STATE OF SOUTH CAROLINA )

)

(Caption of Case) )Examphx Application for a Class C Charter Ccrtigcstc from )

John Do» dba Doc's Limo

)

tinrxnst~ Ar ~ 5~r f. tr r)

fry4 R~ @~' + tr~'"*gr; +balf,;e & rA&a( tr-naprt)

W E~S &&v,-m 6~SCmior a

))

I I I I r

2f f7rgPUBLIC SERVICE COMMISSION

OF SOUTH CAROLINA

TRANSPORTATION COVER SHEET

NUMBER:go/5

tf this ts your f)rst time qtina an septic»finn with the PSC, ynu will nuthave s Dnctrct Number, The Cnmrnlssiun witt asstxn ens m ynu, If yuubsve filed with rbe Crnnmissinn bcfnrr, s Docket Number ws» a»sian»dsnd shnutd be entered abnvs.

{Ptcsscrypc or print) Qcirl)rotfns.Submitted bytRufstt t

Avuv raAddress:

Telephone:~rnrar I t f

Fnx:

3-SA- {Xd "y t,

Other:

E,ik y. ~l, Cu

NOTp.; Thc eever sheet sett information contained herein uciurcr replaces nor supptenrcnts the Qtiug sud service of pleadings er other papersas required by law. This form is required for use by the Public S»rvice Cnmmission of South Camlina fnr the purple ef dncttettng and musthe 0)led nut corn let»i .

NATURF. OF ACTION {Cheek all that apply)

Q Application - Class Ai A Restricted COPY

P Application - Ctsas C Taxipeated:

Q Application - Class t." Charter

Q Application - Class C Charter Bus

Q Application - Class C Non-Emergencygate:

g Application - Class C Suet»her Yan T~

Q Application - Class K Household Goods

g Application - Class it llsxardous %nate

Q Application

Q Request for Extensible m Comply with Order

r t Request for Order Granting Autltority to Obtain a Certilicate~ of Public

Convenience»

and Ncccssity to bc Rescinded

Q Request for Cancctttttinn of CertiBcate

Q Request for Suspension

g Request for Reinatsthrnent

Q Request for Name Change on Certilicate

g Request to Amend Scope ofAuthority

Q kequest to Amend Tariff {rate incr»sac, etc.)

Q kequcst to Amend Passenger Limit

Q Request

Q Exhibit

Q Late-Piled Exhibit

Q Letter

g Proposed Order

Q Publisher's AAigvit

Q Reservation Lettyd'pg Response O@

g Return to Petition

Q Other:

Ifyuu have atty qucstibns about this fttrm, please contact the PUBLIC SERVICE COMMISSION ut 803-II96-5I00.

PUBLIC SERVICE COMMISSION QF SOUTH CAROLINA101 Executive Center Drive, Suite 100

Columbia, South Carolina 29210

Phone: (803) 896-5100 Fax: (803) 896-5199

APPLICATION FOR CERTIFICATE OF PUBLIC CONVENIENCE AND NECESSITY FOROPERATION OF MOTOR VEHICLE CARRIER

CLASS C - CIIAR7RR

Application is herebyof S.C. Code Ann., $

,'ade for a Certificate ofPublic Convenience and Necessity, in accordance with tbe provision58-23-10, et seq. (1976), and smcndmcnts thereto.

!, Name under which bustness is to bc conducted (co)pcrstion, partnership„or sole proprietorship, with or without trade name.)

Ro 2 f)/) ll S,L 8-/I'49utree) ss c pp )cant

s»ns ress e pp)can) ) ) eront rom s)rect a ss

2. If thc Applicant isSecretary ofStateCarolina Scc)eta+

sn LI.C or a corporation, a copy of )hc Certificate ofExisteacc from the South Carolinaand tile Aft)clos of Incorporation )nest be attached, (If )neo)pure)cd outside of SC) attach SouthofStale Foreign Corporation" Certificate.)

3. SctrptEntity T

5 Individual O

E3 Partnership

C3 Corporation.

ypb: (Check one)

peer/Sole ProprietorshipI.ist names and~s ofall person having an interest ir) the business.

List names and addresses of two principal oAicers,

Applicant is fman4statement ofasset)

I

BALANCE SHEET4 Pj~ zcc. ast~g ~i~'e +

Balance at Time Appticatioc is Filed:noae tV~~ Vear ~ao

ially able to finnish the services as specified in this appiicaticn and submits the fc Ilyingand liabilities,

Receivables

Real Estate

Buildin sand ui tnent(Net

Motor Vehicles ct

Machine a

Su lies on Ha~nd

Pre aids and Other Assets

Total Assets* 'pit.QQ&'4'&

Accounts

Notes Pa able

Mort cs Pa

2 ui tncntObI t1ons

Accrued Salari and Wa es

Other Accrued Obli ations

Other Liabilities

Total Liabllltl

Total Llabllltljs and Equity*

Ca ital Stock

Retained Barn 1 gs

Total Equity

November D

To: Public SeFrom. RuthfeRe: Detailed

pica Commission & Office Reguiatory Staff's Medical Transport 8 En;ands Service for Seniors, LLC (iscqueffne l Strong, Owner)Explanation of Assets & Usbglties

0ear PSC& 6

l am a new smvehicle} sndsny extra wcjrk

any type of f(erof my persof(

ag business owner, and do not cun ently have any real assets (with the exception of myisbf(fries, fn regards to my above named business. I work full-time, and attempt to pickup

hours avsgable, so that i can finsnre my new venture. Currently, l do not plan to seeksonal loans of sny sort, to finance my company, Please find below, s detafled breakdown

al assets & ffsbffftfes:

Assets:S005 MercuMonthly fncoTotaf Assets:

ny- $2000 (approx)me - $5000 ~ SSS00 (grossj$5000- SSS00

monthly'abfi(ties (Rent-$655

'tlgtles-$500Credit cards 5lnsursnces - $Dass- SZS0Groceries - $

Pharmacy/CrfCsr MainteneMisc. - SU.STotal Usbffftf

l don't makeexcellent se

I(50-pays - SS0nce-$50

Ss. $1T00

much money, but lf given spprovaf by your commission & staff, i wig offer nothing butryfces

touche

Rne seniors of York County, SC.

&acqueffne l strongfor go&le's fyfedfcsf Transport ik Errands servfce for seniors, LLc

PROPOSED RA.TKS AN9 CHA.RGKS FOR SKRVICK

'!r'ou will oniy!besuthortty ifyou f

Q Abbcvitle

g Aiken

Allendsle

g Anderson

Q Ban &berg

gBsmwe! I

Q aesnfort

Q Berkeley

g Calhoun

Q Charleston

Q Georgetown Q Lexington Q Spsrtanbnrg

Q Sumter

g Union

Q Wgttamsbnrg

g York

Q Grocer!tie

Q Greenwood

Q Hampton

Q Hrery

Q Jasper

Q Marion

g Marlboro

Q McCormtck

Q NewberG!

QOconee

Q Grsngebnrg

Q Pickens

Q Richland

Q Chestergeld

Q Ctarendon

g Collelon

Q gtatewideDorchester

Q gdgettetd

Q Fstrgeld

!

Q i~arena

t'ai ji be, 4M'r'O (Gr i'D!„(e+ y) ~tera + W'4~ r~r&eaA apjatyi~~kh

6t r t 'r~ Vrkr ~ ~ra A @~~en

f~rso;(ptrfr, p4&tt'.'wf'l')cA~'g is'c~') &+0 ).i3

preIonterl ~ ~ ~~! Q"g rp e Q~r

j~(,„„, ~Q'~-5z..r~bs ~~lr. + Isrrihr&rn lay.'~( (g(5;„fz reaid~ A cia@Me y Q~ ~d;M ~d~M~ j g'er!'jg rigid~

)~~re rj,z ':: ~ i,S Gerf.s ~rr'tr. +'l F!"jkI

rrt! I~a 8-Jc i~ ~r-e~('d~c +o lstaaa. ef ~rd C'' 4! rlrotrg~ pIttre Ogerrn ci +e Qierrt'8 re'rd~e.gXF r o~c '!lAo

tyre. ~, &M ~rd S'f 8'er 4 Pe-r 'ie;kekuecr ~ errrsr tt)Reqttng&kmpj ~mi~

aHowed to operate in those counties cheeked below. You tnay request "Statewide"

ntend to operate in alt counties in South Carolina,

+Cherokee +Florence Qt.ce Q Satuda

@Chester

DESCRIPTION OF EQUIPMRNT

Yon are not required

young be required t

to own a vehicle to illa «n application. However, prior to being Issued a certificate by ORS,o have obtained a vehicle,

to carry ia based on tffhc nutnber ofpassengers a vehicle is equipped

e number of~ in the vehicle, including the driver's seatbelt)

rs, including driver

Q 8-I5 Passcngers, including driver

INSURANCEQUOTE PIC/Llc. &f. AH'ecLoP Stan~

This founThc insurance quote rauatinsurance policics may bI.

purchase insurance anti )/our

by anbe complete, listing currant insurance premiums. At the disneion of the Ccrnrntasicn, a copy ofcurrctarequired, Do not provide a copy of insunutcc policies unlax« requested, You will not ba required to

application has been approved and an order haa been issued by the PSC, THIS 18 ONf.Y A QUOTE.

The fo)lowing insurance quote is 1'r:

Name ofApp!icant

Atttttttttt.afar~

Address of Applicant

Lhtbillty Insurance '5

premium is for a term of months.

Mintmntn Dmits - Intrastate

Only.'ngers*

5 25,000/50,000/35,0001-7 Pass

8-15 Passenger«a 0 25,000/100,000/35„000

a Passengers "- Number of scatbclts in the vehict

ame o urance,.om

erne Ge css 0 ornpsny

I am SN1iliar wtth tilemeets the minttnum tnSouth Carolina Depa

Commission.'s Rules snd Regulations relating to insurance requirements and thc above quotesurancc limits prcscrtb@L Thc insut'ance company making this quote is authorized by the

ttrncnt of insurance to do business in South Carolina,

Authorized Insurance Company Rcprcscntative's Signature

hiQXKF'f

you wish to se'if-i

Ann, Sections 56-9-6Vehicles at (803) 896

qsurc your motor vehicles for liability and property damage, you must comply with S,C. Code0 and 58-23-910. For more information, contact Vickie Coker with the Deparuncnt of Mote r-845'/,

lf you wish to apply asthe South Carolina W'0

bond or lcttcMf&redi3) agree to pay an snittt/C"r" %"tf'oe n"ace

s self-'insured for worker's compensation coverage in South Gtrolina you may do ao withrkcr's Compensation Commission (O'CC) provided that you wiH bc able to; 1) post a surety

t with the %CC tnr a minimum of $500,000, 0) agree to psy a yearly self insurance nts, andual asscsstncnt to thc South Carrdina Second Injuty Fund. For more information, contact theivtaion at rttn'4 7't7 «717 At nn ttM ~ nl www ccrc anup ac'a/w If'nNtnrooea

NrCGRsts for Soph Cerolllra Columbfa Insrrrsrros Com rr

Account SuErrand Sefv

mrnary For Ruthie's Medical Transport &

for Senio

vehicle rrrlormsllo

Snit

2Q08 MERCURCorrorlCoreRsdlos: Uolo

NICO-Rats Verslorr; 8.3.3481~ QS QR ~ Eh3LQun hltLaam QSt MARAUDER 3,671 412 NfA 2N 1,078 Nr'A NVA 6,392

310,000 Oedsooble; 500r800300 Miles

Drit/er Information for Ruthie'8 Medicai Tranepoft 8 ErraMI Sew for Senlot4CO-Rate tcr Soulh CsrolireColumbia lnsurartcs Cor!pean!

Quote tr; 46086rt0 Revision: rtSC2NSR06

Driver

1 JB!xtuesne StiÃ0

Date ol Ueensa Years TotalStrtb Class Ixp. Points

: Ail Ctr!er 2+ 0

New venture / pririr

I driver w/over 2 Y

record, the premill

State fdilng spplipcancellation is issubdsale or lease csncellan

300 mile radius sppI

experience! no losses in psst 3 years

ears experience / clean mvr, If there sre any tickets or accidents on the drivingm will increase. All new driver must be approved prior to driving,

sll owned, operated and leased vehicles must be mcluded on the policy, If s, a 3$ day notice applies and the premium is earned during tliis thne, A biII of'on is required is s vehicle is to be removed from the policy.

ies

Must have signed Iqstionsl Indemnity spplistion and um form to bind

Premium is due in full within 10 dhys ofbinding either by insureds check or finance contract

I0~/e commission!

arne o pp leant

I. Are there currentLy

Q Yes

IfYes, indicate rIatare ofjudgement(s) against applicant.

any outstanding judgments against the Applieet'f

Q No

2. Is Applicant farnijcarrier operaticsta(u~ and rc

9 Yes

iar with all statutes and regulations, including safety regulations and governing for«hire motorin South South Carolina, and does Applicant agree to operate in compliance with thesetlons7

Q No

3. Is Applicant awaretherewith'PS Yes

of the Commission's insurance requirements and the insurance premium costs associated

l, Applicant understartds that al! drivers must be a minimum of 18 years of age.

lire Ycs Q No

2, Appgcant undcrstatIand such record frobc maintained in th

's that a certified copy of the driver's three (3) year driving record issued by the SC DMVpi the DMV of the state in which the driver is or has been domiciled for such period muste Applicant's business oAicc.

3. Applicant undcrstsrimust be maintained I

ds that a ci'hninal history background check from the state whete the driver currently iivesin the Applicant's business ofhce,

Q No

4. Applicant understantheir possession whstate of residence o)

dh that ail drivers operating a vehicle under a Class C Certificate must have inan operating a chatter vehicle, a valid driver's hcensc issued by the SC DMV ca'he currentthe driver,

5Aes Q No

$ . Applicant understandsvehicles to drivers whState Law Feforcege

that all Class C Certificate holders are prohibited from employing or teasingo are registered, or required to be registered, as scx offenders with the South Carolinaet Division or any national registry of sex offenders.

Q No

PUBUC SERVICE COMMISSIOH OF SOUTH CAROLINA1st EXECUTIVE CENTER DRIVB, S'IJITB Ito

COLUMBIA, SOUTH CAROI.INA 2SS IO

Applicant is familisand R.103-100 tltrdS.C, Code Ann. RegsRegulations for Mqpromises conrplisnhc

r with the provision of S,C. Code Are. 4I58-23-10, et seq.(19'?6), and amendments thereto,ugh R.I03-241 of the Commission's Rules and Regulations for 54otor Carriers (Volume 26,

., 1976), and R.38400 through R.38-503 of the Department of Public Safety's Rules andtor Carriers (Volume 23A, B,C, Code Ann., 19?6} and amendments thereto, and hereby

therewith.

S.C, Code Ann. Secelectronic service, rc

tion 58-3-250 states, in part, that every final order of the Commission, must be served bygistered or certificdmail, upon, the parties to the proceeding or their attorneys.

Bcable box:AGREES io reaeiv» furore Commission orders rchrnvI ro ihe ApplicnnA authority in South Carognnmmission's cServicc SysrerL The Applicant authorizes the Commission to serve its orders by using &he e-it appears on page ane of'this Appticstian. To sign np ihr egssvfcc noitfrcndons, please visit vnnvrpscsc,My DMS neconno

,DOES IIOT AGREE io receive thous Commission orders related ra the Ayplicnnl's suumriiy in Southh the Commission's eServiee Sysretn.

Please check the appT

Applicant.

gh rhe &gmail address nigov io create n

The ApplicantCarolina thronlt

The Applicant for thcaffirm that nll statcdn

I

Certificate ofPublic Convenience and Necessity as net forth in the fbregoing, swear orants contained in the above application are true and correct.

pp leant s nature

tteo p& r e,g, rest cnt, ner„etc,

pSWORNIITMs ~l day sr

'O BBPORB MEzo )s

STATE OF SOUTII AROLIIdA

COIINTF OF

Not yuhuc

Canunlssion Espircs=:;,. j':=-

rrsrrstsssss

DICAL TRANSPORT 5 ERRANDS SERVICE FOR SENIORS, LLC, Alty Company duly organized under the laws of the State of Southctober 13th, 2015, with a duration that ls at will, has as of itis date fliede this office, including its most recent annual report as'required by-211, paid all fees, taxes and penalties owed to the Secretary of State,tery of State has not mailed notice to tha company that it is subject tod by administrative ection pursuant to section 3344-809 of the South, and that the company has not Ied a certificate of cancellation as off.

RUTHIE'S MELimited lj,labllCarolina on Oall reports dusection 3~that the Secrebeing dis'solveCarolina Codethe date herao

Certificate of Existence

I, Mark Hlainmond, Secretary of State of South Carolina Hereby certify that".

Oiven under my Hand and rhe Great Seal cf theState nf South Carolina this 13th day ofOctober,20I5

STATE OF SOUTH CAROLINASECRETARY OF STATE

ARTICLES OF ORGANIZATIONFOR A

LIItfllTED LIABILITY COMPANY

The undersigned delivers the foltorrtng articles ol organisation to I'orm a South Ceroltr&s limited Ifabllty companypueusnt to Soctfons 33&4 202 and 33-44-203 of the South Csmllna Cods of Lsdre, as amended,

1. The norns of ths limited llablilty company utttoh oompges arith section 3344-t05 of tho f878 Southcsl'ollns cods of Laws, so emended ls ROTN18'8 NKolcAL TRAN8poRT s ERRANCS 8snvtcs

Pt)k SSNIORS LLC

2, Ths address of the initial designated office of the Limited Liability Company In South Carolina ls

131 CLKGGAN RD Af& 102sdoet ruidrddd

RCCÃ NXLL SC

oar

29'P305878rdd Cddd

Ths lniflal agent for eorvtco of process of the Limited US088y company ls

SACQSSLINS O. STRONG slectxcrutcally tiled 'on scBOSStgr.studs nct Tcqulded,

Nod|a elerdnwo

ond ths etreel address ln South Carolina for this initial agent fcr sowtce of process ls

131 CLSOSAN RD APT 102Sudor AdFeaa

ROCK liIL SC

ctr

The name and address of each organizer ls

JACQUELINE 3. STRONS

Meme

131 CLEOGAN SD APT 102

Street

ROCÃ fULL

State

297303838

Zlp Code

BUTH1E'8 MEDTCAL TRANSPQRT 4ERRANDS SERVICE PQR SENXQRS, LMi

frrrm rrr ceprrarun

Check this box If ths company ls to be 8 tenn company, lf so, provide ths term speclded;

Q check this box only If menegemerd of the limited liability company ls vested in 8 manager ormanagers. If this company is to be managed by managers. specify the name and address of eachInitial manegen

8) JACQUKLCNE 8 STPQNG

Meme

131 CLEGGAN RD APT 102

Street

PQCS 8 1LI SC US 283305878

City 2tp Code

Check this box II'ne or more of lhe members of dls company are to be liable fcr lta debts sndobkgstiona under section 3344-303(ck gone or more members am so liable, epedfy whichmembers, end For vrhtch debts, obligations or liabilities such members sre liable ln their capecfly asmembers.

tees 8 delayed effective date fs speHsd, these aredee wlk be effective when endorsed for Sting by thesjretary of Slate. Specify any delayed effective date and time;

SstInciudope

forth any other provisions not inconststerd with Isw which ths organizers determine kt Include,ing sny provleIone that sr'o rsqutmd or sre permitted to be aet forth ln the Ilinksd liability company

rating egre8ment.

tg. Signet

Streefus fe

urs of each organizer

ceca'cal ly Salad on SCBQS,cc ebkaohed slgnacuce page,

3018-10-'3

relw nrvlsw re Mlmr ovrcLlrrarrscrtarrvrr cr MAYA JAvurrrY rtur