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Home My WebLink About17-068Julie: Roger Bradley <yellowcabic@gmail.com> Thursday, May 04, 2017 4:15 PM Julie Voparil David Stoddard request to remove driver Per our conversation today, Yellow Cab of Iowa City requests the removal from the list of drivers for us as follows: 17-068 Steven Warner Shrock exp. 1/17/2018 Thank you very much. Roger E. Bradley Manager Yellow Cab of Iowa City (319)541-0533 FAX 319-338-2708 yellowcabic(&zt tail.com www.yellowcabic.com , n CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 5 22 40-1 82 6 (319) 3S6-5040 1319) 356-5497 FAX 1. Name (REQUIRED) 2. Address (REQUIRED IDENTIFICATION NO. (Office Use Only) r J APPLICATION FOR TAXICAB / MOTORIZED PEDICAE (Police Department review must be made between 8 a.m. to 3. Contact Information (REQUIRED) Email: Cell Phone: (All written communication sent via email) l � 4a. Driver's License expiration date (REQUIRED) �[ l gyp— b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of passengers: `LG l%Az(/ / /il/ /r/ 7 i 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? F4 t 7. 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? Type of offense Where 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? V�o Type of offense Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an individual Department of Criminal Investigation Report (form available upon request). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 07/2016 ✓ APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereb ty tha I av i sued to me by the Iowa Department of Transport tion vall Driver's license number I < , A _ 0 �s issued on 3 -& / C expiring on ' / . I understand that if I falselly answer any questions in th sl application, that this application may be denied. I agree that in making this application, I 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 this application, and I further agree that, if authorization to be a taxicab driver is gri ed, to comply at all times with all of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a loary Runc) Signature of Applicant Date n� wVIA n� N STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to Z before me by ��-e,JPiA ILkVb on this 3 day of J MNDY S. MAYER u er om ssi Expires ow Of I 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 Driver's license I h /X->1 >,,a& k) -- Signature of Police Chief or designee 25/\,6► 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. Sig City Clerk or designee s13�tq Date «+asaaaaaaaYaaaak:»:�»r<aaaaaa�aaaaaaaaaaaaaaar`xxaaaaaaaaaaaaaa+aa:�a:waaaaaaaaaa+a+++:awaaaa++++aaaaaaaaaaaraaaa+++aaaa+aaaaa+aaa+aaaaa Office Use Only Approved application DCI report State certified driving record Website update CleteTAXIDRPAADGEAPPL92014am W.Doc 07/2016 —IV I/^,_Y:/VHIVI_I arkV IV OT LYlml ndl Investigation 0-/24/2017 10:1 No. 190986, P. 302,002 a0 g'rATE OF IOWA "v Criminal History Recoird Check Request Form y To: Iowa Divislon of Criminal lrvestigation Support Operations Bureau, 1" Floor 215 R. 7'a Street Des Moines, Iowa 50319 (515) 725.6066 (515) 725-6000 Fax 1 ant requesting an Iowa Criminal History Record Check on: DO Account Number;'702 (ifapylinbic) From: Cite df Iowa Cit City Clerh'g Office. --_ _±I 0 E. lllashittgt n Sired Iowa City, IA $2240 Phone: 319-356-5041 rax: 319-356-5497 Last lYasne Onaneam) First Naaie (mandatory) Mjddle jYame (recommended) Date Of Birth (mends/loryy) Gender mandmon9 Social Security Number (meumsnended / ®Female �• -eJs eeeuaavn: wnnout a signed waiver Umn the subject of the request, a complete criminal history record may not be releasable, per Code of Iolva, Chapter 692.2. For complete criminal history record information, as allowed by law, always Obtain a waiver signature from the subieet of the rem,.et IFO&Cr Release:1 hereby give permission for the above rcquening oRlcisl to consists, rn Iowa wimiall Mlory record oberk ssilh she Division ofCrimind Investigalton (DCI). My criminal hialory data sonis maintained by the DCI meceming me that b �� Y/ ` nb1e -leased as a/llosred by law, ff�aiversie1�L(%/nnlure• � I,n "/ . n it IDCI use ORMAS of a search of tilt provided name and date of birth revealed: El No Iowa Criminal History Record found with DCI Iowa Criminal 14islory Record attached, DCI # DCl initials ��71 uCi -77 (08/25/10) —� Received Time Apr.24, 2017 9:59AM No, 8948 _npr.[o, tvlt 7 : z v mvi u i v o t,riininai investigation IOWA CRIMINAL HISTORY DCI 00166530 FELONY CONVICTION PAGE 1 OF 2 DATE PRINTED- DCI:0O1B6530 2017/04/26 NAME: SHROCK,STEVE SHROCK,STSVEN WARNER DOB SEX RAC MGT WGT EYE HAIR SKN POE 19460117 M W 506 ISO GAN BRO MED IA ADDITIONAL IDENTIFIERS SC L CHK CCH RECORD +++ 01 ARRBSTED/TAREN INTO CUSTODY 19721124 AGENCY? ZA0770000 POLK CO SO CHARGE NO- 01 DANGEROUS DRVGS/POSSESSION OF CONTROLLED SUBSTANCE TRK#: L07373601 COURT DISPOSITION AGENCY: IA077015J POLK CO DIST COURT COUNT 90- 01 IA STATUTE: DANGEROUS DRUGS/ POSSESSION/CONTROLLED SUBSTANCE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#; L07373601 SENTENCE PLEAD GUILTY JAIL 1801) 02 ARRESTED/TAKEN INTO CUSTODY 19740430 AGENCY: IA0070300 WATERLOO PD CHARGE NO- 01 IA STATUTE 1A204-401 DANGEROUS DRVGS/POSB959I01;/CONTROLLED SUB/INTENT TO DELIVER TRK#: L07373701 COURT DISPOSITION AGENCY: IA007015J SLACK HAWK CO DIST COURT COUNT NO- 01 IA STATUTE: POSSESSION/CONTROLLED SUBSTANCE WITH INTENT TO DELIVER CHARGE CLASS: FELONY CONVICTION TRK#: 1,07373701 SENTENCE DISP EFF DAT SUSPENDED PRISON SY 19751025 PROBATION 19751025 03 ARRESTED/TAKEN INTO CUSTODY 19900722 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- Ol IA STATUTE IA235-12-2 ASSAULT/CAUSING INJURY/ DOMESTIC ABUSE TRK#: L07313801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA236-12-2 ASSAULT CAUSING INJURY CHARGE CLASS: MISDEMEANOR CONVICTION NO. i m Y. 4 .Iy. O % D� i nVr•[U. [U II 7;LIAM UIv 0T GrlminaI Investigation TRK#: L07373001 SUBSTANCE ABUSE EVALUATION SENTENCE PROBATION ly SUSPENDED 30D 13ATTERERIS EDV PROG No. 1909 P. 5 DCI 00106530 PAGE 2 OF 2 T o�'��'C'� Bp's DISP EFF DAT C`� 19901212 19901212 19901212 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 CmJ10WAD0T www iowadotgov Inquiry Date: Customer Name: SMARTER I SIMPLER I CUSTOMER DRIVEN Office of Driver Services PO Box 9204 1 Des Molnes, IA 50306-9204 Phone: 515-244-91241800-532-11211 Fax: 515-239-1837 w w.iowadot.gov Certified Abstract of Driving Record 4/28/2017 DL/ID #: 435AA5012 (IA) CDL Permit Class 0cop �� j 0224854 Class: D CDL Permit Issue t� 10 Shrock, Steven Warner Audit #: 9840015 Address: 1512 1ST AVE APT 3015 Issue Date: 03/08/2016 Expiration 01/17/2018 History Information Convictions Date: VAL Date: City/State: CORALVILLE, IA Endorsements: 3 Expiration Date: Date: 522414012 CDL Cert Status: Mailing 1512 IST AVE APT 301S Restrictions: NONE Address: None Restriction None Mailing CORALVILLE, IA Supplement: City/State: 522414012 Date of 1/17/1946 Birth: Sex: M History Information Convictions Date: VAL CDL Status: CDL Permit CDL Permit ELG Expiration Date: Date: ,02/03/2015 CDL Cert Status: None 1 IA CDL Permit None 861 Endorsements: Johnson IA CDL Permit None Restrictions: ID Status: None DL Status: VAL CDL Status: None CDL Permit ELG Status: ,02/03/2015 CDL Cert Status: None CDL Med Status: None Citation Date Conviction Date ACD Explanation County )UR 01/31/2015 ,02/03/2015 IM14 Fall to Obey Traffic Sign/Signal ,Johnson IA 08/06/2016 '09/26/2016 861 Violation of Accident Requirements Johnson IA Name: Shrock, Steven Warner DL/ID: 435AA5012 Pursuant to Iowa Code §321.10, I, Melissa Spiegel, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by the Office of Driver Services, that this is a true and accurate copy 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 so certify. In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: 'IC)WA ?(p4/28/2017 s :o D. 0. T. hilvEs � Office of Driver Services