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PEDICAB Non Motorized Horsedrawn Business APP 2021Clerk/Pedicab Non Motorized Horsedrawn BusinessAPP2015.doc March 2015 NON MOTORIZED PEDICAB/HORSEDRAWN BUSINESS APPLICATION (Police Department review must be made between 8 a.m. to 3 p.m. Monday – Friday.) BUSINESS APPLICATION FEE — $20 1. Business Name 2. Business Office Address _ . Email address _______________________________ (Email address will be used for notification purposes .) 3. Business Telephone Number: _________________ Name of Office Manager (if any) 4. List of names and addresses of all persons having a financial interest in the business thereof. (In the case of a corporation, LLC, or partnership, all officers, directors , members and persons owning or controlling ten percent interest in the business must be listed.) % Interest Name Address (Total should equal 100%) A. B. C. D . ********************************************************************************************************************************************** *** I have reviewed the application, DCI report, and state certified driver’s records of owners and determined 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.(Title 5, Chapter 2, City Code) Police Chief or designee Date City Clerk Date N.D.S.. Date Clerk/Pedicab Non Motorized Horsedrawn BusinessAPP2015.doc March 2015 BUSINESS ADDE NDUM – OWNER INFORMATION (ONE FOR EACH PERSON LISTED IN ITE M 4 OF BUSINESS APPLICATION) Owner Name ________________________________________________________________________________________ Owner Address____________________________________ City/State/Zip _______________________________________ Contact Phone Number (o ther than business number) ______________________________ A. Applicant's prior experience in transportation of passengers: B. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When _____________________________________________________________________________ _____________________________________________________________________________ C. 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 _____________________________________________________________________________ _____________________________________________________________________________ D . Have you been convicted of any traffic offenses in the last five years?______ Type of offense Where When _____________________________________________________________________________ _____________________________________________________________________________ E. Has your driver’s license or chauffeur’s license been suspended or revoked in the last five years?___________ Type of offense Where When _____________________________________________________________________________ _____________________________________________________________________________ F. DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY EACH ADDENDUM FOR POLICE CHIEF REVIEW FOR EVERYONE LISTED IN ITEM NUMBER 4. G. I understand that if I falsely answer any of the questions in this application, 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 d ocuments relating to this applicat ion, 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 Owner (Must be one of those listed on item 4 of business application) STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by ____________________________________. On this ___________ day of _____________________. Clerk/Pedicab Non Motorized Horsedrawn BusinessAPP2015.doc March 2015 ________________________________________ Notary Public in and for the State of Iowa