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Home My WebLink About17-100 IDENTIFICATION NO. / ) Or) At _ 1 (Office Use Only) 41:14211;Alt 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 Middle Last 1. Name(REQUIRED) gob)eY De‘,/, /K,r 2. Address (REQUIRED) '13/ 5. ili /J tie. Wad L;ny 1-6,11 ..r 5.2 3 "3 3. Contact Information (REQUIRED) Email: ro c(_ 2;/!'1 LL& 400. •CO3"l Cell Phone: 3/9-,'5$-ocdo (All written communication sent via email) 4a. Driver's License expiration date (REQUIRED) t? 3- 0 S •- b. Taxicab Business Name(REQUIRED) )4c/taw -ToW& c;Fy 5. Prior experience in transportation of passengers: 114dL dr;ucit -(cf y</feW Cit for- 7 YtarX 6. Have you ever been arrested/charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense a 1 / Where When Lei (Jf.Vc_z_ What happened to the charge?(Circle one) Convicted Dismissed Deferred SuspendedPlead Guil Other 7. Have you been arrested/charged with any traffic offenses in the last five years? Type of offense Where When Pc We ic'l�', Tk G- c S- .2,1(, What happened to the charge?(Circle one) Convicted Dismissed Deferred Suspended Guilty Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? An Type of offense Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please VIVIde namoil D DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND ST• a ERVIEDrry� DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLIC ,,+� EF$EVIE Ci You must apply for an individual Department of Criminal Investigation Report(form aJitIlable upon request). Cn (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 07/2016 APPLIOATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Driver's license number n,o �q�+ X'67 issued on 0,/2.- 2,G(S expiring on 153-o5 2c Z o . I understand that if I falsely answer any questions in this 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 granted, to comply at all times with all of the provisions of Title 5, Chapter 2, o,the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant '1(r / P-ee4,, 77'1/ Date S-7- .261? STATE OF IOWA COUNTY OF JOHNSON ) Subscribed nd swornto by � zDt,� Nbefore me oICA- r on this Art._ day of WEDY S.MAYER . • _ V Commission Number 729428 Notary Public in and for ar State of Iowa fly Ca.� ' aae� ow 1-1 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 n›p-- cs/2//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. J) ( 7 ig -ture of City •rk or designee VI o :474 Office Use Only 'CC c `--) .001.101 Approved application rn DCI report = 1 State certified driving record o Website update 1 Cr. Clerk(TAXIDRIVBADGEAPPL92014amended.DOC 07/2016 , irilIowa Department of Transportation 43, Office of Driver&erwices (Toll Free)8DD'32-1121 PO Box g204,Des Manes, 50306,9204515.244-9124 NIIIIIIP PAX:515-239-1E07 Certified Abstract of Driving Record Inquiry Date: 7/28/2017 DL/ID#: 960AA9807(IA) Customer#: 2228817 Name: Blair, Rodney Dean Class: B ID Status: None Address: 431 S 7TH AVE Audit#: 8838470 DL Status: VAL Issue Date: 02/12/2015 CDL Status: ELG City/State: WASHINGTON, IA Expiration Date: 03/05/2020 CDL Cert Status: Non-Excepted 523531519 Interstate Endorsements: Motorcycle CDL Med Status: Not Certified Mailing Address: 431 S 7TH AVE Restrictions: NONE Restriction None Supplement: Date of Birth: 03/05/1966 Mailing WASHINGTON, IA Sex: M City/State: 523531519 CDL Medical Examiner's Certificate Certificate Specifics Explanations Medical Examiner First Name Krista Medical Examiner Last Name Ford Medical Examiner License Number A116969 Medical Examiner National Registry Number 3880330225 Medical Examiner Jurisdiction IA Medical Examiner Phone (319) 337-9066 Medical Certificate Restriction 1 Wearing corrective lenses Medical Certificate Issued Date 01/16/2015 Medical Certificate Expiration Date 01/16/2017 Date Added to CDLIS Driving Record 01/16/2015 eV CDL Downgrades CP _J ter) n, Effective End Issuing]UR *...:.4 G'i •""'"' r 03/17/2017 IA n ':.-41-- 7:14. 0 rn History Information c to :iv r. `r, Convictions Citation Date Conviction Date ACD Explanation County JUR 05/30/2016 06/05/2016 592 Speed Poweshiek IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 08/20/2007 389515 IA 09/07/2007 392736 IA Name: Blair, Rodney Dean DL/ID: 960AA9807 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: 4Alt. ,�' ........ 7/28/2017 t'',...1? 0 Ti :: -177144641114161848649‘ � r�'�rr..t� Office of Driver Services Iowa Department of Transporation Name: Blair, Rodney Dean DL/ID: 960AA9807 +.a c9 C7 1' m-4 CI _... C—)—‹ i r -gyp t ON 07,.Ju1. 24. 20171c12: 34PMcar, (Div of Criminal Investigation (FAX)31933&27.N0. 3351 P• _1_/_('.002 • STATE OF IOWA .;_;`.�,, y ' Criminal History Record Check ,. :,ti . Request Form I,•: h > `- t • DCI Account Number: 9967-F (If eppticabte) To: Iowa Invision of Criminal Investigation From: Yellow Ca J cef ow City Support Operations Bureau,1"Floor P,O,Box 428 216 g.714 Street Des Moines,Iowa 50319 Iowa City,7A, 52244 (515).7154066 _ (515)125.6080 Fax ( 338=9' 7'1_ Phones Fax: (319)339-7302 .I am requesting an Iowa Criminal History Record Check on: • Last Name mandolfo ) . First Name(mandatory) • Middle Nate recommondsd ' IC1acr j.) , P- ,4 Data of Birth(mandatory) Gender(mandatory) Social Security Number(,eeommcnded) 1 . 3 - 5 - /966, ale UFemals 't g i•"ciD '7.. 32 4 Waiver itzformation:Without'a.alaned'walvor from the subject of the request,a domplete criminal history record mny not be releasable,per Code of Iowa,Chapter 692.2.For oomplet e'crimina l history reoord information,as allowed by law,always obtain a waiver sl!nature from the sub ect of the re•uest, _.w_,__ Waiver Release:i herebygive pemntssion(Or the above tcquestIng'omvlel to conduct ea lows criminal hlotoryrecord cited:with the Division orCriminat investigation(DCA. My criminal history data concerning..e that Is maintained b deo DCI msY bo rc ELS 24 allowed by law, - - / -- � Waiver Sign - % • Zowa Criminal History Record Check Results • ' OCI use only) 4 As of —1' .1— , l\ , a search of tho provided name and date of birth revealed. 0 No Iowa Criminal History Rccord found with DCI ",( r in I Q ..---i\r—Iowa Criminal History Record attached, DCI# 1 L '2111. DCI initial DCI-77 (08/25/10) • Received Time Jul. 19. 2017 4: 31PM No. 3195 Jul. 24. 2017 12: 34PM Div of Criminal Investigation No. 3351 P. 2/6 IOWA CRIMINAL HISTORY DCI 00316955 FELONY CONVICTION PAGE 1 OF 5 DATE PRINTED- 2017/07/24 DCI:00316955 NAME: SLAIR,ROD BLAIR,RODNEY DEAN DOB SEX RAC HGT WGT EYE HAIR SKN POB 19660305 M W 601 321 HAZ HLK FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y SC R WRIST SC UL ARM TAT UL ARM CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19940401 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 TA STATUTE IA715-1-6 VLS USE FIN INSTR 2ND TRK#: L25803001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA715-1-6 FLS USE FIN INSTR 2ND CHARGE CLASS; STATUS UNKNOWN TRK#: L25803001 SENTENCE DISP EFF DAT JAIL 11D 19840412 02 ARRESTED/TAKEN INTO CUSTODY 19040530 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-2-2 THEFT 2ND TRK#: L25803101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: OPERATE MOTOR VEHICLE W/OUT OWNER CONSENT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L25803101 SENTENCE DISP EFF DAT PLEAD GUILTY 19840822 JAIL, 72D 19840822t.�C'? m 03 ARRESTED/TAKEN INTO CUSTODY 19050625 AGENCY: IA0520200 IOWA CITY PA --tc CHARGE NO- 01 IA STATUTE IA714-2-5 =�rn Z THEFT 5TH DEG 3 C� TRK#: L25803201 COURT DISPOSITION (7� AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE; IA714-2-S THEFT 5TH DEG Jul. 24. 2017 12: 34PM Div of Criminal Investigation No. 3351 P. 3/6 DCI 00316955 PAGE 2 OF 5 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L25803201 SENTENCE DISP EFF DAT PLEAD GUILTY 19850708 FINE $100 19850708 04 ARRESTED/TAKEN INTO CUSTODY 19050725 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA713-5 BURG 2ND DEG TRK#: L25803301 COURT DISPOSITION AGENCY: XA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE. THEFT 4TH CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: L25803301 RESTITUTION SENTENCE DISP EFF DAT PROBATION 1Y 19851002 SUSPENDED 90D 19851002 05 ARRESTED/TAKRN INTO CUSTODY 19060320 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA714-2-2 THEFT 2ND DEG TRK#: L25803401 COURT DISPOSITION AGENCY: 1A052015J JOHNSON CO DIST COURT COUNT NO- 01 XA STATUTE: IA714-2-2 THEFT 2ND CHARGE CLASS: FELONY CONVICTION TRK#: L25003401 SENTENCE DISP EFF DAT PROBATION 5Y 19870129 Q CREDIT 22D all 06 ARRESTED/TAKEN INTO CUSTODY 19060610 oES G AGENCY: IA0520200 IOWA CITY PD ')IIPCY'4 re �"R CHARGE NO- 01 IA STATUTE 1A714-1-3 THEFT 2ND DEG --ip rn 3. TRK#: L25803501 Z COURT DISPOSITION To AGENCY: IA052015J JOHNSON CO DIST COURT m COUNT NO- 01 IA STATUTE: IA714-1-3 THEFT 2ND DEG CHARGE CLASS: FELONY CONVICTION Jul. 24. 2017 12: 34PM Div of Criminal Investigation No. 3351 P. 4/6 DCI 00316955 PAGE 3 OF 5 TRK#: L25803501 RESTITUTION SENTENCE DISP EFF DAT PROBATION 5Y 19670129 07 ARRESTED/TAKEN INTO CUSTODY 19870107 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01. IA STATUTE IA70B-4 WILLFUL INJURY TRK#: L25803601 COURT DISPOSITION AGENCY: IA052015a7 JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE: TERRORISM CHARGE CLASS: FELONY CONVICTION TRK#: L25803601 RESTITUTION SENTENCE DISP EFF DAT CONCURRENT W/CYCLE DOA 06/10/86 19870226 PROBATION SY 19870226 08 RECEIVED 19870129 AGENCY: 1A052015M OAKDALE IMCC CHARGE NO— 01 IA STATUTE IA714-2-2 THEFT 2ND TRK#: L2580370]. INMATE #: 803150 CHARGE NO— 02 IA STATUTE IA714-2-4 THEFT 4TH TRK#: L25803702 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO— 01 TA STATUTE: IA714-2-2 THEFT 2ND CHARGE CLASS; FELONY CONVICTION TRK#: L25803701 SENTENCE DISP EFF OAT PROBATION SY 19870129 Q COURT DISPOSITION J AGENCY: IA052015J JOHNSON CO DIST COURT COUNT N0- 02 IA STATUTE: IA714-2-4 C7"4 r- THEFT 4TH 1C) l CHARGE CLASS; MISDEMEANOR CONVICTION TRK#: L25803702 SENTENCE DISP EFF DAT Vi CONSECUTIVE SENTENCE WITH CT 01 19870129 CP JAIL 90D 19870129 COURT DISPOSITION Jul. 24. 2017 12: 35PM Div of Criminal Investigation No. 3351 P. 5/6 DCI 00316955 PAGE 4 OF 5 AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 03 IA STATUTE: TERRORISM CHARGE CLASS: FELONY CONVICTION TRK#: L25803703 SENTENCE DISP EFF DAT JAIL 5Y 19870226 CONCURRENT WITH CT 01 & 02 19870226 CUSTODY AGENCY: IA053015C ANAMOSA MENS REFTY A 19870226 RELEASED BY COURT ORDER CUSTODY AGENCY: IA053015C ANAMOSA MENS REFTY 8 19870226 RECEIVED RETD ON COURT ORDER CUSTODY AGENCY: IA077015G ADULT PAROLE SVC C 19080302 PAROLED CUSTODY AGENCY: IA052015M OAKDALE IMCC b 19801208 PAROLE REVOKED CUSTODY AGENCY: IA077015G ADULT PAROLE SVC E 19890510 PAROLED CUSTODY AGENCY: IA0770150 ADULT PAROLE SVC F 19890831 DISCHARGED FROM CRIMINAL JUSTICE SYSTEM 09 ARRESTED/TAKEN INTO CUSTODY 19881116 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA906-1 PAROLE VIOLATION TRK#: L25803801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA906-1 PAROLE VIOLATION CHARGE CLASS. FELONY CONVICTION TRK#; L25003801 SENTENCE DISP EFF DAT .Q --a TO SERVE BAL 06/10/86 19900703 5 art 10 ARRESTED/TAKEN INTO CUSTODY 19901102 {")--< 1, AGENCY: IA0520200 IOWA CITY PD 7.1c1 CHARGE NO- 01 IA STATUTE IA714-1-6 :(Ft I sl THEFT 1ST up TRK#: L25803901 Vy - COURT DISPOSITION `� Jul. 24. 2017 12: 35PM Div of Criminal Investigation No, 3351 P. 6/6 • DCI 00316955 PAGE 5 OF 5 AGENCY: IAOS2015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA714-2-1 THEFT 1ST CHARGE CLASS: FELONY CONVICTION TRK#; L25803901 SENTENCE DISP EFF DAT JAIL 10Y 19910912 2D CREDIT 11 RECEIVED 19910913 AGENCY: IA052015M OAKDALE IMCC CHARGE NO- 01 IA STATUTE IA714-2-1 THEFT 1ST TRK#: L25804001 INMATE #: 803150 COURT DISPOSITION AGENCY: IA05201SJ JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: TA714-2-1 THEFT 1ST CHARGE CLASS; FELONY CONVICTION TRK#: L25804001 SENTENCE DISP EFF DAT JAIL 10Y 19910913 CUSTODY AGENCY: IA077015G ADULT PAROLE SVC A 19940714 PAROLED CUSTODY AGENCY: IA077015G ADULT PAROLE SVC B 19960714 DISCHARGED FROM CRIMINAL JUSTICE SYSTEM AN ARREST WITHOUT DISPOSITION TS 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 HY 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 4 CP CD C '-Wi G, .r