HomeMy WebLinkAbout106-12 RESOLUTIONr
• •
RESOLUTION NO. 106-12
A RESOLUTION GRANTING A CERTIFICATE OF PUBLIC
CONVENIENCE AND NECESSITY TO A TO Z TAXI FOR THE
OPERATION OF UP TO FIVE (5) TAXICABS IN THE CITY OF
FAYETTEVILLE
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 hereby grants a
Certificate of Public Convenience and Necessity to A to Z Taxi for the operation of up to five (5)
taxicabs in the City of Fayetteville, in accordance with Chapter 117 of the Fayetteville Code of
Ordinances.
PASSED and APPROVED this 15th day of May, 2012.
APPROVED: ATTEST:
B
By: 7ty. , AA.
SONDRA E. SMITH, City Clerk/Treasurer
................
....R t...''o
FAYETTEVILLE:
•
Vit.
•City of Fayetteville Staff Review Form
Greg Tabor
Submitted By
City Council Agenda Items
and
Contracts; Leases or Agreements
5/15/2012
City Council Meeting Date
Agenda Items Only
Police
Division
Action Required:
•
Police
Department
Schedule a public hearing to determine if a Certificate of Public Convenience and Necessity should be issued to A to
Z Taxi.
N/A
Cost of this request
Account Number
Project Number
Budgeted Item
$
Category / Project Budget
Program Category / Project Name
Funds Used to Date Program / Project Category Name
Remaining Balance Fund Name
Budget Adjustment Attached
Departme erector//�/% ,"
Cit(�ICttorney
Previous Ordinance or Resolution #
Date
(41142-
/ Original Contract Date:
/'1 /2 Original Contract Number:
Date
i • 21-201L
Finance and Internal Services Director Date
Date
ate
Received in Cit9 4- 27 -1 2 Al l :49 RCVD
Clerk's Office
lho
Received in
Mayors Office
Comments:
Revised January 15, 2009
•
avlevi1e
•
THE CITY OF FAYETTEVILLE, ARKANSAS
DEPARTMENT CORRESPONDENCE
ARKANSAS
www.accessfayetteville.org
CITY COUNCIL AGENDA MEMO
To: Mayor Ltoneld Jordan and Members of the Fayetteville City Council
From: Greg Tabor — Chief of Policet4
Fait
Date: April 27, 2012
Subject: Request for Public Hearing on a Certificate of Public Convenience and Necessity for A to Z Taxi
PROPOSAL:
The council should schedule a public hearing to determine if a Certificate of Public Convenience and Necessity
should be issued to A to Z Taxi.
RECOMMENDATION:
City Ordinance §117, article IV governs taxicabs and requires a public hearing to determine if there exists the
further need for taxicab service.
The applicant has provided a completed application, proof of insurance and financial statement. The applicant
have asked for a permit to operate 1-4 cabs.
BUDGET IMPACT:
None
• •
RESOLUTION NO.
A RESOLUTION GRANTING A CERTIFICATE OF PUBLIC
CONVENIENCE AND NECESSITY TO A TO Z TAXI FOR THE
OPERATION OF UP TO FOUR (4) TAXICABS IN THE CITY OF
FAYETTEVILLE
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 hereby grants a
Certificate of Public Convenience and Necessity to A to Z Taxi for the operation of up to four (4)
taxicabs in the City of Fayetteville, in accordance with Chapter 117 of the Fayetteville Code of
Ordinances.
PASSED and APPROVED this 15`h day of May, 2012.
APPROVED: ATTEST:
By: - By:
LIONELD JORDAN, Mayor SONDRA E. SMITH, City Clerk/Treasurer
•
•
Tracy&
TWE airy OF rAVBT..tALLE,ARRANSAS
Development Services • 125 W. Mountain Street • Fayetteville, AR 72701
Business Status:] ExlsUng (Opened prior to October 31, 2011)
Typo of Business:
Q Industrial Q Institutional 0 Nonprofit Q Home OccupeUon
Naw
Holel/Mbtel Qliguor Sales ja Bar Restaurant/Food Preparation
3ac!isonr'!• .YHers 4 Am?
Business/Organization Name: A to �- TetY
Street Address: 1 17 iv1x. Doom; e
Malting Address: s4nlE
Web Address:
OutdorxlSidawalk Vendor
Phone: 97T --O //-ot3ge
Business Owner/Operator. 3. -et JO —3-0)) Jac ppPrlmary C.ontact)(YES Q NO
Street Address: 1),7I92. Panner 3"aId• 3elt3on t/,• n? I,(5 9d', 7,2.709
7
Phono: 71/ - 2 z-' 0 '5 0 Emergency Phone:
E -Mail Address: l- 7 J / c r r. eali
Building owners name: .,5:..7'i
Emergency Contacts (additional contact information Is not required for businesses operated out of the hone) In the event of a
police or fire emergency. the Information you provide assists us In contacting you alter hours. Ideally, the first contact person should
be able to respond to the business In a short amountoftime and have the necessary keys or alarm codas M enter the building.
•
1st Contact Person' Cr 1.Vdvielf fl9 Emergency, Phone: 4 -301-L`327
n' ,Mi
2nd Contad Pmsom r 1 G C.; /7! Emergency Phone: 7 i - 903 -3W
Detailed desatptlon of business (a thorough description aids In faster application processing): ' 1 e (j S e Iry I c.e
Oalc opened/to open: /' 2 fel.: 12- •
# of employees (full time): ` t /'r 1G nc•-.-fC-' j) / I I,1% #of employees (pan time): -TS D
nofparWrgspaces: N(.ec
it or handicapped (ADA) spaces tail R
Square feet of building (total): t-,.]' Square feet of your spam: t-' ( pe
Previous use of building: - N11
Chock all of the foltovdng that apply to your business/organization. If Yes, please describe.
Q Ye. Q No: Does the building have a sprinkler system?
Q Yes Q No:.ts Orem a fire alarm?
Q Yes Q No: Do you store flammable/explosive matedels?
Q Yrs Q No: is there outdoor storage of materials and/or equipment?
Q Yen 014o: Is the business a bar, restaurant or lodging?
0 Yes 0 No: Is outdoor music or dance fiocrproposod?
Q Yes Q No: Do you share parking with another business?
Q Yes 9 No: Is the business an adult establishment under City Coda 163.11? 4
a
Is business: business: minority WeITit n veteran owned? (For data purposes only)
V rc 0 Net Would you like to be listed on a web directory? (Company name, addreso, Pima anly)
IaCce Q No: Would you like to receive °malls with BID & RPP announcements (i ii the City?
No bUlneer Of other warty awl Is repulsed by Chapter 110 trap City code to *Kilns Gusto= Uennee shell operate, without Riving and displaying nt the
business 0 cod and cunt City of Fayetteville BirnNeseLtGMO. 1 hereby certify that Um shove Infemallon la Remote and true to The best of my knowledge.
Ilasnl Name (Print): l v�<nIh . J o h 113,17n Data:_�_O� t ~ �•
APP
Applicant Signature
IN
•
•
•
•
j (AS
• Certificate of
A. required to comply
ovt \Jt)rutt&yn .
Public Convenience & Necessity
Applicatlon/Renewal
with Chapter 117 of the Fayetteville Code of Ordinance.
Illi 2_ D ti ADJ.e, .JCLGIC.srin IRI' R -r-9 ., Sumh'UL6T, Pc2%zi}
(<
Applicant
k
TO
Name
Z
Address
4-19-?J:19•
Phone
Numbor LFA
32y
er Z -28.0'7S0
to .i
Nome of
\ let
Buslnoaao
2— .cv „a,.\
or\
Phone
Numbor
PT?:
1 2 `L CI
c c.tL
1
\ , T �OnC l SU1nVneVS,
Business
SCLV
Locatlbn
VL
L
Malting
Address
Type of
Name and
J[:L.`50
Business
address
V'\
(Sole
of
--\0
Proprietor,
all owners,
Ne•-
�.S
Corporation,
officers and
v6--� /
•
stockholders:
I.
LLC)
412
\\
_u C»t e•-i?%LC. tc-
''''
��cY, So/v14.1.-1l'..
F
�v-I. \7
�,
Name of person
to whom complaints
should bo directed:
Financial status of applicant (Attach financial statement or profit and lose statement)
•
•
•
List any unpaid Judgments against any of the owners, officers and stockholders and the nature
to�said Judgments:
l
or acts giving rise
0 L:t'1,•
111Q,irC aye,
=,.,.. c -c (XC i Cr�...kc.pi t;3
tii it yNxk�- ;,\-rClr.,
C,.v -„,-\.6,_,,,r-
r%frii � '. CTC S 0L.:Ytc>\CS. .('-r
Ln, ,Kap i 1
Describe the experience of all owners, officers and stockholders In the transportation of passengers:
E-Sci 5 1/4--•sp \Gula Sc -Aro) C -e.- C.vvrcvCL, \ t-- 0\DL..v«F; �`.,,
a S ].f7Y '' moi•. s
C.Evc`O` LL-� 1 t✓0GL_L.titiCL.)).
Y_
J
Give facts believe tend to prove the necessity of granting a certificate:z
any you tock , lite
csvere.A.aij. -tvavc.. •S s C.•-. 'v t e . c�e.l'.'�q,,,d„ Po v- tcvci Se-Witr s
(Spzc_.:.al '. i.c• On-'vcvs.r,i oP
ak-ctic_k-~_s wz„cSs
0.a, iwl_ tWr'cs
u.:).( Pxk s c am+ ?.,vim%- cm R t\Las
C1cnc.a..,..s4.6. Cc .e ,.SEs ; v. ,
t CL
S\
Cut_ Y O \tom .N,+Gt. t1p.� civ. a-§.LC.v Nec_.rj .
Q
V.+- . s c -.v.&
S AS-, Sic. t.l:l'Y�& t tnn.0 ` GItL>l n -v cs
-.n— c -L•S::i-L0-L
"JPXI.\\C.iS L..J.:9Lti C.V,C.I.=_re-s-Nr-' �YO' 9� oA-!sl.lY
Yom' Y �+ C LQ L e. , -
feet.)
�1
- p
that will be bnder your operation or control: •
: `(^� h �`
11�orehe
LiIstst the number of vehicles CcS
:'O A
'C4 cLCLCL -
1 5
to be
Minimum and Maximum number of vehicles permitted:
List tho location of proposed depots and terminals:
S 'f••.0
4c_
Minimum Maximum
Loci—.—0:Q c'—i--
R -w CSe cg_ LOCCL4-eCvA ; o-
-e
r
OU5D S. Sc,V.oe,l Nutt-• -c;. tkr n�- 121Ct GAS
\t'tkiv
•
Describe the color scheme or Inelgnla to be used to designate your vehicle:
RLaclt over 4.9
List your days and hours of operation:
A 4 16V4 r
7 Clays per week-
List
eek
List any days you do not propose to provide taxicab service to the general public:
\'‘,Ij 6 -
List your proposed passenger rate schedule:
1P-Pv- S1-ct1c re.o,Vka C -v_5 (1A:.ck'fc may'", ,•Li . *0
lice epertment Repro.sbntative
--Ta tykes i r
L 4-12
Data
•
ATOZTAXI
11792 Donnie Jackson Pit Road
Summers, Arkansas 72769
April 24, 2012
City of Fayetteville
Attn: Sgt. J. Harter
100 A West Rock Street
Fayetteville, Arkansas 72701
Dear Sergeant Harter:
•
Please accept this letter as a financial statement on behalf of A TO Z TAXI as per the
City of Fayetteville new business application requirements.
A TO Z TAXI, LLC is an Arkansas limited liability company who is in good standing
with the State of Arkansas and does not have any liens or judgments against it;
furthermore, I am the owner/managing member of the company and I do not have any
outstanding liens/judgments against me personally.
Respectfully,
'ason Johnson
Owner/Managing Member
• •
Endorsement *1
GENERAL CHANGE ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement changes the policy on the inception date of the policy or on the date shown below.
It is agreed that the policy is changed as follows:
THE NAMED INSURED INFORMATION IS AMENDED TO READ AS FOLLOWS:
Name and Address:
JASON JOHNSON DBA: A TO Z TAXI
11792 TONNIE JACKSON TITT ROAD
SUMMERS, AR 72769
Business Form: Individual
Named Insured Description of TAXI
Additional Premium $
Return Premium $
All other terms, conditions and agreements remain unchanged.
N-2904 (11120)
Company Name
National Liability & Fire Insurance Company
Policy Number
73 APR 271643
Endorsement Effective
01/25/2012 11:17 AM
Named Insured
JASON JOHNSON
Countersigned at
by
M.2904 (11180)
onzed nepresentaove
(The Attaching Clause need be completed only when this endorsement is issued subsequent to preparation of the policy.)
01/28/2012 15:0817280015-1364-47F8-9084-EEBF999E4000
• •
MOTOR VEHICLE LIABILITY INSURANCE
IDENTIFICATION CARD
COMPANY NUMBER COMPANY NAIC No.
73 National Liability & Fire Insurance Company 20052
POLICY NUMBER
73 APR 271843
EFFECTIVE DATE EXPIRATION DATE
0112312012 11:39 AM 01/2312013 12:01 AM
YEAR MAKE/MODE VEHICLE IDENTIFICATION NUMBER
2000 PONTIAC MONTANA 1GMDU03EIYD204318
AGENCY/COMPANY ISSUING
Argenta, LLC
11524 Fairview Road
Little Rock, AR 72212
INSURED
JASON JOHNSON DBA: A TO 2 TAXI
11792 TONNIE JACKSON TITT ROAD
SUMMERS, AR 72780
SEE IMPORTANT NOTICE ON REVERSE SIDE
M -4566a (11119991
CUT *tt:ONG TH7 S i:INE
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:
ctaims@nationalindemnity com
MOTOR VEHICLE LIABILITY INSURANCE
IDENTIFICATION CARD
COMPANY NUMBER COMPANY NAIC No.
73 National Liability S Fire Insurance Company 20052
POLICY NUMBER
73 APR 271843
EFFECTIVE DATE EXPIRATION DATE
01121201211:39 AM 01(21201312:01 AM
YEAR MAKE/MODE VEHICLE IDENTIFICATION NUMBER
2000 PONTIAC MONTANA 1CMDU03E1Y0204318
AGENCY/COMPANY ISSUING
Argenla, LLC
11524 Fairview Road
Little Rock, AR 72212
INSURED
JASON JOHNSON DBA: A TO Z TAXI
11792 TONNIE JACKSON TITT ROAD
SUMMERS, AR 72789
SEE IMPORTANT NOTICE ON REVERSE SIDE
M -4566a (1111999)
CUT ALONG -THIS UNE
CIPFALONG nes 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@nabonalindemnity.com
CUT -ALONG Isms LINE
0112612012 15:07 0890E4A141EA4.4120-ACC1.14133049DAFF5
Endorsement *2
• •
GENERAL CHANGE ENDORSEMENT
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement changes the policy on the inception date of the policy or on the date shown below.
It is agreed that the policy is changed as follows:
In consideration of an additional premium shown below, the following coverage has ban MODIFIED on the policy and hereby modify the Declaration, page -NLF
sans (01r2006):
Coverage Old Limb
New Limit
Liability 100,000
100,000000,0001100,000
The following endorsements and forms an attached and become part of the policy:
M 5171 00/2004 Split Liability Limits
Coverage Old Limit
New Limit
M-2904(11190)
Vett
year
Make
Model
VIN
Use
Old Annual Premium
Llab
UM
UIM
Med Pay
PIP
I
2000
PONTIAC
\8ONTANA
1GMD103E1YD201319
c
2,720
Incl.
Incl.
391
Ne
Annual Premium
Prorated Premium
Named Insured
JASON JOHNSON
Countersigned at
by
Veh
#
Llab
UM
UIM
PIP
Med Pay
Llab
UM
UIM
PIP
Med
Pay
Subtotal by
Vehicle
f
3.099
Incl.'
Incl.
391
376
Incl.•
Incl.
376
Subtotal
376
Pro -Rate Factor:
0.995
AO other terms, conditions and agreements remain unchanged.
Additional Premium $ 376
Return Premium $
Company Name
National Liability St Fire Insurance Company
PolicyNumber
73APR271643
Endorsement Effective
01/25/2012 2:57 PM
Named Insured
JASON JOHNSON
Countersigned at
by
M•291:14 (11180)
(The Attaching Clause need be completed only when this endorsement is issued subsequent to preparation of the policy.)
01/26/2012 15:08 E53C13101-D3AF-99E9-92CD-03209238F7E2
• •
NF5174 (08/2004)
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.
"Bodily Injury' Liability:
Total "Property Damage" Liability and
"Covered Pollution Cost or Expense"
SCHEDULE
$ 100,000
$ 300,000
$ 100,000
Each Person
Each Accident'
Each "Accident"
(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"
caused by any one "accident" is the limit of "Bodily Injury" Liability shown in the Schedule for each
"accident'.
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
National Liability 8 Fire Insurance Company
Policy Number
73APR271643
Endorsement Effective
01/25/2012 2:57 PM
Named Insured
JASON JOHNSON
Countersigned at
By
(Auttmzed Representatr. )
(The Attaching Clause needs to be completed only when this endorsement is issued subsequent to preparation of the policy.)
01128/2012 15:08 48185F85D.A5C7-4563-8910.5C8F6DCECE9A
NI -5174 (08/2004)
•
•
1
Argenia, LLC
P.O. BOX 17370
Little Rock, AR 72222-7370
1
Bill To: AGT313
Insured: 591934 Agent: AGT313
CSR: ehale Acct Exc: rvshort
McKinney Agency *
P.O. Box 1069
Fayetteville, AR 72701
Attn:
Submission No: 0690583
INVOICE
Invoice Date.
Invoice Number:
Page:
1/27/2012
117008
1
Insured:A to Z Taxi
INVOICE PAYMENT
Payment Due On: 2/16/2012
DBA : Jason Johnson
Expires:
Insurance Company:
Policy Number:
Effective:
Expires:
National Liability & Fire Insurance
73APR271643
1/25/2012
1/23/2013
Type Of Transaction Line Of Business
Endorsement - Addl Premium NLF Business Auto - Liability RM0006
CompID Amount Comm($)
$376.00 $37.60
Net Due
S338.40
Amount Invoiced:
Comm %
Commission
Invoice Amount
$376.00
10
$37.60
$338.40
1
Note:
1
Agency 841
ehele
MOTOR VEHICLE LIABILITY INSURANCE
IDENTIFICATION CARD
COMPANY NUMBER COMPANY NAIC No. 20052
73 National Liability & Fire Insurance Company
POLICY NUMBER EFFECTIVE DATE
73 APR 271643 01/2312012 11:39 AM
YEAR MAKE/MODEL
2000 PONTIAC MONTANA
AGENCY/COMPANY ISSUING CARD
Argonla, LLC
11624 Fairview Road
Little Rock, AR 72212
INSURED
JASON JOHNSON DBA: A TO Z TAXI
11792 DJ PIT RD
SUMMERS, AR 72769
M4566a 11111999)
EXPIRATION DATE
01/23/2013 12:01 AM
VEHICLE IDENTIFICATION NUMBER
IGMDUO3EIYD204318
SEE IMPORTANT NOTICE ON REVERSE SIDE
CUrALONG- TINS 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@naUonalindemnity.com
MOTOR VEHICLE LIABILITY INSURANCE
IDENTIFICATION CARD
COMPANY NUMBER COMPANY NAIC No. 20052
73 National Liability & Fire Insurance Company
POLICY NUMBER EFFECTIVE DATE
73 APR 271643 01123/2012 11:39 AM
YEAR MAKE/MODEL
2000
PONTIAC MONTANA
AGENCY/COMPANY ISSUING CARD
Argenla, LLC
11524 Fairview Road
Little Rock, AR 72212
INSURED
JASON JOHNSON DBA: A TO Z TAXI
11792 DJ PIT RD
SUMMERS, AR 72769
M4566a (1111999)
EXPIRATION DATE
0112312013 12:01 AM
VEHICLE IDENTIFICATION NUMBER
1GMDUO3EIYD204318
SEE IMPORTANT NOTICE ON REVERSE SIDE
CUT ALONG - THIS LINE
CUT AI ON(:•'1'11 IS•LIN E
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
,ti.ONG THIS I INE
0112412012 15:21 E92F66CC-F94849EC-9E03-03E8DD72C368
• •
National Liability & Fire Insurance 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 ISA LEGAL
CONTRACT BETWEEN THE POLICY OWNER AND THE COMPANY.
READ YOUR POLICY CAREFULLY
011241201218:21 E92F66CC-F9413.49EC-9E03-03E8DD72C368
M -4600a (04/2003) Page 1 of 3
COMMON POLICY CONDITIONS
All Coverages included in this policy are subject to the following conditions:
A. CANCELLATION
1. The first Named Insured shown in the
Declarations may cancel this policy by mailing
or delivering to us advance written notice of
cancellation.
2. We may cancel this policy by mailing or
delivering to the first Named Insured written
notice of cancellation at least:
a. 10 days before the effective date of
cancellation if we cancel for nonpayment
of premium, or
b. 10 days before the effective date of
cancellation if we cancel for any other
reason.
3. We will mail or deliver our notice to the first
Named Insured's last mailing address known to
us
4. Notice of cancellation will state the effective
date of cancellation. The policy period will end
on that date at 12:01 a.m. unless another time
is stated on the cancellation notice.
5. If this policy is cancelled, we will send the first
Named Insured any premium refund due. If we
cancel, the refund will be pro rata. If the first
Named Insured cancels, the refund may be
less than pro rata. The cancellation will be
effective even if we have not made or offered a
refund.
6. If notice is mailed, proof of mailing will be
sufficient proof of notice.
B. CHANGES
This policy contains all the agreements between you
and us concerning the insurance afforded. The first
Named Insured shown in the Declarations is
authorized to make changes in the terms of this policy
with our consent. This policy's terms can be amended
or waived only by endorsement issued by us and
made a part of this policy.
C. EXAMINATION OF YOUR BOOKS AND RECORDS
We may examine and audit your books and records
as they relate to this policy at any time during the
policy period and up to three years afterward.
D. INSPECTIONS AND SURVEYS
We have the right but are not obligated to:
1. Make inspections and surveys at any time;
2. Give you reports on the condition we find;
and
3. Recommend changes.
Any inspections, surveys, reports or
recommendations relate only to insurability and
the premiums to be charged. We do not make
safety inspections. We do not undertake to
perform the duty of any person or organization to
provide for the health or safety of workers or the
public. And we do not warrant that conditions:
1. Are safe or healthful; or
2. Comply with laws, regulations, codes or
standards.
This condition applies not only to us, but also to
any rating, advisory, rate service or similar
organization which makes insurance inspections,
surveys, reports or recommendations.
E. PREMIUMS
The first Named Insured shown in the
Declarations:
1. Is responsible for the payment of all
premiums: and
2. Will be the payee for any return premiums
we pay.
F. TRANSFER OF YOUR RIGHTS AND DUTIES
UNDER THIS POLICY
Your rights and duties under this policy may not
be transferred without our written consent except
in the case of death of an individual named
insured.
If you die, your rights and duties will be transferred
to your legal representative but only while acting
within the scope of duties as your legal
representative. Until your legal representative is
appointed, anyone having proper temporary
custody of your property will have your rights and
duties but only with respect to that property.
M -4600a (04/2003) Page 2 of 3
NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT
1. The insurance does not apply:
A. Under any Liability Coverage, to "bodily
injury" or "property damage":
(1) With respect to which an "insured" under
the policy is also an insured under a nuclear
energy liability policy issued by Nuclear
Energy Liability Insurance Association,
Mutual Atomic Energy Liability
Underwriters, Nuclear Insurance
Association of Canada or any of their
successors, or would be an insured under
any such policy but for its termination
upon exhaustion of its limit of liability; or
(2) Resulting from the "hazardous properties"
of "nuclear material" and with respect to
which (a) any person or organization is
required to maintain financial protection
pursuant to the Atomic Energy Act of 1954,
or any law amendatory thereof, or (b) the
"insured" is, or had this policy not been
issued would be, entitled to indemnity from
the United States of America, or any
agency thereof, under any agreement
entered into by the United States of
America, or any agency thereof, with any
person or organization.
B. Under any Medical Payments coverage, to
expenses incurred with respect to "bodily
injury" resulting from the "hazardous properties"
of "nuclear material" and arising out of the
operation of a "nuclear facility" by any person
or organization.
C. Under any Liability Coverage, to "bodily injury"
or "property damage" resulting from the
"hazardous properties" of "nuclear material," if:
(1) The "nuclear material" (a) is at any "nuclear
facility" owned by, or operated by or on
behalf of, an "insured" or (b) has been
discharged or dispersed therefrom.
(2) The "nuclear material" is contained in
"spent fuel" or "waste" at any time
possessed, handled, used, processed,
stored, transported or disposed of by or on
behalf of an "insured" or
The "bodily injury" or "property damage"
arises out of the furnishings by an "insured"
of services, materials parts or equipment
in connection with the planning,
construction, maintenance, operation or
use of any "nuclear facility," but if such
facility is located within the United States
of America its territories or possessions
or Canada, this exclusion (3) applies only
to "property damage" to such "nuclear
facility" and any property thereat.
(3)
(Broad Form)
2. As used in this endorsement:
"Hazardous properties" include radioactive, toxic
or explosive properties;
"Nuclear material" means "source material,"
"Special nuclear material" or "by-product
material";
"Source material," "special nuclear material," and
"by-product material" have the meanings given
them in the Atomic Energy Act of 1954 or in any
law amendatory thereof;
"Spent fuel" means any fuel element or fuel
component, solid or liquid, which has been used
or exposed to radiation in a "nuclear reactor";
'Waste" means any waste material (a) containing
"by-product material" other than the tailings or
wastes produced by the extraction or
concentration of uranium or thorium from any ore
processed primarily for its "source material"
content, and (b) resulting from the operation by
any person or organization of any "nuclear facility"
included under the first two paragraphs of the
definition of "nuclear facility."
"Nuclear facility" means:
(a) Any "nuclear reactor";
(b) Any equipment or device designed or
used for (1) separating the isotopes of
uranium or plutonium, (2) processing or
utilizing "spent fuel," or (3) handling,
processing or packaging "waste";
(c) Any equipment or device used for the
processing, fabricating or alloying of
"special nuclear material" if at any time •
the total amount of such material in the
custody of the "insured" at the
premises where such equipment or
device is located consists of or
contains more than 25 grams of
plutonium or uranium 233 or any
combination thereof, or more than 250
grams of uranium 235;
(d) Any structure, basin, excavation,
premises or place prepared or used for
the storage or disposal of "waste';
and includes the site on which any of the
foregoing is located, all operations conducted
on such site and all premises used for such
operations.
"Nuclear reactor" means any apparatus
designed or used to sustain nuclear fission in
a self-supporting chain reaction or to contain
a critical mass of fissionable material;
"Property damage" includes all forms of
radioactive contamination of property.
M -4600a (04/2003) Page 3 of 3
• •
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ARKANSAS NOTICE
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTOMOBILE COVERAGE PART
PERSONAL AUTO POLICY PART D - COVERAGE FOR DAMAGE TO YOUR AUTO
The following statement is added to the policy:
IN THE REPAIR OF YOUR COVERED MOTOR VEHICLE UNDER THE PHYSICAL DAMAGE COVERAGE
PROVISIONS OF THIS POLICY, WE MAY REQUIRE OR SPECIFY THE USE OF MOTOR VEHICLE PARTS
NOT MADE BY THE ORIGINAL MANUFACTURER. THESE PARTS ARE REQUIRED TO BE AT LEAST
EQUAL IN TERMS OF FIT, QUALITY, PERFORMANCE, AND WARRANTY TO THE ORIGINAL MANUFACTURER
PARTS THEY REPLACE.
IL 09 09 03 98
IL 09 09 03 98
0112412012 15:21 E92F88CC-F948-49EC-9E03-03E80D72C388
Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 0
NEW
RENEWAL OF NUMBER
73 APR 271643
ITEM ONE NAMED INSURED & ADDRESS
JASON JOHNSON
DBA: A TO Z TAXI
11792 DJ PIT RD
SUMMERS, AR 72769
POLICY PERIOD: Policy covers FROM
• •
NATIONAL LIABILITY & FIRE INSURANCE COMPANY
STAMFORD, CONNECTICUT
BUSINESS AUTO COVERAGE DECLARATIONS
O The Declarations
include a second part
designated "Part r
GA Code: N03001
FORM OF NAMED INSUREDS BUSINESS: Individual
NAMED INSURED'S BUSINESS: TAXI
01/23/2012 11:39 AM TO 01/23/2013 12:01 AM. Standard Time at the Named
Insured's Address stated above.
ITEM TWO — SCHEDULE OF COVERAGES AND COVERED AUTOS
This policy provides only those coverages where a charge is shown in the premium column below. Each of these coverages will apply only to those
"autos' shown as covered 'autos'. "Autos' are shown as covered "autos' for a particular coverage by the entry of one or more of the symbols from the
COVERED AUTO Section of the Business Auto Coverage Form next to the name of the coverage.
COVERAGES
COVERED AUTOS
IE"w aani m n onici as
1e130. hem e. COVERED
AUTOS e.m,mthe
Fvmn„ws tach Dubban
—event
LIMIT OF INSURANCE
THE MOST WE VMLL PAY FOR ANY ONE
ACCIDENT OR LOSS
PREMIUM
LIABILITY
7
$ 100,000 CSL
$ 2,720
PERSONAL INJURY PROTECTION
(P.I P )(of equivalent No-fault coverage)
SEPARATELY STATED IN EACH P I.P. ENDORSEMENT MINUS
S Deductible
$
ADDED P,I.P. or equivalent added No -Nue
SEPARATELY STATED IN EACH ADDED P.I.P. ENDORSEMENT
$
PROPERTY PROTECTION INSURANCE
(P.P.1.)(Michigan only)
SEPARATELY STATED 114 THE P.P.I. ENDORSEMENT MINUS
$ Deductible FOR EACH ACCIDENT
S
AUTO MEDICAL PAYMENTS
7
S 5,000
E 391
UNINSURED MOTORISTS
10
S 100,000 CSL (BIIPD)
S 231
UNDERINSURED MOTORISTS
(When root mduded in Uninsured Malone
10
S 100,000 GSL
(BI Only)
S 204
PHYSICAL DAMAGE INSURANCE
COMPREHENSIVE COVERAGE
ACTUAL S D.auaiS. FOR EACHCOVEREDAUto
CASH VALUE OR
$
COST OF REPAIR
on REPLACEMENT $ Deductibo FOR EACH COVEREDAUTO
$
SPECIFIED CAUSES OF LOSS
WHICHEVER IS
LESS MINUS $ Deductible FOR EACH COVEREDAUTO
$
COLLISION COVERAGE
TOWING AND LABOR
$ Deductible FOR EACH COVERED AUTO
$
FORMS AND ENDORSEMENTS CONTAINED IN THIS POLICY AT ITS INCEPTION
See M4572 (1211994)
PREMIUM FOR ENDORSEMENTS S
ESTIMATED TOTAL PREMIUM $ 3,546
ENTER SYMBOL 10 DESCRIPTION HERE:
Only (hose autos described in Item Three of the Declarations with Liability premium shown.
POUCY SUBJECT TO A FULLY EARNED POLICYWRInNG MINIMUM PREMIUM OF $ 0 IF CANCELLED BY THE INSURED.
ITEM THREE — SCHEDULE OF COVERED AUTOS AS ATTACHED
Argenla, LLC
Countersigned at Little Rock, AR
In Witness whereof, we have caused this policy to be executed and attested.
NLF-4489c (07/20081
Secretary
By
AUTHORIZED SIGNATURE
President
01/2412012 15:21 E92F88CC-F94849EC-9E03-03E8DD72C368