INTERNAL REFERENCE ID Maxi Taxi Concessionaires Public Transport Service Corporation 60 Railway Buildings, South Quay (School Transport) Service Port of Spain [SUA-002] Application Form INSTRUCTIONS 1. All Operators must be a National of Trinidad and Tobago between 25 6. Must not have any criminal record for previous or current offences as to 60 years of age. evidenced by a certificate of character from the Trinidad and 2. The Applicant must provide valid Driver’s Permits and another form of Tobago Police Service. ID (Identification Card or Passport) for each Operator listed. 7. The Applicant and each Operator listed in this form must possess a 3. Two passport size photographs (portraits with white background) of mobile phone with the following minimum requirements. the Applicant and all Operators must be submitted. The photographs ii. Android 6.0 and newer should not be taken more than one month before the date of the iii. IOS 13 and newer submission of the application). iv. Minimum ram 2GB 4. A Medical Certificate for each Operator listed in this form must be v. Minimum screen size of 4.7 Inch / 60.9 cm2 submitted. vi. Location hardware: Device must have both A- 5. Two Reference Letters for the Applicant and each Operator listed in GPS and GLONASS chips internally this form must be submitted. vii. 1GB data per month/access to WiFi connection. PLEASE PRINT INFORMATION IN BLOCK LETTERS USING DARK BLUE OR BLACK INK PEN SECTION 1 – APPLICANT INFORMATION: Name of Applicant: _______________________________________________________________________________________________________________ Address: _______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________ Telephone Contact: (C) ____________________ (W) _____________________ Email: ___________________________________________________ Identification No.: ________________________ Passport No.: _____________________ Date of Birth: __________________________ Driver’s Permit No.: ______________________ Driver’s Permit Expiry Date: __________________ Maxi Taxi Badge No.: __________________ Are you an Authorised Bus Route User? Yes No Are you? Owner Owner/Operator SECTION 2 – VEHICLE INFORMATION: Details Primary Vehicle Information Alternative Vehicle Information Vehicle Information Name of Owner of Vehicle: Maxi Taxi Registration No.: Colour Band: Licensed Capacity of Vehicle: Make of Vehicle: Model of Vehicle: Insurance Information Name of Insurer: Insurance Certificate No.: Policy Expiry Date: Authorised Drivers – Persons authorised to operate the vehicle as per insurance and with owners’ instruction. Name of Driver 1 Address of Driver 1: Has this person been convicted of a Summary of Offences/Felony? If yes, please explain Name of Driver 2 Address of Driver 2: Has this person been convicted of a Summary of Offences/Felony? If yes, please explain Name of Driver 3 Address of Driver 3: Has this person been convicted of a Summary of Offences/Felony? If yes, please explain Name of Driver 4 Address of Driver 4: Has this person been convicted of a Summary of Offences/Felony? If yes, please explain Page 1 of 4 [SUA-002] Maxi Taxi Concessionaires (School Transport) Service Railways Building, 60 South Quay, Port of Spain, Trinidad. W.I. SECTION 3 – SERVICE DETAILS (LIST OF ROUTES): From the list of routes below please indicate in order of Priority which routes you will be interested in operating: 1. ___________________________________________________ 3. _________________________________________________ 2. ___________________________________________________ 4. _________________________________________________ List of Routes 1. # 2 Old Clarke Road/Penal Junior 40. Coromadel/Granville/Point Fortin 83. Gran Couva/Couva Secondary 41. Coromandel/Cedros 84. Gran Couva/Gasparillo Composite 2. 10 MM Penal Rock Road/Moruga 42. Coryal/Carmichael/Sangre Grande 85. Gran Couva/Tabaquite 3. Agostini Junction/Mayaro Composite 43. Coryal/Carmichael/Sangre Grande 86. Gran Rivere /Matelot School 44. Coryal/ North Eastern College 87. Gran Rivere/Toco 4. Arima/Brazil High School 45. Coryal Village/Coryal High School 88. Grand Trace/Point Fortin 5. Arima via Blanchisseuse Junction/Morne 46. Couva/Waterloo High School 89. Granville/Point Fortin La Croix 47. Cuche/Nave/Rio Claro/Mayaro 90. Guaico/Tamana/Coryal High School 6. Arima via Blanchisseuse Junction/Paria 48. Cumana/Toco Composite School 91. Guaico Tamana/Nesto/Sangre Brasso Seco 49. Cumuto/Sangre Grande Junior Grand/North Eastern College 7. Barrackpore/Moruga/Christ College Secondary School 92. Guaracara/Marabella Junior 8. Biche/Mayaro 50. Cumuto/Wallerfield/Valencia Primary Secondary School (via Whiteland 9. Biche/Plumitan/Sangre Grande/North 51. Cunaripo/Coryal High School )/Gasparillo Eastern College 52. Cunaripo/Sangre Grande 93. Guaracara/Tabaquite Composite 10. Biche/Plumitan/Sangre Grande/Sangre 53. Cunaripo/Sangre Grande Junior 94. Guaracara/Williamsville Junior Grande Junior Secondary School Secondary School Secondary School 11. Biche Police Station/Rio Claro 54. Debe/Penal 95. Guayguayare/Mayaro/Tableland 12. Blanchisseuse/Port of Spain 55. Diamond/Barrackpore 96. Guayguayare/Rio Claro High 13. Bon Air Road & Howson Village/Sangre 56. Duncan Village/Barrackpore 97. Guiaco Tamana/Nestor/Sangre Grande Grande 57. Ecclesville/Rio Claro 98. Guyaguyare/Mayaro 14. Bon Air Road/Housing Village/North 58. Erin/Penal 99. Icacos/Cedros Eastern College 59. Erin/Penal 100. Icacos/Point Fortin 15. Boodran Trace Granville/Cedros 60. Erin/Point Fortin 101. Iere Village Moruga/Cowen Hamilton 16. Brasso/Venado/Chaguanas Junior 61. Erin/Point Fortin 102. Indian Walk/Moruga Composite Secondary School 62. Erin/Siparia 103. Jairasingh/Sangre Grande 17. Brasso Venado/Chaguanas 63. Felicity/Waterloo High School 104. Kowlessor/Sangre Grande 18. Brasso Venado / Tabaquite Composite 64. Fifth Company/Moruga Composite 105. KP lands Valencia/Valencia 19. Brazil/San Raphael/Sangre 65. Fishing Pond/Oropouch/Sangre Grande Government Primary School Grande/North Eastern College Junior Secondary School 106. La Brea/Fyzabad 20. Brick Field/Princes Town 66. Flanagin Town/Tabaquite 107. La Brea Trace/Penal 21. Brother’s Road/Princes Town 67. Fonrose/Lazari/San 108. La Fillette/Blanchisseuse 22. Brother’s Road/Tabaquite Pedro/Pool/Tableland High 109. La Fillette/Blanchisseuse 23. Brother’s Road/Tabaquite Composite 68. Four Road Tamana/Sangre Grande 110. La Fillette/Brasso Seco 24. Brother’s Road/Tableland High School 69. Four Roads/Tamana/Coryal High School 111. La Fillette/Port of Spain 25. Caparo/Chaguanas Senior Secondary 70. Four Roads Tamana/Coryal High School 112. La Lune/Moruga Senior Comprehensive School 71. Four Roads Tamana/North Eastern 113. La Lune/Princes Town Junior Secondary 26. Caparo Village/Mayaro College School & Senior 27. Caura Valley/Caura Junction (Eastern 72. Four Roads Tamana/Sangre 114. La Pastora/Arouca (Eastern Main Road) Main Road) Grand/North Eastern College 115. La Romaine/Marabella 28. Cedros/Point Fortin 73. Four Roads Tamana/Sangre 116. La Vega/Gran Couva/Couva 29. Chaguanas/Tabaquite Grande/Sangre Grande Junior 117. Lal Beharry/Debe/Barrackpore 30. Charuma/Mayaro Secondary School 118. Las Cuevas/Port of Spain 31. Charuma Village/ Rio Claro 74. Freeport/Waterloo High School 119. Las Lomas/Chaguanas Junior 32. Chatham/Cedros 75. Frisco Junction Point Fortin/ Cedros Secondary 33. Chatham/Granville/Point Fortin 76. Fullerton/Cedros 120. Las Lomas/Felicity 34. Cito Lane/Tabaquite 77. Fulleton/Vessigny 121. Lengua/Barrackpore 35. Clarke Road/ Barrackpore Secondary 78. Fyzabad/Penal 122. Long Circular/Trinity College, Moka 36. Clarke Road Junction/Debe High 79. Fyzabad/Siparia Senior Comprehensive 123. Lopinot/Arouca School/Parvati College 80. Gasparillo/Williamsville Junior 124. Mammoral/Chaguanas 37. Coalmine/Sangre Grande/North Secondary School 125. Mammoral/Tabaquite Composite Eastern College 81. Gasparillo Village/La Pastora/Cantaro 126. Mammoral/Todds Road/Cunupia High 38. Coalmine/Valencia 82. Gran Chemin/Princes Town Junior School 39. Cocorite/Trinity College, Moka Secondary School 127. Mammoral No. 1/Caparo R.C. School Page 2 of 4 [SUA-002] Maxi Taxi Concessionaires (School Transport) Service Railways Building, 60 South Quay, Port of Spain, Trinidad. W.I. 128. Manahambre/Magretote/Main Road 162. Palmiste/Ravine Sable/Cunupia High 201. San Francique/Palo Seco Secondary 129. Marabella/Gasparillo Composite School 202. San Francique Pluck Road/Penal 130. Marabella/Marabella Round About 163. Parryland/Point Fortin 203. San Juan/Trinity College, Moka 131. Marabella/Williamsville Junior 164. Penal/Barrackpore Secondary 204. San Pedro/Rio Claro High School Secondary School 165. Penal/Fyzabad 205. San Souci/Toco 132. Marac/Grancheim Police Station 166. Penal/Palo Seco 206. Sangre Grande/Coryal High School 133. Marac/Moruga Senior Comprehensive 167. Penal/Siparia 207. Sangre Grande/Toco 134. Maracas/La Fillette 168. Penal Rock Road/Barrackpore 208. Santa Cruz/Trinity College, Moka 135. Maracas/Port of Spain 169. Penal Rock Road 10 MM/Barrackpore 209. Santa Cruz/San Fernando 136. Maracas/St. Joseph/Luengo 170. Pluck Road/Fyzabad Composite 210. Sharpe Road/Tabaquite Composite Village/Curepe 171. Point Fortin/ Cap-de-Ville/Cedros 211. Siparia/Debe 137. Maracas Bay/Las Cuevas 172. Point Fortin/Cedros 212. Siparia/Debe High & Parvati College 138. Matilda/Fifth Company Baptiste 173. Point Fortin/Erin