aarto :4 sm
TRANSCRIPT
Sep/15/2015 12.58.d2 PM
89/16/2815 12:53 13854682178SC ORB 8037370815
STAPLE51188
1/17PAGE 81/17
STATE OF SOUTH CAROLINA
(Cnp(lon of Case}
Example Applicatlan For a Class C Charter Cert(geste fram
John iycc dbs Doc's Limo
%fllTSICM AA.ROruy P/(ILJ IFMh(n~
AA,/r OrvSS TAJt I WFfQ/ I (/vI
TMm/noafrcfro& 90LoVlty/uS
BEFORE THEPUBLIC SERVICE COMMISSION
OF SOUTH CAROLINA
TRANSPORTATION COVER SHEET
ER:4
) IF ibis ls your Fnu time filing un appttccdau wire Sic PSC, yau will nartuivu u Ouukct%uuber. The Ccmmtmkui will vsvhp one m ycu IF yauhave gled wflh the Ccmmisskm berate. c Docket Itwulur wm assigned
) aud shouktbucuicivd abave,
(Please type ar print) AArtourn t%A,v Sdc/Lsrr canSnbmltted by: rt Sm:4 ~v-..
~0~Othe „t
+8/is +Stg A3(g;~ Ftnnfh o.aran rrun Wicnso 's
NOTB The cover sham aud Information can@mad herein neither replaces nor supplmncnts the filing snd service af pleadings or other papersss requimd by lsvr. This tbrm is requhed for usc by the Public Senilce Commission of South Caralme for thc pmpose of docketing sud mustbc gllcd aut corn lctel .
NATURE OF ACTION (Check all that apply)
Q Appliaation — Claus A/A Restricted
lass C Tant
Q Application ~ Class C Clmrter
Q Application - Chss C Chatter Bus
Application - Class C Non-Emergency
SP 15 891II
~8 DPPPQ Appgcsdon - CIMs C Snatcher Van
Q Application - Class E Household Gorxku
Q Application - Class E Hazardous V/cate
Application
Q Request for Extenskm m Comply vvidr Order .
g Request fbr Cancellation ofCerdficntc
Request for Suspension
Q Rcqucst for Reinstatement
r i Request for Order Granting Authority to Obtain a Certificate~ afPublic Convenience and Ncccuvtty to be Rescinded
Q Rcqucst for Name Change on Cettificate
p Request to Amend Scope of Authority
Q Request to Amend Tariff(rale increase. ctc.)
Q Request to Amend Passenger I Jmlt
Rcqum
g Exhibit
'ato-Piled Exhibit.
Letter
P Pro/iosed Order ' 'Cc'
Publishm's Affidavit
Q Reservation Letter
Response
Return to Petition
Other:
li'ou have any questions about this Rrrm, please contact the PUBLIC SERVICE COMMISSlON at 803dt96-Si 00.
Sep!18l2015 12:58:42 PM
89/16/2815 12: 53 13854682178SC ORS 8037370615
STAPLEB11882/17
PAGE 82/17
PUBLIC SERVICE COMMISSION OF SOUTH CAROLiNA101 Executive Center Drive, Suite 100
Columbia, South Carolina 29210(Mailing address: Post Office Drawer.11649, Columbia, SC 29211)
Phone: (803) 896-5100 Fax. (803) 896-5199
APPLICATION FOR CERTIFICATE OF PUBLIC CONVJr22RWCE AN9 NECESSITY FOROPERATION OF Ii/IOTOR VEHICLE CARRIER
CLASS C - TAXI
Zsit".SAMey ](1515
Application is hereby made for a Certificate of Public Convenience and Necessity, in accordance with the provisionof S.C. Code Ann., tI'58-23-10, et seq. (1976), and amendments thereto.
I. Nmae unde which business is to be conducted (corporation, partnership, or sole proprietorship, whh or without mde nama)
)ill'p i/t ek o. lgso t a orat o ot
100Street ress pplicent
iu mg A meso App cant(it orant m street a
one
//crier rtrss+f'aore o +~pi/tigot to
2. If the Applicant is an I,LC or a corporation, a copy ofthe Certificate of Bxistence from the South CarolinaSecretaty of State and the Articles of Incorporation must be attached. (If Inoorporated outside ofSC, attach SouthCarolina Secretary of State oporeign Corporation" Certificate.)
3. Select 'ype; (Check one)t
dividual Owner/Sole Proprietorship
Cj Partnership - List names and addmsses ofall pemon having an interest in the business.
Q Corporation - List names and addresses of two principal otiicera
tTlC l~
WS PO Ic7& C.
I of9
Sep/18/2015 12:58:42 PM83/16/ 2815 12: 53 13854682178
SC ORS 8037370815STAPLES1188
3/1 7PAGE 83/17
Applicant is financially able to ftrmish the services as specified in this app! ication and submits the followingstatement of'assets and liabilities,
BALANCE SHEET
Asse
.'alance at Time Application is Plied;Month Sar~~ Year ~Z~ '
Total Assets = Total Liabilities and Equity2 of 9
Sep/1 8/201 5 12:58:42 PM89/16/2816 12:53 13854682178
SC ORS 8037370815Sl'APLES1188
4/17PAGE 84/ 17
PROPOSED RATE~S AND CHARGES FOR SERVICE
O'.%A ger ~ I4 or 4.SWc@ tQ. ay~ pg,r htoLrr Mw+ +1 nrrr
QDvrertgrt- SEt2al't Cta g C g. 4/P E54r t/tyst-
~rta.t otBz-, ~, i /24"-t tW S'gl s/77'LE%, Wc 6 f
]~+ 2- gau.s'4 I@a,Strip ~ 4"-t/'B Qt ~ cs- L?r&C/pe&$ !a+ t owl-sr oAan /s vg l ltks5 +ban sr .Sugar ~i M. '& ofc4C
+ay ba -Pe.r r ~ ~~ a~ 4/wrier g co/ytoa~y& -l-o &~ +@& &+Hd~V"/ ~l'Pt~~& ~ S'77~ &a'ST 8/tPG-y md% QRS dte e
WMF&5t~ Tl Pf W/~Y i
Dt++@~ $ rJ~QGL6 f21 duvc'aP- M'lr /a"mM~S ~rS6'sts/tk m~ bM& /a,~ Au ~ CR~ -7'~~
ion/Bear» tsag 42ts15 ~ ~u~ We elL t o & VC
~th ~4r /htd Ctp. ~Qtit" twsm~h W ~OSgtg'n/ ~6iV tt-tyi-l ggnstcd ScntkeN ': C nll co ti '
u uesti' t ~
You will only be allowed to oiterate in those counties checked below. Xou ntay request "Statewide"authority ifyou intend to operate io all counties in South Carolina.
PAb vdgs QaP Aiken P Chester
Q Allsndale
Anderson
PChcstcrfiatd
Q Clarendon
p Florence
Q Osotgctown
viIle
P Crccnwood
P Lexington
Q Madon
Marlboro
p Bambctg p Colleton p Hantpton Q McCormick
p Bsrnwsil p Darlington Q Hurry P Newbcny
Beaufort p Dillon Jasper [POconee
p Satm
Q Spartanbutg
P Sumter
P Union
P Witfismsburg
P York
s
P Berkeley P Dorchester P Ksrshaw POrsngaburg Snuswido~ ~TbCalhoun P Bdgefisld ckens ~/s5k
Q Charleston P Fairficld P Lantana Richland
ttnuta tgot6sv tag/kur&ss 'tr /rWKrrrsa/6r & ra/st Fazsrrrs fssarrgrasv~ VigtacrcLa ~~~ Wonr ovtrrs- z +errotrs. M ~ ~/k&tatsw ~o /BEtstau|srt- rvt f ors/ap t/tfrt tc,~lpvmcatvssr w Am PA/ear/at/ 7 2?ten/trgfcxD /tLIX? w A~ Qrrvt~ rE'tlsrrt~/4i 5 ~4„ftrtrs tetr Tu 645 tt ~/hS6', 'tel tc/tts-'f X sya/s.g PtcK VP' dyes th
*radii/2 rctr2raA& /a,~ zg? t.sn/ ~Y 4'star~ x~~ tsth D/2astara/rs wrt
3ofp
Sep/16/2015 12:58:42 PM89/16/2815 12i53 13854662176
SC ORS 803737061551APLES1168
5/1 7PAGE 85/17
DESCRIPTION OF EQUIPMENT
You are not required to own a vehicle to file an application. However, prior to being issued a certificate by ORS,you will be required to have obtained a vehicle,
to carry is based on the number of~i in the vehicle, including the driveA seatbelt,)
-7 Passengers, including driver
Q 8-15 I'assengers, including driver
YEAR st MODEL
fss rvrr5 /8/erS'ale%„AT W44 (S 2"r /V&6 W A rrrv rp/i/C~ (al gv sti 4l igJ/a-MSST5't2- g ~G/SVC~/2 tV'ra ~re@'OODt»6 ~rgsRVAVM» imtsr55 MStmlr .
4of9
Sep/1 5/201 5 12:58:42 PMBs/16/uuln 12: us 18uu46821 /tl
SC ORS 8037370815STAPLEG118B
8/17PAGE BG/17
INSURANCE QUOTE
This form ArtD 5 by tn tf CgXRhln~RFZlRSIEMZX'ihe insurance quote instr be complete, ihting current Insurance premiums, At the discretion of tbe Corn/nisei on, s copy ofcurrentIran/ance policies msy be requinpk Do not provide a copy of insurance policies unless requested, Ycu v/ill nct be required to
The folhwmg insurance quote ls for:
Name ofApplicant
Address of Applicant
UabiTity Insurance 8
The above quoted premium is for a tenn of ~~ months,
3/iinhnum I butts- Intrastate Oniy;
1-2 Passengers" S 25,000/50,000/25di00
8-15 Pasuargars* $ 25/000/100,000/25,000
e Passengers Number ofscatbcits in the vehicle,
including the drive's scatbeit
amen I urance ompany
I am Ihmifisr with the Commission's Rules and Regulations reiatlng to insurance requirements and the above quote
meets the minimum insurance lhnits prescribed. The Insurance company making this quote is authoriexl by the
SouthCarolinaDepartmentoflns tod b Inessi S th Car I
ifyou wish to self4nsure your motor vehicles for liability and property damage. you must comply with S.C. CodeAnn. Sections 55-940 and 58-23-pt0. For more Infonnadon, contact Vickie Coker with the Department of lvloiorVehicles at(803) 8954457.
ifyou vttsh to apply as a self-insured for worker's coinpensation coverage in South Carolina yoa may do so withthe South Cardtina Worker's Compensation Commission (WCC) provided that you will be able to: I) post a suretybond or Icucn4Ifwredit with the WCC for a mlnhnum of 8500,000, 2) agee to pay a yearly self'-Insurance tax, and
3) agree tn psy an annual assessment to the South Carolina Second Intury Fund, For more information, contact theWCC Self-insurance Division at (803) 737-57I2 or on the web at wcvw.wcc.state,sc.us/self-insurance,
5 of 9
Sep/1 8/2015 12:58:42 PM
89/16/2815 12: 53 13854682178SC ORS 8037370815
ST/tPLES118B?/17
PAGE 87/17
i tilt i I
arne o App tcant
I. Are there currently any outstandin ants against the Appgcant?
0 Yes 0
If Yes, indicate nature ofjudgement(s) against applicant,
2. Is Applicant familiar with all statutes shd regulagons, Including safety regulations and governing for-hire motorcarrier operations in South South Carolina, and does Applicant agree to operate in compliance with thesestatutes ations?
es 0 No
3. Is Applicant aware of the Commission's insurance rctiuircments and thc insurance premium costs associatedthetewi
cs Q No
Sep/18/2015 12:58:42 PM
89/16/2815 12:53 13854682178SC ORS 8037370815
BTAPLES1188
8/1 7PAGE 88/17
OD tt if3 08
i. Applicant un tends that all drivers must be a minhnum of f8 years ofage.
Yes 0 No
2. Applicant understands that a certified copy ofthe driver's three (3) year driving record issued by tlvs SC DMVand such record from the DMV of the state in which the driver h or has been domiciled for such period mustbe maintained e Applicant's business office,
es 0 No
3. Applicant understands that a criinfnal history background check from the state where the driver curnnitfy livesmust be mai
'the Appgcant's business office,
es 0 No
4. Applicant undersbmds that all drivers opetuting a vehicle under a Class C Taxi Certificate must have intheir possession when operating a charter vehfcle, a valid driver's license issued by thc SC DMV or thc currentstate ofresiden of the driver.
Yes O'No
S. Applicant understands that nfl Cfass C Taxi Cltificate holders are prohibfted tlom employing or leasingvehicles to driveis who am registered, or mpired to be regfstered, as sex offenders wftfi the South CarolinaState Law Eu t Division or any national regisuy ofsex offenders.
cs Q No
Sap/1 8/2015 12:58;42 PM
89/16/2815 12: 53 13854682178SC ORS 803737081 5
BYAPLEB11889/1 7
PAGE 89/17
PUBLiC SERVICE COMMISSION OF SOUTH CAROLINAPOST OFPICB DRAWBR I 1649
COLUMBIA, SOUTH CAROLINA 29211
Applicant is famigar viith the provision of S.C. Code Ann. $58-23-10, et seq.(1 976), and amendments thereto,and 8.103-100 through R.103-241 of the Gnnmission's Rules and Regulations for Motor Carriers (Volume 26,S.C. Code Ann. Regs., 1976), and R.38400 through R.38-503 of the Department ofPublic Safety's Rules andRegulations for Motor Carriers (Volmnc 23A, S.C, Code Ann., 1976) and amendments thereto, and herebypromises compliance thmewith.
The Applicant for 0Ie Cmtificate of Public Convenience and Necessity as set forth in the foregoing, svvear orafFirm that all statements contained in the above application ans true and correct.
BPATI? os'sotrr8 cARDLINA
coUNFv oF (OCbh&
WORN TOThis l + dsy of
Commission Bxpims
8cf9
Sep/16/2015 12:55:42 PM SC ORS 803737081588/16/2815 12: 53 13854682178 STAPLES1188
Ysl, 2/Po
FlLED FOR RECORDOr~r COV'iTY 5 C
4--,.", REGISTER OF DFFDS
ll!H SP lit A Hr@l
11/1 7PNK 11/17
Voa, PD QCsgd Csfik Od
RegisRr ofDeeddi Oc ⅇ"0';-'TATEOR SOUTH CAROLINAOCONEE COUNTY AT SENECA
MatthewAaron PMhps1oo Gail Court, 84San~ SC 29678
September 14th, 201S:
To All For Whom These Presents Shall Come:
Now comes Entrepreneur, "Matthew Aaron Phillips, wbo being sui-juris, does herebydeclare under his sworn oath, creates and make in to the PublicDomain, notice hereof the following to-wit:
sn That effective hereon he has created an Enterprise entitled:
"Aaron's Taxi Service"aka
"Aaron's TraLhortation Solutions"
That forthwith and heredter perpetually and in perpetuity he shall engage as asole proprietorship and do business as 0).EA.), said Enterprise, Aaron'8 Taxi Service;"also known as and to be inclusive of "Aero 'ra rtati Sol
'Hence the
State of South Carolina.
Dated September 14 aot5;
With said Matthew Aaron PhHlips, having personally appeared and provided hisnal h identification, hss subaerial and sworn to before
a Notary Public of Oconee County South Carolina,5, that the above statements are true and correct to
b bes (N Slips'), kuowledge and belief, I said Notary Publichave as vertfication of his identity and signature sg forth above affixed my seal andsign/dpre below. My Commission Expires on the ~ day ofQ~~n the Yearno~ ofOconee County South Carolina.
Sep/18/2015 12:58:42 PM89/16/2815 12:53 13854682178
SC ORS 8037370815STAPLES1188
12/1 7PAGE 12/17
Fug FOSSFCORQ
OCOlIFc CeulIIY 5 C
I RFSlsTFROF DEEDS;
I5%P1% AN4$
STATE OZ SOUTH CAROLINA )
COUNTV OF - ~ )) BBGISTBATION OF
TRADE NAMB .
IN ACCORDANCB WITH SBCrION 39-13-I 0 OF THB CODE OF LAWS OFSOUTH CAROLINA FOR 1978, AS AMENDED, THB UNDERSIGNED HEREBYDECLARES AND FILES WITH THB REGISTER OF DEEDS OF OCONBB COUNTYNOTICE THAT
IS DOING
DATED
SUPI16l201512:58:42 PM89/16/2815 12I 53 13854682178
SC ORB 8037370815STAPLES1188
13I1 7PAGE 13/17
NEW BUSINESS/100TE00td Ilnotudr OAlbs/RULEFBe Rarnbeu TR ULEUL0UOUI 0 LLLdgd'I Torsion 0 d, Resfslun 0 L
tnsuredr NATTNEw PUILL1Ps UEA AARoN's Tddht sEEYtcE
JOllrt50%: 'OhllSOyl
'tnn TERNU ANO CUNOKIXCNS CP TINS QUDTAYtON IIAY NUT APPLY W1TN TEE SPEUIFECATI OS $ SU BrutTIUO FOR CINIStUERATLUN .PLEASE REAO Tgtn QUOTE CAREFUld Y AS 0 COUPARE TT AUntlrnT YOUR SPEC1FECATLONS,To bled aovaragor Please sorltaut the cooU»orolal Trnasoortnuoa Uaparoeenh et L-EU04UP-Tsns oatonstoo nots. You do not basebladla3 aatborlLy oe thts nm»uet aed scent speekmRR sa aodarwrlter to blml. A stNUER cDNFIRNATTDU wILL as EEET To Yoa ONcaYOUR REQUEST IS FRUUESBEU.
lws Is dot an Insanmrs pogcr nor an Inswaneo binder. This noose Ir as Indlcrtlon of laswnnco prembnn banal on the Inlmmntlon provided. Iboamy lm rddrdrnan by the nmurer st ant time prtrr to blndlng.uvote ls basal upon Ure trauma sgreemeot to Use(a and ls tound by tba undersigned without sny llabggy vrhahonvar oa ths I . ThIoavaf on lrlsufon Thb Uootd
Sep/16/2015 12:58:42 PM88/16/2815 12: 53 13854682176
NICO-Rate for South Caroline
SC ORS 8037370815STAPLES1188
14/17PAGE 14/17
Columbia Insuranos Company
Account Summary For Matthew A Phillips
VsNole Inforrnatlon
unS
1 2010 DODGE CARAVAN(42656)Comp/coll: 3"I5,000Hsdlasr Up to 50 Mlles
Revlston: 71SC2015R04NICO.Rate Version: 6,3.34.15
~iabt ~LJ UINt ~ ~hOa ~Ca ~lor ~ulg~ow Sob Total
2,269 31 4 31 4 245 1,369 N/A N/A 4,501
Dedtlotlbte: 500/500
NationalInc94bmnityCornpctny~ SlrrcB 1940
Sep/16(2015 12:58:42 PM89/16/2815 12: 53 13854682178
SC ORS 8037370815STAPLES1188
JQkNSOl4 a 40HNSW PREFERRES RNAISCIIII61 NC.
PREMIUM FINANCE SECURITY AQREESIENTr~ rvwsnvrncevso smvssmvvvn memo,snrev mtsomnn-bvumsmvss roomsccohevsnmsmncman
Pheon 80tntrdufrf Fnc 843-724.7080
15/17PAGE 15/17
Ftirt pltbonsstNOMAIL Ybi
po hbx ammoOOEEI4900RO NO 97020
Fma949-724.7090
nainustlnnncndEsr.coin
OENIIBROKBRUPSTAVBINSISIA)4CS AGStrCY INC
200 GAOBR94REBOA 4ESSSCIL SC IPFM
220-9120
OREGWZR
)4LTI RSÃ PBILLESIOO GAE. CT, APT, 4SEIISSRr SC 89822
OL Nun u(bndchbgrfUpgcc tmo PAY(IIIENT SCHEDULE
WEEN PAYMENTS ARB DUB
ERSTGET~DUE INBTALL44SNT DUB DATES
10r IS/10L»
$33'75.'FS
TOTAL OPPAYMSPDB
Ihs nnuuct ym whllmrs psld slitrycu mutc
dt sppctmtss oD)
APROcNOf fiasacc dmgcsL
F. Year(yrsmhcsuupf
)4397908
Uotm NUlttbet: 1803283
0/LSEOtf
SCHEDU/.E DF POLICIES
48(ORIANA COMPANY ANDhhhttA(BNGBI4BIIAJ AGENT
htsum.ds ichssm)nc
TYPE QPQ4ytrERAGR
Psdmgc
FIN 1XEIFEEB
ERR IXetpRES
JPP LICENSBNUMBBIU IOISOS
FIN IXS/FEtS
ERI4 TIIS/FEES
TOTAL PIEEMIU(ES IBUSl ABREE WITH BOX nA" ABOVE n»&888 PA(73 3 FQR AIXETIO)v(AL S norm
GROSSPRELSUM
04&701.00
$0/m
$4401.00
TQ THE BORROWER:tfpmsitu bdsm)sm sdmoolotge nmdpl ats copyof~mtnd yei spec to the pievldans;BOIH 0'N ISE FIRST AND Tttg SecoND pAGB 0F YHIO
GEIBBODMT You farthwvErcs lhst7cu wvoptmhmrm LBNDER ymr AY)GBIIE%1N+Aoym musd thcpcllcies ctdthied In thc Asmcmmc Ycu further 40nn ENdsclmnic or dtsOdhmmmmlaafofSns Ocmmmt
inchi+tm notSmitch m fscdmgclamsmMmw tbsg be IsSNly bindias.
IF FOR A~N YOU DO NOT REC YEBJR PAYMENT SNIUPS)NS OR II(VOICE FOR INSTALLMEtilTS DUE, YOU MUSTNiKIILERFYIPDFCP
AGSEEMENT I 8)OALL ttEEOUND FD/ANGIALLY TO THE TERM ANO CONDITIONS OF YHE CQNTRAGT.X
Stet(ATURECE BO1!ROWEROI) OR DULY AIPIIICRIZBD BGORCustdgl) DATE
PBBF(BD 14AS(B BOIIBDtsrgtbS Pt/ONE NUMBER
PRODUCERS WARRAKflES AND REPRESENTATIONS:THE DNDERSGNEDWARRANTS ANDSOUARANYEESR
(1) Yhp Bumnpm hos received n copy of NOOAgrcoirnmt, and the Required Fadcml Tnennknndhcp msctosuresfor Pcmnnst Ltree Insurance, IfspPtcabls,(24 The prdmes herein ma 8 frtl force and olfed shd the tnfcrmptlon ln tha schedule ofpolio!os snd the premlunm ens ocrtocL (8) fha ecrmwsr hassuthodted Ihb unrmonocn snd recotmlses the suuurgy Interest nsdgrted hmaln. (8 t)m Own Payment 4wwn ebmm has been paid oy or cn behalf of theBnriawcr and the Tctsl pramhsn dwwnisaws has boon or wg hn used to purchase In suranos pmldcs shown In nm sohedulo of pesetas. In) vhcra sra nocxcopuons lo Ihe poudco other thmi those hidlcssid nnu the pensee cwnpiywan I ENDER's suotmmy rvvssmmonts, toi No AUDIT oR REpoRTiNG FoRMPOLICIES POUOIES SURIECT TO RETR~ RATING OR YO MINIMUM EARNED PREIvIIUMS ARE INCLUDED EXCEPT Ag INDICATED ANDTHAT THE DEPOSIT OR PROS/IERH4/4AL pREMIUMB ARE NCT LEOS THAN THE ANTIC)PATED PREMIUMB TO BE EARNED FOR YHE FUI L TEAM OFTHE POLICIES, IF PQUCY Ie'SUBJECT TO A hul4IMUM EIIRRED PREMUM IT IB . Iy) The pcgden cmt bo cancelled by Ihe BorrowerIhe mmpnny on 10 days nafoa and ma unsanrao ps-mlums et! be ccnbuted cn oio standard chcitrslc ur pm mte table except as Indicated. Upmtcancssnnch afsny af Iha schecMed pclmiss, prcdtcerstmt remit to LENDER the loo amount of thh unamned prmnhrm, Inciadlrig unowned ccnunbdm aswan,ss anydhm pnymmds or cmrEs tecelvptl by prodopar. Op lo mo uopsld balance due under Ibis Agraarncnt, within 10 days of recolpL (8) The~ad represents Ihsto nmcescling ln bnnkrufttoc moolvelshts ar tmsfvancy hss nat been oisotu ted byar against oie named ecnowar cr 0 ihonsmml Barmwsr Is Ihe suNaat af such s proceeding, 8 Is nrsed an 944 vgremnsm
inurn
apses In which Iho Boirmvcrs nmne mid sddross Is placcrtE
SGRAYtIRE Op AGBHI OR BRO DATE
nnopnwnc
Sep/1 SI2015 12:58:42 PM
89/16/2815 12:53 13654682178SC ORS 8037370815
STAPLES11 BB
18(17PAGE 16/17
PROVISIONS OF YOUR SECURITY AQREBOORNT1. PROOOSE OF REPAYOIENT: The bcnower request LENDER to psy Ihe premiums on the pdldrw xhuan cn Ihe reverse. The Bcrramr prordscs to
yto LENDER at Its oEca Ora anount stated In Stock 6 ahern, acoongng to the Payment Schedule shown an Iha reverse, sublect Ihs rest of Ihonns oftlfx Security AgroaemenL
2. SECURllY IMTEREBTt The Bonower assigns lu LENDER ss sdarky for the tdet amcunt paysbia In thb Agreement any and ag unownedprenfums ahd f6vidends which may beoorne payable under Ibo Insurance pcgcles and loss paymenhr which remiss the
unearned
premiums,subject to sny matgsges or Irws payee ooamxta lho Borrower gives to LENDER a cacurky Inl arnot Ih eg items meNonsd In this paragraph.
3. DEFAULT CHARGER Bomower agrees Rial If eny inslsgment ls mare Ihen 5 dsya past due, or mlnimunl number of days prenhncd by date lsw, itwif pay to LENDER s dsonqucncy oharge In sn smooth up lo Illa msxknum peridged by app6csbla state law. Renewer agrees If dofsult results Incalcsgshcrl 'la pay Ole msxknum soowahlc csllcaeaqcn chape ulfowcd hy eppocsble st!Ila I!lan
4. FINANCE GHARGER lha onanca charge, chow In Bar qy on the oah olde of this Agmanrat, bcfons to acaue an Rie eergest posshfa dataaoowed by sppxoable state lsw and amgnuca ungl c I furrds sro paid In luo Refer to box F pkm bur G cn Rra sacuhty egraonumt fortcfsi
5, WARRANTY OF ACCURACY: The barcwar wammts to LENDER thai Iho Inswanco pogclcs Iided in Iha above sonedula have been issued to Owboncmsr and ma In orf ferne snd egad snd Ihat ma bouower hao not assigned any Intamct In Iho pc6das racept for the Interest ofmcrtgagcasefrd I ass plr'jess.
6, REpREsENTATION OF SOI VENcv: lhe Bonowsr rapnwents Inst It ls nct insolvent a presently Ore subicct of any Insolvency proceeding.7, CANOSIATIO(k LENDER may osncel Ihe Inxurenoe pdides and Iha unpaid balanoes duc lo LENDER chug be Immodlalefy peysbla by ihe
Bcmowar If any of the fdkwlng occur (a) The Borraver does not psy any instsgment eocordng to Iha terna of ibis AgreemenL (b) lbe bonowsrdocs nct comply woh any of the ianna cf Ibis Agioanenk (c) lho Bonowera thc Insurer volunteroy or Inwxuntwgy becomes tha sub)oct ol ahrmknqhcy, rodovsrshlp cr any dher Nnd at krodvoncy proceafng: (4) lf the Bomowcr G a business end stays dcirrg buclnem or ceases lo bequsglhd Io do budnewx LENDER at Rs opnon msy enforce payment cf trhs debt without recourse to the security given to LENDER,
IL POwER CF ATTORNEY - Uhllt OF I.IABILllY: lhe Barava Irrvocabllr sppdnts LENDER, or Ra successors or assigns, Os
Adorn
ay Inq:ad wghIuo sIBIcroy lo cancel the Insurance pdides, cr eny renewal thereof lo recdvc sg sunw assigned to LENDER cr In which It has granted LENDERa securRy Idcmd and LENDER may wmarts end daover ra the Baraverh betldf so documents, Instruments of payment, nano and nohoes ofanyIdnd retngng tO Ihe Inxumnoe Pogaiea In fcnhaanCe Of ihla AIFaemeht. LENDEIFS OWIOytO any PerSCn Or OOrPCraOOn an ihe ecerdaa Of OS
authagy to amccl oa Insurarwe polidas ls omltad to the snlounl cf Ihe prlndpal bslanco, except if LENDER wlmuoy fags to denver Ihe ncgoesrecpkcd by Iaw. when LENDER slfaols csncc6atlon ln aoccrdenca woh stats lsw, tha Bomaver wlo bo responskxe fcr ahanayx foes snd othercost in any unsuccsssfd schon Bod as a rssuo Ihcrccf to Ihe adsnt permitted by appgoslxe state law.
8. I4ONEY RECEIVED AFIER Noltcg CF cANGELLATIQN; Any pqnnent Inada lo LENDER ager LENDE&s Notice ofcwroegnnorl aforeInsaancs pcfdes has been dsgvcrud msy ba credited to Ihe 8arwweA account wghan alfecgng tha acceleration of this Aasomcnt ond wBwulany Oabgqr or cbfgagcn cn the LENDER's part lo mamst m wtaramsnl of Iho oanceled pohdes. Any money LENDER receives Ihxn an Insuranoscompany ahao be credtal to the alnarnt due LENDER xfOI any swplcs Mng paid to whenever is enRtled to Ibe menay. Mo reluhd ol Isss thangfpro shag be made. If Ihara Is a balance dua soar LENDER mcelves the unearned prcnhunw, dvldonds cr loss payments from the Insumruacanpony then Ow Borrcwar wB pay Iha balance to LENDER whh tutored at Ihe rais show cn the sgrecrnenL
10. PREPAYOIENT: Bcnuwsr hss Oa hght to prepay Or s angra cutsbmdlng balance OI OB at any Ome before the due dele of the Onsl indsitmcnL Uporlprepeymart In og, aupon amusesqon and fdl payment to LENDER, Baivnror wkl be caBled to rccctva a retund of the Finance charge tc becomputed by the Rule el 7tps ('sum ofOre Years Dig gw) method, or as raqdmd or pemgtad by tha applicable mw, alter dsdudlng any ally earnedcharge permktsd hy lsw. If cencegcgra ocoum, Iha Bamwer agnes to pays FInsnca charge on the balance due at the mls m Ihe reverse side of(his Agmcment untl 6 is paid In OG, or antg arch agardata ss Is requlredby eppgcsbm state law. Barowsr agrees to pay LENDER reascnabladiem e)is Oms and cogadkn awl under the terms end ccndgca heraofsnd Io Ihe anent snd amount pardgod by applicable atda law.
11. INBURANcE AGENT oR BRoKER,'ha Irimmos agent or brckw named an Ibis Agrsemenl is me Bamwerw agent, nct LENDER's endLENDER Is Ilst legsxy bound by anything the agerh cr broker represents lo Ihe Bannmr, orsgy or tn writing,
12. SPECtAL (NSURANCE POUOIER If Ihe Insuranoa policy Irmrcd to the barower le audltebla cr ls a reporting form pdky a sub)ad to ra!reapsdivemgag, Oren Bo Borrower planless to pey the insurance company the earned premium compufed ln accordance woh Oro pogcy prohdcus wrxcn IsIn excess of the savant d the pradum adwmcsd by LENDER shish Ow insurance company rara Inc.
13, sUccESSORS AND ABOIS(c Ao legal rlgtos Ijiven to LENDER shall bane@ LENDER's aswgn. The Borrower wRr not assign Rlo pcddss agleutLENDERh whnan ccascnt except fcr the intaasl ofmatgsgces end loss payssn
14. LOBBING AND IN OCR REct INFCRIOATICN: If Ore pogcy tws nct been Issued at the gine of signing INs Agreement, Ihen the Borrowa egress Ihenanw of the Inswancc aepany, and Ihe pohcy numbem cf Ihe Insulwloe pofoles msy be lett bhmlr end may be subsequenqy lnsenso tn Rhs~ ln sddwan, Barcwar authorlxd LENDER or ths agent or broker to correct on Ibis Agreement at any time, If Iruarreck thc nants at theinsurance campsnias, the pdwynumbers snd Iho nstasmero due dates. LENDER wif noOIy Iba Bonuwer of ihe oaredad and/cr insertedIn(amain.
16. ADDITONAL PREMIIBER The money pakl by LENDER is cnly fcr the pranlum as delaiminadl al the Ome fne Olsurance pdicy Is issued.LENDERh peymarlt shag nct be appfed by Ihe Insurance company to psysr soy addntanet parnlunw owed by the mowed ss s result at any lypsofofsdssclsctlon cf Ibis hsk Ttm Bcmorrar agrees lopay Ore company any addglonel pranlums which become due f«eny meccn. I ENDERmay assign to Olo oompany any rkorto It has againd Iha Barayor fcr premkuns dva the company in excaw of Ihc pranlum nuurncd lo LENDER.
18. AGEMFB wARRAMTIER To cotnfrioa I ENDER lo enter Orle Agmorncnt ahd aooept Ihe security underlying Ibis Agrccmcni, the paxon arecutlngthis~ ifnot Ihe Bamwar, warrants severagy end as the duly euthatud agent of Ihe Borfowoc Ihat he Is the duly authorized agent of OrcBaiamr sppchhed cpcclgcrh(y to ester Into Rhs Irsnsacecn an Ora Bomoweho bchsln thai hv can pcrfarn any act Inc earcwcr caud or cnculdnolronn wrln rvwowx Io ufo transocean: racine wxl hard In rrucr av LENDER any payments mous er wadi lo the uorrcwer Ihrcunh Ihc vndadoncdcr lo Ihe undersigned, drecuy, Indlnagy, a Gussy or oonmucgvely by sny al Oa Inxunmoo canpenlas aud that he wB pay the marlos to LENDERupas demand to cagdy Ihe than outstuncmg Indebtedness of ihs Bomnvcr,
17. ABGGMIOEMT: AO of LEMDEIFs llghls under fhh Agreement shell Inure to Rs succcoxas snd assign. This Apmancnt maynd tw assigned by Ihebouoww except ss pnwidcd fcr ln Ibis AOraoment.
18. DocuhlENTAND GovERNING LAw This dcaxncnt Is ma cnnm Agrecman between LENDER audrhe Baravcr and can only be changal srwrlqcp and signed by bath pxdhrs. Tba laws ofIho cialo or ecncwarvr rasklence rw ast fath abcwa wg govern Ofs AgreananL ifany provision ofRhs Agreamcct ls hold to ba Invagd a'nennxcaabla. the vcgdty and anf rcosblEy cf lbo ranahdng praxcicns shall nol be impaired.
18, sERvicE cHARSIR The mexsnum service fee sIhwabto by stats regdaqcnu wE ba charged cn ag returned checks. This same fca wig also boauscsscdif Iha Inxaed nngtatxss s pe)mant Ocm a deposit account through an akalrcnlo Omds bsnsfa cr acme mshred alber Ihsn s papacheck signed by the Irwursd, and lhs Insureels bann or tincodd Icstkutlan where Iha dcposR aacaan is Inaintainod nhuxas to honor suchwohdnnml or payment request because there sro hrsuBdent ands 8 the sccaaL
Sep/16/2015 12:56:42 PM89/16/2815 12:53 13864682178
sc DRs eo37370615STAPLE'51188
17/17PAGE 17/17
Driver Information for Mettthew A PhillipsNICCr Rale for Smrlh Carolina
Columbia!nsuranoe Company
Policy Driver Rating Fadtor. D.SOOO
Quote 8: 4396923 Revision: 71SC2015R04
Diver
Matthew A, Phillips
Date of License Years TotalBirth Class Exp. Points
7/24/1974 All Cthei
Points Age Driver WRd-
Factor Factor Factor term Vnft
1.OOOO O,BOOO 0.9000