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Home My WebLink About17-112 N IDENTIFICATION NO. / / i t 1 (Office e U Use On y) i1 � rltl M. AI APPLICATION FOR TAXICAB/MOTORIZED PEDICAB VEHICLE DRIVER CITY OF IOWA CITY (Police Department review must be made between 8 a.m.to 3 p.m., Monday—Friday) 410 East Washington Street Iowa city, Iowa 52240-1826 Failure to complete the "required"information will result in denial of the application (319) 356-5040 (319) 356-5497 FAX First MiddleA /Last 1. Name(REQUIRED) j n`j I') ri'-et/j•)'L71/r22. Address REQUIRED 3 2 p S( ) � l�l�l7p�ri T rt,G ") 3. Contact Information (REQUIRED) Email: O r1 h e h�/Y WS Z 3�1-a)/r14' Cell Phone: ) 13- 90-12--SL tAll written communication sent via email) 4a. Driver's License expiration date (REQUIRED) ) 62. 2.02-v ) b. Taxicab Business Name (REQUIRED) J e, W 91b 5. Prior experience in transportation of passengers: dli 6 i,/ A i hil Cr y e//Al 6. Have you ever been arrested/charged with any misdemeanors and/or felonies in this State or elsewhere? ii 6 Type of offense Where When nv ,,, What happened to the charge?(Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested/charged with any traffic offenses in the last five years? ) 6 5 Type of offense . / Where When 0- 1/17 ' L (�ra J a I10 What happened to the charge?(Circle one) onvieted Dismissed Deferred Suspended Plead Guilty Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last fivetars? gi 67 Type of offense Where Ailinenti ?OP-4 G, .0.66 M 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please pro a tliinamIV O w Ns 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 e -t 41 I APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I h reby certify th, 13 ,61611 t I h ve issued to me by the Iowa Department of Transportati n valid Driver's license number 7 S-2-, ,g 1Q J 1 issued on / / o expiring on / h0 7 . I understand that if I falsely answer any questions in this application, that this a plic ion may be denied. ag a 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 granted, 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 Notary Public) Signature of Applicant a� Date i L 7 *********************************************************************************f*************,********************************...************** STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by 3alitv. F. Au,,e1.d e-ws on this 7 day of • / ..• 6" li IAENDN S.MAYER �� r/ » np�r�24t2E Notary Public ing' d f.r e State of Ili a Tiketia 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 ! /2-/2-02- 0 — 8)/2-14///7 Signature of Police 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. / / - CP • Si nature of City Cleaor designee410 D G, .0mmi Office Use Only ti at CA rxs Approved application DCI report State certified driving record Website update Gerk(TAXIDRIVBADGEAPPL92014amended.DOC 07/2016 CJIowA DOT SMARTER I SIMPLER I CUSTOMER DRIVEN VWVW'IOWBdOt.90V Office of Driver Services PO Box 9204 I Des Manes,IA 50306-9204 Phone:515-244-9124 1800-532-1121 I Fax:515-239-1837 www.iowadot.gov Certified Abstract of Driving Record Inquiry Date: 8/22/2017 DL/ID#: 152889099(IA) CDL Permit Class: None Customer#: 1621134 Class: D CDL Permit Issue None Date: Name: Andrews,John Fredric Audit#: 1541746 CDL Permit None Expiration Date: Address: 832 RUNDELL ST Issue Date: 01/11/2017 CDL Permit None Endorsements: Expiration Date: 01/02/2020 CDL Permit None Restrictions: City/State: IOWA CITY,IA 522406254 Endorsements: Chauffeur 3 ID Status: None Mailing 832 RUNDELL ST Restrictions: NONE DL Status: VAL Address: Restriction None CDL Status: None Mailing IOWA CITY,IA 522406254 Supplement: CDL Permit Status: ELG City/State: Date of Birth: 1/2/1963 CDL Cert Status: None Sex: M CDL Med Status: None History Information Convictions Citation Date Conviction Date ACD Explanation JUR County 05/13/2017 06/07/2017 _ F04 Seat Belt Violation IA Johnson 05/30/2017 !06/21/2017 NO1 Fail to Yield Right of Way IA Johnson Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date JUR Case Number 05/30/2017 IA 1984444 Name:Andrews,John Fredric DL/ID: 152869099(IA) 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 I 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: ...., allit2 30. (ow . O.T.�� 17( f�� e")::#4 g :iliiiiiiii,.., -� ‘h,„,8,14.1:100-16I%' ` Office of Driver Services 0 Iowa Department of Transportation :S, !V 3t• C!! f`r► Name:Andrews,John Fredric DL/ID: 152B69099(IA) Aug. 23. 2017 9:48AM Div of Criminal Invest igat ion . .1/2 ---/002 M ,..,r .cu i+ 1r.3v i c i i w Cab u i i N•i� ..-.1Ly )• 01 It lr 7 rG A11y STATE O 7YA .!4T., i4', f,,— '':M. `' 3\ Criminal History Record Check ;7, ;;;;:. .` ".? I•,ti{,.t Request Form '� � , ter, yea ��,;.,,.,• DCI Acoount Number: 9967-F (ft apphcabfc) To; Iowa Division of Criminal Investigation From' Yellow Cab of Iowa City_ Support dperatlons Bureau, 1r' Floor P.O. Box 428 • 215 E.71"Street Des Moines, Iowa 50319 Iowa City, IA. 62244 (51s)725.6066 (515)•725-64a0 Fax - -- (3T97-33g.9777 — ' Phone: ' Fax; (319)339-7302 1 am re ueq sting an Iowa Criminal History Record Check on: Lust Name (mandatory) First Name (mandatory)' Middle Name recommended) I i ii - Jh irr- ri---(, Date of Birth (mandatory) Gender(mandatory) •Social•Security Number(recommended) 1 Male Female i` k. ef, 77_,1c ( q) Waiv r Information: Without n signed waiver from the subject of the regtiest, a complete criminal history record may not be releasable,per Code of Iowa)Chapter 692.2. For complete criminal history record Information,as allowed by law, always i obtain a waiver signature from the subject of the request, . Waiver Release;I h:ruby give pesmieslon(of 1ho above,r•questfng omolol to conduct an(own er(mlnaf history mord cheek with the Division of Criminal Inverttaatlon(DCI). Any criminal history data concerning me that is maintained by the DC(m y bo toleased as enowets by law. • faluer Signature; — — — • Iowa Criminal -Iistdry Record Check Results -,rocTuroonly) As of g` 2 1 -1 a search of the providod naTne tend data of birth revealcd;�._4 c-, .rar ri. -45_ rot " 0 No Iowa Criminal History Record found with DCI -, —0 1 Pi Iowa Criminal 1-listory Record attached, DCI # 583,=, 'ND DCI initials VTV ` DCI.77 (0&/25/10) • Received Time Aug. 18. 2017 2. 47PM No. 5158 Aug. 23. 2017 9: 48AM Div of Criminal Investigation No. 8868 P. 2/2 IOWA CRIMINAL HISTORY DCI 00389335 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- 201'1/08/23 DCI:00369335 NAME: ANDREWS,JOHN FREDRIC DOB SEX RAC HGT WGT EYE HAIR SKN FOB 19630102 M W 509 260 HAZ SRO MED IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19990510 AGENCY: IA0820200 DAVENPORT PD CHARGE NO- 01 IA STATUTE IA708-7 HARASSMENT TRK#: L36031301 CHARGE NO- 02 FOSS DRUG PARAPH TRK#: L36031302 COURT DISPOSITION AGENCY: IA082015J SCOTT CO DIST COURT COUNT NO- 01 IA STATUTE: IA708-7 HARASSMENT CHARGE CLASS. MISDEMEANOR CONVICTION TRK#: L36031301 SENTENCE DISP EFF DAT PLEAD GUILTY 19890607 FINE $25 19890607 COURT COSTS 19890607 COURT DISPOSITION AGENCY: IA082015J SCOTT CO DIST COURT COUNT NO- 02 IA STATUTE: FOSS DRUG PARAPH CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L36031302 SENTENCE DISP EFF DAT FINE $50 19900510 0 `� IMMO COURT COSTS 19900510 CEJ ]er► AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT, THIS RECOR Gam'! _w_ ` MAINTAINED BY THE IOWA DIVISION OP CRIMINAL INVESTIGATION, BUREAU OF P.) IDENTIFICATION IS A PUBLIC RECORD RUT CAN ONLY BE RELEASED TO NON-LAW 1 'fl m ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IgtplE� fV BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECOUP" GM COVERS THE SUBJECT OF YOUR INQUIRY. ti, DIVISION OF CRIMINAL INVESTIGATION dY�