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Home My WebLink About18-085IDENTIFICATION NO. �6-08 !�- l t ^,(Office Use Only) 71.III`�'�lt n -TI . _ APPLICATION FOR TAXICAB / MOTORIZED PED1 /ENICLE AVER (Police Department review must be made between 8 a.m. 3 p.rf .., Monday — Friday) CITY OF IOWA CITY -<:r 7,- fill 410 East Washington Street Iowa City. Iowa 52240-1826 (319)356-5040 (319) 356-5497 FAX Last 1. Name (REQUIRED) 2. Address (REQUIRED) ':�P' y� First Ln r Mide rz ,' k, <. 3. Contact Information (REQUIRED) Email: - /� h enc l !CTU 1, 3'Z n ly i y 6�C Il Phone:3Jf All written communication sent via email) 4a. Driver's License expiration date (REQUIRED) K,la// b. Taxicab Business Name (REQUIRED) r/ (�e 6 5. Prior experience in transportation of passengers: 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended lead'ilty Have you been arrested / charged with any traffic offenses in the last five years? 7 Other Type of offense Where When What happened to the charge? (Circle one)(^tel G e - i Convicted Dismissed Deferred Suspended Pl�ad'l;uilty Other 8. Has your driver's license or chauffeurs license been suspended or revoked in the last five years? /,Iy. 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) 04/2018 fruo� - v. t4,01 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 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). a a r I herebycert' that I have issued to me b the Iowa Department of Transportation rfY y p po �A_*'d Wver's Jieense number R19''50y9 issued on )expiring on / A �' ? I un and that iffalsely answer any questions in this application, that this a0pli6ationmay be denied. a reetf,'a making t pplication, I consent to allow agents or employees of the City of Iowa City, Iowa, in their discretion, to exa ine arm and ecords and documents relating to this application, and I further agree that, if authorization to be a taxicab driveg,�s gl3rlted, �mply at all times with all of the provisi sof Title �hapter 2, of the City Code. (Needs to be signed in frob - f aWary Public) Signature of Applicant 6 Date �Q Gnr 11f1N1flfff1f11f 1fflflNlNfNfNfHIfIfNNN1H1fi-f fNffff lNNIlfNN4N1N/1NfHN1N1f NN11fNNNMNk1ff111f f f ffff fI1NN1N1ffffNlNf STATE OF IOWA ) COUNTY OF JOHNSON ) bscribed and swor to before me by S " CHRISTINE OLNEY Commission Num r t ' r Or mh�Mon 'm I fffffNfN this g0 ) day of 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 da f er' nse 0 d2 - Z4z-v Signa f 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. -mac Signature of City ClerCbr designee Date ffllefff'lflfflNlNNlflNfffff1f11ff111fff1f1f1f N.,fNNNff11f .1NNfNNNf. Office Use Only Approved application DCI report State certified driving record Website update O&kN xDRKWDG�2018a�WDoc 04/2018 0401 UI!'A► DOT SMARTER I SIMPLER ►nrvvvviowadot gov CUSTOMER DRIYEII Drlvsf & tdnwncanon Smilm PO Box 92041 Des Molnes. IA 5030S92U Hone 515-244-9124 1 Fax Si5-Mt837 Certified Abstract of Driving Record Inquiry Date: 8/8/2018 DL/ID #: 152BB9099(IA) Customer #: 1621134 Name: Andrews, John Class: D ID Status: None Fredric Address: 832 RUNDELL ST Audit #: 1541746 DL Status: VAL Issue Date: 01/11/2017 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 01/02/2020 CDL Cert Status: None 522406254 Endorsements: Chauffeur 3 CDL Med Status: None Mailing Address: 832 RUNDELL ST Restrictions: NONE Restriction None Supplement: Date of Birth: 01/02/1963 Mailing IOWA CITY, IA Sex: M o City/State: 522406254 m CD 3:w History Information n r Convictions W �S-, t 1'1 - m = Citation Date Conviction Data ACD Ex lanationCoun Og: IURn 05113/2017 06/07/2017 F04 Seat Belt Violation Johnson p' IA Ln 05/30/2017 06/21/2017 N01 Fail to Yield Right of Way Johnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a Citation. Name: Andrews, John Fredric DL/ID: 152BB9099 Pursuant to Iowa Code §321.10, I, Darcy Doty, Director of Driver & Identification Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by Driver & Identification 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: Aug.20. 2018 3:13PM 08/1512018 07:45 Yellow Cab Div of Criminal Investigation l� No. 9908 P. 1/3 fA)0319 338 2708 P.0021002 STATE OF IOWA Criminal History Record Check ' Request Worm To; Iowa Division of Criminal Investigation Support Operations Bureau, I" Floor 215 E. 71a Street Des Moines, Iowa 50319 (5.15) 723-6065 1 (515)725-6080 Fax I am requostinit an Iowa Criminal Rlstorvllircnrri Ohnn4 . ". o' DCI Account Number:, 9d;-F�' �i.(PIK-oblc) qo r From; -Yellow Cab oiitlfva P.O. Box 428 � r Iowa City, IA. :5 *4 (319)3 38-9777 J, phone: Fax: (319) 339-7302 Last Na (mandate .;First Name (manda(ory) Middle Name 0wemaw;ded) --Atil Data of Birth (ma�ydatory) Cender (mandatory) iSOCIaI•Set:Rrl Number mmenaod bale ❑Female 16 6l q W ver i fOrgtatt011: Without a signed waiver from the sublecf of the request, a complgte. 4rlminai history record may not be releassble per Cade of Iowa, Chspter 692.2. For comulete criminal history -record Information, as. allowed bylaw, always obtain a waiver signature from ihe'sub ectbf the request. Waiver ,Release: I hereby give ponnitrion lbt the, above mquradng official to conduct an Iowa ahulnal history record check with the Division ol'CeI nfaal lnvtsliganon (ocr). MY odminbl hlrtory dere eanx g me that Ir maintained by the DCI may be released As allowed by law. Waiver Signature: (PCl use only) As of z 0 �' $ .a search' of the provided name and date of birth revealed, ❑ No Iowa Crimille! history Record found with DCI m c Iowa Criminal History Record attached, DCI # 3009335 nCI ttirtals ,,,, DCI -77 (08/25/10) . Aug.20. 2018 3:13PM Div of Criminal Investigation No -9908 P. 2/3 IOWA CRIMINAL HISTORY DCI 00389335 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- DCI:00389335 2018/08/20 NAME: ANDREWS,JOHN FREDRIC DOB SEX RAC HGT HOT EYE HAIR SKN POB 19630102 M W 509 260 HAZ BRO MED IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19890510 AGENCY: IA0620200 DAVENPORT PD CHARGE NO- 01 IA STATUTE IA708-7 HARASSMENT TRK#: L36031301 CHARGE NO- 02 PUSS DRUG PARAPH TRK#: L36031302 n� COURT DISPOSITION O c AGENCY: IA082015J SCOTT CO DIST COURT :5:n y COUNT NO- 01 IA STATUTE: IA708-7 GG) r HARASSMENT rina CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L36031301 p SENTENCE DISP EFF DAT PLEAD GUILTYCA 19890607 Y r FINE $25 19690607 COURT COSTS 19890607 COURT DISPOSITION AGENCY: IA082015J SCOTT CO DIST COURT COUNT NO- 02 IA STATUTE: POSE DRUG PARAPH CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L36031302 SENTENCE DISP EFF DAT FINE $50 19900510 COURT COSTS 19900510 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. 1 DIVISION OF CRIMINAL INVESTIGATION 0 1j^I'_`