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21.263 Cosmic Cab Taxi License ApplicationsTHAT' K YOU I C I T CL-ERK N O H A M P T O N 210 MAIN ST, ROOM 4 (413) 587-1224 04-27-2021 15:55 REG 000013 BUISNESS CRT $50.00 PED/TAXI CAB $25.00 PED/TAXI CAB $25.00 PED/TAXI CAB $25.00 PED/TAXI CAB $25.00 PED/TAXI CAB $25.00 PED/TAXI CAB $25.00 PED/TAXI CAB $25.00 PED/TAXI DRI $25.00 PED/TAXI DRI $25.00 PED/TAXI DRI $25.00 PED/TAXI DRI $25.00 PED/TAXI DRI $25.00 PED/TAXI DRI $25.00 PED/TAXI DRI $25.00 PED/TAXI DRI $25.00 CHECK $ 4 2 5. 00 In City Council, City of Northampton Application for Annual License NORTHAMPTON, MASS., q 20 1 z I v Council of the City of Northampton: pectfully petitions your honorable body for a License as follows: of Business: of License: Cosmic Cab :ion of Business: 23 Hooker Avenue Print Name of Applicant: (V) .Q S'e� *A" I��'� Signature of Applicant: M Address of Applicant: (V) No. 241 Street OWAAQAVA_ Z.. Referred to Committee on Licenses. ATTEST: City Clerk In City Council, In Committee on Licenses, Voted to recommend that Petition be granted, not granted ATTEST: Clerk (date) Voted that Petition be not granted Attest: Clerk to City Council granted Form 03-Vehicle .r- ter• ��,. City of Northampton Application for Vehicle Registration - Vehicle for Hire PRINT ALL INFORMATION (except signature) (Check one) Name (First, Middle, Last) Taxi Vehicle Residential Address 2LI Business Address /60 M 0,;r\ e, F Livery Vehicle Today's Date: 24,Z012J V Me- W �M�oio5-3 Number Street r..p Yth0. � rF I4 0 1 O6 Q City o State Zip Cade Mailing Address Number Street city/Town State Zip Code Telephone Number L1 13 - 260 - C 1 Vehicle Information Make w Uo Model Year Color Registration Number -74 N G F Vehicle ld Number 2 i7 If H U w y H X$ 7�1 Zg6J Seating Capacity (exclusive of operator) Number of Seat belts Ifety spat' nh... of vehicle Liability Limits: $100,0001$300,000 injury or death, $50,000 property damage ' Polity must show that the policy shall not be cancelled without giving the City clerk 10 days notice thereof. Sworn to this gam- clay of 20�Q-/ before ore me. Al2Z ._ ___—_—.—.;---.—_— - — - City Clerk FOR LICENSING AUTHORITY USE In City Council, , voted that this petition is is not granted, Attest: Clerk to the City Council r City Ordinance c. 316 s. 19 Appeal Filed ? Date 4 4 REWSTRYor MbTL7A VEHICLES +rqi,.oS{i CERTIFICATE OF REGISTRATION L. V M.G.L. Chapter 90 Section 24B makes it a crime to alter this Certificate MASSACHUSETTS DEPARTMENT OF TRANSPORTATION EXTERHAL CODE REGISTRATION TYPE PLATE NUMBER EFFECDVE GATE TITLE NUMBER TAN Taxi Normal 11 GF 20-A r-2021 �FW-Nov-2021 ICL VEHE IDEMIFICATI N NUMBER MODEL YEAR MAKE MODEL GRAND MODEL NUMBER BODY STYLE COLOR 2008 DODG CARAVAN VAN GRAY 2D8HN44HX8R772469 RESIDENTIAL ADDRESS OF DIFFERENT THAN MAJUNCI TOTAL REWSTEREOWEIGHT FOR A COMMERCIAL VEHICLE OR TRAILER GARAGE ADDRESS US DOT NUMBER FOR COMMERCIAL VEHICLE 160 MAIN ST STE 8 NORTHAMPTON MA 01060-3187 HAMEIBi OF GYIMER(S)AND MAILINDADDRESS PMRANCE COMPANY JEFFREY D MILLER ARBELLA PROTECTION INSURANCE 160 MAIN ST STE 8 COMPANY NORTHAMPTON MA 01060-3187 M%XU MSEATINGCMACMFORVEHICLESFORHIRE LESSEEAN CUSTODY of Registrar of Motor Vehicles SPECNLMESSAOE CKQCEOFADURMs -1 RESIDENTIAL MAILING � GARAGE If this vehicle Is newly acquired. It must be Inspected within 7 days (- , 11-1 �i�4Fl� A $ i� t,, I E ( RATION of registration. r;; 9 '.I. iri, d r P. I 'I s . 1 .I �; r `•I 'ra 't r. i r r 1 . Itr iTi 'r. .C:I IlJSE Ti 0):'F'EIRTMENT OF 1'f7APJ•'.;f''I:)h'F111'IUt`i Lr TE;. Nch ILU} Important informaltton r�iLf �7Jrllq:f< •�fyL. I6t., '"FI i'k i ei°i 130-Nav-zr�2� .for',Wehitio Q ._a>rs__-- tk ` lir .4:1! vurl.a'�rleNrrrlr•,�n,�asiir.l�IFI. � r i t ' I • Certificate of Registration: Every person operating -a -me! VAIcle-shall hav J fi � I- X f 'd . 4 the, Certificai4%J'# ��s bfi ir�r-the- otol� he vehicle and/or trailer, in the vehicle, in some easily accessible place. The re rr?T Hlad �uw� r-w.ei SnS •�•�rl•.]Ai W11H. .r 8 of the RMV constitute the 6WI' is status of the vehicle registration. • Change of Address: By law, you must report any change of address to the I MV within 30 days. Visit mass.gov/rmv to change your address. Once you have reported the address~change-to-the- RMV..;;nlease-.write•correctad-address in-hor provided above. f ARBEI L A r'Ro .'.0 CTION IIv:;I.)RANCE i I ;F,)l;lil-' AN Y No Insurance Card Required: Massachusetts law does not require an InsurAi r,%c;j V4,,M1;. ,L-; Chaptgl'; 0„Section-34;�nrf Chapter 175, Section 113A, requires the vehicle's owner to maintain a compulsory motor vehicle liability insurance policy or bond for bodily Injury coverage and property damage insurance. The insurer is required by law to electronically notify the Registry of Motor Vehicles If coverage lapses. The iieiilcie 6Wner-1`s tKi notifed by�the RMV to obtain nsw #nsurance within 10 days or the registration will be revoked. Bonds are filed with the StatelrTrensurei's Office. I% gl' iror r:l hk><c�r VI+IIIcI Transferring Your Plates: Massachusetts General`Lai v (M: j0XFa-pT --4(F, lat%riiallow ygu,i i lister valj'+ registration plates from this vehicle to a newly acquired no,or used motor vehicle or trailer lhile you obtain insurance and a new registration. See the Transferring a Reiiilkfttior Section on the RMV's website at mass.gov/rmv for more information. I - Cancel the registration plates if: _ The vehicle has been sold or junked and the registration is not going to be transferred to another vehicle. You move to another state and you register thQ Ygl(1iglpiilnfJhat"ttt@#pi:I rr)vrtci'{ The insurance policy is not renewed or is cancelled and there is no plan to obtain a new policy. 1' I111Aoi- w-,11 P -Alalf have the CL:riiflaito of RogisWitiun fur the motor ;I i� lrt 01' addrosc, to lin? I ;MV within 30 days. Vi;:it inans.gov/rmv to �icldress ri-ango to Me RMV. please write correcled address in box ri{il;:e tIU1 rt;(IUI((; L'f)-t11SLm;-icL:• (,.aid. M.G.L. 90,--r-chon 34, aiie, .. a..r -r.. i.. .�. uwt..ir•. •. .....a...�L... r.� ._..��.... .... 1..-.i.� �:. �.I:r.. ._ ...-_- __ Commonwealth of Massachusetts Motor Vehicle Inspection and Maintenance Program MASSACHUSETTS Vehicle Inspection Report cleaner Air • Safer Reads Please Review This Important Information Your vehicle has PASSED both its SAFETY TEST and its EMISSIONS TEST.The results are summarized in this report Questions? Visit www.mass.gov/vehiclecheck or call Customer Service at 1-844-35Ml35. Customer Service is staffed from 7 a.m to 5 p.m. Monday, Wednesday, Friday, and Saturday, and from 7 a.m. to 8 p.m. on Tuesday and Thursday. Overall Result: PASS Vehicle Information Station Information Safety Result PASS VIN 2D8HN44HXBR772469 ERNIE'S GARAGE INC Emissions Result PASS License Plate 11GF 72 KING STREET Start Test Date/Time 4/26/2021 9:50 AM Plate Type/State TAN / MA NORTHAMPTON MA End Test Daterrime 4/26/2021 9:58 AM Vehicle Type PASSENGER (413) 584-0716 Test Type Regular Year I Make 2008 Dodge Sticker Number 221003751 Model Grand Caravan Station Number PB100149 Inspection Type Initial Fuel Type GASOLINE Workstation Number MAW00000648 Inspection Counter 1 Engine Cyl / Size 613L Inspector Number "*'*5128 GVWR 7000 Odometer 113398 Inspection Fee $35.00 Safety Inspection Results License Plato Mounting and Condil:cn PASS Service Brakes PASS Parking Brake PASS Horn PASS Slop Lights and Tail Lights PASS Headlight Aim and Operation PASS Lighting Devices and Reflectors PASS Directional Signals and 4-Ways PASS Front End PASS Steering and Suspension PASS Frame PASS Windshield Wipers and Cleaner PASS Safety Belts PASS Air Bags NIA Muffler and Exhaust System PASS Window Tint PASS Windshield PASS Rear View Mirror PASS BumperslFenders/Exterior Sheet Metal PASS Fuel Tank Filler Cap PASS Fuel Tank Filler Neck and Components PASS Visible Smoke PASS Altered Vehicle Height PASS Tires PASS Other PASS Inspection Comments None On -Board Diagnostic (OBD) Results OBD Readiness Monitor Results OBD Additional Data Tampering Check PASS Catalyst READY Miles Since Code Clearing 330 Connector Result PASS Catalyst Heater UNSUPPORTED Warm -Ups Since Code Clearing 11 RPM Result PASS Evaporative System READY Pin 16 Voltage 14.1 Key -On BulbCheck NIA Secondary Air System UNSUPPORTED Engine -Running Bulb Check NIA A/C System UNSUPPORTED OBD Diagnostic Trouble Codes Scan Tool Check NIA Oxygen Sensor READY Communication Result PASS Oxygen Sensor Heater READY MIL Status Result PASS EGR and/or VVT System READY OBD Permanent Fault Codes Readiness Result PASS 7F 0A 80 VIR Number IIIlIf Illlsll�l�l�lll�lll��l�lllr�lll�lill I�fl�ll�ll� Scan to visit website n_� I v Form 03-Vehicle -1ii:Ll• /r City of Northampton Application for Vehicle Registration - Vehicle for Hire PRINT ALL INFORMATION (except signature) (Check one) ®�Taxi Vehicle Livery Vehicle Today's Date: Z 6/Z Name (First, Middle, Last) Residential Address Business Address 1,,60 If4G� 51. SSE l�` ILr J- 016 C6 Mailing Address Number street Cty Town State Zip Code Telephone Number ' 1 / 3 - 236 - 6 1 Vehicle Information Make _ Registration Number ! A Model Vehicle Id Number12-P y GTZ K ? Vx 5 N 6-11216 Year Z � Seating Capacity (exclusive of &perator) Color Number of Seat belts of vehicle Liability Limits: $100,000/$300,000 injury or death; $50,000 property damage Policy must show that the policy shall not be cancelled without giving the City clerk 10 days notice thereof. Sworn to this 11,—day of , 20 �-I ,before me. City Clerk —______.__,_—___!_____—_,____._—___—___,_,_.-___ :#_ _-_-_- FOR LICENSING AUTHORITY USE In City Council, , voted that this petition is is not granted. Attest: Clerk to the City Council )er City Ordinance c. 316 s. 19 Appeal Filed ? Date i REGISTRY cr MOTOR VEMCLE5 Plate Type Registration Type Plate Number TAN TAXi NORMAL 26983 Model Year Make Model Body Style 2005 DODG MGN STWAG Residential Address (If bilferent than Mailina', Garage Address CERTIFICATE OF REGISTRATION M.G.L. Chapter 90 section 248 makes it a crime to alter this certificate MASSACHUSETTS DEPARTMENT OF TRANSPORTATION anff Effective Date Title Number Month Year 01-Dec-2020 BV095470 11 21 241 HAYDENVILLE RD LEEDS MA 010539768 Name(s) of Owner(s) and Mailing Address r�rllrirlrlh�„��,nlllrhlrlrnhrllrrll��rll�ulir�h���Ili�l 003427 "'AUTO"'5-DIGIT 01060 JEFFREY D MILLER 160 MAIN ST STE 8 NORTHAMPTON MA 01060-3187 Lessee!Ir. Custody Of Special Message Change of Address •{sl Vehicle Identification Number GRAY 2D4GZ48VX5H511216 Total Registered Weight for Commercial Vehicle or Trailer US DOT Number for Commercial Vehicle Insurance Company If ARBELLA PROTECTION INSURANCE COMPANY I Maximum Seating Capacity for Vehicles for Hire r ��ii�l.!• Signature of Registrar ❑ Residential ❑ Mailing ❑ Garage Information for Vehicle Owners • Certificate of Registration: Every person operating a motor vehicle shall have the Certificate of Registration for the motor vehicle and/or trailer, in the vehicle, in some easily accessible place. The records of the RMV constitute the official status of the vehicle registration. • Change of Address: By law, you must report any change of address to the RMV within 30 days. Visit Mass. Gov/RMV to change your address. Once you have reported the address change to the RMV, please write corrected address in box provided above. No Insurance Card Required: Massachusetts law does not require an insurance card. M.G.L. Chapter 90. section 34, and Chapter 175, Section 113A, requires the vehicle's owner to maintain a compulsory motor vehicle liability insurance Policy or bond for bodilv iniury coverage and property damage insurance. The insurer is required by law to electronically notify the Registry of Motor Vehicles if coverage lapses. The vehicle owner is then notified by the RMV to ob-Ga new insurance within 10 days or the registration will be revoked. Bonds are filed with the State Treasurer's Office. Transferring Your Plates: Massachusetts General Law (M.G.L. Chapter 90, Section 2) allows you to transfer valid registration plates from this vehicle to a newly acquired new or used motor vehicle or trailer while you obtain insurance and a new registration. See the Transferring a Registration Section on the RMV's website at www.mass.gov/rmv for more information. • Cancel the registration plates if: - The vehicle has been sold or junked and the registration is not going to be transferred to another vehicle. - You move to another state and you register the vehicle in that state. - The insurance policy is not renewed or is cancelled and there is no plan to obtain a new policy monwealth of Massachusetts Motor Vehicle Inspection and Maintenance Program MASSACHUSI_TTS ehicie Inspection Report Caner At • Sdw Roads Please Review This Important Information Your vehicle has PASSED its SAFETY TEST. The results are summarized in this report. Questions? Visit www.mass.gov/vehiciecheck or call Customer Service at 1-844-358-0135. Customer Service is staffed from 7 a.m. to 5 p.m. Monday, Wednesday, Friday, and Saturday, and from 7 a.m. to 8 p.m. on Tuesday and Thursday. Overall Result: PASS Vehicle information Station Information Safety Result PASS VIN 2D4GZ48VX5H511216 ERNIES GARAGE, LLC Emissions Result NIA License Plate TA26983 72 KING STREET Start Test DateMme 5/6/2020 8-48 AM Plate TypelState TAN i MA NORTHAMPTON MA End Test Date/Time 5/6/2020 8:56 AM Vehicle Type PASSENGER (413) 584-0716 Test Type Regular Year;' Make 2005 Dodge Sticker Number 210718353 Model Magnum Station Number PB005056 Inspection Type Initial Fuel Type GASOLINE Workstation Number MAW00000648 Inspection Counter 1 Engine Cyl 1 Size 613.51- Inspector Number '••"0933 GVWR 6000 Odometer 226736 Inspection Fee $35.00 Safety Inspection Results Lrcense Plate Mounting and Condition PASS Service Brakes PASS Parking Brake PASS Horn PASS Slop Lights and Tail Lights PASS Headlight Aim and Operation PASS Lighting Devices and Reflectors PASS Directional Signals and 4-Ways PASS Front End PASS Steering and Suspension PASS Frame PASS Windshield Wipers and Cleaner PASS Safety Belts PASS Air Bags NIA Muffler and Exhaust System PASS Window Tint PASS Windshield PASS Rear View Mirror PASS Bumpers/Fenders/Exterior Sheet Metal PASS Fuel Tank Filler Cap PASS Fuel Tank Filler Neck and Components PASS Visible Smoke PASS Altered Vehicle Height PASS Tires PASS Other PASS Inspection Comments None VpIR (INumberII��II ��pp�� rr IImm Scan to visit website owl ■ lip rz7 �, �. �.��� ./ wwdwmmk�m * � \\ 2 Pr ,t4L g. I _ � \ � � : \ � _ \���`\ JL- u � .\�`�/ | § + Form 03-Vehicie City of Northampton Application for Vehicle Registration - Vehicle for Hire PRINT ALL INFORMATION (except signature) (Check one) Name (First, Middle, fast) QTaxi Vehicle Residential Address 1ZL1 Business Address %c) rt Nt—h— Livery Vehicle Today's Date: `'i 20 f 21 V L& -R� Mailing Address 'laic Zip Code Number Street City own State Zip Cade 'telephone Number Ll 13 - 230t C i j CJ Vehicle Information Make 'Uo, Model(���a u Year 20OC6 ColorCot„�� k"ari,-- Registration Number TA 6 Zcj 1) Vehicle Id Number t f'sO Seating Capacity (exclusive of operator) Number of Seat belts '7 ofof vehicle Liability Limits: $IOg000/$300,000 injury or death; $50,000 property IISI—_ Policy must show that the policy shall not be cancelled without giving damage the City clerk 10 days notice thereof. Sworn to thi day of 20 before me. —_—.—_----------l-"---a'_—_—--__.�_ City Clerk FOR LICENSING Al1Tii0RITY USE In City Council, voted that this petition is is not granted. Attest: Clerk to the City Council r City Ordinance c. 316 s. 19 Appeal Filed ? Date REGISTRY CP MOTOR VEHICLES CERTIFICATE OF REGISTRATION M.G.L. Chapter 90 section 24B makes it a crime to alter this certificate MASSACHUSETTS DEPARTMENT OF TRANSPORTATION Plate Type Registration Type Plate Number Effective Date Title Number Month Year TAN TAXI NORMAL 629D 01-Dec-2020 BT474639 11 21 Model Year Make Model Body Style Colors} Vehicle Identification Number 2008 DODG CARAVA VAN BROWN 1D8HN44H18B184670 Residential Address (If Different than Mating) Total Registered Weight for Commercial Vehicle or Trailer Garage Address US DOT Number for Commercial Vehicle 241 HAYDENVILLE RD LEEDS MA 010539768 Name(s) of Owner(s) and Mailing Address Insurance Company 1I-1Ilr111111,1l+11111'1"II'11'1Irlrh111111l'111111Iq'f11181Ir ARBELLA PROTECTION INSURANCE COMPANY 003446 —*- **AUTO"5-DIGIT 01060 D MILLER JEFFREY160 MAIN 160 MAIN ST STE B Maximum Seating Capacity for Vehicles for Hire 9 p tY NORTHAMPTON MA 01060-3187 8 Not -Valid -Without -Official �a—nW\- Signature of Registrar I,esseelln Custody Of Special Message Change of Address ❑ Residential ❑ Mailing ❑ Garage 9 Information for Vehicle Owners • Certificate of Registration: Every person operating a motor vehicle shall have the Certificate of Registration for the motor vehicle and/or trailer, in the vehicle, in some easily accessible place. The records of the RMV constitute the official status of the vehicle registration. - Change of Address: By law, you must report any change of address to the RMV within 30 days. Visit Mass.Gov/RMV to change your address. Once you have reported the address change to the RMV, please write corrected address in box provided above. - No Insurance Card Required: Massachusetts law does not require an insurance card. M.G. L. Chapter 90, section 34. CD 0 and Chapter 175, Section 113A, requires the vehicle's owner to maintain a compulsory motor vehicle liability insurance N policy or bond for bodily injury coverage and property damage -insurance —The insurer is required by law to electronically notify the Registry of Motor Vehicles if coverage lapses. The vehicle owner is then notified by the RMV to obtain new insurance within 10 days or the registration will be revoked. Bonds are filed with the State Treasurer's Office. N • Transferring Your Plates: Massachusetts General Law (M.G.L. Chapter 90, Section 2) allows you to transfer valid registration plates from this vehicle to a newly acquired new or used motor vehicle or trailer while you obtain insurance and a new registration. See the Transferring a Registration Section on the RMV's website at www.mass.gov/rmv for more information. • Cancel the registration plates if- - The vehicle has been sold or junked and the registration is not going to be transferred to another vehicle. You move to another state and you register the vehicle in that state. The insurance policy is not renewed or is cancelled and there is no plan to obtain a new policy. MASSACHUSETTS Commonwealth of Massachusetts Motor Vehicle Inspection and Maintenance Program Vehicle Inspection Reft Cleaner Air • Safer Roads Please Review This Important Information Your vehicle has PASSED both its SAFETY TEST and its EMISSIONS TEST.The results are summarized in this report. Questions? Visit www.mass.govlvehiciecheck or call Customer Service at 1-844-358-0135. Customer Sen1ce is staffed from 7 a.m. to 5 p.m. Monday, Wednesday, Friday, and Saturday, and from 7 a-m. to 8 p.m. on Tuesday and Thursday. Overall Result: PASS Vehicle information Station Information Safety Result N/A VIN 1 DBHN44H18B184670 ERWE'S GARAGE INC Emissions Result PASS License Plate TA629D 72 KING STREET Start Test DatefTime 3/2312021 B-40 AM Plate Type/State TAN 1 MA NORTHAMPTON MA End Test Date/Time 3/2312021 8-48 AM Vehicle Type PASSENGER (413) 584-0716 -est Type Regular Year f Make Modei 2008 Dodge Grand Caravan Station Number PB100149 Sticker Number 221003392 Retest Fuel Type GASOLINE Workstation Number MAW00000648 'rrspection Type inspection Counter 2 Engine Cyl 1 Size 6 # 3L Inspector Number *****5128 GVW R 7000 Odometer 311460 inspection Fee $a.no Safety Inspection Results insnecfinn Comments Done r. Con -Board Diagnostic (OBD) Results OBD Readiness Monitor Results 01313 Additional Data Tampering Check PASS Catalyst READY Miles Since Code Clearing 119 Connector Result PASS Catalyst Heater UNSUPPORTED Warm -Ups Since Code Clearing 0 RPMResult PASS Evaporative System READY Pin 16 Voltage 14.6 Key -On BulbCheck NIA Secondary Air System UNSUPPORTED OBD Diagnostic Trouble Codes Engine -Running Bulb Check NIA AIC System UNSUPPORTED Scan Tool Check NIA Oxygen Sensor READY Communication Result PASS Oxygen Sensor Heater READY NIL Status Result PASS EGR and/or VVT System READY OBD Permanent Fault Codes Readiness Result PASS 7F OA 80 VIR Number 1 ICl111111111'111I'1n1 11111111111111111111111111 Scan to visi-. webs ;i!- S of N I Sal t( /000" VI ol Form 03-Vehlcle t1'S1 ar City of Northampton Application for Vehicle Registration - Vehicle for Hire PRINT ALL INFORMATION (except signature) (Check one) Name (First, Middle, Last) Taxi Vehicle Residential Address 'ZL( Livery Vehicle Today's Date: `"� ZO f 21 V'� Business Address /64 1�I Cc; rt g L �f Mailing Address Telephone Number LIJ 3- 2 30 - C i i el Vehicle Information Make Uo aC. Modelatyl Year O Color r` n..._ . V�A'A 0105-3 State n., r..a, i i _ f Registration Number -T-4 2 t7 5 6 el Vehicle Id Number 2 D Li RZ1,I 9 D E g A R. 20 *7 29 7 Seating Capacity jexciusive of operatorl 6 Number of Seat belts 7 ifetV seat nlmn..-,,.,.. of vehicle Liability Limits: $100, 000/$300, 000 injury or death, $50,000 property damage ---- Polity must show that the policy shall not be cancelled without giving the Cityclerk 10 days notice thereof L4--clay Sworn to thi of C14 202 , before me. r-------w—w---------- �+��� _ - City Clerk FOR LICENSING AUTHORITY USE In City Council, voted that this petition i5 is not granted. Attest: Clerk to the City Council 'City ordinance c. 316 s. 14 Appeal Filed ? Date 80CERTIFICATE OF REGISTRATION �r5y1,�~� M.G.L..L. Chapter 90 Section 24B makes it a crime to alter this Certificate �`19F.� aFciS7grwMarae vEr�rc�Fs MASSACHUSETTS DEPARTMENT OF TRANSPORTATION 04ANCEOFnnMEW � RESIDENTIAL 0 MAILING � GARAGE: If this vehicle Is newly acquired, it must be Inspected within 7 days of registration. Important information for vehicle owners • Certificate of Registration: Every person operating a motor vehicle shall have the Certificate of Registration for the motor vehicle and/or trailer, in the vehicle, in some easily accessible place. The records of the RMV constitute the official status of the vehicle registration. • Change of Address: By law, you must report any change of address to the RMV within 30 days. Visit mass.gov/rmv to change your address. Once you have reported the address change to the RMV, please write corrected address in box provided above. No Insurance Card Required: Massachusetts law does not require an insurance card. M.G.L. Chapter 90, Section 34, and Chapter 175, Section 113A, requires the vehicle's owner to maintain a compulsory motor vehicle liability insurance policy or bond for bodily injury coverage and property damage insurance. The Insurer is required by law to electronically notify the Registry of Motor Vehicles If coverage lapses. The vehicle owner is then notified by the RMV to obtain new insurance within 10 days or the registration will be revoked. Bonds are filed with the State Treasurer's Office. • Transferring Your Plates: Massachusetts General Law (M.G.L. Chapter 90, Section 2) allows you to transfer valid registration plates from this vehicle to a newly acquired new or used motor vehicle or trailer while you obtain insurance and a new registration. See the Transferring a Registration Section on the RMV's website at mass.gov/rmv for more information. • Cancel the registration plates if: • The vehicle has been sold or junked and the registration is not going to be transferred to another vehicle. • You move to another state and you register the vehicle In that state. • The Insurance policy is not renewed or is cancelled and there is no plan to obtain a new policy. Commonwealth of Massachusetts Motor Vehicle Inspection and Maintenance Program MASSACHUSETTS Vehicle Inspection Report • .. . Cleaner Air • Saver Roads Please Review This Important Information Your vehicle has PASSED both its SAFETY TEST and its EMISSIONS TEST. The results are summarized in this report. Questions? Visit www.mass.gov/vehiciecheck or call Customer Service at 1-844-358-0135. Customer Service is staffed from 7 a.m. to 5 p.m. Monday, Wednesday, Friday, and Saturday, and from7 a.m. to 8 p.m. cin Tuesday and Thursday. Overall Result: PASS Vehicle Information Station Information Safety Result PASS VIN 2D4RN4DE8AR207297 ERNIE'S GARAGE INC Emissions Result PASS License Plate 27569 72 KING STREET Start Test Date/Time 3/15/2021 9:31 AM Plate Type/State TAN I MA NORTHAMPTON MA End Test DatelTime 3/1512021 9:40 AM Vehicle Type PASSENGER (413) 584-0716 Test Type Regular Year / Make 2010 Dodge Sticker Number 221003255 Model Grand Caravan Station Number PB100149 Inspection Type Initial Fuel Type GASOLINE Workstation Number MAW0000DS48 Inspection Counter 1 Engine Cyl / Size 613L lnspector Number *****5128 GVWR 7000 Odometer 131150 Inspection Fee $35.00 Safety Inspection Results License Plate Mounting_and.Cond:ticn PASS Service Brakes PASS Parking Brake PASS Horn PASS Slop Lights and Tail Lights PASS Headlight Aim and Operation PASS Lighting Devices and Reflectors PASS Directional Signals and 4-Ways PASS Front End PASS Steering and Suspension PASS Frame PASS Windshield Wipers and Cleaner PASS Safety Belts PASS Air Bags NIA Muffler and Exhaust System PASS Window Tint PASS Windshield PASS Rear View Mirror PASS Bumpers/Fenders/Exterior Sheet Metal PASS Fuel Tank Filler Cap PASS Fuel Tan'R Filler Neck and Components PASS Visible Smoke PASS Altered Vehicle Height PASS Tires PASS Other PASS Inspection Commonts None On -Board Diagnostic (OBD) Results OBD Readiness Monitor Results OBD Additional Data Tampering Check PASS Catalyst Connector Result PASS Catalyst Heater RPM Result PASS Evaporative System Key -On BulbCheck NIA Secondary Air System Engine -Running Bulb Check NIA A/C System Scan Tool Check NIA Oxygen Sensor Communication Result PASS Oxygen Sensor Heater MIL Status Result PASS EGR and/or VVT System Readiness Result PASS V1R Number READY Miles Since Code Clearing 14776 UNSUPPORTED Warm -Ups Since Code Clearing 255 READY Pin 16 Vcltage 14.5 UNSUPPORTED UNSUPPORTED OBD Diagnostic Trouble Codes READY READY READY OBD Permanent Fault Codes Scan to visit website Illll�llll�lllll�l'1�11A1�11�11�11[all�lllllll�lllll�l�� Wk .11 i AV *,A6qp Form 03-Vehicle yf City of Northampton Application for Vehicle Registration - Vehicle for Hire PRINT ALL INFORMATION (except signature) (Check one) Name (First, Middle, Last) ©Taxi Vehicle Residential Address 2LI Livery Vehicle Today's Date L7aU'� lti1 � Il.z�r' Business Address /Co M C,;,rt 1� � Mailing Address Telephone Number 3 - 23O - b l j 61 1p� '-% 20/2 j Z I\1A Of0T3 01Of, p Vehicle Information Make �a � La Model ` Registration Number -iA C. 3 0 C �1`�►nU Vehicle Id Number Year 2 0 0 0( Seating Capacity (exciusive of operator) Color e— Attach the followin : Insurance Policy for this vehicle• child Number seat f Seat belts af vehicle ins ection• of vehicle color Kato Liability Limits: $100,000/$300,000 injury or death, $s0,000 property damage Policy must show that the policy shall not be cancelled without giving the Cityclerk 10 days notice thereof. — — — — — — —�. — —. �. mil,,. — _. �.... Sworn to th;'k day of , 202� beforemel City FOR LICENSING AUTHORITY USE In City Council, voted that this petition is is not granted. Attest: Clerk to the City Council City Ordinance c. 316 s. 19 Appeal Filed ? Date ,��� .�� Balm '�„ rpr REGISTRY cp MOTOR YEliIGLES CERTIFICATE OF REGISTRATION M.G. L. Chapter 90 section 24B makes it a crime to alter this certificate MASSACHUSETTS DEPARTMENT OF TRANSPORTATION Plate Type Registration Type Plate Number ve Date Title Number Month Year rocilFEM TAN TAXI NORMAL 603C -Dec-2020 CB535233 11 21 Model Year Make Model Body Style Color(s) Vehicle Identification Number 2009 DODG GRANDC VAN BLUE 2DSHN44E59R576432 Residential Address (If Different than Mailing) Total Registered Weight for Commercial Vehicle or Trailer Garage Address US DOT Number for Commercial Vehicle 241 HAYDENVILLE RD LEEDS MA 010539768 Name(s) of Owner(s) and Mailing Address Insurance Company ,[,��„il�i�i��l�!'�Iiili,I[i�[i,Il��[,ui�'��'!ll!'��"I�i"il! ARBELLA MUTUAL INSURANCE COMPANY 003431---*AUTO"5-DIGIT01060 JEF160 REYMAIN D MILLER 160 MAIN 5T STE 8 Maximum Seating Capacity for Vehicles for Hire 9 p ty NORTHAMPTON MA 01060-3187 7 NofValld Withou:Official �• Signature of Registrar Lesseelln Custody Of Special Message Change of Address ❑ Residential ❑ Mailing ❑ Garage 9 Information for Vehicle Owners • Certificate of Registration: Every person operating a motor vehicle shall have the Certificate of Registration for the motor vehicle and/or trailer, in the vehicle, in some easily accessible place. The records of the RMV constitute the official status of the vehicle registration. Change of Address: By law, you must report any change of address to the RMV within 30 days. Visit Mass.Gov/RMV to change your address. Once you have reported the address change to the RMV, please write corrected address in box provided above. No Insurance Card Required: Massachusetts law does not require an insurance card. M.G.L. Chapter 90, section 34, Q and Chapter 175, Section 113A, requires the vehicle's owner to maintain a compulsory motor vehicle liability insurance policy or bond for bodily injury coverage and property damage insurance. The insurer is required by law to -electronically notify the Registry of Motor Vehicles if coverage lapses. The vehicle owner is then notified by the RMV to obtain new r insurance within 10 days or the registration will be revoked. Bonds are filed with the State Treasurer's Office. N • Transferring Your Plates: Massachusetts General Law (M.G.L. Chapter 90, Section 2) allows you to transfer valid registration plates from this vehicle to a newly acquired new or used motor vehicle or trailer while you obtain insurance and a new registration. See the Massachuseitls Transferring a Registration Section on the RMV's website at www.mass.gov/rmv for more information. • Cancel the registration plates if: 21 - The vehicle has been sold or junked and the registration is not going to be transferred to another vehicle. - You move to another state and you register the vehicle in that state. - The insurance policy is not renewed or is cancelled and there is no plan to obtain a new policy. Commonwealth of Massachusetts Motor Vehicle Inspection and Maintenance Program MASSACHUSETTS Vehicle Inspection Report Chwer Air • Satyr Roads Please Review This Important Information Your vehicle has PASSED both its SAFETY TEST and its EMISSIONS TEST.The results are summarized in this report_ Questions? Visit www.mass.gov/vehiclecheck or call Customer Service at 1-844-358-0135. Customer Service is staffed from 7 a.m. to 5 p.m. Monday, Wednesday, Friday, and Saturday, and from7 a.m. to 8 p.m. on Tuesday and Thursday. Overall Result: PASS Vehicle Information Station Information Safety Result PASS VIN 2D8HN44E59R576432 ERNIE'S GARAGE INC Emissions Result PASS License Plate 603C 72 KING STREET Start Test Date/Time 9/9/2020 3-1 8 PM Plate Type/State TAN 1 MA NORTHAMPTON MA End Test Dater/ ime 9/9/2020 3,25 PM Vehicle Type TRUCK (413) 584-0716 Test Type Regular Year 1 Make 2009 Dodge Sticker Number 214989126 Model Grand Caravan Station Number PB100149 Inspection Type Initial Fuel Type GASOLINE Workstation Number MAW00000648 Inspection Counter 1 Engine Cyl 1 Size 613.3L Inspector Number *"*'0933 GVW R 6000 Odometer 137924 Inspection Fee $35.00 Safety Inspection Results License Plate Mounting and Condition PASS Service Brakes PASS Parking Brake PASS Horn PASS Stop Lights and Tail Lights PASS Headlight Aim and Operation PASS Lighting Devices and Reflectors PASS Directional Signals and 4-Ways PASS Front End PASS Steering and Suspension PASS Frame PASS Windshield Wipers and Cleaner PASS Safety Belts PASS Air Bags NIA Muffler and Exhaust System PASS Window Tint PASS Windshield PASS Rear View Mirror PASS BumpersfFenders/Exterior Sheet Metal PASS Fuel Tank Filler Cap PASS Fuel Tank Filler Neck and Components PASS Visible Smoke PASS Altered Vehicle Height PASS Tires PASS Other PASS Inspection Comments None On -Board Diagnostic (OBD) Results OBD Readiness Monitor Results OBD Additional Data Tampering Check PASS Catalyst READY Miles Since Code Clearing 14505 Connector Result PASS Catalyst Heater UNSUPPORTED Warm -Ups Since Code Clearing 255 RPM Result PASS Evaporative System READY Pin 16 Voltage 14.2 Key -On BulbCheck NIA Secondary Air System UNSUPPORTED Engine -Running Bulb Check NIA A/C System UNSUPPORTED OBD Diagnostic Trouble Codes Scan Tool Check PASS Oxygen Sensor READY Communication Result PASS Oxygen Sensor Heater READY MIL Status Result PASS EGR and/or VVT System READY OBD Permanent Fault Codes Readiness Result PASS 7F OA 80 ViR Number I11l111IllllliI111lll1111111111111 Scan to visit website all Nil 2 1 ~� CC3 SI C C 13 (413)230-61 9 -jr- �' ..era •+Y-'7 8 .i Y1.f" , • � 1•yy Form 03 Vehicle �l .4 T City of Northampton Application for Vehicle Registration - Vehicle for Hire PRINT ALL INFORMATION (except signature) (Check one) Name (First, Middle, Last) Residential Address Taxi Vehicle '2-'l I Livery Vehicle Today's Date: `�zD f Z j T� Business Address %60 M C, S � 1 ltil lA O 10 T3 a1060 "OLU zip Code Mailing Address Number Street oN/Town State Zip Code Telephone Number L 1 -3- 238 - C l I Gj Vehicle Information Make �p k � Registration Number 'rA 2roCf,;E� Model /" - Gyn v Vehicle Id Number I'D N LI 0 o V, ���� Year. Oa Seating Capacity Color '�` �,.L iexdusive of operator} Attach the following: InSUranrP Palic for this vehicle- child safe Number seat f Ian Seatbelts of veha ins ection• color of vehicle h�t� Liability Limits: $100,0001$300,000 injury or death, $50,000 property damage ,I Policy must show that the policy shall not be cancelled without giving the City clerk 10 days notice thereof Sworn to thisR/Y\,day of ZO�, before me. .� City Clerk FOR LICENSING AUTHORITY USE In City Council, voted that this petition i5 is not granted. Attest: Clerk to the City Council r City Ordinance c. 316 s. 19 Appeal Filed ? Date Commonwealth of Massachusetts Molor Vehicle Inspection and Maintenance Program MASSACHUSI:TTS Vehicle Inspection Repon -� • - .� Please Review This Important Information �� � s.rrr laoeds Your vehicle has PASSED both its SAFETY TEST and its EMISSIONS TEST. The results are summarized in this report. Questions? Visit www. mass. govlvehiclecheck or call Customer Service at -I-844-358-0135. Customer Service is staffed from 7 a m to 5 p M. Monday. Wednesday, Friday, and Saturday. and from7 a.m. to 8 p m c,,, Tuesday and Thursday. Overall Result: PASS Vehicle Information Safety Result pASS Station Information VIN Emissions Result PASS 1DBHN44HO88162479 ERNIFS GARAGE INC Start Test Date/Time 2/27/2021 8-39 AM License Plate TA26981 Plate Type/State 72 KING STREET End Test Date/Time 2/27/2021 8 44 AM TAN / MA Vehicle Type TRUCK IVORTHAMPTON MA Test Type Regular Year / Make 2008 Dodge (413) 584-0716 Sticker Number 220999340 Model Grand Caravan Inspection Type Initial Fuel Type GASOLINE Station Number PB10D149 Inspection Gaunter 1 Engine Cyl I Size 613E Workstation Number MAWQOOGU643 GVWR 7000 Inspector Number `" **0933 Odometer 323240 Safety Inspection Results Inspection Fee $35.001 '_tcease Plate M0untrng and Coeciih,�. PASS 5ellbice Braces Horn Lighting Devices and Reflectors PASS PASS Stop Lights and Tail R hts PASS PASS Parking Brake Headlight Aim and Operation _F„S5 Steering and Suspension PASS Directional Signals and 4-W Frame PASS Front End PASS PASS Safety Belts PASS PASS Air Bags Windshield Wipers and Cleaner PASS Window Tint PASS WA Windshield Muffler and Exhaust System PASS Bumpers/Fenders/Exterior Sheet Metai PASS Fuel Tank Filler Cap PASS Rear View Mirror PASS Visible Smoke PASS PASS Altered Vehicle Height Fuel Tank Filler Neck and Components PASS :)ther PASS PASS Tires PASS Inspection Comments None On -Board Diagnostic (OBD) Results OBD Readiness Monitor Results Tampering Check PASS Catalyst OBD Additional Data Connector Result PASS READY Catalyst Heater Miles Since Code Clearing 34201 RPM Result PASS UNSUPPORTED Evaporative System Warm -Ups Since Code Clearing 255 Key -On BulbCheck NIA READY Secondary Air System Pin 16 Voltage 13,4 En i R UNSUPPORTED to ne- ummng Bulb Check N/A A/C System UNSUPPORTED OBD Diagnostic Trouble Codes Scan Tool Check NIA Oxygen Sensor Communication Result PASS OREADY Oxygen Sensor Neater READY MIL Status Result PASS EGR and/or VVT System READY Readiness Result PASS OBD Permanent Fault Codes 7F OA 80 Scan to visit websile VIR Number � r rol _ L ' *0810CERTIFICATE OF REGISTRATION M.G-L. Cha ter 90 section 24B makes it a cri p me to alter this certificate MASSACHUSETTS DEPARTMENT OF TRANSPORTATION Plate Type Registration Type Plate Number Effective Date Title Number Month Year TAN TAXI NORMAL 26981 01-Dec-2020 BS088668 P—M11 21 Model Year Make Model Body Style Colors) Vehicle Idenliflcaiion Number 2008 DODG CARAVA VAN BLACK IDBHN44HOBS162479 Residential Address (If Different than Mailingj Total Registered Weight for Commercial Vehicle or Trailer Garage Address US DOT Number for Commercial Vehicle 241 HAYQENVILLE RD LEEDS MA 010539768 Name(s) of Owner(s) and Mailing Address 1'11iIIhfill 11111111111111111111111111111Il'IIIII111111111111111 Insurance Company 003444 """'AUTO"5-D1GiT 01060 ARBELLA PROTECTION INSURANCE COMPANY JEFFREY D MILLER 160 MAIN ST STE 8 Maximum Seating Capacity for Vehicles for Hire NORTHAMPTON MA 01060-3187 7 Not Valid Without Official Lessee/In Custody Of �Qa - Signature of Registrar Special Message Change of Address ❑ Resldenfial ❑ Mailing ❑ Garage 9 Information for Vehicle Owners • Certificate of Registration: Every person operating a motor vehicle shall have the Certificate of Registration for the motor vehicle and/or trailer, in the vehicle, in some easily accessible place. The records of the RMV constitute the official status of the vehicle registration. C Change of Address: By law, you must report any change of address to the RMV within 30 days. Visit Mass-Gov/RMV r to change your address. Once you have reported the address change to the RMV, please write corrected addrecc in box d• provided above. • No Insurance Card Required: Massachusetts law does not require an insurance card. M,G,L. Chapter 90, section 34, and Chapter 175, Section 113A, requires the vehicle's owner to maintain a compulsory motorvehicle liability insurance _ N _ _policy or bond for bodily injury coverage and property damage insurance The insurer is required by law to electronically r notify the Registry of Motor Vehicles if coverage lapses. The vehicle owner is then notified by the RMV to obtain new CV insurance within 10 days or the registration will be revoked. Bonds are filed with the State Treasurer's Office. • Transferring Your Plates: Massachusetts General Law (M.G.L. Chapter 90, Section 2) allows you to transfer valid registration plates from this vehicle to a newly acquired new or used motor vehicle or trailer while you obtain insurance and a new registration. See they Transferring a Registration Section on the RMV's website at www.mass.gov/rmv for more information. • Cancel the registration plates if. - The vehicle has been sold or junked and the registration is not going to be transferred to another vehicle. - You move to another state and you register the vehicle in that state. - The insurance policy is not renewed or is cancelled and there is no plan to obtain a new policy. Ski■ the Line, Goavailable r} 0 " "- n no tia 1 ma ifs'�+ I •+444� *�. r _ =X il` ,f f ' +� YI. ,,. ,.��. +",J.J:'".". ..yw.."l'•����—ems " ! tel: - a.' ��{}t r. a"'r*-��'a�r{.•ti��� ter ��, i .YT -2�'�. • 0 sir ..r 1 '•r ` r wig. . ray r ��}�� �i �5' {��.�yry ti 'ICf ' l r✓,.. , , e' :.'{� it .i' .' r�fh�:•. d'/' t�=+�''r : �''• +�,4 3!,.�r .�c��4F jfj:1;�I�, ¢�, d' fir, �?r,:'' -�� ,,i,t�;_"'} y�►i r b �9 JV �►": i.�w" �R� + iy y! !' i •K . Cj+-3` { 5ti' '-•.t-eP-{i+R,%��I .'tili"z �;r�l l r•. rf'..' .}y�s1i '`►�. tilt, ,��}5r� er�'•'�' Form 03-Vehicle City of Northampton Application for Vehicle Registration - Vehicle for Hire PRINT ALL INFORMATIO (except signature) (Check one) Taxi Vehicle Livery Vehicle Today's Date: ZO Z, i Name (First, Middle, Cast) `� Q � f �G I � M., 1 t0 Residential Address 24 1 Business Address .d J�17 Mailing Address Number Street City Town State Zip Code Telephone Number y12j 61P7 j Vehicle information Make �/ I eVQrro Registration Number rA 2 Gel %-7 -7 _ Model 6ubU r-tG ,n Vehicle Id Number 3 (r' F I IT-661y Year Z0017 Seating Capacity �• (exclusive of operatvr) Color Number of Seat belts 17 Attach the following: Insurance Policy for this vehicle; child safety seatplan: copy of vehicle inspection; color photo of vehicle Liability Limits: $100,000/$300,000 injury or death; $50,000 property damage Polity must show that the policy shall not be cancelled without giving the City clerk 10 days notice thereof. Sworn to this day of 14"- , 20,,2/ , before me. In City Council, FOR LICENSING AUTHORITY USE voted that this petition Attest: City is is not granted. Clerk to the City Council 3er City Ordinance c. 316 s.19 Appeal Filed ? Date MASSADILISEM Commonwealth of Massachusetts Motor Vehicle Inspection and Maintenance Program . • • r �nk _Vehicle Inspection Report CteanerAir • SahR Road - Please Review This Important Information Your vehicle has PASSED both its SAFETY TEST and its EMISSIONS TEST.The results are summarized in this report. Ouestions? Visit www mass govlvehictecheck or call Customer Service at 1-844-358-0135. Customer Serxice is staffed from 7 a.m. to 5 p.m. Monday, Wednesday, Friday, and Saturday, and from 7 a m to 8 p.m on Tuesday and Thursday. Overall Result: PASS Vehicle Information Station Information Safety Result Emissions Result Start Test Dalefrime End Test Datefrime Test Type Sticker Number ;rispecbon Type inspection Counter PASS PASS 3/20/2021 8:16 AM 3/2012021 8:23 AM Regular 221003358 Initial 1 Safety Inspection Resu!ts VIN License Plate Plate Type/State Vehicle Type Year/ Make Model Fuel Type Engine Cyl / Size GVWR Odometer 3GNFK16367G155614 TA26977 TAN IMA TRUCK 2007 Chevrolet Suburban FLEXIBLE 8/5L 8000 ERNIE'S GARAGE INC 72 KING STREET NORTHAMPTON MA (413) 584-0716 Station Number PBi00149 Workstation Number MAWOODO0648 Inspector Number "'"0933 Inspection Fee $35.00 L ee Ase Plat 44oun'ang and :.ond- ian PAG5S Se-in.v 0;akw Horn PASS Stop Lights and Tail Lights PASS Headligh• Aim and Operatic . PASS Lighting Devices and Reflectors PASS Directional Signals and 4-Ways PASS Front End PASS Steering and Suspension PASS Frame PASS Windshied Wipers and Cleaner PASS Safety Belts PASS Air Sags N/A Muffler a' ,d EXhaL.;1 SyStem PASS Window Tint PASS Windshield PASS Rear View Mirror PASS SumpervFenders/Extenor Sheet Metal PASS Fuel Tank Filler Cap PASS Fuel Tan',( Filler Neck and Cc:liponents PASS Visible Smoke PASS Altered Vehicle Height PASS Tires PASS Cther PASS inspection Comments None Gn-Board Diagnostic (OBD) Results OBD Readiness Monitor Results OBD Additional Data Tampering Check PASS Catalyst READY Miles Since Code Clearing 76 Connector Result PASS Catalyst Heater UNSUPPORTED Warm -Ups Since Code Clearing 6 RPM Result PASS Evaporative System NOT READY Pin 16 Voltage 14.9 Key -On BuibCheck NIA Secondary Air System UNSUPPORTED OBD Diagnostic Trouble Codes Engine -Running Bulb Check N/A A/C System UNSUPPORTED Scan Tool Check N/A Oxygen Sensor READY Communication Result PASS Oxygen Sensor Heater READY MIL Status Result PASS EGR and/or VVT System UNSUPPORTED OBD Permanent Fault Codes Readiness Result PASS V'IR Number ! 111111111111111111111111.11111111111[1111111i1111111 Scan to visit website r ® p *Oslo CERTIFICATE OF REGISTRATION M.G.L. Chapter 90 section 24B makes it a crime to alter Phis certificate REGISTRY Cs HOTCR %tHKLES MASSACHUSETTS DEPARTMENT OF TRANSPORTATION Plate Type Registration Type Plate Number Effective Date Title Number Month Year TAN TAXI NORMAL 26977 01-Dec-2020 BV081520 11 21 Model Year Make Model JBody Style Color(s) Vehicle Identification Number 2007 CHEV K15SLA SUV BROWN 3GNFK16367G155$14 Residential Address (If Different than Mailing) Total Registered Weight for Commercial Vehicle or Trailer Garage Address US DOT Number for Commercial Vehicle 241 HAYDENVILLE RD LEEDS MA G10539768 Name(s) of Owner(s) and Mailing Address I'I"lItIIIIIIII[IIIIIIIIIII�llhllllllll��ulllilllllll[II'IIIII insurance Company ARBELLA PROTECTION INSURANCE COMPANY 003445--AUTO-5-DIGIT 01060 JEFFREY D MILLER Maximum Seating Capacity for Vehicles for Hire 160 MAIN ST STE 8 NORTHAMPTON MA 01060-3187 7 Not.Valid Without Official Signature of Registrar Lesseelin Custody Of Special Message Change of Address L] Residential []Mailing ❑ Garage Information for Vehicle Owners • Certificate of Registration: Every person operating a motor vehicle shall have the Certificate of Registration for the motor vehicle and/or trailer, in the vehicle, in some easily accessible place. The records of the RMV constitute the official status of the vehicle registration. M Change of Address: By law, you must report any change of address to the RMV within 30 days. Visit Mass.Gov/RMV � to change your address. Once you have reported the address change to the RMV, please write corrected address in box provided above. • No insurance Card Required: Massachusetts law does not require an insurance card. M.G.L. Chapter 90, section 34_ C and Chapter 175, Section 113A, requires the vehicle's owner to maintain a compulsory motor vehicle liability insurance __pGric or bond for bodily n ury coverage and_property damage insurance. The insurer is required,_y law to electronically notify the Registry of Motor Vehicles if coverage lapses. The vehicle owner is then notified by the RMV to obtain new r insurance within 10 days or the registration will be revoked. Bonds are filed with the State Treasurer's Office. N • Transferring Your Plates: Massachusetts General Law (M.G.L. Chapter 90, Section 2) allows you to transfer valid registration plates from this vehicle to a 'newly acquired new or used motor vehicle or trailer while you obtain insurance and a new registration. See the Transferring a Registration Section on the RMV's website at www.mass.gov/rmv for more information. • Cancel the registration plates If: - The vehicle has been sold or junked and the registration is not going to be transferred to another vehicle. - You move to another state and you register the vehicle in that state. - The insurance policy is not renewed or is cancelled and there is no plan to obtain a new policy_ woof,y rev r- l7�j 1� �kc c U C) )-230-6, Child Safety Seat Plan 2021 22. As per the order of the City of Northampton 319-19-4 April 26, 2021 Cosmic Cab will provide a front or rear facing Child Safety Seat or Booster Seat upon the request of any customer. The customer will need to schedule at least 1 hour in advance to ensure the availability of the safety restraint required. - Bards, effrey r Miller Owner Cosmic Cab Coml2any 160 Main St. #8. Northampton MA 01060 (413) 230-6119 Office ! Agent: 46a0028 DECLARATIONS - MASSACHUSETTS Tax I.D. No.: BUSINESS AUTO COVERAGE FORM Policy Number: 1020093350 02 MM 00 97 09 98 A R B E L L A ITEM ONE- NAMED INSURED AND ADDRESS Producer Name and Address 415-0028 JEFF MILLER LIGHTHOUSE INS AGCY LTD DBA COSMIC CAB 540 GALLIVAN BLVD 160 MAIN ST STE 8 SUITE 211 NORTHAMPTON, MA 01060 DORCHESTER, MA 02124 POLICY PERIOD: Policy Covers FROM 01/18/2021 TO 0111812C22 12.01 A.M, Standard Time at the Named Reason for Declaration. VC ENDORSEMENT Insured's Address slated above (Named Insured's Business: INDIVIDUAL DIRECT BILL Effective Date. D412012021 IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. ITEM TWO -SCHEDULE OF COVERAGES AND COVERED AUTOS This policy provides orrly'hoee covarages where a charge is shown in" premium column below Each of these coverages will apply only to those *AuIW shown as mvered'Autos' for a particular coverage by the entry of one or more of the symbus Irom the COVERED AUTOS Section of the Business Aube Coverage Form next to the name of the coverage. I IIltall ITV INSIIRIlNCE COVERAGES COVERED AUTOS LIMIT PREMIUM :Entry of ono or more Ina symbols from the COVERED The mostwe vvB pay for ruiy fate aradent or loss AUTOS Sector of the Business Auto Coverage Form sha+v which autos are covered autos Compulsory Bodily Injury 7 20ODD Each Person 40,000 Each der I 11,081 Personal Injury Pratecpurt 7 &DOO Each Party^ 4 Ophonal Bodily Injury 7 100.000 Each Person 13,279 300,000 EachkGide I Property Damage 7 50,000 Each Arllde t 10.598 (COMPULSORY LIMIT ssso0l Auto Medrell Paymenn Insurance Each Perim Uninsured Motorists (COMPULSORY 7 SEE SCHEDULE Each Pernior 308 LIMITS s20,000440,000) SEE SCHEDULE Each boride Undennsured Motorists 7 SEE SCHEDULE each Perlior INCL SEE SCHEDULE Each Acadir l PHYSICAL DAMAGE INSURANCE ..er ..r .-..e;...,t. nh.,..r 1. 1... min,re th., dertuchhle for each Covered Auto_ Ua Comprehenuw Coverage~ Ded ict"is specified Peru Coverage Deductible Collison Coverage Deductible Limited Collision Coverage Deductble Loss of Usa•Rental Reimbursement Towing and Labor of • a For each disablement er Forms and Endorsements attached to this Coverage Form: 26 AP 1056 01110)} CA 00 01 ((10/01) tL 00 21 (04198) 26 AP 1057 (01110) CA 23 86 (01106) MM 99 11 (10111) 26 AP 1092 Will CA 24 02 f 12193) MM 9918 (09198) PREMIUM FOR ENDORSEMENTS ADDITIONAL OR RETURN PREMIUM 'ESTIMATED TOTAL PREMIUM 911201 26 AP 1102 (04111) CA 99 17 (07197} i 26 AP 1109 (07116) IL 0017 (11/85) m,arw. eapP,prsw muiw ar.,urr.. a«rK.. car,. ,.,m r. n.�r,+uen MM 99 23 09198) 'This policy may be subjectro final audit MM 99 54 rCV98) trove dbf wry Aq. MSURED COPY OY2312021 Office IAgent: 46-0028 DECLARATIONS - MASSACHUSETTS Tax I.D. No.: BUSINESS AUTO COVERAGE FORM Policy Number: 1020093350 02 SCHEDULE - MM 00 97 09 98 A R B E L L A ITEM THREE- SCHEDULE OF COVERED AUTOS YOU OWN '+o„er,r„,„,„... .. VEHICLE INFORMATION Auto DESCRIPTION Year. Make. h7otlN, eady Original Sae GVW GCW or No. Vetuele IdeMir.w ri No. IVIN) Cost New Territory, Glyd Slate 001 O08DODGE GRAND CARAVAN SEEXTENDED 21.74p SeasngCapaaty waa.ax«.r.e,.ar,w.r,e 1 DOHN44HOBB162479 LEEDS 002 008 DODGE GRAND CARAVAN SE EXTENDED 21,740 MA 1DOHN44H18B184670 LEEDS 003 007 CHEVROLET SUBURBAN K1500 WAGON 4 39,665 MA GNFK16367G155614 LEEDS 004 005 DODGE MAGNUM SXT WAGON 4 DR. 27 900 MA D4GZ48VX5H511216 LEEDS CLASSIFICATION MA Auto Busmo . - Samoa Symbol Age Class Na. Re Gommerclal Radius Mobile MsAact leas of Grprp of Operation Equip Cale Use 001 D7 $ 4189D LOCAL AmVDa 002 07 9 41890 LOCAL 7 003 08 9 41890 LOCAL D04 41890 LOCAL 1 LIABILITY Compulsory Personal LIMBS i• Limits In Thousands 800y Iryury in4u7 Optional Property Damage Auto Uninsured (f20.000rf40,000) Proteon ao Es Bodily Injury IComPulsory Limit hledcal Materials underinsured darn persleaeh ace. PersonSS,0011) payments Canputsory Lftls Motorists Auto (S20,0001ta .1)00) No. Premium Premitrn •Limit premium 'Limit Dad. Premium LimitPremum 'Umet Premium 'Limit Premium 001 1,5W 622 100 1,897 50 1514 300 20 44 20 INCL 002 1,583 622 100 t,897 50 40 40 300 1.514 20 44 20 INCL 003 1,583 622 700 1,897 50 1,514 40 40 300 20 44 20 INCL 004 i,563 622 100 1,897 50 40 40 1,514 20 44 300 20 INCL PHYSICAL DAMAGE 40 40 Auto Q Vitus Type •• Specified PeNa No. and Limit ComprehensMa Cddsfan LintltaO Codislpn _ Cov Ded, Premium Dad. Premprm Ded 001 ACV -- Premium Ded Premium 002 ACV 003 ACV 004 ACV Auto Pasarve .•• Tc Mrrg No. AM Waiver Lose and F - Fee Coverage, T - Then Coverage, FIST- Fin and Then, CAC - RV3L of Did. of Use Labor Combined Additional Coverage. •• YES-DeilOmtae Waives at Dnduetibla. rap Designates Policy Leval Additional Insured -Lessor applies, Designates whether Actual Cash Value, Slated Amount Or Agroed Value and, except for ACV, the knit of Liabddy, No I "Wt far towing all Physleat damage loss Is payable to you and the loss Payee named Glow as Interests may gppear at the time of loss. INSURED COPY osa:lnn» Office 1 Agent: 46.0028 DECLARATIONS - MASSACHUSETTS Tax I.D. No.; BUSINESS AUTO COVERAGE FORM Policy Number: 1020093350 02 SCHEDULE - MM 00 97 09 98 A R B E L L .A ITEM THREE -SCHEDULE OF COVERED AUTOS YOU OWN ..anenwr,..... ei....• VFHICt1= INFORMATION DESCRIPTION Auto Year, Kiska. Model. Body Original It GVW, GCW v Territory, City 6 State No Vehicle ldenhilcatlan No. (VON i Cost New Seating Capacty .MnM rowr¢artaN Ei erap.r 006 2009 DODGE GRAND CARAVAN SE SPORT VAN 23,530 LEEDS D8HN44E59R576432 MA 009 2010 DODGE GRAND CARAVAN SE SPORT VAN 23.175 LEEDS D4RN4DEBAR207297 MA 010 2008 DODGE GRAND CARAVAN SE EXTENDED 21,740 LEEDS DBHN44HXBR772469 MA CLASSIFICATION Auto Business use - Pow -cc Symuo Age Cu►s Radar a Mobile Inspect Lass of No Retail. Canmard* Group I O1 Operation Equip Code Use AmeDa a 006 07 9 41890 LOCAL ! 009 07 9 41890 LOCAL 1 010 07 9 41890 LOCAL LIABILITY LIMITS (• Umd(s)) in Thousands) Compulsory Bodily Injury Personal juryOptional Damage Auto Uninsured Motary Undetmsured ($20,00(+Si00001 Protection $B4O00 Es Bodily I Nury (Compul ory Liit SS,000) Medical Payments L Compulsory Limits Motornu each pers.leach arc. Persian000(S20.000IS40,000) Auto No Premium Pmm7un 'Umit Premium '4imR Dad. Premium Limit Preir,um 'tJmlt Premium 'Lkmst Premium 006 1,583 622 100 1,897 50 1514 20 44 20 INCL 300 40 40 009 1,583 622 100 1.897 50 1,514 20 44 20 INCL 300 40 40 010 1,583 622 100 1,B97 50 1,514 20 44 20 INCL 300 40 40 PHYSICAL DAMAGE Auto eta WN&TyPe - Specified Pedls Cornptehanskve Collision Limited Collision No. and Limn Cov. Dad. Premum Dad. Premium Dad. Premium Dad. Premium 006 ACV 009 ACV 010 ACV Towng uld A art Passive Waiver Lou and F - Fee Coverage, T - Theft Coverage. FaT - Fare and Theft, CAG - No Rest. ATD of Dad, of Vale Labor Combined AdditiorW Coverage. " YES -Designates Waiver of Dedtm bbla. as Designates Policy Level Additional Irisured - Lessor applies. iM Designates whether Actual Cash Value, Stated Amount or Agreed Value and, except forACV, the lime of Liability. Auto NO. Except lot towing all physical damage loss Is payable to you and the loss payee nomad below as Interests may appear at the time of loss copyrigmod marorwr ar msuranca aarviaa... ca *0.. — P INSURED COPY 041,7312021 Office 1 Agent: 46-0026 DECLARATIONS - MASSACHUSETTS ' Tax I.D. No.: BUSINESS AUTO COVERAGE FORM Policy Number: 1020093350 02 (Continued) - MM 00 97 09 98 A R B E L L A ITEM FOUR- SCHEDULE OF HIRED OR BORROWED COVERED AUTO COVERAGE AND PREMIUMSrr{r o. r» •a»�•-. LIABILITY COVERAGE - RATING BASIS COST OF HIRE State Estsmatod Corr of Rite per each 5100 Fodor Hire for each Ssate �e1n1nn Cost of Hhe means the total amount you Coel of Hire fit ilab, my s Primary) incur for the him of •autos' you don't Sod, Injury Prop Damage sod Injury prop Damage own {not Inrludog'autoa- you borrow or rant fmm your Partners or employees or their family mnrmersl. Coss of Hire does red include charges for services performed by motor nmem d property Total premium or passerigars. PHYSICAL DAMAGE COVERAGE Coveregea 4md of Insurance The meal vie vw ,.... n......,��_ Es[snated Annual Rate per each Stoo 0,....+.�... Camptehenuve AC1WI wlaa..re ties m+.ru e 11 rl ercaKada b sees ww,wr-ft are M erda.Eth Specific causes Value, arrrwrropw resew hrfnd Wl.se of Loes Cost of wrw...,ssn., mnw i-Sao swu'1'raY 4ra'Yiewary fwo av ems a�,.r Rapairs by manyfa nwatr,n Collision or weir..., wweaaw ti,..arn mwrw ruA Total Premium a ITEM SIX -SCHEDULE FOR GROSS RECEIPTS OR MILEAGE BASIS. I IA.u—--L.--- -- — - ![:�]'G—�roz*R&-celoptz Per 3100 of Grose Receipts Premiums 17 Per mile LIaWh Covere a Lfabihry Coverepe Auto Afed+eal Pa enta Auto Medico! Paunu,x i 'titian used as a pnmlum basis FOR PUBLIC AUTOS Total Premiums Mlnlmum Premiums Gross Rece,pla means the total amount to whkh you are enlilled for Iransparting passe of whether you or any other tamer ongirese the trans p ngen, mail a mslchartdisa during the poky Period regerdler A Amount you Pay to railroads, steamship line��es and other motorea Gem opert kWuating under then own JCC or PUC permits. B Tatn which you Coed as ■ separate Rem and remit direcay to a govemerMal division. C. C.O.0 Cope"bome for wet of mail or merchondna irxWMng eollections lees. O Advertlabrg Revenue. FOR REN TA LEASING t CQNCl I've E5 ad mileage of al revenue producing units operated during the policy pent. RN GloeS IUMIAte means the total amount to wdich you are enhged or the leasing or rental of •&doe during the (hose lath which you collect es A seprtrate item and remfl directly to a govemmental divglon. poky period and Includes tames except %bteape means the total of as Yve And dead mileage developed by a3 the 'Wool you leased or tented to others during die policy period. INSURED COPY 0443/2021 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESCRIPTION OF POLICY CHANGES POLICY NUMBER POLICY CHANGES COMPANY EFFECTIVE 1020093350 02 0412012021 ARBELLA PROTECTION NAMED INSURED AUTHORIZED REPRESENTATIVE JEFF MILLER CHANGES TRANSFER 2010 DODGE VIN 067 TO 2008 DODGE VIN 2469 26AP1109 07 16 Copyright, Insurance Services Office, Inc. 1933. Page 1 of 1 Era! Used vehh Its permission