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RES NO 11-05-2022 CITY OF VAN BUREN,ARKANSAS RESOLUTION NO.jj -0 -2022 BE IT ENACTED BY THE CITY COUNCIL, FOR THE CITY OF VAN BUREN, ARKANSAS,A RESOLUTION TO BE ENTITLED: A RESOLUTION APPROVING A PERMIT TO PROVIDE TAXICAB SERVICES IN THE CITY OF VAN BUREN, ARKANSAS. WHEREAS, Kyle Empsall, d.b.a.,Payless Taxi,LLC.,has submitted an application for a permit to operate a taxicab service in the City of Van Buren; and WHEREAS, pursuant to Ordinance 24-2001, notice of a public hearing on the taxicab service permit application was published on November 4, 2022, and November 11, 2022; and WHEREAS, the City Council has heard all persons desiring to be heard on the question of approving the taxicab service permit application described above; and WHEREAS, the City Council finds that the public convenience and necessity require the issuance of a permit to operate a taxicab service. NOW,THEREFORE,BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF VAN BUREN,ARKANSAS,THAT: SECTION 1: That Payless Taxi,LLC., is hereby granted a permit to operate a taxicab service in the City of Van Buren,Arkansas. IN WITNESS WHEREOF, the City of Van Buren, Arkansas, by its City Council, did pass, approve, and adopt, by a vote of_L for and 0 against,the foregoing Resolution at its regular meeting held on the 28'day of November 2022. 8 Jos h P.�Hut Mayo ATTESTED: APPROVED AS TO FORM: 6? P 1 is Thomas J o b Hsu City Clerk/Treasurer City Attorney CITY OF VAN BUREN,ARKANSAS ORDINANCE NO.__A-4001 AN ORDINANCE REGULATING TAXICAB SERVICES IN THE CITY OF VAN BUREN. WHEREAS, There is a growing need for taxicab services in the City of Van Buren; and WHEREAS, Taxicab services are currently operating in the City of Van Buren; and WHEREAS, It is in the public interest that the City of Van Buren regulate the operations of said taxicab services for the public health and safety; NOW, THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF VAN BUREN, ARKANSAS: SECTION 1: Definitions. For the purposes of this article, the following words and phrases shall have the meanings respectively ascribed to them: Driver shall mean any person who actually drives a taxicab whether for himself as the operator or as an employee of the operator thereof, Operator shall mean any person who makes use of and employs taxicabs in a business for proCt, whether or not such person actually owns the taxicab so employed: provided, that the term does not include a driver who pays a consideration to a taxicab operator for the furnishing of common business facilities for more than one (1) driver. Taxicab shall mean a motor-driven vehicle having a seating capacity not in excess of seven (7) passengers used for the transportation of persons for hire, provided, the term does not include a vehicle have a seating capacity in excess of seven (7) passengers employed in transporting persons over a regular schedule of operation. Furthermore, the term shall not include any private or publicly operated bus or mini bus transportation system. Penalty, revocation of permit. The failure to comply with any requirement contained in this section for any person, operator or driver or the doing of any act by any person, operator or driver prohibited herein is declared to be unIawful, and any person convicted of such unlawful act shall be deemed guilty of a misdemeanor. In addition to the penalty provided for misdemeanors: the commission of any act prohibited by this section, or the failure to comply with any of the requirements of this section or the supplying of any false information to the City with reference to this section by an operator or by an applicant for an operator's permit shall be grounds for the Council to withdraw and cancel the permit of such operator or to deny a permit to such applicant, and the commission of any act prohibited by this section or the failure to comply with any of the requirements of this section or the supplying of and. false information to the City with reference to this section by a driver or by an applicant for a driver's certificate shall be grounds for the City Clerk to revoke the driver's .certificate of any driver or to deny a certificate or renewal of certificate to such applicant. Daily records. (a) Every operator of a taxicab shall prepare and maintain a permanent daily record witli reference to his business operation which shall contain the' following information: (1) A complete list of all vehicles used in the business. (2) The names of the owners of such vehicles if not owned by the operator and a description of the ownership arrangement with reference to such vehicle. (3) A description of the vehicles, including each vehicle's make, model, seating capacity, motor and serial number and assigned cab number. (4) The name and address of each driver employed by such operator and the hours each driver operated each vehicle. (b) Such daily records shall be maintained by each operator at its permanent place of business for inspection by the public, including any agents or officers of the City. Annual report. Within ten (1 Q) days before or after the first day of January and the first day of July of each year, each operator shall deliver to the City Clerk of the City a sworn statement containing the following information: (1) Operator's business or trade name. (2) Operator's correct legal entity and, if a corporation, the names, addresses and interests of the stockholders in the corporation and the names and addresses of the executive officers of the corporation. (3) Operator's business address and telephone number. (4) A list of vehicles used by the operator during the preceding six (6) months period (a compiled list of the daily permanent record may be submitted as compliance with the requirement of this subsection). (5) A list of all cab drivers with their driver's license number for the preceding six (6) months. Identification of vehicle. Each and every operator of a taxicab shall cause the trade or business name of the taxicab operator and a taxicab number, consisting of no more than two (2) numerals, to be shown on each side and the rear of each taxicab in contrasting colors and in letters and numerals not less than four(4) inches in height each. Receipt for fare. Upon request by any passenger, each driver shall furnish a receipt showing the amount of fare charged, point of pickup and delivery and name of driver. Alternate route, extra fare. In every instance that a passenger is to be taken to his destination by a course of travel other than the most direct possible, the driver shall so advise the passenger. The passenger shall then have the opportunity to not travel with the taxicab. Every operator and driver shall be permitted to provide a special, direct service in such instance, and such .operator shall charge therefore a fare of not more than, nor less than; fifty cents ($0.50) in addition to.the Tegular fare provided herein. Required. �No taxicab operatorAiall :commence the activities of operating a taxicab within the City until that person has applied for and been granted a permit for that purpose by the City Council. Application. -, The City'-Council-may'grant:per-nits for the operation of taxicabs in the city upon written application. The appl:i.catIon shall be verified by oath and shall contain the following: i-(1) Thetnanie,,,address.ardicorrect legal entity of the person making application. .. (2) The proposed.business:addrdss of the applicant. A (3) A statement of=facts°:sh6wiii.g•applicant's qualifications to render the service of �< operating a.taxicab together with the facts which he considers to justify and ' require the rendering.to.the.public of such service. (4) A statement that,the applicant will comply with all provisions of this article and with all:other city ordinances and laws of the state regulating taxicabs. Hearing. The City Council shall hold a public hearing on the application for a permit required by the provisions of this.section, shall cause a notice of such public hearing to be published in a newspaper having general circulation in the city at least one (1) time at least seven (7) days prior to the date of such public hearing and shall cause a written notice of such hearing to be given to all taxicab operators holding permits from the City. After such public hearing,•the City Council, in its discretion, shall determine whether the public convenience and necessity requires the granting of the application. 4 T .t Condition ofvehicle- No operator shall operate and no driver shall drive a taxicab which is in an unsanitary condition or is mechanically unsafe. The Mayor, or his designated agent, is hereby authorized to order any operator and/or driver to immediately discontinue the use of any vehicle as a taxicab until specific, designated unsanitary conditions have been remedied and /or until such vehicle is in sufficient mechanical condition to be successfully reinstated. The provisions of the preceding sentence shall be in addition to any other penalty or remedy provided for in this section. Fares generally. The fares which>shall*be charged by taxicab operators and drivers within the City shall,be established by the City Council-from time to time and kept on file in the office of the City Clerk. Quotation of fare. In every instance of;.pi&mp:of passenger for delivery the driver shall immediately after pickup determine and quote:to.t:the•passenger the fare for the service. Upon request by any passenger,-eacb'driver':shall request from the dispatcher a confirmation of the fare to be charged, if -the taxicab operatg ..'utilizes a dispatcher and two-way radio communication_ _IE: Signs. (a) Each operator.and,each-d"river shall cause the following signs and information A to be•rnaintained'.in°each.taxicab operated and driven- (1) A .copy of the-,.zone map in a size of at least fourteen (14) inches by twenty (20) inches-and a copy of the fares authorized to be charged shall bemaintained:in-each taxicab and shall be subject to inspection at the.request+of any passenger. (2) A.sign maintained on the interior portion of the vehicle in print easily legible to 'a passenger entering the cab; which states the fares establisliediundenthis section. (3) A sign maintained on the interior portion of the vehicle in print of sufficient sizeao:be 1egible by the passengers which shall contain the information set forth 4n item a. and the language set forth in subsections b.and c.. a. Driver's name, photograph and taxicab number; b. Taxis are controlled by City ordinance; C. tZone'fare map; A. Complaints or comments may be directed to the City :Clerk's Office,474-8936. (b) The driver'is required to furnish requested information about fares. S •,z i Insurance. (a) Before commencing to operate a taxicab; every operator shall deposit with the City Clerk a policy of liability insurance, or a certificate of insurance, issued by a responsible insurance company duly licensed to transact such business in the State; such insurance to be in amounts as required by A.C.A. § 27-22-104. Such policy shall provide that it may -not be cancelled without first giving the City Clerk ten(10)days written notice. (b) In lieu of such policy of insurance; such owner may file a bond, in a form approved by the City Attorney, to 'be signed by a corporate surety company licensed to do business in this state which bond shall be conditioned for the payment of property damage and.personal injuries in the same manner and to the same extent as herein provided:inr.the­case�of filing;an insurance policy. (c) Alternatively, in lieu ,of a policy of .insurance or such bond, such owner may provide proof of self-insurance, for '.both property damage and bodily injury, as authorized by A.C.A. 5 27 1=9-107 Stich proof shall consist of certification as self-insured by the appropriate.department.oftile State. Surety bond. No permit to operate-wa-taxicab shall be issued by the City Council until the applicant for permit files With the 'City Clerk a bond signed by a corporate surety authorized to do business ul:the-.state;,-an«a:Sorni.,approved by the City Attorney, in the amount of hive Thousand Dollars.($5;0.00:00)..conditioned upon such applicant for permit establishing, maintaining and contintiing 4he :proposed service until such time as the permit issued to applicant is cancelled,°withdrawn or has expired. If the applicant fails to comply with the provisions of the bond,.the.Cit}r=shall forfeit the bond as compensation to the City for loss of applicant's service. Transfer. No permit issued under the-proN%iMons af--this section shall be sold, transferred, assigned, leased or otherwise disposed-of without the consent of the City Council. Privilege license tax and permit fee. (a) Each taxicab operator shall pay�a privilege-license tax and permit fee to the City. . in lieu of any other occupation.license taximposed by this Code, for each taxicab employed and used by the operator during any calendar year according to the following schedule: (1) First taxicab, per year........_.,._.......$.75.00 (2) Second taxicab, per year—..........$50.00 (3) Third and subsequent taxicabs, Per year,each..............._........$25.00 ID (b) The privilege license .tax and permit fee provided for herein shall be due and payable on the-first day of January of each calendar year and shall be past due if not paid by January fifteenth of such calendar year and a penalty in the amount of ten (1 0) percent of the tax due shall be assessed for any payment made after January fifteenth. The payment of the privilege license tax and permit fee shall be based on -the number of taxicabs employed and used by the operator on January first of each calendar year. No operator shall add an additional taxicab to the total number for which a privilege license tax and permit fee has been paid until the operator shall have paid for such additional taxicab a privilege license tax and permit fee in the amount of a pro rata portion of the fee and tax established by subsection -(a) -above >according to the number of months, or parts thereof._ remaining"in.the calendar year at the time of application. Minimum age. It shall Abe utlawful for any person under twenty-one (21) years of age to drive or operate a•taxicab.upon.1he :public streets, alleys or other public ways of the City; and it shall.:be unlawful rforany person to employ, hire or permit a person who is less than twenty-one:(21) years:of age to so drive or operate a taxicab. Permit required. V:o person shall -drive"a taxicab for any taxicab operator who does not have a validpeurTent,permit:,froni-the.City Council for that purpose. Al L AppiiLmation for°Permit. , (a) An�application,Tor a permit shall be submitted in writing to the City Clerk, on forms--provided ty `the City Clerk for that purpose, for a taxicab driver's certificate. (b) Such application .shall contain the applicant's name, age and address, and the applicant shall furnish to the City CIerk his fingerprints, one (1) print of a photograph-of the applicant and proof of a current, chauffeur's license issued by the State. Issuance,denial. 'The City Clerk.shall issue a taxicab permit to such driver within five (5) days or notify the applicant by telephone or in writing that such permit will not be issued and the reasons therefore. Renewal. Each dfiver shall obtain a renewal of the driver's permit from the City Clerk's doNk office on or before .the :fifteenth day of January of each calendar year, "vhicli renewal certificate shall be valid-until January Fifteenth of the following calendar year. As part of ,� �Y c • y•e the renewal procedure, such person shall submit written evidence of passage of an eyesight examination by the state police department within thirty (30) days prior to the date of application for renewal. Cancellation. An issued taxicab driver"s permit shalt be automatically cancelled in the event that his chauffeurs license issued by the State is for any reason revoked, cancelled or otherwise discontinued. SECTION 2: If any section, subsection, subdivision, paragraph, sentence, clause or phrase in this Ordinance or any part thereof is for any reason held to be unconstitutional or invalid or ineffective by any court of competent .jurisdiction, such decision shall not affect the validity.or-effectiveness of the remaining portions of this Ordinance or any part thereof. PASSED AND APPROVED THIS )54"—DAYOF OCTOBER,2001. 3 MAYOR JbHkkIGGS ATTESTED: CITY-iCLERKITREASURER 10/13/22,7:28 AM Arkansas Secretary of State (D Search Incorporations,Cooperatives,Banks and Insurance Companies This is only a preliminary search and no guarantee that a name is available for initial filing until a confirmation has been received from the Secretary of State after filing has been processed Please review our NAME AVAILABILITY GUIDELINES HERE prior to searching for a new entity name. Printer Friendly Version LLC Member information is now confidential per Act 865 of 2007 Use your browser's back button to return to the Search Results Begin New Search For service of process contact the Secretary of State's office. Corporation Name PAYLESS TAXI,LLC Fictitious Names Filing# 811199873 Filing Type Limited Liability Company Filed under Act Domestic LLC;1003 of 1993 Status Good Standing Principal Address 12258 SOUTHEAST CAMPBELL ROAD WEST FORK,AR 72774 Reg.Agent KYLE LEE EMPSALL Agent Address 12258 SOUTHEAST CAMPBELL ROAD WEST FORK,AR 72774 Date Filed 04/04/2019 Officers KYLE LEE EMPSALL,Incorporator/Organizer JERRY BURNETT,Incorporator/Organizer Foreign Name N/A Foreign Address State of Origin N/A Purchase a Certificate of Good Fay Franchise Tax for this corporation Standing for this Entity hUps://www.sos.arkansas.gov/corps/search_corps.php?DETAIL=525843&core type id=&corp name=payless+taxi&agent search=Kyle+Empsall&age... 1/1 LOCALio order Confirmation Not an invoice Times Record Account Number: 835532 Date: 11/02/2022 Customer Name: City Of Van Buren Order Number: 8014598 Customer City Of Van Buren Prepayment $0.00 Address: 1003 Broadway ST Amount: CITY HALL Van Buren AR 72956-5800 Contact Name: City Of Van Buren Contact Phone: 4794748936 Column Count: 1.0000 Contact Email: Line Count: 23.0000 PO Number: Height in Inches: 0.0000 s, a , Product t#Insertions Start-End Category FTS Ft Smith SW Times 2 11/04/2022-I1A1/2022 Public Notices Record FTS swtimes.com 2 11/04/2022-11/11/2022 Public Notices otal'Orde'G;Cnnfierination #135 OWES 1/2 Ad Preview PUBLIC NOTICE Notice is hereby given that the Van Buren City Council will meet to consider approv- ing an application for a busi- ness license for Payless Taxi, LLC at its regular scheduled for Monday,. November 28, 2022. The meeting will be held at 5:30 p.m. at the Van Buren City Complex, 1003 Broadway Street, where all interested parties are invited to attend and entitled to be heard.. Phyllis Thomas, City Clerk/Treasurer This publication was paid for by Payless Taxi, LLC, at a cost of $135.00. 2/2 Ad Preview PUBLIC NOTICE Notice is hereby given that the Van Buren City Council will meet to consider approv- ing an application for a busi- ness license for Payless Taxi, LLC at its regular scheduled for Monday, November 28, 2022. The meeting will be held at 5:30 p.m. at the Van Buren City Complex, 1003 Broadway Street, where all interested parties are invited to attend and entitled to be heard.. Phyllis Thomas, City Clerk/Treasurer This publication was paid for by Payless Taxi, LLC, at a cost of $77.50. 2/2 Payless Taxi LLC Kyle Empsall (Owner) 9/20/2022 To whom it may concern, I Kyle Empsall does know that Bobby D. Brown has his passenger endorsement and is working for Payless Taxi LLC as a driver and as the General Manager. For any other questions please contact me at: Dispatch (479) 236-2392 Personal (479) 871-9528 Paylesstaxi54@gmail.com Sincerely, Kyle Empsall (Owner of Payless Taxi LLC) APPLICATION FOR TAXICAB DRIVER'S CERTIFICATE GO TO TINE FOLLOWING LOCATIONS FOR PROCESSING: (1) Arkansas State Police Office 5728 Kelly Hwy,Fort Smith (2) Arkansas Driver's License Office 221 Main Street,Van Buren (3) City Clerk's Office 1003 Broadway,Van Buren (4) Van Buren Police Dept.Code Enforcement 800 Fayetteville Road,Van.Buren ............................................................................................................................... NAME ^n EM JJ DATE ADDRESS ISS so 6 G ��i10 CITY&�S/TATE WGS� Or�i PHONE - a36 :a3%? AGE 7 P ��,,/'L DATE OF BIRTH S"I.3"pQZ CITY&STATE ////G�/ ��'� �� ...............................................................................................................•............... LIST OF EMPLOYERS DURING THE PAST THREE'YEARS: NAME ADDRESS CITY&STATE ............................................................................................................................... ARKANSAS STATE POLICE COMMENTS: APPROVED NOT APPROVED TROOPER DATE ................................................................................................................................ VAN BUREN POLICE DEPT.CODE ENFORCEMENT COMMENTS: APPROVED NOT APPROVED OFFICER 2 ............................................................................................................................... **NOTICE**IF NOT APPROVED THIS APPLICATION SHOULD BE RETURNED TO THE CITY CLERK BY POLICE DEPARTMENT. ............................................................................................................................... $10.00 ADMINISTRATIVE AND PROCESSING FEE DUE IN THE CITY CLERK'S OFFICE BY APPLICANT. NONREFUNDABLE. Z t 3 x!' RLIP.O.BOX 3967 PEORIA,IL 61612-3967 CONTINUOUS LICENSE AND P:(800)645-2402 E:surevjtx@rlicorp.com SURETY RLISURETY.COM PERMIT BOND Bond No. LSMI735363 KNOW ALL MEN BY THESE PRESENTS: That we, navless taxi Ile , 12258 se campbell West Fork.AR 72774 as Principal,and the RLI Insurance Company a corporation duly licensed to do business in the State of Arkansas as Surety,are held and firmly bound unto the City_ of Van Buren ,State of Arkansas Obligee,in the penal sum of Five Thousand and 00/100 DOLLARS( $ 5,000.00 ), lawful money of the United States,to be paid to the said Obligee,for which payment well and truly to be made,we bind ourselves and our legal representatives,jointly and severally by these presents. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH,That whereas,the said Principal has been licensed as a(n) taxi service by the Obligee. NOW,THEREFORE,if the said Principal shall faithfully perform the duties and in all things comply with the laws and ordinances, including all Amendments thereto,pertaining.to the license or permit applied for,then this obligation to be void,otherwise to remain in full force and effect for a period commencing on the 31 st day of October 2022 This bond may be terminated at any time by the Surety upon sending written notice to the clerk of the Political Subdivision with whom this bond is filed and to the Principal,addressed to them at their first known address,and at the expiration of thirty(30)days from the mailing of said notice,or as soon thereafter as permitted by applicable law,whichever is later,this bond shall terminate and the Surety shall thereupon be relieved from any liability for any acts or omissions of the Principal subsequent to said date. Dated this 3 1 st day of October 2022 payless taxi 11c Principal (Individual,Partner,or Corporate Officer) `t`tUtugtdryii .�`�J�p,NCE CO•,,,�� . SEAL . RLI Insurance Company i 0 s uN ntuttO• By � BartonW.Davis ,yf Vice President R0060307-30,30 POWER OF ATTORNEY RLI Insurance Company 9025 N.Lindbergh Dr. Peoria,IL 61615 Phone: 800-645-2402 Bond No. LSM1735363 Know All Men by These Presents: That this Power of Attorney is not valid or in effect unless attached to the bond which it authorizes executed,but may be detached by the approving officer if desired. That the RLI Insurance Company ,a corporation organized and existing under the laws of the State of Illinois ,and authorized and licensed to do business in all states and the District of Columbia does hereby make, constitute and appoint: Barton W.Davis in the City of Peoria .State of Illinois , as it's true and lawful Agent and Vice President , with full power and authority hereby conferred upon him/her to sign,execute,acknowledge and deliver for and on its behalf as Surety,for the following described bond. Principal: nayless taxi Ile Obligee: City of Van Buren (Valid only when a County,City,Town or Village is named as Obligee) Type Bond: taxi service Bond Amount: 9 5,000,00. Effective Date: October 31 2022 The acknowledgement and execution of such bond.by the said Attorney in Fact shall be as binding upon the Company as if such bond had been executed and acknowledged by the regularly.elected officers of the Company. The RLI Insurance Company further certifies that the following is a true and exact copy of a Resolution adopted by the Board of Directors of RLI Insurance Company ,and now in force to-wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President,Secretary, any Assistant Secretary,Treasurer,or any Vice President, or by such other officers as the Board of Directors may authorize. The President,any Vice President,Secretary,any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds,policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF,the RLI Insurance Company has caused these presents to be executed by its Vice President with its corporate seal affixed this 31 st day of October 2022 • -..,io RLI Insurance Company cARPOF4TF State of Illinois = ; SEAL : BY= SS _ Barton W.Davis Vice President County of Peoria %.�l C i N o`',•� CERTIFICATE '�nn,nnnn••• On this 31 st day of October ?0?? before me, a Notary Public, I,the undersigned officer of personally appeared Barton W.Davis who being by me RLI Insurance Company duly swom, acknowledged that he signed the above Power of Attorney as the do hereby certify that the attached Power of Attorney is in full force aforesaid officer of the RLI Insurance Company and effect and is irrevocable; and furthermore,that the Resolution of and acknowledged said instrument to be the voluntary act and deed of said the Company as set forth in the Power of Attorney,is now in force. In corporation. testimony whereof,I have hereunto set my hand and the seal of the RLI Insurance Company By: this 1 st day of October 2022 . ,������ Catherine D.Glover Notary Public RLI Insurance Company CATHERINE D.GLOVER . By: �Ut "� noilm OFFICIALSEAL Jeffrey DUMP Corporate Secretary N otM Public-Slate of 19uiois na M Conn tssion $ Y Matet►24,2� A0083221 ACQ® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/27/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT- If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,subject to the terns and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME:Progressive Commercial Lines Customer and Agent Servicing American Business Insurance Services PHONE FAX 32133 LINDERO CYN 100,WESTLAKE VILLAGE,CA 91361 A/C,No,Ext:1-800-444-4487 (A/C,No): E-MAIL ro ressivecommercial email. ro ressive.com ADDRESS:P 9 @ P 9 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:United Financial Casualty Company 11770 INSURED INSURER B: KYLE EMPSALL DBA:PAYLESS TAXI 12258 SE CAMBELL INSURER C: WEST FORK,AR 72774-0000 INSURER D: INSURER E- INSURER F: COVERAGES CERTIFICATE NUMBER:761 049 61 6 624 04270 8D102722T212752 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMBS LTR INSD WVD (MMIODIYYYY) (MMIDDIYYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE❑OCCUR PREMISES Ea occu GE TO ence _ MED EXP(Any one person) S _ PERSONALA ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE ❑PRO- ❑ __ ____ PRODUCTS-COMPIOP AGG s —�- POLICY JECT LOC OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Per person 25000 AHANYAUTO OWNED SCHEDULED N N 07557097 04/24/2022 04l24l2023 AUTOS ONLY X AUTOS BODILY INJURY Per accident 50 000 HIRED NON-OWNED PROPERTY AMAGE AUTOS ONLY AUTOS ONLY Peraccident $25.000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS"LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? (Mandatory in NH) EL DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN KYLE EMPSALL ACCORDANCE WITH THE POLICY PROVISIONS. 12258 SE CAMBELL WEST FORK,AR 72774 0000 AUTHORIZED REPRESENTATIVE ©1988 2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD "name and logo are registered marks of ACORD L �V AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED American Business Insurance Services KYLE EMPSALL DBA:PAYLESS TAXI PoucYNumeER 12258 SE CAMBELL WEST FORK,AR 72774-0000 07557097 CARRIER NAIC CODE United Financial Casualty.Company. 11770 EFFECTIVE DATE:04/24/2022 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Additional Coverages Insurance coverage(s) Limits ............................................................................................................................................................................................................ Underinsured Motorist Bodily Injury $25,000/$50,000 Uninsured Motorist Bodily Injury $25,000/$50,000 Description of Location/Vehicles/Special Items Scheduled autos only ......... ..... .. .............................. ..................._.................... .................................... .............._............._.._.._............................... 2015 MA.. ZDA...6...J..M1.. GJ1....W5XF1224495 Roadside Assistance Selected w/$0 Ded Uninsured Motorist Property Damage $25,000 w/$200 Ded 2012 MAZDA CX-9JM3TB3BV8C0362820 Roadside Assistance Selected w/$0 Ded Uninsured Motorist Property Damage $25,000 w/$200 Ded ................................................................................................................................... 2011 MAZDA CX-9 JM3TB3CA4B0310384 Roadside Assistance Selected w/$0 Ded Uninsured Motorist Property Damage $25,000 w/$200 Ded Liability coverage may not apply to all scheduled vehicles. ACORD 101(2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AS PER CITY ORDINANCE 24-2001 APPLICANT, CONFORMS TO ALL RULES,REGULATIONS AND LAWS CONCERNING TAXI DRIVER'S CERTIFICATE AND IS AUTHORIZED TO OBTAIN A CITY OF VAN BUREN TAXI DRIVER'S CER'11FICA1'E NUMBER .................................................................. ........................................................ TO OBTAIN A TAXI DRIVER'S CERTIFICATE FROM THE CITY OF VAN BUREN,THE FOLLOWING REGULATIONS MUST BE FOLLOWED: (1) COMBINED OPERATORS AND DRIVERS MUST ATTACH PROOF TO THE APPLICATION THAT OPERATOR COMPLIES WITH ALL CITY REGULATIONS CONCERNING TAXI OPERATION.SEE CITY CLERK FOR INFORMATION (2) DRIVERS EMPLOYED BY OPERATORSWUST ATTACH A STATEMENT THAT OPERATOR HAS KNOWLEDGE OF DRIVER'S POSSESSION oF A CURRENT LICENSE WITH A"P"ENDORSEMENT. (3) ATTACH PROOF THAT DRIVER HOLDS CURRENT STATE DRIVER'S LICENSE. (4) ATTACH PROOF THAT DRIVER HAS PASSED EYE EXAMINATION BY STATE POLICE. 1,HEREBY STATE THAT I UNDERSTAND THAT THE CITY TAXI DRIVER'S CERTIFICATE EXPIRES EACH YEYAR ON DECEMBER 3 IST AND THAT IMIUST OBTAIN RENEWL OF LICENSE BEFORE THAT DATE TO RETAIN THE CITY TAXI CERTIFICATE.I FURTHER STATE THAT I AM FAMILIAR WITH ALL STATE AND CITY LAWS CONCERNING THE OPERATION OF ATAXI.I WILL IMMEDIATELY NOTIFY THE VAN BUREN POLICE DEPARTMENT OF ANY CHANGE IN MY SITUATION THAT MIGHT AFFECT THE HOLDING OF A TAXI DRIVER'S CERTIFICATE. ...........................................I.... ....... ......................................... SIGNAT E OF APEILKANT rD ATE -02 1- 6t�pk COLLECTION-REPRESENTATIVE'S SIGNATM61,"i'00AIAA-r'— CITY SEAL APPLICATION FOR TAXICAB DRIVER'S CERTIFICATE , GO TO THE FOLLOWING LOCATIONS FOR PROCESSING: (1) Arkansas State Police Office 5728 Kelly Hwy,Fort Smith (2) Arkansas Driver's License Office 221 Main Street,Van Buren (3) City Clerk's Office 1003 Broadway,Van Buren (4) Van Buren Police Dept.Code Enforcement 800 Fayetteville Road,Van Buren ............................................................................................................................... NAME 'r1 foc-d . DATE Z Z ADDRESSc O�— ( inn - CITY&STATE PHO 7/' yJ - Z Z AGE 5-0 IL DATE OF BIRTH )2 Z 6 7 CITY&STATE G 11,Nto NIa• ............................................................................................................................... LIST OF EMPLOYERS DURING THE PAST THREE YEARS: NAME ADDRESS CITY&STATE �•t�e�s x; L L C. ILLS Si- Cpe,o6�/ 17S nowvi 1-6 nA i Ma✓r 5e e ne_ z/55 T,rtli f-?yim:n ............................................................................................................................... ARKANSAS STATE POLICE COMMENTS: APPROVED NOT APPROVED TROOPER DATE ............................................................................................................................... VAN BUREN POLICE DEPT.CODE ENFORCEMENT COMMENTS: APPROVED NOT APPROVED OFFICER DATE ............................................................................................................................... **NOTICE** IF NOT APPROVED THIS APPLICATION SHOULD BE RETURNED TO THE CITY CLERK BY POLICE DEPARTMENT. ............................................................................................................................... $10.00 ADMINISTRATIVE AND PROCESSING FEE DUE IN THE CITY CLERK'S OFFICE BY APPLICANT. NON REFUNDABLE. AS PER CITY ORDINANCE 24-2001 APPLICANT, CONFORMS TO ALL RULES,REGULATIONS AND LAWS CONCERNING TAXI RIVER'S CERTIFICATE AND IS AUTHORIZED TO OBTAIN A CITY OF VAN BUREN TAXI DRIVER'S CERTIFICATE NUMBER TO OBTAIN A TAXI DRIVER'S CERTIFICATE FROM,THE CITY OF VAN BUREN,THE FOLLOWING REGULATIONS MUST BE FOLLOWED: (1) COMBINED OPERATORS AND DRIVERS MUST ATTACH PROOF TO THE ' APPLICATION THAT OPERATOR COMPLIES WITH ALL CITY REGULATIONS CONCERNING TAXI OPERATION. SEE CITY CLERK FOR INFORMATION. (2) DRIVERS EMPLOYED BY OPERATORS MUST ATTACH A STATEMENT THAT OPERATOR HAS KNOWLEDGE OF DRIVER'S POSSESSION OF A CURRENT LICENSE WITH A"P"ENDORSEMENT. (3) ATTACH PROOF THAT DRIVER HOLDS CURRENT STATE DRIVER'S LICENSE. (4) ATTACH PROOF THAT DRIVER HAS PASSED EYE EXAMINATION BY STATE POLICE. I,HEREBY STATE THAT I UNDERSTAND THAT THE CITY TAXI DRIVER'S CERTIFICATE EXPIRES EACH YEYAR ON DECEMBER 31ST AND THAT I MUST OBTAIN A RENEWL OF LICENSE BEFORE THAT DATE TO RETAIN THE CITY TAXI CERTIFICATE.I FURTHER STATE THAT I AM FAMILIAR WITH ALL STATE AND CITY LAWS CONCERNING THE OPERATION OF A TAXI.I WILL IMMEDIATELY NOTIFY THE VAN BUREN POLICE DEPARTMENT OF ANY CHANGE IN MY SITUATION THAT MIGHT AFFECT THE HOLDING OF A TAXI DRIVER'S CERTIFICATE. ................................................... .................... ................_...................................... SiGNATU4E 9F APPLICANT DATE17tZ COLLECTION REPRESENTATIVE'S SIGNATURE CITY SEAL