Mya Frazier of Bloomberg Businessweek details one Ohio community’s experience with an incentives-fueled Amazon project.

The emergency responders of Licking County, Ohio, are under strain. At least once a day, a medical unit from West Licking Fire Station 3 makes a run to the Inc. warehouse 3.1 miles away, in the township of Etna, about 20 miles east of Columbus. The calls for routine medical issues that occur in grueling warehouse jobs come at all hours, says Steve Little, the fire district administrator. Shortness of breath. Chest pains. Myriad minor injuries. During the busy holiday season, he says, the warehouse sometimes issues multiple emergency calls a day.

Amazon isn’t helping cover the costs. Under the deal the company negotiated in 2015 with local officials and the state’s private economic development agency, JobsOhio, it’s paying no property taxes to Licking County for 15 years. As part of a two-warehouse deal, the state gave Amazon $17 million in tax incentives, and JobsOhio handed over $1.5 million in cash, funded with income from the state’s liquor monopoly. The new facilities are “almost a million square feet we have to protect, but we get no extra money,” Little says. “We have no voice in these deals, and we get no cash. Our residents are being forced to pay instead.” In November, voters in Little’s district will be asked to approve a five-year, $6.5 million property tax levy to keep the fire department operating.

While most big companies extract tax breaks from states and municipalities where they’re looking to expand, in Ohio Amazon has become something of a poster child for incentives that make it tough for public services to accommodate the added strain its facilities bring. In four deals struck through JobsOhio since 2014, the company has received at least $123 million in tax breaks, plus $2.9 million in cash grants. The terms of a fifth agreement, which Republican Governor John Kasich announced in September, haven’t been disclosed because the deal hasn’t yet been signed by the state’s Tax Credit Authority, a five-person panel composed mostly of local business leaders.