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Home My WebLink About133-24 RESOLUTION113 West Mountain Street Fayetteville, AR 72701 (479) 575-8323 Resolution: 133-24 File Number: 2024-21 CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY - AFFORDABLE TAXI COMPANY: A RESOLUTION TO CONDUCT A PUBLIC HEARING FOR THE ISSUANCE OF A CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY TO AFFORDABLE TAXI COMPANY TO OPERATE AS A TAXI COMPANY IN THE CITY OF FAYETTEVILLE. WHEREAS, Article IV TAXICABS OF CHAPTER 117 Vehicle Related Businesses of the Fayetteville Code governs taxicab services and requires a public hearing for the City Council to consider whether or not to issue a Certificate of Public Convenience and Necessity in order to authorize the Affordable Taxi Company to conduct a taxicab business in the city; and WHEREAS, proper notice of this Public Hearing has been published in the newspaper with the proposed schedule of rates and charges included within this publication at least 10 days prior to this Public Hearing. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1: That the City Council of the City of Fayetteville, Arkansas after conducting the required Public Hearing during the City Council Meeting of May 7, 2024, and allowing public comment by all interested persons, hereby determines that a Certificate of Public Convenience and Necessity should be and hereby is granted to the Affordable Taxi Company to enable it to operate within the City of Fayetteville as long as the Affordable Taxi Company continues to comply with all requirements of Article IV TAXICABS and its certificate is not suspended, revoked, or cancelled pursuant to § 1 17.36 of the Fayetteville Code. PASSED and APPROVED on May 7, 2024 Page 1 `��1111ttlt�tl�I TRF _v: FAYEITEVILLL; CITY OF FAYETTEVILLE ARKANSAS MEETING OF MAY 7, 2024 TO: Mayor Jordan and City Council THRU: CITY COUNCIL MEMO 2024-21 FROM: Mike Reynolds, Police Chief SUBJECT: Public Hearing on a Certificate of Public Convenience and Necessity for Affordable Taxi of Pope County. RECOMMENDATION: Affordable Taxi Company of Pope County is requesting a public hearing for the issuance of a Certificate of Public Convenience and Necessity to operate as a taxi company in the City of Fayetteville. BACKGROUND: City Ordinance 117.30 Article IV governs taxi cab services and requires a public hearing for the City Council authorizing the holder to conduct a taxicab business in the city. Rose Shaddon is the owner and holder of the Affordable Taxi Company of Pope County Taxi Service in Russellville, Arkansas, and is petitioning for a Certificate of Public Convenience and Necessity. DISCUSSION: Attached is the application for the Affordable Taxi Company of Pope County. The application contains the information required by City Ordinance 117.30. There is currently one taxicab company, Fayetteville Taxi, and one limousine company, Hotel Executive Transportation, permitted to operate in Fayetteville. BUDGET/STAFF IMPACT: There is no budget or staffing impact. ATTACHMENTS: SRF (#3), SRM (#4), Affordable Taxi Application (#5) Mailing address: 113 W. Mountain Street www.fayetteville-ar.gov Fayetteville, AR 72701 == City of Fayetteville, Arkansas y 113 West Mountain Street Fayetteville, AR 72701 (479)575-8323 - Legislation Text File #: 2024-21 Public Hearing on a Certificate of Public Convenience and Necessity for Affordable Taxi of Pope County. A RESOLUTION TO CONDUCT A PUBLIC HEARING FOR THE ISSUANCE OF A CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY TO AFFORDABLE TAXI COMPANY TO OPERATE AS A TAXI COMPANY IN THE CITY OF FAYETTEVILLE. WHEREAS, Article IV TAXICABS OF CHAPTER 117 Vehicle Related Businesses of the Fayetteville Code governs taxicab services and requires a public hearing for the City Council to consider whether or not to issue a Certificate of Public Convenience and Necessity in order to authorize the Affordable Taxi Company to conduct a taxicab business in the city; and WHEREAS, proper notice of this Public Hearing has been published in the newspaper with the proposed schedule of rates and charges included within this publication at least 10 days prior to this Public Hearing. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1: That the City Council of the City of Fayetteville, Arkansas after conducting the required Public Hearing during the City Council Meeting of May 7, 2024, and allowing public comment by all interested persons, hereby determines that a Certificate of Public Convenience and Necessity should be and hereby is granted to the Affordable Taxi Company to enable it to operate within the City of Fayetteville as long as the Affordable Taxi Company continues to comply with all requirements of Article IV TAXICABS and its certificate is not suspended, revoked, or cancelled pursuant to § 117.36 of the Fayetteville Code. Page 1 City of Fayetteville Staff Review Form 2024-21 Item ID 5/7/2024 City Council Meeting Date - Agenda Item Only N/A for Non -Agenda Item Mike Reynolds 4/19/2024 Submitted By Submitted Date Action Recommendation: POLICE (200) Division / Department Affordable Taxi Company of Pope County is requesting a public hearing for the issuance of a Certificate of Public Convenience and Necessity to operate as a taxi company in the City of Fayetteville. Budget Impact: Account Number Project Number Budgeted Item? No Total Amended Budget Expenses (Actual+Encum) Does item have a direct cost? Is a Budget Adjustment attached? Available Budget No Item Cost No Budget Adjustment Remaining Budget Fund Project Title Purchase Order Number: Previous Ordinance or Resolution # V20221130 Change Order Number: Approval Date: Original Contract Number: Comments: CITY OF FAYETTEVILLE ARKANSAS MEETING OF MAY 7, 2024 TO: Mayor and City Council FROM: Mike Reynolds, Chief of Police DATE: April 19, 2024 1 CITY COUNCIL MEMO SUBJECT: Public Hearing on a Certificate of Public Convenience and Necessity for Affordable Taxi of Pope County. RECOMMENDATION: Affordable Taxi Company of Pope County is requesting a public hearing for the issuance of a Certificate of Public Convenience and Necessity to operate as a taxi company in the City of Fayetteville. BACKGROUND: City Ordinance 117.30 Article IV governs taxi cab services and requires a public hearing for the City Council authorizing the holder to conduct a taxicab business in the city. Rose Shaddon is the owner and holder of the Affordable Taxi Company of Pope County Taxi Service in Russellville, Arkansas, and is petitioning for a Certificate of Public Convenience and Necessity. DISCUSSION: Attached is the application for the Affordable Taxi Company of Pope County. The application contains the information required by City Ordinance 117.30. There is currently one taxicab company, Fayetteville Taxi, and one limousine company, Hotel Executive Transportation, permitted to operate in Fayetteville. BUDGET/STAFF IMPACT: There is no budget or staffing impact. Attachments: Certificate of Public Convenience & Necessity Application Exhibits A-K Mailing Address: 113 W. Mountain Street www.fayetteville-ar.gov Fayetteville, AR 72701 Certificate of Public Convenience & Necessity Page 1 of 3 Updated 02/26/14 Certificate of Public Convenience & Necessity Application/Renewal As required to comply with Chapter 11' of the Fayetteville Code of Ordinances Rose Shaddon 136 Jennings Rd Russellville Ar 72802 479-880-3449 Applicant Name Address Phone Number Affordable Taxi of Pope Co LLC _ _ _ 479-280-2132 Name of Business Phone Number 136 Jennings Rd Russellville Ar 72802 Business Location - — — — - 136 Jennings Rd Russellville Ar 72802 Mailing Address - -- Sole Proprietor LLC Type of Business (Sole Proprietor, Corporation, LLC) Name and address of all owners, officers and stockholders: None Name of person to whom complaints should be directed: Rose Shaddon or Heather Richardson Complaint form can be emailed to each customer also on website Type of Permit Requested: Taxicab yes Limousine Financial status of applicant (Attach financial statement or profit and loss statement) Attached Exhibit F Credit Report List any unpaid judgments against any of the owners, officers and stockholders and the nature or acts giving rise to said judgments: Attached Credit Report Certificate of Public Convenience & Necessity Page 2 of 3 Updated 02/26/14 Describe the experience of all owners, officers and stockholders in the. transportation of passengers: Operated a taxi for another company for 18 months before opening my own business in March of 2021 Give any facts you believe tend to prove the necessity of granting a certificate: Necessity of customers needing rides rises from people not having transportation and/or from them not wanting to use their own vehicle to get ro point a to point putt ing miTeage on their vehicle Some think that Taxi services area great asset due to the fact that they do not have a car payment, insurance payment, nor any of the maintenance that it requires to maintai. ving transportation. List the number of vehicles that will be under your operation or control: _6 Minimum and Maximum number of vehicles to be permitted: 3 3 Minimum Maximum List the location of proposed depots and terminals: Russellville Arkansas Describe the color scheme or insignia to be used to designate your vehicle: Each one of my vehicles that are used for the transportation, has a Purple Taxi sign in the front window MyTaxi's are not advertised as a commercial vehicle, making them safer for the customers. Example: Some may hit a commercial vehicle expecting a huge payout from Insurance companies, due to the fact that it is commercial insurance. List your days and hours of operation: We work 24 hours a day 7 days a week, weather permitting! List any days you do not propose to provide taxicab service to the general public: Only if/when in the hiring process of another driver because of the increase of call volume List your proposed passenger rate schedule: See attachement of Rates 5i nature o A plicant State o1 -1 t? County of _ FFopc Certificate of Public Convenience & Necessity Page 3 of 3 Updated 02/26/14 Z, Date :cS NOTARY m; t I PUBLIC 1� . On this the _ day of /`c(3QtJt42i/ 20 before me, �•�''�� ►►��` personally appeared _ nZE c },4 aDon) known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and affirms that the statements In this document are true and complete. In witness whereof I hereunto set my hand and official seal. J u My Commission expires: � 13 ( 1202,3 Notary Publi Police Department Represe tive l q zoZy Dat ° O ° _ Vl CD fD fD fD ,� ^ G� 3 O Cp N 3 3 � y C N 0 m a) coy O Oi 0 a r o c m ° a x m v CI4 Cr4 ° T ° y CD 67 N N fD (9 7 n m o O c O n O O O En O C 7 3 m m fA FA b} fA 64 69 404 fA EA {0} 113 -eo £f} .64 fR SF} lu r -G } 69- bq E{} f}} Eft o 3 C 0 (D N =�• A A W W W W W W N N N N N } 1 N W N CO 00 a) a1 N CD �! cy) A N I ' (D V M .A Iv O CD -,J Ul O CD N En Cb r+ A V O GJ CD N Cn Cp i-+ v O O O O O O O O O O CD O CD CD O O O CD CD O O CDJO CCD 3 m co N NN N N f► µ F► + Fa F+ ►+ I-► N F+ aq W N F ti O tD O V T Cl1 A W N i- % O CD w V 0 0 Efl 6s 6g b4 fA 63 619. 64 64 -64 1604 64- 64 Eft CA G� fA fi3 64 63 EA -Co {g W W W W W W N N N N N N i-+ N N E i-- F-. (D w A N O W V Cn W N O W V cn W r O 00 Cn W W N :I O W �T) Co N Cn 00 i-" p V O W O (D N *cn W�-- .p V 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 G� 3 c W W W N N N N N N N N N F-h F► f+ F+ �.A N F+ F► N �� W N i� W CO 0o V iT) to A W N i A N Co 0o V CA N A W N f+ co co (D (D 0 m o0 00 00 0 .i .� rn rn rn rn rn rn cn 3 v Cr N I CD �1 Cn A IV o (D �1 cn A N O Cb V Cn W N O co —CD T O CD N cn (b N A V O W CD N cn W N A J NCD CD rl 3 3 r' jjjjjj�o ' CL C CA cu IM 0 L' s �r AFFORDABLE TAXI OF POPE COUNTY LLC 136 JENNINGS RD RUSSELLVILLE AR 72802 479-280-2132 ?11�hrr.iC1["7113C�XI,.C�v�IV�I' i.VPITIc].I�_011l Affordabletaxianddelivery.com The company was formed in March 2021 ! The owner had suffered abuse, had lots of trouble finding and keeping jobs due to having to continuously move to keep safe. She formed a company where she could be behind the scenes and help others who had suffered the same thing or had been placed in similar situations. She has been abused, homeless, and had to rely on others for transportation. Relying on Churches, police Departments, DHS workers, Battered Women's Shelters, judges, for help in situations where she had to stay safe or lose her life. She started with 1 vehicle in the small town of Dardanelle and has since expanded to Russellville, Clarksville, Fort Smith, Mulberry, Ozark, Altus, Ward, Cabot, Austin, and Morrilton, with a total of 10 vehicles. And would Like to add Fayetteville to that list. 1-.—Attached with Application, -is Equifax Credit -Report, -Drivers Reports; Drivers Background reports, Including Reports of Owner. Court Connect Records are below. We do not charge the 35.00 Minimum Fee per customer, 13.00 Reservations Fee, or 25.00 Cancellation Fee like Uber (See Attachment) .(t'L.._nrcn Phonetic Search: off Last Name: Affoidable Taxi of Pope Cainly LLC ., .,,oros lwrd ?; Home .� Help k ftw..:. I 'At � * Phonetic Search: Y' Last Name: Shaddon First Name: Roq(,, JID — INamelkorpors on Case 6-e—Gr��-tion— fpifi� Tipe flinibAipuige R65E -H)SH�UWADDNI- Case: glA66 T ISTH CIRGUIT 00 lAllases�:' ON ROSE:Sratuslt!tt�k ' '21 f� fft"ij;e6;�� CLOSED Page: I Records: I - I Phonetic Search: Off Last Name: Alkwiobip Fayetteville was established on October 17, 1828, and since that time, Fayetteville has become the 2"d most populous city in Arkansas with a population of 99,285 in 2022. It is 53.8 square miles of land with 1.4 square miles of water. From 2010 to 2020 Washington County increased in population by 24.2 %. Which shows to be an increase of 2.4 percent per year. Fayetteville has public transportation of two major providers they are Razorback Transit and Ozark Regional Transit, Razorback Transit is centered on Campus while Ozark Regional Transit runs throughout Washington and Benton Counties. Fayetteville issued the following Taxi permits: 1. Fayetteville Taxi LLC on 10/10/2023 it was opened on 08/14/2012. 2. Issued another permit to Hotel Executive Transportation on 1 1 /7/2011 the revoked the License on 10/31/2020. Also known as NWA Taxi LLC 3. Issued another permit to Gear Gaming Store on 01 /17/2014 and revoked their license on 10/31 /2020. Making Fayetteville Taxi the only Taxi service in Fayetteville. Our Company: Our Goal Is to provide transportation for customers who would otherwise have to walk, to and from locations, keep battered women/men safe, provide roadside assistance to customers who are broke down on the side of the road, offer delivery services, offer services to customers who live in urban areas with no transportation available day and night. We have a system that goes through our dispatch, where the dispatcher is dispatching the call while still on the phone with the customer. Making a quicker response for the driver and customer. As well as knowing where the driver is to go next on the call list. Making it to where there are 3 places for this call to be in the system. 1. On the Dispatched Work Crew 2. On the Payroll System for the Drivers times 3. On the Drivers call log, 4. We keep accurate records of Names, Pick up locations, drop off locations and times as well as amount collected, via: Cash-App, Venmo, Debit, Cash, Ticket, etc. 5. We do not charge the 35.00 Minimum Fee per customer, 13.00 Reservations Fee, or 25.00 Cancellation Fee like Uber does (See Attachment) If the driver (he/she) does not have time to write on the call log, they can go back and see all the calls in the system. All Drivers, and Dispatchers go through a hiring process of 1. Driving Record Check 2. Arkansas Background Check 3. Drug/Alcohol testing. We are an opportunity company who hires reformed felons, but they must not have: 1. Abuse 2. Molestation/Rape 3. Theft 4. Recent DWI's or DUI Our Company does not advertise with a Big Taxi sign on the roof of our vehicles for the purpose of Safety for our customers. The reasons for that being. 1. Our customers need to feel safe when going from one destination to another. 2. Arkansas has the highest insurance ratings in the United States due to accidents of commercial vehicles. 3. If you don't advertise commercial, then: a. People do not see a big payout from a commercial insurance company. b. Protected people are harderto find i.e. battered women's shelters. c. Confidential information does not get outtojust anyone, d. None of our vehicles are listed under the company name, so no one knows that it is commercial. Just Owners name only. All our vehicles used has a GPS/Wi-Fi system installed: 1. Easy tracking 2. Routes taken. 3. Precise location of our drivers at all times. 4. Able to calculate a pickup time for our customers. 5. Offerfree Wi-Fi to our customers. Our drivers also have Life360 installed on their phones: 1. Free towing up to 50 miles 2. Roadside assistance 3. SOS system if there is trouble for a driver. Such as beingfollowed, threatened etc. 4. All drivers and dispatchers know the location of another driver. Our company does not have a big machine installed in our vehicle: reasons for that. 1. We feel that we should not charge a customer based on waiting on trains, red lights, emergency vehicles, traffic jams, funerals, or things beyond their control. 2. We feel they should be charged accordingly: to their time spent on mileage, their time in a store for wait time, and their transportation back to where they are going. Making it more economical for the customer. What our company does have: 1. Our corppany has its own website and app where customers can request rides directly or indirectly from customers, just like Uber or Lyft. 2. We charge a cancellation fee, but we do not charge a fee for booking rides through our system. 3. We have Commercial Insurance on all our vehicles! 4. We have Workers Comp Insurance on all our independent contractors! 5. We have a 1,000,000-insurance policy on the company! 6. Free wi-fi in our vehicles 7. GPS Locator B. Life 360 9. Drivers Logs 10. System logs 11. 5 phone lines 12. 3 dispatchers and 1 dispatcher/Supervisor/Manager 13. Account Manager/System Tech/Payroll Clerk/VP 14. Authorization from State of Arkansas Highway Commission 15. Certificate of Good Standing from the Secretary of State 16. Federal Tax Numbers 17. Pass Certificate 18. National Provider Identification number 19. Professional Independent Contractors 20. System on Tablets/Phones to calculate prices for our customers. 21. Cameras in every vehicle 22. Roadside reflectors 23. Fire Extinguishers 24. Medical Kits 25. A little about the owner and company: The company was formed in March 2021 ! The owner had suffered abuse, had lots of trouble finding and keeping jobs due to having to continuously move to keep safe. She formed a company where she could be behind the scenes and help others who had suffered the same thing or had been placed in similar situations. She has been abused, homeless, and had to rely on others for transportation. Relying on Churches, police Departments, DHS workers, Battered Women's Shelters, judges, for help in situations where she hattto, stay -safe -or -lose -her life. Stye started- with- 1-vehlcLein the small town of Dardanelle and has since expanded to Russellville, Clarksville, Fort Smith, Mulberry, Ozark, Altus, Ward, Cabot, Austin, and Morrilton, with a total of 10 vehicles. Your trip earnings are calculated using the rates below. These are the rates you will earn for every minute and mile you drive. Rates are based on your Uber activation date. For full details on your earnings, rider payments, and Uber fees, tap Fare Details on your trip receipt. Little Rock Base Fare A $0.9375 Long Pickup Fee Per Mile Variable Per Minute $0.57 Threshold $0,1125 12 minutes Per Mile $0.57 Per Minute A $0.1125 Reservations A ECONOMY Minimum Fare $35.00 Reservation Fee $13.00 Fixed Cancellation Fee $25.00 Cancellation Fee Policy FIXED FEE Minimum Trip Earnings A $3.7578 Cancellation Fee Variable Standard Driver Initiated Cancellation Fee $3 822 Standard Rider Initiated Cancellation Fee $3 822 Per Mile $0.57 Per Minute $0.1125 Booking Fee You will be charged a Booking Fee for every trip. The amount is posted and updated on uber.com/cities. Uber will collect this fee from riders on your behalf. Taxi fare from Washington Regional Medical _center to 1145 N Mission Blvd to show map & route Uber X Initial fee: 2.70 $ Cost of ride time: 1.80 $ Cost of distance: 5,25 $ Total Fare: — 9.75 $ Uber XL Initial fee: 5.00 $ Cost of ride time: 2.70 $ Cost of distance: 9.10 $ Total Fare: — 16.80 $ Dynasty Taxi Service Springdale_ ._.....-_........ _ Abundant Taxi -') 13e n l u u s--==--------:-.- Presidential Car Services Cenfcrlon -- - Distance between Washington Regional Medical Center and 1145 N Mission Blvd is approx. 3.5 miles (5.64 km) with 9 min travel time. This taxi fare estimate from Washington Regional Medical Center to 1145 N Mission Blvd was updated 2 seconds ago. Did you know that we have all the fare rates for Uber Fayetteville? _ See all the taxi services and find your next cheap Fayetteville ride. * Uber fare estimate from Washington Regional Medical Center to 1145 N Mission Blvd may vary ClUe to weather and traffic. Our estimates in 3215 N Northhills Blvd, Fayetteville, AR 72703, USA do not include any discounts or promotions. 'T' New Uber fares from Washington Regional Medical Center $51-68 .) I ��, I i �j -.1.1 . ....... bnD to '15 tdenhall I-n a_ n te ,LLJ \ \ - -- �f I , CQ� / e ,E ° ¥ / / \ c D < § E ce �< 1 k � CL � a. cc 0. Q a.CL � C CL a a- � CL � CL a CL CL » _ \ @ j 3 ± u ± a) 2 $ $ ± 5 a)2 5 ± u u u u u u u u u d ) p Q p Q Q p Q Q p @ A R > o Q) u u u u u ,u u u u u u U 2 o o 3 o o �o o o o o o 3 EL u a v u u u § % q / to ± < 0 0 J O -j u � 2 t R �f// i f k \ m u \ } = e # p 2 w 2 m e E ii _ _ 0 � / k R e % LAJ 2 c \ u $ I 3 It k ° k CL u < LU c u I c 2 \ � a _ u E \ cu 2 & / / CL u § \ \ $ - § z 3 \ q o $ \ K ¥ta):\ � �\ $y TDC�DEPENREVVENUE SERVICE Y ��I++�'1lii�� JJ CINCINNATI OH 45999-0023 AFFORDABLE TAXI POPE COUNTY LLC ROSE L SHADDON SOLE MBR 705 WILLIAMSON WAY RUSSELLVILLE, AR 72801 Date of this notice: 05-30-2023 Employer Identification Number: 93-1598139 Form: SS-4 Number of this notice: CP 575 A For assistance you may call us at: 1-800-829-4933 IF YOU WRITE, ATTACH THE STUB AT THE END OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN). We assigned you EIN 93-1598139. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. Taxpayers request an EIN for their business. Some taxpayers receive CP575 notices when another person has stolen their identity and are opening a business using their information. If you did not apply for this EIN, please contact us at the phone number or address listed on the top of this notice. When filing tax documents, making payments, or replying to any related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear -off stub and return it to us. Based on the information received from you or your representative, you must file the following forms by the dates shown. Form 941 Form 940 07/31/2023 01/31/2024 If you have questions about the forms or the due dates shown, you can call us at the phone number or write to us at the address shown at the top of this notice. If you need help in determining your annual accounting period (tax year), see Publication 538, Accounting Periods and Methods. We assigned you a tax classification (corporation, partnership, etc.) based on information obtained from you or your representative. It is not a legal determination of your tax classification, and is not binding on the IRS. If you want a legal determination of your tax classification, you may request a private letter ruling from the IRS under the guidelines in Revenue Procedure 2020-1, 2020-1 I.R.B. 1 (or superseding Revenue Procedure for the year at issue). Note: Certain tax classification elections can be requested by filing Form 8832, Entity Classification Election. See Form 8832 and its instructions for additional information. IMPORTANT INFORMATION FOR S CORPORATION ELECTION: If you intend to elect to file your return as a small business corporation, an election to file a Form 1120-S, U.S. Income Tax Return for an S Corporation, must be made within certain timeframes and the corporation must meet certain tests. All of this information is included in the instructions for Form 2553, Election by a Small Business Corporation. (IRS USE ONLY) 575A 05-30-2023 AFFO B 9999999999 SS-4 If you are required to deposit for employment taxes (Forms 941, 943, 940, 944, 945, CT-1, or 1042), excise taxes (Form 720), or income taxes (Form 1120), you will receive a Welcome Package shortly, which includes instructions for making your deposits electronically through the Electronic Federal Tax Payment System (EFTPS). A Personal Identification Number (PIN) for EFTPS will also be sent to you under separate cover. Please activate the PIN once you receive it, even if you have requested the services of a tax professional-or,representative. For more information about EFTPS, refer to Publication 966, Electronic Choices to Pay All Your Federal Taxes. If you need to make a deposit immediately, you will need to make arrangements with your Financial Institution to complete a wire transfer. The IRS is committed to helping all taxpayers comply with their tax filing obligations. If you need help completing your returns or meeting your tax obligations, Authorized e-file Providers, such as Reporting Agents or other payroll service providers, are available to assist you. Visit www.irs.gov/mefbusproviders for a list of companies that offer IRS a -file for business products and services. IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN_ * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax -related correspondence and documents. * Provide future officers of your organization with a copy of this notice. Your name control associated with this EIN is AFFO. You will need to provide this information along with your EIN, if you file your returns electronically. Safeguard your EIN by referring to Publication 4557, Safeguarding Taxpayer Data: A Guide for Your Business. You can get any of the forms or publications mentioned in this letter by visiting our website at www.irs.gov/forms-pubs or by calling 800-TAX-FORM (800-829-3676). If you have questions about your EIN, you can contact us at the phone number or address listed at the top of this notice. If you write, please tear off the stub at the bottom of this notice and include it with your letter. Thank you for your cooperation. I,r karisas Sul Chu N of Stat(� ^«_ John Thurston L�,'-,1: tilalc ('tllii,ll LSuilcful! Little Aork.Arkan.as?2"2i11-1094 0501-682- 409 Certificate of Good Standing 1, John I hur;ton. seactan. of.statc of the Stag t-lf Ark<nlsas. and a. Such, keeper ill the records l'clun'tc>tic and (c'+rclt n ,.urhnr;lti�+n�. elt+ ltctrchv cta-tifl' Thal the records ul'this ol'tice show AFFt.)tiU,013LE --FAXI POOPE COUNTY, LLC authorised to trtul',,lct husine" ill the Slilte ofArUnsns as n Limited Liahilitl ('onlllatly,. filed ;Articles of (1r�_•alli[�ltion in ibis ofiiee rlu�ust !>. 20'_2. c )ur record, rellcet Ihat paid entity, h;k ins, complied 1% ith Lill lallltol'. I'c(Ilrtl-LI11c;I1L5 ill L11C State of,lrkan.,a,. is yuliliii .11 to hail ac't husine,s in lhi, Slab. In Testirnom '11'he1-coF, I ha�c hcrcunto set illy hand and afti.wd my oPicial Seal. [)one at my oPlirc ill the ��k�`i' f ,• `��r�. 01.ol' Litllc Dock- this 12I11 day of'nu�y.ua 2022• r l�l\ 1 I r: l �•i1t,�Jtl.�i;tl. i ht!��lui CI'tlit :ne u.�!, riali„n c.`Odr. IT3M `dlec59d1�3 i��l�iV \11111141,-Aii.111 C'nde. , i�i1 �„s. trktulsa�. s„ of t, 14 4 jj jj A i�' ;I A A 4% ft 7et..bsi at1 4w- ' 6 4-1A ki 'ki �t't 4 ;,4 let". K 6', V- Iok, ;6- 'r4'W XH VNI-S Is TATE John Thurston AHKANSAS, SLCH L I'A H Y 0 1- S TAT FE TO M to Whom These Presents Shall Come. Greetings'. I. John Thurston. Arkansas Secretary of State of Arkansas, do hereby certify that the following -Illcf hnl-etcj )tjached in-.trunient of writing 15 Lt 1111E, and perfect copy of Certificate of Organization an AFFORDABLE TAXI POPE COUNTY, LLC bled fri this office August N. 2022 In Testimony Whereof I hill/0 hCrOlil'to SCII lily hand ill'-d alfiv-xl riny cfhcial Seal, Done at my cffice. in tno. Sily of 1-1111(! Ruck 11w, 9!h day o! AU91-ISI 20-22. III Him, .1.1 0 1-1.11 . 1.1 1131C Celt 1 care 1 F, 'M-M , ... .. ..... . y �c 9 O f�jl IRS �r 1,FIE Tj'r rTNL1rMNr.. jt,� 45999'. 002J "" A this Qtjc,_ 03-23-2021 Mhavy, ; Conti fl""On RASE Form: SS,,, ArpuWASLM TAXI 215 L 16TH Tit NumberOL, th.i_ 8 notice, C; You may call us at: l-(lUU-f129-9.933 J" YOU WRITE, ATTAQ TH"y, STUB AT THE END OF'THIS NOTICE. Thank WE ASSIGNED YOU AN SMVLOYER IDENTIFICATION NumtqgR you for aPPlyinq lor an EIN 06-2005647 Employer ldentific-ati,, Hum,-K, doCuments, - This EIN lilt identify you, your. 'r (EIN). We 858ignod you even if You have no empaccounts, tax return,, and records. "Yees. Please keep this notice in Your permanent When filing tax documn--nti;, Payllu-nLs, and related correNPOMdencu, it is very important that you use Your EEN and complete MOM address exactly as ahown above ceMy cause a dolay 10 PCOCossing, resmit in incorrect inFnIrmation in your a . Any vdMation -'Ilse YOU to be assign-1 morecount, Or even above, please make Me correction one E.T.N.EIf the information is not correct as shown A MUM ion using the attached tear Off stub and return it to us, LiabiLity company (1") MY file Form B832, E"Llry Classification Election eligible to he treaLed as a CO�-'F)Oratlon that meets certain tests and it will be Old elect to be alasaitind as an ansuciation taxable as a corporation. If the LLC is corpnration 0t) status, electing - The 1,14' Will. be treated as a corporation as of the effective date of the S Cor-poratiit must timely file Form 2553, Slection by a gmall Bu,j... corporation election and does not need to file Form R032. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs,gov. If you do not have access to the Internet, call 1-000-029-3676 (TTY/TDD 1-000-029-4059) Or visit your local IRS office. IMPORTANT RMMINOMRS: -k Keep a copy of t1lis nOti-00. in your permanent records. This notice is issued only One time and the IRS will not be able to generate a duplicate copy for you. you May dive. a. c0i;)y of this document to anyone anlctnq for proof Of your. E.T.N. OSC this EIN and Your name exactly as they appear at Me top of this notice on all your federal tax forms. * Refer to this EIN on your tax-rolated correspondence and documents. If you have qucjLLon.-.i about YOU: EN, YOU C,,ill will us aL the phone numbeJ.- Or: write to us at the address shown at the top of this notics. If you write, please tear off the stub at the bottom of this notice and send it along with your letter. If you do not need to write us, do not complete and return the stub, Your name control associated with this EIN is SHAD. You will need to provide this information, along with your. EIN, if you file your returns electronically. Thank you for Your cooperaLion. Filing Number: 811387353 Tax Year: 2024 AFFORDABLE TAXI POPE COUNTY, LLC 1. Tax Contact Information: AFFORDABLE TAXI POPE COUNTY, LLC 136 JENNINGS RD RUSSELLVILLE, AR 72801 USA Phone # of tax contact: 4798803449 Change of Registered Agent Information: NOT APPLICABLE. NO CHANGES MADE. 2. Required Information Federal Tax ID#: 931598139 LIMITED LIABILITY COMPANY MANAGEMENT IS MEMBER(S) OR MANAGERS(S) Please provide current names: ROSE LEE SHADDON Tax Preparer : ALL LIMITED LIABILITY COMPANIES PAY $150.00 TAX DUE: $ 150.00 I declare, under penalties of perjury, the foregoing statements are true to the best of my knowledge and belief. Signed this 06 day of FEBRUARY, 2024. Signature: ROSE LEE SHADDON This form must be signed in ink by: Member / Manager (Listed in ? Abovel. Due on or before May 1 -Substantial penalties due after May 1 Remittance must accompany this report and must be written and signed in ink. Checks Payable to Arkansas Secretary of State • Phone (501)-682-3409 or 1-888-233-0325WBusiness Services Division 9 State Capitol Building 0 Little Rock, Arkansas 72201-1094 You may file this electronically over the Internet @ http://www.sos.arkansas.gov/ National Provider Identifier rustotlaerservic@C-11Vi.enUmerator.com<.;:u>Inms,rr-r+ncr3;ii:n;>ir�numr=rilol com> L^ : fforda:�l':!_ixf,dRlrv$t:Ylry!gn�rlll.r:om Affordable Taxi <afforciablctaxl.(felivery,,ggrnail com> rhu, Mai-30 2023 at 12 49 Pf,1 A reuuesl fori�ruu l-r Ft!enfli�F'r .Wf-)I; or ;I :h:lnyr> In (I,e '3 jg lq'I11'! for f-�itdlrN•vulg pluvidiir i�iis rerenTly ;u5mi : 1 to n. 1. i , I •Tit d Yatl Mir;: lis!G'I as the r:c'rlla;: persl;n 7N`rs Is Iti rnrorm yFX that the request w:IS SLIMIS h.Illy ;ubrrntled and the follow ny T^,1C41nit ID has been as(;11f,3r1 It, the: equnsr 01'020-4'46520 I1 tha 5tif,nu!lerl NPI 7pphi d;Ini1 or r;hnngr: IhglrEa:,t Ic:r,uir nn +; 'I III: rdums the rnurnerallrm orchanaes ntav he effective within the hex[ 2,1 hour; ve,nff(:abon Is ragLIJI't>d pro;:r•;,SIn(I Ina:, lake ur: to 30 •7s Provider Name Hose Shaddon !'nm;ary Contact Person Ruse Shadrlon PI-Mli-(YP1'aclice 1..ocaiion Aduress 705 VJillirimsr)n Wily Russellville. AR 7 '601-6923 United States SSN: Xxx-XX 9439 Date .SUbmllled: Mar-30.202 If YOU hn-jep any qurahons n:_1:+Ir1in':1 tins ripolwrlt:on ;:r if ne ± s(Ir.aio;1 ri,nllicl I±c:rsor ,%esn'I Irr..erve the provider's NPI via'emall within 15 working dayg. plearn_ reler to the: f qC' L1f=nu ;It . NPI Enunlerc+lor Cjntacl InfoiniaLlon tvMonoay throuclh I::rrday gam to 5, (F:rastern Time) By phone -800-;65-3203 EMPf Toll -Tree; °i)0-6�2.2326fAiPl'T"FY for then (jrsni, lewd )f haaflmj. ra Iho:::: v✓Ith spe ch difhcultlEa) 'Holiday hours may van; By '-In:.rd al By mall at NPI l=nnnleralor 7125 MOBASSADOR RD STE Ior) VANDSQR Mit_I. ML) 2 I244-2751 II you arc uol lhu provider, you are: requlrcau !o i.111(ni ;he urovidel of the infornrahon Irl this k.tlsr and furnish a copy of tfus notification to the provider customerservicr:gnpienumerator.com <'(-uston-erscr Icu;2i:,noiranLIfrler;:unl cnnl1 Tb: a' nrdaihletaxi :IFhvery(c`gr;vau c:;;m Enumeration Dilate Marcit :30. 2028 Thu, Mar 30 2023 at 12:50 PM A request for a Nr;honril l'rovioe' IJen[ifler for nose Le:,� Snaddon lam vies re c.owly s(Ibmltted [o !' Itl:,:; " I.;:,' h : , l and you were Ilsle(1 as the (:nn:ac; per :on This Is 'o mfurrn ypo h u IIIc reque :r :aus sui:c:ess°oily pr.)u(asud and the following NPI has boon+assigned' 1235833,102 Prartice I-ocatlon — Provider Tax,onolnies Taxonomy I T; A000WK License fI.171-ul6013 AR Details: t,. u"ef This is the Ptrm;a•; L940ntimiv If you h3vo..'any questions about :his nouficatri)n ynu may conl:Ict ;he NPI Enumolator fdonday through Friday, gam to 5pm (Eastern 'rime), at: :blftii! 1-80C-41[35-3203 (NPI Tull-Free! -800-69 -2326 (NPI T rY for me deaf hard of heamIC.l. or those with speech dii`Icullres) i-loliday i)OWs may vary You may vr(1w or changu Ihia arovlder's NPPES inforinahnn by Icgginq or'lo the IVPPES websile at I,[I(r5 ' I:.pp( •• ;;r ::,,f,!I.;,y;;',. Please nir4e. If you :alb not III& arnvide•' you ern roquired to Inform !Ile piovlder of the informalion III this n-mall and furnish a copy of t)ls notification to he pro'nr. er. 1F11L h_,V_4 2 1b b_F Rc,� za tt&U BEFORE THE ARKANSAS STATE HIGHWAY COMMISSION IN THE MATTER OF APPLICATION OF ) AFFORDABLE TAX] OF POPE COUNTY, LLC ) DOCKET NO. M-58689 FOR AUTHORITY AS A CONTRACT, ) CARRIER, INTRASTATE. REPORT AND ORDER Application fled May 8, 2023 with the Arkansas State Highway Commission Afforable Taxi of Pope County, LLC, an Arkansas corporation, seeking authority to operate as a contract carrier by motor vehicle in intrastate commerce transporting passengers, under a aw inuing contract(s) between all points and places in the State of Arkansas, over irregular routes, as -�:t forth in the application and notice of hearing. There were no protests filed to the application, and after due notice the matter was heard by the Commission's duly -appointed Hearing Officer on June 2, 2023. The hearing was held pursuant to the Commission's rules and regulations at its hearing offices, Arkansas Department of Transportation, Little Rock, Arkansas. FINDINGS Upon full consideration of the evidence and all matters and things involved herein, and being well and sufficiently advised in the premises, we find the requested service to be in the public interest and in furtherance of the state transportation policy. The applicant is fit, willing and able properly to perform the proposed service and to conform to the requirements of the Motor Carrier Act and rules and regulations thereunder. We further find that the application should be granted. Kamp,. !T IS, THEREFORE, ORDERED, that the application of Afforable Taxi of Pope County, LLC, an Arkansas corporation, of Russellville. Arkansas, for authority to operate as a contract carrier motor vehicle, in intrastate commerce, be, and is hereby granted, subject to such conditions and limitations as are now or may hereafter be attached to the exercise of the privileges herein granted. IT IS FURTHER ORDERED that the transportation service to be performed by said carrier in intrastate commerce shall be as specified below: IRREGULAR ROUTES: Passengers and their belongings, under continuing contract(s), Between all points and places in the State of Arkansas, over irregular routes. IT IS FURTHER ORDERED, and made a condition of this certificate, that the holder hereof shall comply with all rules and regulations of the State of Arkansas concerning the operation of a motor vehicle over the highways of this State. IT 1S FURTHER ORDERED, and is made a condition of this authority, that the holder thereof shall render reasonably continuous and adequate service to the public in pursuance of the authority herein granted, and that failure to do so shall: constitute sufficient grounds for change, revocation, or suspension of this authority. Entered this 2nd day of Jwle , 2023. BY ORDER OF THE COMMISSION: DAVID S. LONG, HEA1dNG OFFICER ATTEST: _ 1��" UI)a a LAKEYVIA WALKER LEGAL ASSISTANT Approved and ratified on behalf on the Arkansas State Highway Commission this 2nd day of June , 2023. BY ORDER OF THE COMMISSION TRELLA A. SPARKS INTERIM CHIEF LEGAL COUNSEL ATTEST: 49&� U')a&41L' LAKEYSAA WALKER LEGAL ASSISTANT EqUIFAX PrepercA N ROSAL.SHADDO Personal & co0iidenlial Date generated: Jan 27, 2024 At a glance FICOta Score B 6 5 quuiifaax data Jan 27, 2024 300 Account summary Overall cretin usage Debt summary Open accounts 11 Credit card and credit line debt S2,907 Amounts ever late 2 Loan debt $0 Closed accounts 0 Colleclions debt $0 Collertlons 0 23 % Total debt $2907 Average account age 2 yrs 3 mes Oldest account 3 yrs 9 mos Credil used: $2,907 Credit Ilmll: $12,450 EgUIFAK Personal information !la i•. ROSALSHADDON H! 136 JENNINGS RD RUSSELLVILLE, AR 72802 ROSE L UNDERWOOD 705 WILLIAMSON WAY RUSSELLVILLE, AR 77001 ROSE HIGMAN 701 EE ST RUSSELLVILLE, AR 72001 PO BOX 1382 ' 'I : f •:h STILWELL, OK 74960 1970 2526 W B ST RUSSELLVILLE, AR 72001 215 E 16TH ST APT 1 RUSSELLVILLE, AR 72801 PO ODX 45 EVANSVILLE, AR 72729 2512 BLUE RIDGE OR EDINBURG, TX 78539 16G32 HALE MOUNTAIN RD MORROW, AR 72749 319 N 12TH ST BURLINGTON, KS 66939 No Statements) present at this time Preoared For ROSA L. SHADDON Date generated: Jan 2/ 2024 AFFORDABLETAXI OF AA TAXI PINK TIGER EQUIFAX Prepared For ROSA L. SHADDON Date generated* Jan 27, 2024 Open accounts CAPITAL ONE s9• payment lunory 30130ca updated Jan Oa, 2024 EIx Account info Account name CAPITAL ONE Balance 391 Account number 515307XXXXXX Balance updated Jan 09,2074 Original creditor - Credit limit $1,750 Company sold Credit usage 5 1. Account Lype Ravelving Monthly payment S40 Date opened May 09, 2021 Past due amount Open/closed Opon Highest balance $1,497 Status Pays account as agreed Terms Status updated Jan 2024 Responsibility p tY Individual Account Your statement Payment history Jan rim Mar •vnr May Joy Jul Aug Sao c1ct -4 207a ✓ / ✓ ,� � ✓ 2027 � ✓ ✓ ✓ J ✓ ✓ � ! , 2ll21 ✓ ✓ ✓ ✓ ✓ r ✓ 2020 2n19 . / ]nle•m - 7nla 4nnv]eNfrn Contact info Address PO BOX 31793 SALT LAKE CITY, UTB4131-1293 Ptune Inrmher 1900) 955.707a D Comments ?C1 Ic{ 96,17 1/8' FgUYFA Prepared For ROSA L. SHADDON Data generated: Jan 27, 2024 CIAIIAEFW STRlpi SANK $D osymard history Balance Updated Jon 03, 2024 EA Account info Account name CHIMErIWSTRIOF. BANK 13alance se Account numtler 255107XXXX%% Balance updated Jan 93, 2D24 Original creditor Credit limit Cnmany wid Credit usage Account type Open Account Monthly payment Date opened Oct 07. 2021 Past due amount Opo.n/closnd open Highest halannc $13 Status Pays account as agreed Terms Status Updated Jan 2024 Responslhllity Indlvldual Account Your statement Payment history J9n Feb Mar Apr May Jun Jul Aug BM Oct Nov Dec 2023 ✓ ✓ ✓ ✓ i ! I ✓ ,� ✓ ✓ ✓ 2022 ✓ ✓ / ✓ / ✓ / ✓ I ./ ✓ / 2021 - _ ✓ ✓ 2019 ._ on Ti— D]ta IInoY.t/.l n Contact Info Address 101 CALIFORNIA STREET, SUITE 500 SAN FRANCISCO, CA 94108 Phone number (520) 73J•3l.3, DComments HKLU MATE EgUIFIL COMENITY BANK/MAURICE payment history BAAccount Info Account name Account number Original creditor Company sold Account type Date -opened Open/ctosrd Status Status updated Payment history Jan Feb 2023 2022 2021 2020 2019 � On Time ly Contact Info Address Phone number Dcomments Prepared For ROSA L. SHADDON Date generated: Jan 21, 2024 $188 Balance updated Jan 24, 2024 COMENITYBANK/MAURICE Balance 77885OXXXXXXXXXX Balance updated • Credit limit - Credit usage Ravalving Monthly payment May 15, 2023 Past due amount Open Illghest [in lance Pays account as agreed l arms Jan 2024 Responslbllity Your statement Mar Apr D.I. U.-Orbie May Jun Jul Aug Sep 3075 LOYALTY CIRCLE PO BOX 11127B9 COLUMBUS, OH 43210 By rend only P-1 a 7 1/2,2 $188 Jan 24, 2024 $700 26% $37 $477 Individual Account Ow Nov Dec EgUIFAX Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 CREDIT ONE BANK $55B ! ', ... - . payment history Balance updated Jan 05, 2a24 E'A Account info Aeuuunt nine CREDIT ONE BANK Bulunce $1558 Account number 379364XXXXXXXXX Balance updated Jan 05, 2024 Original creditor Credit limit $1,050 Company sold Credit usage 53% Account type Revolving Monthly payment $30 Uate opened Jan 04.2022 Past'due amount - Open/closed Onnn llighesl balance $955 Status w,y. aceount as .9read t arms Status updated Jan 2024 Responsibility Individual Account Your stateinant - Payment history Jan Feb Mar Apt May Jun Jul Aug Sep Oc: N- Dec 2023 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ f ✓ 2022 ✓ I ✓ ✓ ✓ ✓ ✓ I ✓ ✓ ✓ ✓ 2021 - 2020 2019 - - - Y On T1— oaWtlna.11abta d Contact info Address 6801 S. CIMARRON ROAD LAS VEGAS, NV O0113 Phone number (977) 025.3242 DComments ?d 5a/ e9 s— /q EgUIFAX cREOIT ONE DANK - payTeal wSlory ER Account info Account name Account number Original creditor Company sold Account type Date opened Open/closed Status Status updated Payment history Jan 2023 2022 2021 7.020 2019 r on Time Ie4 Contact info Address Phune nunlbor Comments Feb Mar Apr r ✓ 3- ilrr 1111.11 Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 $937 3alance. updated tart 03, 2024 CREDIT ONE BANK balance $937 470793XXXXXXXXXX Balance uodated Jan 03,2024 Credit limit $1,000 Credit usage 93% Revolving Monthly oaymen 1 $33 Mar 20, 2023 past due amount Opon Highent halanrr. $937 Pays account as agreed Terms Jan 2024 Responslhlllty, Individual Account Your statement _ May Jun Jul Aug Sep Oct Nov 0" 6601 S. CIMARRON ROAO LAS VEGAS, NV 89113 (077) 925.7242 ejDd �'D6,0r 1/1 ER Account info Account name Account number Original creditor Company sold Account type Uale opened Open/closed Status Status updated Payment history Jan 2023 ✓ 2022 ✓ 2021 202.0 2010 ✓ on Tien d Contact info Addres3 Comments Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 $0 Balance updated inn 24, 2024 f-aa I/MERCURY Valance $0 006236KXXX Balance updated Jan 24, 2024 - Credit limit $1,650 - Credit usage 0% Revolving Monthly payment $25 F.eb 24, 2021 past due amount Open Highest hal0nrn. $1,674 Pays account as agreed Farms Jan 2024 Rosponsiblllty Individual Account Your Matwnent Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Data ta—flab-a 700 22ND AVENUE SOUTH BROOKINGS, SD 57006 (000) 669-3660 pd g3.tsl - �/ EQUIFAX OfINGLRHUT lit• ]ayment EA Account Info Account name Account number Original creditor Company sold Account type Dale opened Oven/closed Stat09 Status updated $ Payment history Jan Feb 2023 ✓ ✓ 2022 1021 7.U20 . 2019 On Tints d Contact info Address Phone number DComments Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 $0 Balance updated Jan 24, 2a24 FINGERNU7 Balance 636992XXXXXXXXXX Balance updated Credit limit Credit usage Revolving Monthly payment Apr 12, 2022 Past due amount Dpen Highest balance Paya account its agreed Terms Jan 2023 Responsihllity Your statement Mar Apr May Jun all 30 Day9 0W Data Jnara:bblc 6250 RIDGEWOOD RD SAINT CLOUD, M N 56303-0811 (320) 694.3900 Jul Aug Sep ✓ ✓ 30 $0 Jan 24, 2024 $600 0% $2.17 Individual Account Oct NOV Dec Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 JPMCe .ARI)3-1V10E $D . . • paynm0 Nsrory Balance updated Jan 08, z024 Bx Account Info Account name JPMCe CARD SERVICF Balance $0 Account number 41474OXXXXXX Balance updated Jan 00. 2024 Original creditor - Credit limit $900 Company sold - Credit usage Os Account type Revolamp Monthly payment Date opened Aar 27. 2021 Past due amount - Open/elosnd Open Highest balance. $714 Status Pays accaunl as agreed 1 erms Status updated Jan 2024 Responsibility Indh4dual Account Your statement $ Payment history .�.0 Feb Mir Apr MJy Jun JW Aug Sep Oct Nov Dec 2023 ✓ ✓ ! ✓ ✓ ✓ ! ! ✓ J ✓ V 2022 ✓ ✓ J ✓ ! I ! ! ✓ ✓ ✓ ,/ 2021 - ✓ ! ✓ / ! J ✓ ✓ ! 70"7 2017 - - ! On Tlme - bMiiJM1I'�.111aM9 Contact Info Address 301 N WALNUT ST, FLOOR 09 WILMINGTON, DE 19801-3935 Phone iumbe, (000) 94S-2000 [1 Comrncnl:. 53/` 9z V9 EQUIFAX Prepared for ROSA L. SHADDON Date generated: Jan 27, 2024 .%MISSION LANE TAB BAN S11G t� Wi •% payment history Balanca updated Jan 04, 2.024 P4 ►/5 Account info Account name MISSION LANE TAB 3AN nalance St Y6 Account number 431503XXXKXXXXXX Balance updated Jan04,2024 Original creditor Credit limit $2,400 Companysold - Credit usage 4R Account type Revolving Monthly payment S25 Date opened Oct Oa, 2020 Past due amount - Open/closed Doan highest balance $436 Status Pay^ account as 4gmeu Perms Status updated Jan 2074 Responsibility Individual Account Your statement Payment history Jon Feb Mor Atu May Jun Jut Aug Sop Oct Noy — 2023 ✓ ✓ J ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ . 2022 J ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 2B2t ✓ ✓ ✓ i ✓ ✓ ✓ 2070 - - ,✓ ,� _ ✓ On Tim - unta Unavailable d Contact info Address lot 2ND STREET., SUITE350 SAN FRANCISCO, CA 94105 Phone number (4t5)462 02B0 Q Comments EQUI FAX Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 SELF RENT RENTTRAC $a unknown oayment Nvory Balance updated uan so, 2a21 E'A Accountlnfo Account name SM r RFNT•RFNTTRAC Ralance $D Account number L11066X Balance updated Jun 10, 2021 Original creditor Original balance S450 Company sold Monthly payment S450 Account type Dpen Account Past due amount Date opened Jon 01, 2021 1 erms - Open/closed open Responsibility Imiivirlwd A, —,Al Status Puy% account as egrecd Your statement Status updated ,tan 2021 Payment history No payment blatory avatlobla to dlspiny. d Contact info Address 4601 EXCELSIOR BLVD aK503;*501 0503; ST. LOUIS PARK MINNESOTA, MN 55416 Plena numoer (6511 212.2181 Qcomments —EUUIFAX SYNCOIX PENNEY DC - ; I payment history ER AccountInfo Account name Account number Original creditor Company sold Acapunttype Date opened Open/closed Status Status updated Payment history Jan 2023 2022 2021 2020 2019 ✓ On Time d Contact Info Address Phone number p Comments Feb Mar Apr Data Un.-O Ne Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 $1,017 Balance updated Jan 23, 2024 SYNCB/JC PENNEY DC 0elanco $1,017 546660XXXXXX Balance updated Jan 23,2D24 - Credit limit $2,500 - Credit usage 40% Revelvmq Monthly payment $39 May 12.2023 Past due amount - Open Highest bnlertre $1,23g Pays account eo agreed Terms Jan 2024 Responsibility Individual Account Your staterrignt May Jun Jul Auq Sup Oct Nov Dee 4125 WINDWARD PLAZA ALPHARETTA, GA 30005 By ma0 only f"' 3 i 041 Closet] accounts CNAG-AR107 I late aymera BR Account Info Account name Account number Original creditor Company sold Account type Dale opened Open/closed Status Status updated Payment history Inn Feb !722 ✓ ✓ 2n2+ - I[f': 0 ZD17 - Zola i Oa Th- d Contact Info Address Phone number OComments CHARGED OFF ACCOUNT FIXED RATE Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 CNAC-AR107 Balance 112160XX Balance updated Original balance - Monthly payment Iomnitment Past due amount Mor 13, 2021 Terms closmd Responsibility chergo off Yout statement May 7022 MAW Apr May Jun ,Iu1 ✓ 30 3030 Days Laic R+tn llnnva!lahln 3405 E MAIN STREET CNACRUS, LLC RUSSELLVILLE, AR 72802 (501 ) 529.5711 Aug Sea Oct $9,306 Closed S9.306 May 01.2022 $9,306 39 Months Individual Account Nov Dec ✓ ✓ rEgUIFAX a'FINGERHUT/WEBBANK ti:•�:^ptinn^! payment history ER Account Info Account name Account number Original creditor Company sold Account type Date opened Opentclo srd Status Status updated Payment history Jan Feb Mur 2022 ✓ ✓ ✓ 2U21 2020 2019 2D1B • On Ti—. .Oataunowlebla I� Contact info Addrem Phone number DComments ACCOUNT CLOSED BY CREDIT GRANTOR Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 $0 Closed FINGERHUT/WEBBANK Balance 636992XXXXXXXXXX Balance updated - Credit limit • Monthly payment Revolving Past due amount _ 12, 2021 Highest balance Closed Twins Pays account as agreed Responsibility Sep 2D22 Your statemcnt $0 Sep 23, 2D22 $300 50 Individual Account Apr May Jul,, Jul Aug Sep Ocl Nov Dec 62SO RIDGEWOOD ROAD ST CLOUD, MN 56303 (866) 734-U342 EqUIFAX Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 OPORTUN, INC $0 unknown payment history closets C'A Account info Account name OPORTUN, INC Balance $0 Account number 4950SOX Balance updated Feb 28, 2023 Original creditor - Original balance $535 Company sold - Monthly payment Account type Installmonl 'ass due amount Date opened Out 25, 2021 Term, 13 Months Open/closed closed Responsihility Individual Account Status Pays account as agreed Your statement Status updated Feb 2023 $ Payment history No payment history available to display. d Contac[info Address Phone lumber OComments 2 CIRCLE STAR WAY SAN CARLOS, CA 94070 (650)381-4025 EQUIFAX SELF RENT - RENTTRAC - . .�,�. n asymenl huslory E'A Account Info Account name SELF RENT - RENTTRAC Account number 231343X Original creditor Company sold Account type Open Account Date opened Apr 27, 2020 Open/closed r:losod Status Payv account ae agraed Status updated Nov 2020 Payment history J:v� Feb Mur ,y. May JtRt 2014 - eon 741 f. ' a^ rye • Data UuaWtlhiUla d Contact Info Address 4601 EXCELSIOR BLVD 4503;4601 t1503; ST. LOUIS PARK MINNESOTA, MN 55416 Phone number ; n � t) ., t 7 2191 Ocomments Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 $0 Closed nalance So Balance updated >lav 20, 2020 Original balance $450 Monthly payment Past due amount Perms Responxihility, Indbk111a1 Accnrmt Your statement Jul Aug gap Oct Nov ncc EgUIr—".L' Prepared For ROSA L. SHADDON Date generated: Jan 21, 2024 Collection accounts No collection accounts reported. Prepared For ROSA L. SHADDON Date generated: Jan 27, 2D24 Public records No public records reported EqufFAX' Prepared For ROSA L. SHADDON Date generated: Jan 27, 2024 Inquiries CAPITAL ONE CAPITAL ONE BANK USA EQUIFAX MORTGAGE SER hrgmrrd on May 12, 2023 Inquired on .May 1 I, 2023 Incuurd nn Feb 5, M22 Onslnnn. Tyne: Auto 1-Inonr.ing Uu.i-Sz Type• All Hank, Huslne: s Typo'. Miscollannmia Heplq Agnncien 15000 CAPITAL ONE DRIVE POO US9NY,510211 15000 CAPITAL. ONC DRIVC POO IJS05J4D1 This inquiry i; scheduled to —iUnuu un tcwrd wdil Ma1 'J02.4 RICHMOND, VA 232JO RICHMOND. VA 23236 By mall only By mail only This inquiry is scheduled to continue on record until Jun 2025 This inquiry is scheduled to continue on record :N111I.hln 2925 INFORMATIVE RESEARCH SYNCU/AMAZON PLCC Inquired on Feb 7, 20ZZ Inquired an Nov 29, 2OZ3 Busiecs Tyne: MIsce111treouu Reptg. 4genclen Bu nlnen:; Type: Sales Fkriancing This inquiry s anhedL1IP.d In cnminue on record un111 Mar 2024 PO BOX 96501 S ORLANDO, FL 32896.5015 (866) 634-UJ711 I hIn Inqulry Is scheduled m continuo on rv.cord lintll Dec 2025 'F4 [LL-� C 117, 3 Z Swim �3 q-,)i 4d-T, J1 � .33 Se.c m National Indemnity Company COMMERCIAL POLICY Report ALL Accidents To: 1-800-356-5750 24 Hour Toll Free A STOCK COMPANY IMPORTANT NOTICE TO AUTOMOBILE POLICYHOLDERS If any new or replacement drivers are hired during the term of this policy, notify the company immediately. Failure to do so may result in termination of your policy THESE POLICY PROVISIONS WITH THE DECLARATIONS PAGE, COVERAGE FORM AND ENDORSEMENTS, IF ANY, COMPLETE THIS POLICY THIS POLICY IS A LEGAL CONTRACT BETWEEN THE POLICY OWNER AND THE COMPANY READ YOUR POLICY CAREFULLY 1012312023 M-4600a (04/2003) Page 1 of 3 MOTOR VEHICLE LIABILITY INSURANCE IDENTIFICATION CARD COMPANY NUMBER COMPANY 70 National Indemnity Company POLICY NUMBER EFFECTIVE DATE 70 APS 114574 - 01 10/20/2023 12:46 PM YEAR MAKE/MODEL 2008 BUICK LACROSSE GENERAL AGENCY ISSUING CARD Risk Placement Services, Inc. 356 Hogan Lane, Suite A Conway, AR 72034 INSURED AFFORDABLE TAXI POPE COUNTY LLC 136 JENNINGS ROAD RUSSELLVILLE, AR 72802 EXCLUDED DRIVERS: Nnnn NAIC No 20087 EXPIRATION DATE 10120/2024 12:01 AM VEHICLE IDENTIFICATION NUMBER 2G4WC582481286919 PHONE NUMBER 5012239393 M-5937 AR (1112018) SEE IMPORTANT NOTICE ON REVERSE SIDE COT ALONGTHIS LINE MOTOR VEHICLE LIABILITY INSURANCE IDENTIFICATION CARD COMPANY NUMBER COMPANY 70 National Indemnity Company POLICY NUMBER EFFECTIVE DATE 70 APS 114574 - 01 10/20/2023 12:46 PM YEAR MAKE/MODEL 2008 BUICK LACROSSE GENERAL AGENCY ISSUING CARD Risk Placement Services, Inc. 355 Hogan Lane, Suite A Conway, AR 7ZD34 INSURED AFFORDABLE TAXI POPE COUNTY LLC 136 JENNINGS ROAD RUSSELLVILLE, AR 72802 EXCLUDED DRIVERS: None NAIC No 20087 EXPIRATION DATE 10/20/2D2412:01 AM VEHICLE IDENTIFICATION NUMBER 2G4WC582481286919 PHONE NUMBER 5012239393 M-5937 AR (11/2018) SEE IMPORTANT NOTICE ON REVERSE SIDE CUT ALONGTIIIS-UINE THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND Report All Accidents To: 1-800-356-5750 24 Hour Toll Free Claims may also be reported at: claims@nationalindemnity.com C:UTALONG THIS LINE THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND Report All Accidents To 1-800-356-5750 24 Hour Toll Free Claims may also be reported at: claims@nationalindemnity.com CUT ALONG FHIS LINE 10/2312023 MOTOR VEHICLE LIABILITY INSURANCE IDENTIFICATION CARD COMPANY NUMBER COMPANY 70 National Indemnity Company POLICY NUMBER EFFECTIVE DATE 70 APS 114574 - 01 10/20/2023 12:46 PM YEAR MAKE/MODEL 2012 NISSAN ALTIMA GENERAL AGENCY ISSUING CARD Risk Placement Services, Inc. 355 Hogan Lane, Suite A Conway, AR 72034 INSURED AFFORDABLE TAXI POPE COUNTY LLC 136 JENNINGS ROAD RUSSELLVILLE, AR 72802 EXCLUDED DRIVERS: None M-5937 AR (1112018) SEE IMPORTANT NOTICE ON REVERSE SIDE NAIC No. 20087 EXPIRATION DATE 10/2012024 12:01 AM VEHICLE IDENTIFICATION NUMBER 1 N4AL2APOCN448772 PHONE NUMBER 5012239393 CUTALONGTHIS LINE - - MOTOR VEHICLE LIABILITY INSURANCE IDENTIFICATION CARD COMPANY NUMBER COMPANY 7D National Indemnity Company POLICY NUMBER EFFECTIVE DATE 70 APS 114574 - 01 10/2012023 12:46 PM YEAR MAKE/MODEL 2012 NISSAN ALTIMA GENERALAGENCY ISSUING CARD Risk Placement Services, Inc. 365 Hogan Lane, Suite A Conway, AR 72034 INSURED AFFORDABLE TAXI POPE COUNTY LLC 136 JENNINGS ROAD RUSSELLVILLE, AR 72802 EXCLUDED DRIVERS: None NAIC No. 20087 EXPIRATION DATE 1012DI202412:01 AM VEHICLE IDENTIFICATION NUMBER 1N4AL2APOCN448772 PHONE NUMBER 5012239393 M-5937 AR (11/2018) SEE IMPORTANT NOTICE ON REVERSE SIDE CUT ALONG TFHS LINE THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND Report All Accidents To 1-800-356-5750 24 Hour Toll Free Claims may also be reported at: claims@nationalindemnity.com CUT ALONG THIS LINE THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND Report All Accidents To: 1-800-356-5750 24 Hour Toll Free Claims may also be reported at: claims@nationalindemnity.com CUTALONG THIS LINE 10/23/2023 SCHEDULE OF COVERED AUTOS M-5171 (0612004) POLICY NUMBER: TO APS 114674.01 NAMED INSURED AFFORDABLE TAXI POPE COUNTY LLC EFFECTIVE DATE 1012012023 12:46 PM Policy -Level Coverages The premium charge for Uninsured and Underinsured Motorist Coverage is a policy charge; separate premium charges are not made for individual covered autos. Uninsured .Motorist Coverage Underinsured Molorsl Coverage: Other: Vehicle N Year Make & Model UIN Personal !ujury Protection Premium Use' (CIS/R) Radius Garaging Tarrdoq g 7 Garaging rt Sta!e GVW or 3-I'm Uriblily Prom,ur Medical Pa menls Premium y Additionai Insured Premium In -Tow Premium Cargo Premium Stated Limit nr nor Specified Causes (S) ar Cnrr' r.n«nuvo .0 Specified Causes or r ran nervve pwnF.um Specified Causes or �om rror:en•n.-OeduddUe Collision Premium Collision Deductible 2004 FORD FREESTAR 2FMZA58254BA66129 C 100 Mlles III RU53E1-Udl"E. AR 7 Seats i,'rin z0J8 BUICK LACROSSE LACROSSE 2G4WC582481286919 C 100 Mlles 111 RUSSELLVILLE, AR 6 Seats s,fi19 zoos CHEVROLET COBALT IGIALSOF587200921 C 100 Mlles 711 RUSSEILVILLE, AR 5, Bl9 2010 MERCURY JFDAN 3MFHMDJAKAR614942 C 100 Mlles 711 IIU33ELLVILLE. AR 5 Seals 5.A9 5 Z012 NISSAN ALTIMA 1N4ALZAPDCN448772 too Miles III RU$SELLVn_LE, A < 5 Seats S,t49 2013 CHRYSLER TOWN 6 COUNTRY 2C4RCIBG60RB57614 C too Mlles I 711 RU s':Fl vPLLE, AR 7 Seats i,u49 2014 FORD FLEX 2FMGKSC89EBD03716 C 100 Miles III Rt.S 9t:LLVIU_E, AR 7 Seats I 2017 DODGE JOURNEY 3C4PDCBG9HTST2147 C 100 Miles T11 R!i, El! VILE E. AR 7 Seats S,B4'1 •Use (C = Commercial, S = Service, R = Retail) 10/23/2023 M-5171 (0612004) M-5174(0812004) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPLIT LIABILITY LIMITS This endorsement modifies insurance provided under the following BUSINESS AUTO COVERAGE FORM TRUCKERS COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. SCHEDULE "Bodily Injury" Liability: $ 50,000 Each Person $ 100,000 Each "Accident' Total "Property Damage" Liability and $ 50,000 Each "Accident' "Covered Pollution Cost or Expense": (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Paragraph C. Limit of Insurance of Section II — Liability Coverage is replaced by the following: Regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident', the limit of insurance is as follows: 1. The most we will pay for all damages resulting from "bodily injury" to any one person caused by any one "accident", including all damages claimed by any one person or organization for care, loss of services or death resulting from the "bodily injury", is the limit of "Bodily Injury" Liability shown in the Schedule for each person. 2. Subject to the limit for each person, the most we will pay for all damages resulting from 'bodily injury" (-,au>ed by any one "accident' is the limit of "Bodily Injury" Liability shown in the Schedule for each "a:;�ident'. 3. The most we will pay for the total of all damages resulting from "property damage" and "covered pollution cost or expense" combined caused by any one "accident' is the limit of "Property Damage" Liability and "Covered Pollution Cost or Expense" shown in the Schedule for each "accident". All "bodily injury", "property damage" and "covered pollution cost or expense", resulting from continuous or repeated exposure to substantially the same conditions will be considered as resulting from one "accident'. No one will be entitled to receive duplicate payments for the same elements of "loss" under this Coverage Form and any Medical Payments Coverage Endorsement, Uninsured Motorists Coverage Endorsement or Underinsured Motorists Coverage Endorsement attached to this Coverage Part All other terms, conditions and agreements remain unchanged. Company Name Policy Number National Indemnity Company 70 APS 114574 - 01 Endorsement Effective 10/20/2023 12:46 PM Named Insured Countersigned at AFFORDABLE TAXI POPE COUNTY LLC B (Authorized Representative) (The Attaching Clause needs to be completed only when this endorsement is issued subsequent to preparation of the policy .) M-5174(08/2004) 10/23/2023 POLICY NUMBER: 70 APS 114574 - 01 COMMERCIAL AUTO CA 21 08 11 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ARKANSAS UNINSURED MOTORISTS COVERAGE For a covered "auto" licensed or principally garaged in, or "auto dealer operations" conducted in, Arkansas, this endorsement modifies insurance provided under the following: AUTO DEALERS COVERAUE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsernenl, the piuvisiuns of llie Cuveraye Fuiin apply unless modified by the endorsement. This endorsement changes the Policy effective on the inception date of the Policy unless another date is indicated below. Named Insured: AFFORDABLE TAXI POPE COUNTY LLC Endorsement Effective Date: 10/20/2023 12:46 PM SCHEDULE Limit Of Insurance $ See CA 2102 (11/2006) Each "Accident" Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage 1. We will pay all sums the "insured" is legally entitled to recover as compensatory damages from the owner or driver of an "uninsured motor vehicle". The damages must result from "bodily injury" sustained by the "insured" caused by an "accident" The owner's or driver's liability for these damages must result from the ownership, maintenance or use of the "uninsured motor vehicle". 2. Any judgment for damages arising out of a "suit" brought without our written consent is not binding on us. B. Who Is An Insured If the Named insured is designated in the Declarations as: 1. An individual, then the following are "insureds": a. The Named Insured and any "family members". CA 21 08 11 18 b. Anyone else "occupying" a covered "auto" or a temporary substitute for a covered "auto". The covered "auto" must be out of service because of its breakdown, repair, servicing, "loss" or destruction. c. Anyone for damages he or she is entitled to recover because of "bodily injury" sustained by another "insured". 2. A partnership, limited liability company, corporation or any other form of organization, then the following are "insureds": a. Anyone "occupying" a covered "auto" or a temporary substitute for a covered "auto". The covered "auto" must be out of service because of its breakdown, repair, servicing, "loss" or destruction. b. Anyone for damages he or she is entitled to recover because of "bodily injury" sustained by another "insured". © Insurance Services Office, Inc., 2018 10/23/2023 Page 1 of 3 POLICY NUMBER: 70 APS 114574 - 01 COMMERCIAL AUTO CA 21 51 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPLIT BODILY INJURY UNDERINSURED MOTORISTS COVERAGE LIMITS This endorsement modifies insurance provided under the following: UNDERINSURED MOTORISTS COVERAGE With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named n u es rI d AFFORDABLE TAXI POPE COUNTY LLC Endorsement Effective Date I — "Bodily Injury": $ 10/20/2023 12:46 PM SCHEDULE Limit Of Liability 50,000 Each Person 100,000 Each "Accident' mrormanon required to complete this Schedule, if not shown above, will be shown in the Declarations. Paragraph 1. of the Limit Of Insurance provision in the Underinsured Motorists Coverage endorsement applicable to "bodily injury" is replaced by the following: 1. Regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident", the limit of insurance is as follows: a. The most we will pay for all damages resulting from "bodily injury" to any one person caused by any one "accident", including all damages claimed by any person or organization for care, loss of services or death resulting from the "bodily injury", is the limit of "Bodily Injury" shown in the Schedule for each person. CA 21 51 10 13 b. Subject to the limit for each person, the most we will pay for all damages resulting from "bodily injury" caused by any one "accident" is the limit of "Bodily Injury" shown in the Schedule for each "accident'. © Insurance Services Office, Inc., 2012 10/23/2023 Page 1 of 1 POLICY NUMBER: 70 APS 114574 - 01 COMMERCIAL AUTO CA 21 66 11 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ARKANSAS UNINSURED MOTORISTS COVERAGE - PROPERTY DAMAGE For a covered "auto" licensed or principally garaged in, or "auto dealer operations" conducted in, Arkansas, this endorsement mnriifie.s insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the Policy effective on the inception date of the Policy unless another date is indicated below Named Insured: AFFORDABLE TAXI POPE COUNTY LLC Endorsement Effective Date: 10/2012023 12:46 PM SCHEDULE Property Damage: $ 50,000 Each "Accident" Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage 1. We will pay all sums the "insured" is legally entitled to recover as damages from the owner or operator of an "uninsured motor vehicle" The damages must result from "property damage" caused by an "accident" arising out of actual physical contact with a covered "auto". The owner's or driver's liability for these damages must result from the ownership, maintenance or use of the "uninsured motor vehicle", 2. Any judgment for damages arising out of a "suit" brought without our written consent is not binding on us. B. Exclusions This insurance does not apply to any of the following: 1. Any claim settled without our consent. 2. The direct or indirect benefit of any insurer of property. 3. Property contained in the covered "auto". 4. "Property damage" to any motor vehicle owned by you or any "family member" which is not a covered "auto". 5. The first $200 of the amount of "property damage" to a covered "auto" as a result of any one "accident". However, this exclusion does not apply if: a. Your covered "auto" is insured for collision coverage under this Policy, and b. The operator of the vehicle causing the "accident" has been positively identified and is solely at fault. 6. "Property damage" arising directly or indirectly out of: a. War, including undeclared or civil war; CA 21 66 11 18 © Insurance Services Office, Inc., 2018 Page 1 of 2 POLICY NUMBER: 70 APS 114574 - 01 COMMERCIAL AUTO CA 31 28 11 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ARKANSAS UNDERINSURED MOTORISTS COVERAGE For a covered "auto" licensed or principally garaged in, or "auto dealer operations" conducted in, Arkansas, this endorsement modifies insurance provided under the following AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the Policy effective on the inception date of the Policy unless another date is indicated below Named Insured: AFFORDABLE TAXI POPE COUNTY LLC I Endorsement Effective Date: 10/20/2023 12:46 PM SCHEDULE Limit Of Insurance: $ See CA 2151 (10/2013) Each "Accident' Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage I. We will pay all sums the "insured" is legally entitled to recover as compensatory damages from the owner or driver of an "underinsured motor vehicle". The damages must result from "bodily injury" sustained by the "insured" caused by an "accident". The owner's or driver's liability for these damages must result from the ownership, maintenance or use of the "underinsured motor vehicle". 2. With respect to damages resulting from an "accident" with an "underinsured motor vehicle", we will pay under this coverage only if Paragraph a. or b. below applies: a. The limit of any applicable liability bonds or policies has been exhausted by payment of judgments or settlements; or CA 31 28 11 18 b. A tentative settlement has been made between an "insured" and the insurer of the "underinsured motor vehicle" and we: (1) Have been given prompt written notice of such tentative settlement; and (2) Advance payment to the "insured" in an amount equal to the tentative settlement within 30 days after receipt of notification. However, this Paragraph b. does not apply if the "underinsured motor vehicle" is insured by us for Covered Autos Liability Coverage 3. Any judgment for damages arising out of a "suit" brought without our written consent is not binding on us © Insurance Services Office, Inc., 2018 10/23/2023 Page 1 of 4 POLICY NUMBER: 70 APS 114574 - 01 COMMERCIAL AUTO CA 21 02 11 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SPLIT BODILY INJURY UNINSURED MOTORISTS COVERAGE LIMITS This endorsement modifies insurance provided under the following UNINSURED MOTORISTS COVERAGE With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fed by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: AFFORDABLE TAXI POPE COUNTY LLC Endorsement Effective Date 10/20/2023 12:46 PM SCHEDULE Limit Of Liability "Bodily Injury": $ 50,000 Each Person $ 100,000 Each "Accident" Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Paragraph 1. of the Limit Of Insurance provision in the Uninsured Motorists Coverage endorsement applicable to "bodily injury" is replaced by the following: 1. Regardless of the number of covered "autos", "insureds", premiums paid, claims made or vehicles involved in the "accident", the limit of insurance is as follows: a. The most we will pay for all damages resulting from "bodily injury" to any one person caused by any one "accident", including all damages claimed by any person or organization for care, loss of services or death resulting from the "bodily injury", is the limit of "Bodily Injury" shown in the Schedule for each person. CA 21 02 11 06 b. Subject to the limit for each person, the most we will pay for all damages resulting from "bodily injury" caused by any one "accident" is the limit of "Bodily Injury" shown in the Schedule for each "accident © ISO Properties, Inc., 2006 1012312023 Page 1 of 1 ❑ ARKANSAS POLICYHOLDERS IMPORTANT NOTICE We suggest you contact your agent if you have any questions or problems involving your policy Your agent may be contacted at the following: Ragsdale Insurance, Inc. 216 North El Paso Ave., Suite A Russellville AR 72801 You may contact the Company at National Indemnity Companv 1314 Douglas Street, Suite 1400 Omaha, NE 68102-1944 Telephone: (402) 916-3000 If we at National Indemnity Company with reasonable and adequate service, you should feel free to contact: Arkansas Insurance Department 1200 West Third Street Little Rock, AR 72201 (501) 371-2640 or (800) 852-5494 This notice is furnished in compliance with Arkansas Code § 23-79-138 M-5007a(1012009) fail to provide you M-5007a (10/2009) 10/2312023 At) 10 r-�XJC y . ! 5f; 1630 110 5 . M 2011 FORD F150 PICKUP R,:VIVW OW 1)0aV 91 111.'K4 R"t 11(' 1111(-(Jed CE-WACt YOU agent if youed h!F, with omw.tim Policy Details P.F'.y —o'. (t..) ;iIIAD 0tj ROS-- L A-L-1 date%'05,2621 P-11cy 1-111MV, lddr,..s :,, V'Wf AR '71.01 [.9D Whi'do SIM" Form PW-Irlt P1.11 aerrwnl —11b,!,' Vehicle Details A.MC,011-C., if AN YIN vOkle J,e r— v..0 P' . _P3 Coverages `Q42 i." I"." Property D"'.110 Cow' age Pv Ac W'Pon r—o".'ae W J1 ! 6 n—. Corot-h—,.. C.ve,aV,. L'Id, Ilih-L, it '103 ,,?i ; 56 6 lJninmired Motor ve.olciff :;overage F'.!-, C50000 11—t "'rXIAOU Uninsured Motor Vehicle, - Property Doniak,,-., Coverer,,,. ! I"! N! kl-- d"A Underinsurcri Motor Vehicle C.venij,,r i,rh N., o-'- 5qr'.Occ ..— N, I—d"'! S10.1 00v 119.Q.- 6 4— f)Lulh. Dlsviefrliarmerc and Loss of Sighl Coverage 1.5"11 N.Foult What would you like to do? Sel,..L One My Agent rA Need Help? unonpnry gnarl 3won! C,V, ss'! IS : G — DrivLrs Assigned drin, ACo Discounts 1.. uJv v;hIII TIAII: R1.13., 53'Gmns Surcharges C",!"o, k . . ! lu ".1 Endorsements G)04A.3 'NuVIDATiRy ENVOF5EMENT Quirk links Moot Fiiw., - ..ft4" t "'.idp ?�;rl 1+ Stale Farm® StateFarm Providing Insurance and Financial Services �l ) PO Box 2358 Bloomington lL 61702.2358 Attached as requested are your replacement insurance identification cards. If the attached cards are not accepted by a law enforcement agency or your Department of Motor Vehicle office, please contact your agent to receive additional assistance. Thank you for choosing State Farm for your insurance needs. -----------------------------------------� IMPORTANT - IDENTIFICATION CARDS STATE FARM StateFarm ARKANSAS A, INSURANCE CARD Stalls Farm Flrls and Casualty Company PO Box 2358 Blooibingtoli IL 6170 INSURED SMADDON, ROSE L FIRE 7135 WILLIAMSON WAY CIVIL RUSSELLVILLE AR 72801.6923 IPOLICYNUMBER 3963680-EO6.04 EFFECTIVE YR 2011 MAKE FORD NOV 06 2023 TO MAY 06 2024 (MODEL F150 VIN iFTFW1EF7BFB47749 AGENT CRAIG CAMPBELL INS AGCY INC PHONE (479)967.1880 NAIC 25143 1417.85E COVERAGES A C D1000 G1000 H RI U U1 91 T1 W StateFarm THIS CARD MUST BE KEPT IN THE INSURED MOTOR VEHICLE FOR PRODUCTION UPON DEMAND. L THE COVERAGE PROVIDED BY THE POLICY MEETS THE MINIMUM LIABILITY LIMITS PRESCRIBED BYLAW. IF YOU HAVE AN ACCIDENT - NOTIFY THE POLICE IMMEDIATELY 1. Gat names, addresses, and phone numbers of portions Involved and witnesses. Also pet driver license numbers of persona involved and 11conse plate numberslstatee of vehicles. 2. Dent aa'mlt fault or discuss the ocoiders with anyone but State Farm rx police. 3. Prompiy notify your agent, IN on to of safarm.com®, or use the State Form moblle Opp to his o claim. For EMERGENCY ROAD SERVICE me the Slats Fummobila spp log an to sisislarmocrn et call 1 e77�t7r,757. EXAMINE POLICY EXCLUSIONS CAREFULLY. 7NIS FOAM DOES NOT OOIVST7TUTE ANY PART OF YOUR INSURANCE POLICY. How to Identify your coverage. See polloy for full name and deflnfllon A Lrabdity L Physical Damage T Tolal OttobJey C MerFeel Payments R Car Rental Expense U Unnsurad Motor Vehicle 01 D Comprehensive R1 Car Rental endTraval F3tpcnses Ul Uninsured Motor Vehicle PO G Collision S Dealh, Dismembermentend UNOC Use of Nonowmcd Cars �Emergency Road Service Loss of Sight W UnderinsuradMotor Vehicle � KEEP A CARD IN YOUR CAR. THIS CARD IS INVALID IF THE POLICY FOR WHICH IT WAS ISSUED LAPSES OR IS TERMINATED, KEEP YOUR CURRENT CARD UNTIL THE EFFECTIVE DATE OF THIS CARD. MANY STATES REQUIRE EVIDENCE OF INSURANCE ON DEMAND. ONE OF THESE CARDS SHOULD BE CARRIED IN THE VEHICLE AT ALL TIMES. Emergency Road Service Information Is located on your Insurance card. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — IMPORTANT - IDENTIFICATION CARDS STATE FARM StateFarm ARICANSAS L INSURANCE CARD State Farm Fire and Casualty Company PO Box 2358 Bbolnhgton IL 6170 INSURED SHADDON, ROSE L FIRE 705 WILLIAMSON WAY OVL RUSSELLVILLE AR 72801.6923 POLICY NUMBER 3963680-EO6.04 EFFECTIVE YR 2011 MAKE FORD NOV 06 2023 TO MAY 06 2024 MODEL F150 VIN 1FTFW1EF781`1347749 AGENT CRAIG CAMPBELL INS AGCY INC PHONE (479)967.1880 NAIC 25143 1417-85B COVERAGES A C D10DO GiDOO H Ill U U1 9t T1 W StateFarm THIS CARD MUST BE KEPT IN THE INSURED MOTOR VEHICLE FOR PRODUCTION UPON DEMAND. THE COVERAGE PROVIDED BYTHE POLICY MEETS THE MINIMUM LIABILITY LIMITS PRESCRIBED BY LAW. IF YOU HAVE AN ACCIDENT - NOTIFY THE POLICE IMMEDIATELY 1. Get names, addressee, and phone numbers of perecna involved and witnesses. Also got driver license numbers of persons Involved and license plate numbarelststes of vehicles. 2. Dent admit fault or discuss the accident with anyone but Stale Farm or police. 3. Promply notifyy your agent, log on to stetelarm.com®, or use the State Farm mobile Opp to vie a claim. For EMERGENCY ROAD SERVICE use the Stale Farm mobllespp,IoZy r��s�r�e�Esell 1477-627-5757. EXAMINE POLICY EXCLUSIONS CA L NOT CONSTITUTE ANY PART OF YOUR INSURANCE POLICY. How to Identify your coverage. See policy for full name and dellnhlon A Liability L Physical Damage T Total Disability C Medical Payments R Car Rental Expense U Uninsured Maier Vehicle 01 D Comprehonsive Rt Car Remaland Travel Expenses U1 Uninsured Motor Vehicle PO G Collision S Ocolh,0iomambarmard and UNOC Use of Nonowned Cars H Fmorgency Road Sarvice loss of Sigln W Undefinsured Motor Vehicle KEEP A CARD IN YOUR CAR, THIS CARD IS INVALID IF THE POLICY FOR WHICH IT WAS ISSUED LAPSES OR IS TERMINATED, KEEP YOUR CURRENT CARD UNTIL THE EFFECTIVE DATE OF THIS CARD. MANY STATES REQUIRE EVIDENCE OF INSURANCE ON DEMAND. ONE OF THESE CARDS SHOULD BE CARRIED IN THE VEHICLE AT ALL TIMES. 143229,3 (olsoarld) 01-15.2018 Emergency Rcad Servlce Information Is located on your Insurance card. NOV 09 2023 MOTOR VEHICLE LIABILITY INSURANCE IDENTIFICATION CARD THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR COMPANY NUMBER COMPANY PRODUCTION UPON DEMAND National NAIC No, ional Indemnity Company 20087 POLICY NUMBER EFFECTIVE DATE 70 AP 114574 - 01 EXPIRATION DATE 1012012023 Report All Accidents To: 12:48 PM 1012012024 12;01 AM YEAR MAKE/MODEL 2012 VEHICLE IDENTIFICATION NUMBER NISSAN ALTIMA 1N4AL2APOCN448772 1-800-356-5750 GENERAL AGENCY ISSUING CARD Risk Placement Services, Ina. PHONE NUMBER Jos Hogan Lane, Suite A 5012239393 24 Hour Toll Free Conway, AR 72034 INSURED AFFORDABLE TAXI POPE COUNTY LLC Claims may also be reported at: 136 JENNINGS ROAD RUSSELLVILLER 72802 EXCLUDED DRIVERS: None clalms@nationalindemnity,com M-5937 AR (11/2018) SEE IMPORTANT NOTICE ON REVERSE SIDE • —CUT ALONG TIIIS LINE -CUT-A LONG THIS LINE MOTOR VEHICLE LIABILITY INSURANCE IDENTIFICATION CARD THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR COMPANY NUMBER COMPANY PRODUCTION UPON DEMAND 70 National Indemnity Company NAIC No. 20087 POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 70 APS 114574.01 Report All Accidents To 10120/2023 12:46 PM 10120/2024 12:01 AM YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 2012 NISSAN ALTIMA 1N4AL2APOCN448772 1-800-356-5750 GENERAL AGENCY ISSUING CARD PHONE NUMBER Risk Placement Services, Inc. 5012239393 24 Hour Toll Free 355 Hogan Lane, Suite A Conway, AR 72034 INSURED AFFORDABLE TAXI POPE COUNTY LLC Claims may also be reported at: 136 JENNINGS ROAD RUSSELLVILLE, AR 72802 EXCLUDED DRIVERS; None ciaims@nationalindemnity.com M-5937 AR (1112018) SEE IMPORTANT NOTICE ON REVERSE SIDE ••CUTALONCTHISLINE - . —• CUT ALONG THIS LINE- 1012312023 MOTOR VEHICLE LIABILITY INSURANCE IDENTIFICATION CARD COMPANY NUMBER COMPANY NAIC No, 70 National indemnity Company 20087 POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 70 APS 114574 -01 10120/2023 12:48 PM 1012012024 12:01 AM YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 2008 BUICK LACROSSE 2G4WC582481286919 GENERALAGENCY ISSUING CARD PHONE NUMBER Risk Placement Services, Inc. 5012239393 355 Hogan Lane, Suite A Conway, AR 72034 INSURED AFFORDABLE TAXI POPE COUNTY LLC 136 JENNINGS ROAD RUSSELLVILLE, AR 72802 EXCLUDED DRIVERS: Nono M-5937 AR 11112018) SEE IMPORTANT NOTICE ON REVERSE SIDE CUTALONGTHIS LINE • I• . • • MOTOR VEHICLE LIABILITY INSURANCE IDENTIFICATION CARD COMPANY NUMBER COMPANY NAIL No. 70 National Indemnity Company 20087 POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE 70 APS 114574 -01 10120/2023 12:46 PM 1012012024 12:01 AM YEAR MAKEIMODEL VEHICLE IDENTIFICATION NUMBER 2008 BUICK LACROSSE 2G4WC582481286919 GENERAL AGENCY ISSUING CARD PHONE NUMBER Risk Placement Services, Inc. 5012239393 355 Hogan Lane, Suite A Conway, AR 72034 INSURED AFFORDABLE TAXI POPE COUNTY LLC 136 JENNINGS ROAD RUSSELLVILLE, AR 72802 EXCLUDED DRIVERS: None M-5937 AR (11/2018) SEE IMPORTANT NOTICE ON REVERSE SIDE • -CUT ALONG -THIS LINE • THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND Report All Accidents To: 1-800-356-5750 24 Hour Toll Free Claims may also be reported at; clalms@natlonalindemnity,com CUT ALONG THIS LINE - THIS CARD MUST BE CARRIED IN THE INSURED VEHICLE FOR PRODUCTION UPON DEMAND Report All Accidents To: 1-800-356-5750 24 Hour Toll Free Claims may also be reported at: clalms@natlonallndemnity.com CUT -ALONG THIS LINE- 10123/2023 117.32- & L03 Next I 'Cop I Paein,g Options hiltr.r Options I Main Menu License Number 3909 Company Name F.kYF:TTF.VfLLP. TAXI LC Applied Date 10/10/2023 License Type Commercial Towing/Trucking/Transportation Period Start Date 10/10/2023 Expiration Date 10/31/2024 License Status Issued Address 2556 W MOUNT COMFORT RD Unit: 10 FAYETTEVILLE AR 72704 Company Type Legacy Industry Classification Taxi and Limousine Service Business Status Active Description Taxi Company Main Parcel 765-13582-000 DBA Opened Date 08/14/2012 Closed Date Last Audit Date Description of BusinessTaxi Company Business DescriptionTaxi Company Previous I Next 11011 1 Pagng Options I Filter Oplion; J Vhtin iklenu License Number 3025 Company Name HOT L I X.I"CUT[VI. 'TRANSPORTATION Applied Date 11/07/2011 License Type Commercial Towing/Trucking/Transportation Period Start Date 01/26/2012 Expiration Date 10/31/2020 License Status Revoked Address 3608 N STEELE BLVD FAYETTEVILLE AR 72703 Company Type Legacy Industry Classification Taxi and Limousine Service Business Status Closed Description Provides executive transportation service in NW Arkansas - also owns NWA Taxi, LLC; a taxi -cab company Main Parcel 765-22237-000 DBA Opened Date 0 1/0 1/2005 Closed Date Last Audit Date Business Description Provides executive transportation service in NW Arkansas - also owns NWA Taxi, LLC; a taxi- cab company Previous I Next I lop I Paging Options I Filter Options I ,Main MenLJ Code Case Number 15065 Status Closed- Resolved Type Code Enforcement Project Name Opened Date 03/05/2012 Closed Date Address ;Main Parcel Description 2-10-12 as, letter mailed to NWA Taxi. 7008 1830 0000 99.19 7095 2-14-12 as, letter delivered at 4:45pm Previous I Next 1 Top I Pagin;; Options I Filter Option: I Main Menu License Number 4661 Company Name GEAR GAMINC1 STORE Applied Date 01/07/2014 License Type Commercial Retail Goods Period Start Date 07/23/2015 Expiration Date 10/31/2020 License Status Revoked Address 1434 N COLLEGE AVE FAYETTEVILLE AR 72703 Company Type Legacy Industry Classification Other Miscellaneous Store Retailers Business Status Closed Description We are a retail game and hobby store. We plan to sell board and card games as well as miniature figures and terrain. We will also be holding small tournaments where people will come in and play games. 3-9-19 letter from prosecuting attorney sent demand letter for payment Main Parcel 765-28593-000 DBA Opened Date 01/17/2014 Closed Date 07/21/2021 Last Audit Date If No, Previous UseDance studio/taxi office business_ license_backtabOWN N SEXUALLY ORIENTED BUSINESS: N DESCRIBE: STRUCTURE NEW: N PREY USE/BUSINESS: Dance Studio / Taxi Previous I Next I Top I Paging Options I biller Options I Main [Menu Request Number 116201 Status Complete Type Zoning/Development Project Name Date Entered 02/10/2012 Deadline Date Completion Date Address Main Parcel request_nonaddress_locationTAXI SERVICE - NO LOCATION Previous I Top j Paging Options I Filter Options I Main Menu Code Case Number 2766 Status Closed - Resolved Type In -Operable Vehicle Project Name Opened Date 09/20/2004 Closed Date Address 3570 W MARTIN LUTHER KING JR BLVD FAYETTEVILLE AR 72704 Main Parcel 765-14794-000 Description Catroppa called, and we discussed the disabled taxi cab, the yellow van with expired tags, and the large 1/25/24. 11:26 AM Motor Vehicle Rocord Abtor Vehicle Record Thu ,Ian 25 11;01;51 2024 01-25-24 ARKANSAS INSURANCE TRAFFIC VIOLATION REPORT LINZY,MICHAEL,E, ADL: 923488345 2101 MILITARY OR DOB: 01-12-66 DARDANELLE YELL AR 72834 ISSUED: 06-17-21 ENDORSEMENTS: EXPIRES: 01-12-26 STATUS: NCL IS VALID CDL IS RESTRICTIONS: B CLASS: D ID CARD ISSUED EXPIRES OFFENSE CONVICTION COURT INDEX COM HAZ DATE.... DATE.... OFFENSE/ACTION... LOCATION.. TYPE NUMBER... VEH MAT ----------------------- ----------------------------------------- MNB030I: NO TRAFFIC VIOLATIONS EXIST FOR THIS PERSON THIS DRIVING RECORD IS FOR A THREE YEAR PERIOD. MNB360I: END OF RECORD httns://www.ark.ora/itvr/indox.OhO/Doouo?dlrnumber=923488345&dob=011266&realvoe=1 &requester=&client= 1/1 1 /25/24. 11:27 AM Motor Vehicle Record Motor Vehicle Record Thu Jan 25 1 1:01:05 2024 01-25-24 ARKANSAS INSURANCE TRAFFIC VIOLATION REPORT BROADUS,NAZARETH,R, ADL: 914131272 1616 E L ST COB: 10 28-82 RUSSELLVILLE POPE AR 72801 ISSUED: 04-06-21 ENDORSEMENTS: EXPIRES: 10-28-24 STATUS: NCL IS VALID CDL IS RESTRICTIONS: CLASS: D ID CARD ISSUED EXPIRES OFFENSE -CONVICTION COURT INDEX COM HA7- DATE .... DATE.... OFFENSE/ACTION... LOCATION.. TYPE NUMBER... VEH MAT ------------------------------------ ----------------------- MNB030I: NO TRAFFIC VIOLATIONS EXIST FOR THIS PERSON THIS DRIVING RECORD IS FOR A THREE YEAR PERIOD. MN80601: END OF RECORD httos://www.ark.ora/ltvr/index.ohD/DODUD?dIrnumber=914131272&dob=102882&reotvoo=1&reauester=&client= 1/1 1/25/24, 11:29AM Motor Vehicle Record Niotor Vehicle Record Thu Ja n 25 11:01:26 2024 01-25-24 ARKANSAS INSURANCE SHADDON,ROSE,LEE, TRAFFIC VTOLATION REPORT ADL: 900294454 302 JAMES CIR DOB: 11-15-70 RUSSELLVILLE POPE AR 72801 ISSUED: 04-14-20 ENDORSEMENTS: EXPIRES: 11-15-27 STATUS: NCL IS VALID CDL IS RESTRICTIONS: CLASS: D ID CARD ISSUED EXPIRES OFFENSE CONVICTION COURT INDEX HAZ DATE.... DATE.... OFFENSE/ACTION... LOCATION.. TYPE NUMBER... VEOH MAT -------- MNB030I: NO TRAFFIC VIOLATIONS EXIST FOR THIS PERSON - THIS DRIVING RECORD IS FOR A THREE YEAR PERIOD. MN806OI: END OF RECORD hltos://www.ark.ora/itvr/index.DhD/DoDUD?dlrnumber=900294454&dob=111570&realvoe=1 &reauester=&client= 1/1 Arkansas Criminal History Report This report is based on a name search. There is no guarantee that it relates to the person you are interested in without fingerprint verification. This report includes a check of Arkansas files only. Inquiries into FBI files are not permitted for non -criminal justice or employment purposes without specific statutory authority. Last: Shaddon First: Rose Middle: Lee Date of Birth: 11/15/1970 Sex: F Race: W Social Security Number: 432199489 (not verified, supplied at time of request) Home/Mailing Address: 705 Williamson Way Russellville , AR 72801 ROSA LEE RHEA F ROSA LEE HIGMAN _ ROSE LEE HIGMAN F ROSA HIGMAN F ROSE T UNDERWOOD _ ROSA LEE SHADDON F ROSE LEE SHADDON F ROSA LEE UNDERWOOD F ROSA LEE THOMPSON F ROSA LEE RHEA F 03/22/1994 YELL COUNTY SHERIFF 02/24/2003 LOGAN COUNTY SHERIFF'S OFFICE Transaction Number: 003797501 W 11/15/1970 432199489 W 11/15/1970 000000000 W 11/15/1970 432199489 W 11/15/1970 432199489 W 11/15/1970 432199489 W 11/15/1970 000000000 W 11/15/1970 000000000 11/15/1970 000000000 11/15/1970 000000000 11/15/1970 000000000 F C HOT CHECK/PERSONAL SERVICES $200—$2500 (CONVICTION) F C HOT CHECK/PERSONAL SERVICES $200—$2500 (CONVICTION) Date: 05/17/2023 Agency Reporting: Arkansas State Police Purpose. Non -mandated under Arkansas Code §12-12-1501 through 1513 allows the release of Arkansas non- criminal justice background information to persons who have the signed consent of the subject of the record. The release form on file with the employer, service provider or third party must indicate that the employer or Service ProviderfThird Parry Agent on behalf of the employer or subject shall have the authority to request the criminal background check. INA and the Arkansas State Police will hold the third party responsible for any inquiries or audits that may be conducted. Released To: Rose Shaddon Representing: Affordable Taxi of Pope Co LLC Mailing Address: 705 Williamson Way Russellville, Arkansas 72801 This Arkansas criminal history record report should only be used for the purpose that it was requested. A request that is posed for a different purpose may result in more or less Information being reported. This report does not preclude the possible existence of additional records on this person which may not have been reported to the State Identification Bureau and Central Repository. Changes in a criminal history record can occur at any time due to new arrests andlor ongoing legal proceedings. Arkansas Criminal History Report This report is based on a name search. There is no guarantee that it relates to the person you are interested in without fingerprint verification. This report includes a check of Arkansas files only. Inquiries into FBI files are not permitted for non -criminal justice or employment purposes without specific statutory authority. Last: Linty First: Michael Middle: Date of Birth: 01/12/1966 Sex: M Race: B Social Security Number: 429473172 (not verified, supplied at time of request) Home/Mailing Address: Dardanelle , AR 72834 MICHAEL EUGENE LINZY M B 01/12/1966 429473172 MICHAEL E LINZY M B 01/12/1966 000000000 06/14/1999 YELL COUNTY HOT CHECK/PERSONAL SERVICES $200—$2500 SHERIFF F C (CONVICTION) Transaction Number: 003999518 Date: 02/08/2024 Agency Reporting: Arkansas State Police Purpose: Non -mandated under Arkansas Code §12-12-1501 through 1513 allows the release of Arkansas non- criminal justice background information to persons who have the signed consent of the subject of the record. The release form on file with the employer, service provider or third party must indicate that the employer or Service Provider/Third Party Agent on behalf of the employer or subject shall have the authority to request the criminal background check. INA and the Arkansas State Police will hold the third party responsible for any inquiries or audits that may be conducted. Released To: Rose Shaddon Representing: Affordable Taxi of Pope Co LLC Mailing Address: 705 Williamson Way Russellville, Arkansas 72801 This Arkansas criminal history record report should only be used for the purpose that it was requested. A request that is posed for a different purpose may result in more or less information being reported. This report does not preclude the possible existence of addltional records on this person which may not have been reported to the State Identification Bureau and Central Repository. Changes in a criminal history record can occur at any time due to new arres!s and/or ongoing legal proceedings. This Arkansas crimina! background check report Is for non -criminal justice purposes and may only reflect if a person has any Arkansas felony and misdemeanor conviction(s). any Arkansas felony arrest that occurred in the last five (5) years that has not been to court and whether the person is a registered sex offender or required to register as a sex offender. Juvenile arrest and/or court information will not be released on this report. Arkansas Criminal History Report This report is based on a name search. There is no guarantee that it relates to the person you are interested in without fingerprint verification. This report includes a check of Arkansas files only. inquiries into FBI files are not permitted for non -criminal justice or employment purposes without specific statutory authority. Last: Broadus First: Nazareth Middle: Ray Date of Birth: 10/2811982 Sex: M Race: B Social Security Number: 432498974 (not verified, supplied at time ofrequest) Home/Mailing Address: Russellville , AR 72801 NAZARETH RAY BROWDUS M B NAZARETH R BROADUS M B 05/23/2012 HELENA — WEST HELENA POLICE F C DEPARTMENT Transaction Number: 003999523 10/28/1982 432498974 10/28/1982 000000000 Date: 02/08/2024 Agency Reporting: Arkansas State Police POSS CTRL/CNFT SUB WO PRESC 3RD OFF (CONVICTION) Purpose: Non -mandated under Arkansas Code §12-12-1501 through 1513 allows the release of Arkansas non- criminal justice background information to persons who have the signed consent of the subject of the record. The release form on file with the employer, service provider or third party must indicate that the employer or Service Provider/Third Party Agent on behalf of the employer or subject shall have the authority to request the criminal background check. INA and the Arkansas State Police will hold the third party responsible for any inquiries or audits that may be conducted. Released To: Rose Shaddon Representing: Affordable Taxi of Pope Co LLC Mailing Address: 705 Williamson Way Russellville, Arkansas 72801 This Arkansas cnmmai history record report should only be used for the purpose that it was requested, A request that is posed for a different purpose may result in more or less information being reported. This report does not oreclude the possible existence of additional records on this person which may not have been reported to the State Identification Bureau and Central Repository. Changes in a criminal history record can occur at any time due to new arrests and/or ongoing legal proceedings. 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