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Home My WebLink About15-083CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 356-5040 (3 19) 356-5497 FAX 1. Name (REQUIRED) - 2. Address (REQUIRED) IDENTIFICATION NO. N7-;—G'�3 (Office Use Only) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday) Failure to complete the "required" information will result in denial of the application First 3. Contact Information (REQUIRED) Email: 4a. Chauffeur's License expiration date (R b. Taxicab Business Name (REQUIRED) Middle �ast � 1 Si. il— tdr7iCr9,)p o2 Kell Phone: II written communication s t via email) 5. Prior experience in transportation of passengers: V r UG A toy r 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When What happened to the charge? (Circle one) Convicted Dismissed Deferred�� Suspended Plead Guilty Other Have you been arrested / charged with any traffic offenses in the last five years?L� Cl Tvice of offense What happened to the charge? (Circle one) Where When Convicted Dismissed Deferred Suspended Plead Guilty Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? st, S� Type of offense Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please p%r& the,nam s 0 1 ry DEPARTMENT OF .. j ED DRIVING RECORD MUSCRIMINAL CINVESTIGATION OMPANYTHS APPLICATION CATION FOR POLICE &ICQ REPORT AND ., PEF �VI W® You must apply for an individual Department of Criminal Investigation Report (form available upon request). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 02/2015 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify th t I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number Ul U Z issued on- '(- on 16-31-2&16 1 understand that if I falsely answer any questions in this application, that this application may be denied. I agree that in making this application, consent to allow agents or employees of the City of Iowa City, Iowa, in their discretion, to examine any and all records and documents relating to thi pplication, and I further agree that, if authorization to be a taxicab driver is granted, to comply at all times with all of the pro si ns of Title 5, Ch9ptej,4, of tljq C tt Code. (Needs to be signed in front of a Notary Public) 9 ppgg Signature of A li Date STATE OF IOWA ) COUNTY OF JOHNSON ) Su) cribed nd sworn to before me by C C� 11 1ct v ' 1�' r�c� C2 on this I t� da of JH -t n �1 y Number 2z 10 Notary Public in and for the State of Iowa L have reviewed this application, DCI report, and the State certified driving record of this applicant and have determined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). / Expiration date of Chauffeur's license I -iy-31 L/,(� Sign tore olive Chief or designee Date AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAB IN IOWA CITY FOR NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW. Signature of City Clerk or designee Office Use Only Approved application DCI report State certified driving record Website update / ate N O C#* QA U1 r M 33! w c.n CID ClerWTr IDRNBADOE PL02014amerlde ..DOG 0312015 SMARTER 15(tyAf!' g I CUSTOWEr a ftWE� WWADOT �1� otgov Office of OTivex Services PO Box 5244 Des MDlneg. A ED306-9234 Phone: 515-244-91244844-532-1121 I Fax: 515-239-1837 wwwf[ adat.+7ov Inquiry Date: 4/7/2015 Name: Randle, Gemayal Rashaun Address: 505 7IH ST City/State: CORALVILLE, IA 522412021 Mailing Address: 505 7I11 SI Mailing City/State: CORALVILLE, IA 522412021 Convictions Certified Abstract of Driving Record DL/ID #: 434"6769 (IA) Customer #: 1385335 Class: 0 ID Status: VAL Audit #: 7974562 DL Status: VAL Issue Date: 04/11/2014 CDL Status: None Expiration Data: 10/31/2016 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Restrictions: NONE Restriction None Date of Birth: 10/31/1982 Supplement: Sex: M History Information Citation Date Conviction Date ACD Explanation County JUR 06/12/20100]/20/2010 M34 .fill to Obey Traffic Sign/Slgnal ]ohnson 0A 05/23/2012 :06/26/2012 592 =Speed Polk SIA 05/23/2012 .06/26/2012 869 iNa Insurance Card 'Polk IA Accidents - Accident Involvement indicated does NOT mean the individual was at fault or given a Citation. Accident Data Case Number JUR 02/18/2008427259 IA __.. .....- - 01/07/2015 '.838488487 _ ]A Sanctions Type Effective End ACD Explanatwr, occurrence JUR JUR Suspended 09/08/2010 09/27/2010 051 Non -Payment of Child Support 1A '.IA 6uspmded .10/22/2011 10/23/2013 051 .Non Payment of C011tl Support U '.0 NO SuspeNdetl 07/17/2012 :08/16/2012 051 ',Nan -Payment of Child Support IA :IA Name: Randle, Gemayal Rashaun Ill 434AA6769 Pursuant to Iowa Code 4321.10, I, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that 1 am the custodian of the records held by the Office of Driver Services, that this is a true and accurate ropy of an official record currently in the custody of said office, and that 1 have been authorized by the Director of the Iowa Department of Transportation to w certify_ In witness whereof, I have caused my signature and the seal of the Department to he se[ upon this document, at Ankeny, Iowa thls date: "aIy IOWA 4/7/2015 ofd ). 0. T �••••'•• Office of Dover Services Iowa Department of Transportation Nome: Randle, Gemayal Rashaun DL/ID: 434"6769 Mar -N. 2015 3:22PM Div of Criminal lnvesti7aflcn No.3022 P. 1/3 IY ■ To: town MIA& of Criminal llrvestigation Support Operatfon9 Bureau, Yr Moor 2151E. 7rb Street Deslvl061e9,19Wa 50319 (515) 723.6066 (515) 725.6080 Fax 1DCIAccouutNumber: (ifappiloebfe) From: CkyoflowaClty City Clerlt's Office 430 &, Washington Street Iowa City, 1A 52240 Phone: 319.3565041 Fax: 319356-5497 I am re questing an Iowa Criminal Histol Record Check on: I Last Name rmandafom 1First Nanj rmandalertl 1Vfili �lA pdomP �.. ....a, n DAto of Birth fniandabrvl Gender rn,anarlp vl fa'npial ldaamrrtfv NOm1,49 r.._-, _..y_n 0 -3 (- % °[ &a- 1 OMa18 OFemale 1339 - 7 a--01 Wffivev Ifaforrr allend Without signed walvor from tho subject of the request, a complete criminal history recot,d may Rol J be releasable, per Code of Iowa, Chapter692,2, hr complete erfmiaal history record information, as allowed bylaw, always Waiver Release: lterebYgive per iSsionfor abovoreguerringoffieieltownductanloWacdhiinafhisrorytccordaheoltwithihoDkisionofCdndnal fnvtsllgetloatDCO. Mycdmioalhhloiydarawau n7otharlrmaiulained Db Cl ereleasad as ellawed by lew. Waiver Signnlu Iowa Criminal History ]Record ghee( Results (DClweenlY) As of— 3/ /Fj a search of the provided nazne and date of bbb revealed: ® No Iowa Criminal History Record found with DCI Iowa Criminal Ilistoxy Record attached, .DCIXN # (� Received Time7Mar. 19.))2015 3:41PM No, 2930 "'iar,10. 2015 3:23PNi Div of CrlminaI Investl,ahon IOWA CRIMINAL HISTORY MISDEMEANOR CONVICTIONS ONLY DCI :00708490 NAME: DAVIS,BRYANT L RANDLM, GEMAYAL L RANDLF,OEMAYAL RASHAUN DOB SEX RAC HOT WGT EYE HAIR 19810921 M B 601 185 HRO BLK 19811021 19821031 ADDITIONAL IDENTIFIERS PHOTO AVAXXABLE: Y SC PHD SC HEAD CCN RECORD +*:. 01 ARRESTED 20031003 AGENCY. IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE XA700-1 ASSAULT ON PEACE OFFICER TRK#: 100970401 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708.7(4) HARASSMENT / 311D DEGREE - 1989 COURT CASE ID: 06521 SRCR066636 CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: 100970401 SENTENCE TIME SERVED 3D JAIL 3D 02 ARRESTED 20050116 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 02 IA STATUTE IA714.2 THEFT 2ND TRK#r 101404902 CHARGE NO- 03 IA STATUTE IA715A.6 CREDIT CARD FORGERY/JOINT/CRIMINAL TRK#' 101404903 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE; IA715A.6(2)-C UNAUTHROIZED USE OF CREDIT CARD C $1,000 COURT CASE ID: 06521 FECR070622 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101404902 RESTITUTION SENTENCE FINE $500 COURT DISPOSITION AGENCY: DCI 00708490 PAGE 1 OF 2 DATE PRINTED - 2015/03/20 SKN 20B DRK IL DXSP EFF DAT 200401/6 20040116 DISP EFF DAT 20050908 No.3022 P. 2/3 "Aa r. 20. 2015 3;23PW. Div of Criminal I n v e s t l g a t l 0 n No. 3022 P. 3/3 IA052015J COUNT NO- 03 JOHNSON CO DIST COURT IA STATUTE: IA714.2(3) THEFT 3RD DEGREE - 1978 COURT CASE ID: 06521 FECR070B22 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101404903 SENTENCE FINE $500 03 ARRESTED 20090321 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRX#: lA006EX0I COURT DISPOSITION AGENCY: IA0520ISJ JOHNSON CO DIST COURT COUNT -NO- 01 IA STATUTE: IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE ID: 06521 SRCROB6579 CHARGE CLASS: NON CONVICTION TRK#: IA006EX0I SUBSTANCE ABUSE EVALUATION SENTENCE DEFERRED JUDGEMENT $315 CIVIL PENALTY, CLEAN UA W/IN 10 DAYS AND/AS ORDERED PROBATION lY UNSUPERVISED PROBATION TO DCS DISCHARGED ]FROM DEFERRED JUDGEMENT DCT 00708490 PAGE 2 OF 2 DISP EFF DAT 20050900 DISP EFF DAT 20090730 20090730 20100727 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI, IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION