehicle. In the event a vehicle is removed, the department must be notified in writing. 3. The completed Affirmation of Compliance shall be sent to the DOH regional office for the service's operating area. The regional office will issue the appropriate window decal(s) and NYS Certification "logo" stickers for the vehicle(s). 4. A copy of the completed and executed Affirmation of Compliance shall be sent, along with a cover memo on agency letterhead, to the Bureau of EMS's Central Office. The Central Office will issue the numbered Emergency Vehicle Authorization Cards (DOH - 4136) to the service. As an ems volly in Rockland County, we frequently see pov's, and even ambulances usually belonging to one agency in particular, being operated code 3 and, more often than not, in an unsafe manner. In my experience, it is rare to see a pov bearing; the agency name on the vehicle, the NYS DOH inspection sticker or the NYS DOH certification sticker. This is not to say that all these vehicles are known to belong to the one agency outlined in this article but seems that the requirements are pretty straight-forward. Vehicles need to have the necessary decals and stickers and the operator needs to possess the orange DOH-4136 card, which is supposed to expire on the same date the operator's emt or aemt certification expires. Most of the vehicles encountered, in my experience, resemble the one in the picture that AlpineRunner posted, note the absence of the DOH inspection sticker that is supposed to be mounted on the passenger-side on the windshield in the lower corner. I'm all for doing the most that we can to help those patients that call on us in their time of need but we must do so with due regard and in compliance with the regulations set forth for our profession.