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Home My WebLink About17-135-tea...._ CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319)356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO. (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 annfication First 3. Contact Information (REQUIRED) Email: Last Cell Phone:3/.� sent via email) 4a. Driver's License expiration date (REQUIRED) 0 14 2 a y b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of pa 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State F,,8Tgewlyare? rn r Type of offense Where dW$Lh ` o wy 3-01in'-61,1 C 2I a 11 wAF� What hhapuy�,pened to the charge? (Circle one) dot lspn du I,eauc. scent of C>[[.icP1r4 Convicted Dismissed 1 11 X11990 P1TDh" CPIg(1990 Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? Type of offense Where CD What happened to the charge? (Circle one) When Convicted Dismissed Deferred Suspended Ple Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 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 ' �bbll°YL1�� vosut,�e�. �at'''4 r.1 14 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that I have issued to me by the Iowa Department of Transportaktiorl a valid Driver's license number /z 7�(1�?9 issued is pl 90 m expiring on I understand that if I falsely answer an questions in this application, that this application may be denied.1 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, of the City Code. (Needs to be signed in front of a Notary Public) MfYf11111falflHYi-fYf#iflf}flfflflf111f1f1fYfflfl1f111flffffYf1f1111l11111111f1fYllflfflflfllfY}#Yf}fYf11111111f1}af11111f1ffYflflf11111ffyf1al STATE OF IOWA ) COUNTY OF JOHNSON ) 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). date of er's cense t Loa f Police Chief or designee Date's T 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. " 3 /, ignature of City Clerk or , signee Date aaalaff}lfaaaaaaaf11f11111sfeYlaaalafaaaaaaleff:YaaaalflaalafefYfalafaaaaaalaaal«Yf1aa11aaaaalaffYefafYY#Yafl+faffYllaafaaalaaaaef1111faa1aalaa Office Use Only N O Approved application ? �' DCI report State certified driving record Website update �m M Cler A%IDRIVBADGEAPPL9201aa ndw DOC 0 07/2016 ,kWA DOT SMARTER I SIMPLER I CUSTOMER DRIVEN www.iowadot.gov Office of Driver Services PO Box 9204 1 Des Moines. IA 50306-9204 Phone: 515-244-91241800-532-11211 Fax: 515-239-1837 www.iowadot.gov History Information Convictions Citation Date Conviction Date Certified Abstract of Driving Record Explanation Inquiry Date: 9/27/2017 DL/ID #: 127AC6033 (IA) CDL Permit Class: None Customer #: 1934738 Class: D 1tl CDL Permit Issue None Date: Name: Toomer, David Alan Audit #: 9285470 CDL Permit Expiration None Date: Address: 2742 500TH ST SW Issue Date: 07/28/2015 CDL Permit None Endorsements: Expiration Date: 09/21/2023 CDL Permit None Restrictions: City/State: KALONA, IA 522479214 Endorsements: Chauffeur 3 ID Status: EXP Mailing Address: 2742 500TH ST SW Restrictions: Corrective Lenses DL Status: VAL Restriction None CDL Status: None Mailing KALONA, IA 522479214 Supplement: City/State: CDL Permit Status: ELG Date of Birth: 9/21/1956 CDL Cert Status: None Sex: M CDL Med Status: None History Information Convictions Citation Date Conviction Date ACD Explanation ]UR County 11/17/2013 12/09/2013 N82 Improper Backing IA Johnson Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date JUR Case Number 11/17/2013 ,IA ,767955 06/10/2015 SIA 863060 01/29/2016 IA 904490 Name: Toomer, David Alan DL/ID: 127AC6033 (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: ' p%''4 .............Gi,�oy 9/27/2017 aa�.D. 0. T. rLAs II �fOf Office of Driver 081 -gtc`- Department IowaDe Transportation Name: Toomer, David Alan DL/ID: 127AC6033 (IA) (FAX)3193382703 P.002/002 STATE OF IOWA O..Vw Criminal History Record CheckRequest Form To: Iowa Division of Criminal Invcstlgatlon Support Operations Bureau, l,, Floor 2I5 E.7" Street Des Moines, Iowa 50319 (515) 725.6066 DCI Account Number: _9967—F (Ifappllcable) Fremt Yellow Cab ofTowa Ci P.O. Box 42S Iowa City, IA.. 52244 Phone: Fax: (319) 339,7302 EMale ❑Female M »�� <r(/urmarlon. without a sighed Waiver rrom U 17 the r ori t of the request, a complete criminal history record gray not e releasable, per nateCode of Iowa, Chapter 692.2, For cam pier criminal history o information, a9 allowed bylaw, always obtain a waiver sl nature from the sub act of the reguest. Walveion (D ease: f hereby give permission for she above requesting of&lal to conduct en lora orlminal history mord check with the Division otCriminal Investigation (DCI), My criminal history darn conceming me that Is maintained h n Y the DCi may be relcssed m Mowed bylaw, Waiver Signature; [ r1 „ „ir% -II — As of uuu uete or otrth revealed: No Iowa Criminal History Record found with DCI Iowa Criminal History Record attached, DCI DCI initials_ ,Qct DCI -77 (08/25/10) �ceived Time Sep, 25• 2011 4:54PM No - 7409 (DCI use only) IOWA CRIMINAL HISTORY DCI 00209152 MISDEMEANOR CONVICTIONS Oa�iLY PAGE 1 OF 3 DATE PRINTED - DCI :00209152 2017/09/27 NAME: TOOMER,DAVID ALAN DOB SEX RAC HGT WGT EYE HAIR SKN POB 19560921 M W 511 200 BRO BRO MED IA ADDITIONAL IDENTIFIERS SC CHIN SC R KNEE CCH RECORD *** O1 ARRESTED/TAKEN INTO CUSTODY 19780203 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 DRIVE UNDER INFLUENCE/LIQUOR TRK#: L10173201 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: OPERATE MOTOR VEHICLE UNDER INFLUENCE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173201 SENTENCE DISP EFF DAT JAIL 10D 19791120 02 ARRESTED/TAKEN INTO CUSTODY 19860716 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INTOX TRK#: L10173401 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 IA STATUTE: IA123.46 CONSUMPTION / INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173401 SENTENCE DISP EFF DAT JAIL - 2D 19860717 03 ARRESTED/TAKEN INTO CUSTODY 19901103 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L10173501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173501 SENTENCE DISP EFF DAT JAIL 2D FINE $500 CREDIT W/TIME SERVED 14H 04 ARRESTED/TAKEN INTO CUSTODY 19901103 A AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321-263 LEAVE SCENE OF ACCIDENT TRK#: L10173601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321-261 LEAVE THE SCENE OF PERSONAL INJURY ACCIDENT CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173601 SENTENCE JAIL 10D CREDIT W/TIME SERVED 14H 05 ARRESTED/TAKEN INTO CUSTODY 19921001 AGENCY: IA0920000 WASHINGTON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI/2ND OFFENSE TRK#: L10173701 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 IA STATUTE: OWI/2ND OFFENSE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L10173701 SENTENCE JAIL 30D FINE $750 06 ARRESTED/TAKEN INTO CUSTODY 19931126 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-21 DRIVING WHILE REVOKED TRK#: 006588001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-21 DRIVING WHILE REVOKED CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 006588001 SENTENCE JAIL 2D DCI 00209152 PAGE 2 OF 3 19910214 19910214 19910214 DISP EFF DAT 19920214 19920214 DISP EFF DAT 19930129 19930129 DISP EFF DAT 19940304 DCI 00209152 PAGE 3 OF 3 FINE $250 19940304 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