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Home My WebLink About13-278 Authorization Number 70 r 1 (Office Use Only) "R AO=IaIl APPLICATION FOR TAXI DRIVER CITY OF IOWA CITY (Police Department review must be made 410 East Washington street between 8 a.m.to 3 p.m., Monday—Friday.) Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX -First _I IL j Middle Lot id w 1. Name t - G� 2. Mailing Address 7C' q 6 Ave !'Q ff ,Q V �e 1 r J.-ZLti 3. Telephone: Home ) I ' /WO— l�� Other: 4. Prior experience in transportation of passengers: Co 6 C. / ✓t?r 3 ycc,r-s 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? A u Type of offense Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? / Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? \/e S Type of offense Where When c2pe ,v5 5 2 4504 ( 9 02 1/3 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? //0 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) (7 0 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). (OVER FOR REQUIRED SIGNATURE AND NOTARY) derk/taxidrivbadg 03/2013 I hereby ccertify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number, Z h- I . I understand that if I falsely answer any questions in this application, that this ' application may be denied. I understand that if I falsely answer any of the questions in this application, that this application will 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 a license is granted, to comply at all times with all of the pro isions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) 7 27 Signature of Applicant _ weer ( 4/1 � Date I2-- /I ************************************************* ********x,***:.******************************.,************************************************* STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by Z. rc-d I X. _ 1....e.,,> . On this 1 y--Lv day of The L-esr-il- € D1 444010 WENDY S.MAYER L�� o Commission Number 729428 Notary Public in an or the State of to a M o ss on fres ovi I have reviewed this application, DCI report, and the State certified driving record of this applicant and have deter- mined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of residents of the City of Iowa City (Title 5, Chapter 2, City Code). t/!�7fri------- 12/j/3 gnature of Police Chief or designee ate YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. ? o/ . .,, ,,,,,,i /L // / ture of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width)and 5 1/2" (height) and prominently displayed to all passengers. ******************* ,,,.****************************************************** ",,,,,,,. ,,,.*********************************************** Office Use Only Approved application DCI report State certified driving record Website update clerk laxidrivbadgeapp2010.doc 03/2013 11/Nov. 18. 20135 .1_45PM Div of Criminal Investigation DCI IotNo. 5437 P. 1/1 • ' . STATE OF IOWA an0,111110A, � `10We~� Criminal History Record Check i��d� Request Form • `rt a� DCI Account Number.4383-FC (if applicable) To: Iowa Division of Criminal Investigation From: Marco's Taxi Support Operations Bureau, I"Floor 116 Stevens Dr. 215 E.7'1 Stresl Des Moines,Iowa 50319 Iowa City,In 52240 ' (515)7254066 (515)725.6080 Fax (319)337-9294 Phone: sax: (319)351-9254 l am requesting an Iowa Criminal history Record Check on: Last Namem (mandoioty) FirststNaam�e'�(mminnduory) Middle Name ded) .tv ceiosi ven _ EI Date of Birth(m.ndaw117) Gender(rnaiaatory) Social Security Number(recommended) %/OZ / I latV QMale ❑Female qgl - (3- (OP( Waiver Information: Without a signed waiver from the subject of the request,a complete criminal history record may not be releasable,per Code or Iowa,Chapter 692.2.For complete criminal history record Information,as allowed by maw,always obtain a waiver sipnaturo from the subject of the request. Waiver Release:i hereby give pemdsalon ter Ne novo notating official I tendon en Iowa odminel Madly mord check with the Division of Criminal lnvostigatlon(DCI). Any canton history dots concealing me tamaimaincd he I mayborcltsicd Is allowed bylaw. Waiver Signature:_ Iowa Criminal History Record Check Results (DCI oie only) As of ) � —18 r/3 , a search of the provided name and date of birth revealed: • No Iowa Criminal History Record found with DCI • ❑ Iowa Criminal History Record attached, DC DCI initials CO DCI-77(08/25/10) Received Time Nov. 11. 2013 12:32PM No. 1777 (1111 Iowa Department of Transportation Office of Driver Main (Toll Free)515334- 121 POO Box 9204,Deses Planes,IA 5O306-9204 515-244-9124 FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 12/13/2013 DL/ID#: 322AE6971 (IA) Customer It: 2804420 Name: Rew, Bradley Kenneth Class: D ID Status: None Address: 709 6TH AVE Audit#: 4513566 DL Status: VAL Issue Date: 07/14/2010 CDL Status: None City/State: CORALVILLE, IA 522411940 Expiration Date: 06/02/2015 CDL Cert Status: None Endorsements: 3 CDL Med Status: None Mailing Address: 709 6TH AVE Restrictions: Corrective Lenses Restriction None Date of Birth: 6/2/1982 Supplement: Mailing City/State: CORALVILLE, IA 522411940 Sex: M History Information Convictions Citation_Date Conviction Date ACD Explanation _ _ _ _ County JUR 04/29/2009 05/15/2009 •S92 w Speed (10 mph&under In 35-55 mph zone) Johnson IA: 05/14/2009 05/27/2009 592 SpeedJohnson IA 02/04/2012 02/22/2012 592 Speed ,Johnson IAI 10/03/2013 :10/15/2013 592 Speed Johnson IA Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 01/26/2011 614924 ,IA 10/13/2013 761529 IA Name: Rew, Bradley Kenneth DL/ID: 322AE6971 Pursuant,to Iowa Code §321.10, I, Kim Snook, 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: :� %C �D ....441% 12/13/2013 4: IOWA 1 D. 0. T. '� r ea:. •• y 0,ct••••••••••S Office of Driver Services a"`OAIYtd,= Iowa Department of Transportation i , Name: Rew, Bradley Kenneth DL/ID: 322AE6971