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Home My WebLink About14-096 ' Authorization Number 14-- co • j 1 (Office Use Only) Ii— 7IIIvi cir ..it atigiumcifilr APPLICATION FOR TAXI/MOTORIZED PEDICAB VEHICLE 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 - / , / Middle__ ya t 1. Name CGf 14 L?. 1—X.A/ VV /1 y �. LL i T-- 2. Mailing Address O L 2 he 5 '02 IF- 7"- l� c Ll'`L Cie i vii-1,- -'C 6-2 e(12 ,s� 3. Telephone: Home �i <<(, 5�e( �i E�% Other: j( 4. Prior experience in transportation of passengers: Lti C;'KY— f' . i' /'7 i &---11( i�'1 S `l Le m T— Lt. 3 r r 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? d Type of offense Where When kfrc h f o ' 0,ro i Cf i vi v\ P M1,CA7 e f ZOO 706 vi -d eratin a motorvehicle while under the influence of alcohol or drugs in the last five 3 i 6. Have you bee�o icte � g 9 years? Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? '•.,' i Type of offense Where When 5-- 4, / / e /4" i ii PI < u ll". CJ/2 SI Zv c ._ 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) i 1 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) 1.- 1-eve,,.;a 03/2014 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number C' -)' L L "6: �? . 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 provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) � Signature of Applicant �'� �a `►rr 4/ 64z Date e y// V/ ../ 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. STATE OF IOWA ) COUNTY OF JOHNSON ) 'I I S ed and scribed sworn to before me by �Y u e t��i y\ AI (�i I Te_ . On this ) day of -X iI ac ► 1. k•.ELLIE K.TUTTLE W-e l \ i-C IIL1(7 i omrrisslon Number 221819 Notary Public in and for the State of Iowa NI,Ell)Gr�i �iL W 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). Oa Y/i71/Y Si ' re Police Chief or designee Date 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. v• c � Signature of City Clerk or designee / ate 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/taxidrivbadgeapp2014.doc 03/2014 44f ‘AAPIVV,Iowaiowa Cot. 0) SMARTER I SIMPLER I CUSTOMER DRIVEN .r .. ,, Office of Driver: PO Box 9204 I Des Moines,IA 50: Phone: 515-244-9124 1800-532-1121 1 Fax: 515-: muni Certified Abstract of Driving Record Inquiry Date: 4/16/2014 DL/ID #: 083CC4628 (IA) Customer#: 2146134 Name: Duarte, Quentin Wayne Class: D ID Status: None Address: 406 2ND STS Audit#: 6415703 DL Status: VAL Issue Date: 10/25/2012 CDL Status: None City/State: COGGON, IA 522189417 Expiration 10/06/2017 CDL Cert Status: None Date: Endorsements: 3 CDL Med Status: None Mailing Address: 406 2ND ST S Restrictions: NONE Restriction None Date of Birth: 10/6/1964 Supplement: Mailing City/State: COGGON, IA 522189417 Sex: M History Information Convictions Citation Date Conviction Date ACD Explanation County 1 03/22/2013 03/25/2013 F04 Seat Belt Violation Linn I Name: Duarte, Quentin Wayne DL/ID: 083CC4628 Pursuant to Iowa Code §321.10, I, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do here 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 offic currently in the custody of said office, and that I have been authorized by the Director of the Iowa Department of Transportal 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 yNLCIfki f �,, ....•.4,•l , 4/16/2014 �4IOWA $', s,r: ::41 e,::‘,07*- .• 7 of Driver I+' ^tth<figRS Office Servicesi owaDepartmetofTansportation Name: Duarte, Quentin Wayne DL/ID: 083CC4628 Ap.r. 4. 2014 9:34AM Div of Criminal Investigation No. 6656 P. 1/2 2014-03-31 19:17 AIRPORT SHUTTLE SERV ' 3198621094 >> ' 515 725 6080 P'2/2 ' • (of •ray, a ). STATE OF IOWA �.` lawn 1 -G 1 .>h l ,-' , Criminal History Record Check 11 . •TAc v�`t1. Request .i s. wy DCI Account Number:q SQL -r (ihppiie�aojle) Tol CowaDivislonorCtlmlaalinvestigation FromA.rp®V-3� 1C.c, Support Operations Buren,f"Floor. plat A!- s ( • 215 B.716 Sire el . Des Moines,Iowa 50319 1 n (515)725-6066 ( d,0_r 9.4- ; 5 - "1q (5x5)725-6080 Pax r _ ' Phone; 3k9 31050(0-5g - Eruct -3w 8(aa 1.0914 � I am requesting an Iowa Criminal Hist Record Check-on: List Name(mtodnw,yl First Name(mendeary) • Middle NameOceommepdeo) I J vt "1` t~ U(t=N7" . l/(/i- y X11 e Date of Birth(m.nmloy) Gender(manduoy) Social SectAity Number(meammnded) (0/6 6/‘ V Plate OFetnrle y '7 '79~' ‘27? WaiverInforalalum:Without signed waiver from the subject of the request,a complete criminal history record may not' be releasable,per Code oflowa,Chapter 692.2.For complete criminal history record lhformagon,aB allowed'by Iaw,nl*ays obtala a wolverSignature 110M the subject oldie request. . Waiver Release:thncby give peanisaion forth('ihrwo requesting oWctalta aortal to Iowa erielltl ilistory record chem ailh theDivision ofCriminal investigation(DC1), Any criminal Manny deli renaming me rna It melntalheger MI DO/may be reicsscd as altuwed by law. Waiver Signature .4 /.3.4a..,..4-,...-- C4-1r pea-67- Iowa Criminal History Record Check Results (Del ose only) -tis U 1 of —1 4 \ r A ,A searOA of the provided name and date of birth revealed: r:: 0 110 Iowa Criminal Flistoly Record found with DCI z- :: o ri) . • d Iowa Criminal History Record attached,DCI 11 ��6 i $ ( �''TI ,v� -1 r C: DCI initials Ar- =r'' • i 29-77(08/25/10) • 1 Received Time Apr. 1. 2014 10:41AM No. 3703 Apr. 4. 2014 9:34AM Div of Criminal Investigation No. 6656 P. 2/2 IOWA CRIMINAL HISTORY DCS 00470181 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- 2014/04/04 DCI:00470101 NAME: PUARTE,QUENTIN WAYNE DOS SEX RAC HGT WGT EYE HAIR SRN POB 19641006 M W 507 206 HAS ARO IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19931106 AGENCY: IA0570100 CEDAR RAPIDS PD CHARGE NO- 01 IA STATUTE IA321,1-2 OWI TRIC#: 006381201 COURT DISPOSITION AGENCY: IA0S7015J LINN CO DIST COURT COUNT NO- 01 IA STATUTE IA321.277 RECKLESS DRIVING CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: 006301201 SENTENCE DISP EFF DAT PLEAD GUILTY 19931220 PINE $50 19931220 COURT COSTS 19931220 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OP GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OP 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 1